Deck 34: Alterations of Pulmonary Function in Children

Question 1

The most common predisposing factor to obstructive sleep apnea of childhood is adenotonsillar hypertrophy.

Answer 1

True

Question 2

Signs of acute respiratory failure remain the same regardless of etiology.

Answer 2

True

Question 3

Children with chronic asthma have clubbing of fingers and toes.

Answer 3

False

Question 4

Which of the following shows the correct sequence of events after atelectasis develops in respiratory distress syndrome of the newborn?

A)Increased pulmonary vascular resistance, atelectasis, hypoperfusion
B)Pulmonary hypoperfusion, hypoxic vasoconstriction, right-to-left shunt
C)Respiratory acidosis, hypoxemia, hypercapnia
D)Right-to-left shunt, hypoxic vasoconstriction, hypoperfusion

Question 5

Paradoxical breathing is an ominous sign in premature infants.

Question 6

Asthma is one of the leading chronic illnesses in children and has become more prevalent in the past two decades.

Question 7

Which of the following types of croup is most common?

A)Bacterial
B)Viral
C)Fungal
D)Autoimmune

Question 8

All alveoli are present and functioning at birth.

Question 9

Chest wall compliance in infants is __________ in adults.

A)lower than
B)higher than
C)the same as
D)unlike that

Question 10

Infants up to 3 months of age are obligatory mouth breathers.

Question 11

Respiratory syncytial virus (RSV) infects nearly 100% of children in the United States by 2 or 3 years of age.

Question 12

Why is nasal congestion a serious threat to young infants?

A)They are obligatory nose breathers.
B)Their noses are small in diameter.
C)They become dehydrated when mouth breathing.
D)Their epiglottis is proportionally greater than an adult's.

Question 13

The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born after _____ weeks of gestation.

A)16
B)20
C)24
D)30

Question 14

What is the primary cause of RDS of the newborn?

A)An immature immune system
B)Small alveoli
C)A surfactant deficiency
D)Anemia

Question 15

Surfactant is produced by the fourth week of gestation.

Question 16

The chief predisposing factor for respiratory distress syndrome (RDS) of the newborn is:

A)low birth weight.
B)alcohol consumption during pregnancy.
C)premature birth.
D)smoking during pregnancy.

Question 17

Rhinorrhea, sore throat, a low-grade fever, and a seal-like barking cough are clinical manifestations indicative of:

A)epiglottitis.
B)retropharyngeal abscess.
C)bacterial tracheitis.
D)croup.

Question 18

Which of the following statements about the advances in the treatment of RDS of the newborn is incorrect?

A)Administering glucocorticoids to women in preterm labor accelerates the maturation of the fetus's lungs.
B)Administering oxygen to mothers during preterm labor increases their arterial oxygen before birth of the fetus.
C)Treatment includes the instillation of exogenous surfactant down an endotracheal tube of infants weighing less than 1000 g.
D)Supporting the infant's respiratory function by using continuous positive airway pressure (CPAP). An infant's respiratory function is supported by using continuous pressure (CPAP).

Question 19

About 75% of aspirated foreign objects in children lodge in a bronchus.

Question 20

The primary problem in RDS of the newborn is:

A)consolidation.
B)pulmonary edema.
C)atelectasis.
D)bronchiolar plugging.

Question 21

The release of fibroblast growth factors affects ARDS by causing:

A)atelectasis and decreased lung compliance.
B)disruption of alveolocapillary membrane.
C)pulmonary hypertension.
D)pulmonary fibrosis.

Question 22

An accurate description of childhood asthma is that it is a(n):

A)obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation.
B)pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray.
C)pulmonary disorder involving an abnormal expression of a protein producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens.
D)obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency.

Question 23

Which T lymphocyte phenotype is the key determinant of childhood asthma?

A)CD4 T-helper Th1 lymphocytes
B)CD4 T-helper Th2 lymphocytes
C)CD8 cytotoxic T lymphocytes
D)Memory T lymphocytes

Question 24

Match the sound of stridor with the location of the problem.
Nasal problems, foreign body, polyps, or choanal atresia

A)Sonorous snoring
B)Muffled voice
C)High-pitched inspiratory sound, voice change, hoarse
D)Expiratory stridor or central wheeze
E)Expiratory wheezes

Question 25

Which arterial blood gas values would be expected in the acute phase of childhood asthma?

