Deck 37: Alterations of Renal and Urinary Tract Function in Children

Question 1

Chordee is a congenital defect of the genitourinary tract that results in a ventral curvature of the penis.

Answer 1

True

Question 2

On examination of a male child, it is determined that the urethral meatus is located on the undersurface of the penis.This condition is called:

A)hypospadias.
B)epispadias.
C)hyperspadias.
D)chordee.

Answer 2

hypospadias.

Question 3

The excretion of urea is low in infants because they have:

A)medullary nephrons with comparatively shorter loops at this stage of development.
B)immature tubular transport capacity, which impairs the excretion of urea.
C)a high anabolic state and use their protein for growth.
D)dilute urine due to the immaturity of their glomeruli.

Answer 3

a high anabolic state and use their protein for growth.

Question 4

Which statement is false about why infants have a narrow chemical safety margin?

A)The immaturity of tubules may diminish the response to antidiuretic hormone (ADH).
B)An immature tubular transport capacity impairs the excretion of potassium.
C)An immature tubular transport capacity impairs the reabsorption of bicarbonate or buffer hydrogen with ammonia.
D)The immaturity of tubules may diminish the response to aldosterone.

Question 5

The total electrolyte concentration in extracellular fluids is greater in the newborn than in the adult.

Question 6

Unilateral renal agenesis is the total lack of one kidney and happens more often on the left side and in males.

Question 7

Approximately one third of individuals with horseshoe kidneys are asymptomatic.

Question 8

The number of nephrons in the kidneys increases from birth until puberty.

Question 9

Hemolytic-uremic syndrome frequently causes acute renal failure in young children.

Question 10

Which statement is false about how hypospadias develops? Hypospadias results from:

A)a disruption in male hormones, including testosterone.
B)a mutation of gene HP-1 (chromosome 16).
C)5a reductase mutations.
D)hormones administered for in vitro fertilization.

Question 11

Which cells of the inflammatory process are NOT found in acute poststreptococcal glomerulonephritis (PSGN)?

A)Immunoglobulin G (IgG)
B)Immunoglobulin A (IgA)
C)Complement C3
D)Immunoglobulin E (IgE)

Question 12

Urine formation and excretion do not begin until the eighth month of gestation.

Question 13

What initiates inflammation in acute poststreptococcal glomerulonephritis (PSGN)?

A)Lysosomal enzymes
B)Endotoxins from the streptococcus
C)Immune complexes
D)Immunoglobulin E (IgE) mediated response

Question 14

Structural anomalies that are associated with urinary tract malformations include low-set, malformed ears; absent abdominal muscles; and imperforate anus or genital deviation.

Question 15

Hypertension occurs in acute poststreptococcal glomerulonephritis (PSGN) because of the:

A)increase in capillary permeability along the glomerular vascular membrane.
B)release of endothelin-1 as a result of endothelial injury and platelet activation.
C)activation of the renin-angiotensin-aldosterone system stimulated by decreased renal perfusion.
D)stimulation of b-adrenergic nerves that cause vasoconstriction.

Question 16

Organic causes of enuresis are the most common.

Question 17

Urine formation and excretion begin at:

A)birth.
B)the third month of gestation.
C)the sixth month of gestation.
D)the ninth month of gestation.

Question 18

Epispadias may only be found in males.

Question 19

Which of the following represents the final stage in the embryonic development of the kidney?

A)Metanephros
B)Mesonephros
C)Pronephros
D)Endonephros

Question 20

The adult takes in and excretes 2000 ml/day (representing approximately 5% of the total body fluid), whereas the infant takes in and excretes 700 ml/day (representing ____% of the total body fluid).

A)10
B)90
C)190
D)290

Question 21

Which of the following is not considered part of the nephrotic syndrome in children?

A)Proteinuria
B)Pyuria
C)Hyperlipidemia
D)Edema

Question 22

The first indication of nephrotic syndrome in children is:

A)periorbital edema.
B)scrotal or labial edema.
C)frothy urine.
D)ascites.

Question 23

_____ is an anomaly often associated with Wilms tumor.

A)Renal anaplasia
B)Aniridia
C)Anemia
D)Hypothyroidism

Question 24

What is the mechanism for development of Wilms tumor?

A)It involves tumor-suppressor genes.
B)It is an autosomal dominant inherited disorder.
C)It is an autoimmune disorder.
D)It is a congenital anomaly.

Question 25

Match the kidney disorder with the corresponding descriptions.
IgA nephropathy causing inflammation to glomerular blood vessels

A)Hemolytic-uremic syndrome
B)Henoch-Schönlein purpura nephritis
C)Renal dysplasia
D)Ureteropelvic junction obstruction
E)Polycystic kidney disease

Question 26

The smoky, brown-colored urine in acute poststreptococcal glomerulonephritis (PSGN) is a result of the:

A)presence of red blood cells.
B)presence of urobilinogen.
C)slough from the collecting tubules.
D)protein that is in the urine.

Question 27

Bacteria gain access to the urinary tract by:

A)the systemic blood that is filtered through the kidney.
B)traveling from the lymph adjacent to the bladder and kidneys.
C)ascending up the urethra into the bladder or up the ureters into the kidney.
D)colonizing the bladder when urine is static.

Question 28

Match the kidney disorder with the corresponding descriptions.
The most common cause of hydronephrosis in neonates

A)Hemolytic-uremic syndrome
B)Henoch-Schönlein purpura nephritis
C)Renal dysplasia
D)Ureteropelvic junction obstruction
E)Polycystic kidney disease

Question 29

Match the kidney disorder with the corresponding descriptions.
Autosomal dominant inherited disorder

A)Hemolytic-uremic syndrome
B)Henoch-Schönlein purpura nephritis
C)Renal dysplasia
D)Ureteropelvic junction obstruction
E)Polycystic kidney disease

Question 30

Match the kidney disorder with the corresponding descriptions.
Fibrin rich thrombi can be found throughout the microcirculation

A)Hemolytic-uremic syndrome
B)Henoch-Schönlein purpura nephritis
C)Renal dysplasia
D)Ureteropelvic junction obstruction
E)Polycystic kidney disease

Question 31

The pathophysiologic process responsible for the hemolytic-uremic syndrome is that:

A)an autoimmune disorder in which immunoglobulin A (IgA) coats erythrocytes that are destroyed by the spleen and remnants are excreted through the kidneys.
B)verotoxin from E. coli is absorbed from the intestines and damages erythrocytes and endothelial cells.
C)endotoxins from E. coli block the erythropoietin produced by the kidneys, which reduces the number of erythrocytes produced by the bone marrow.
D)failure of the nephron to filter urea increases the blood urea nitrogen, which binds to erythrocytes that are subsequently destroyed by the spleen.

Question 32

Match the kidney disorder with the corresponding descriptions.
Associated with functional or organic obstruction of the collecting system

A)Hemolytic-uremic syndrome
B)Henoch-Schönlein purpura nephritis
C)Renal dysplasia
D)Ureteropelvic junction obstruction
E)Polycystic kidney disease

Question 33