A)pH 7.6, PaCO₂ 35 mmHg, HCO₃ 32 mEq/L
B)pH 7.4, PaCO₂ 40 mmHg, HCO₃ 24 mEq/L
C)pH 7.5, PaCO₂ 30 mmHg, HCO₃ 26 mEq/L
D)pH 7.2, PaCO₂ 20 mmHg, HCO₃ 30 mEq/L

Question 26

In ARDS, a diffuse pulmonary thrombosis contributes to pulmonary edema by:

A)decreasing the osmotic pressure.
B)increasing the capillary hydrostatic pressure.
C)increasing the pulmonary capillary permeability.
D)decreasing the retention of sodium and water.

Question 27

Cystic fibrosis is best described as a(n):

A)obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation.
B)respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray.
C)pulmonary disorder involving an abnormal expression of a protein producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens.
D)pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency.

Question 28

Match the sound of stridor with the location of the problem.
Pharyngeal problems

A)Sonorous snoring
B)Muffled voice
C)High-pitched inspiratory sound, voice change, hoarse
D)Expiratory stridor or central wheeze
E)Expiratory wheezes

Question 29

Bronchiolitis tends to occur during the first years of life and is most often caused by _____ infection.

A)respiratory syncytial virus
B)influenzavirus
C)adenoviruses
D)Epstein-Barr virus

Question 30

Sudden infant death syndrome (SIDS) occurs most often between _____ and _____ months of age.

A)1; 2
B)3; 4
C)5; 6
D)6; 7

Question 31

Match the sound of stridor with the location of the problem.
Laryngeal problems

A)Sonorous snoring
B)Muffled voice
C)High-pitched inspiratory sound, voice change, hoarse
D)Expiratory stridor or central wheeze
E)Expiratory wheezes

Question 32

Match the sound of stridor with the location of the problem.
Bronchial problems

A)Sonorous snoring
B)Muffled voice
C)High-pitched inspiratory sound, voice change, hoarse
D)Expiratory stridor or central wheeze
E)Expiratory wheezes

Question 33

Match the sound of stridor with the location of the problem.
Tracheal problems

A)Sonorous snoring
B)Muffled voice
C)High-pitched inspiratory sound, voice change, hoarse
D)Expiratory stridor or central wheeze
E)Expiratory wheezes

Question 34

Acute respiratory distress syndrome (ARDS) is best described as a(n):

A)obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation.
B)pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray.
C)respiratory disorder involving an abnormal expression of a protein producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens.
D)pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency.

Question 35

Which immunoglobulin is present in childhood asthma?

A)IgM
B)IgG
C)IgE
D)IgA

Question 36

Cystic fibrosis (CF) is caused by a(n):

A)autosomal recessive inheritance.
B)autosomal dominant inheritance.
C)infection.
D)malignancy.

Question 37

Which cytokines activated in childhood asthma produce an allergic response?

A)IL-1, IL-2, and interferon-alpha (IFN-a)
B)IL-8, IL-12, and tumor necrosis factor-alpha (TNF-a)
C)IL-4, IL-10, and colony-stimulating factor (CSF)
D)IL-4, IL-5, and IL-13

Question 38

What are the clinical manifestations of bacterial pneumonia in children?

A)Mild to high fever, cough, rhinorrhea, crackles, rhonchi, and wheezes
B)High fever, productive cough, and pleuritic chest pain
C)Decreased breath sounds in areas of consolidation and dyspnea
D)Increased respiratory rate and respiratory alkalosis

Question 39

What are the abnormalities in cytokines found in children with cystic fibrosis?

A)A deficit of IL-1 and an excess of IL-4, IL-12, and IFN-a
B)A deficit of IL-6 and an excess of IL-2, IL-8, and granulocyte colony-stimulating factor (G-CSF)
C)A deficit of IL-10 and an excess of IL-1, IL-8, and TNF-a
D)A deficit of IL-3 and an excess of IL-14, IL-24, and colony-stimulating factor (CSF)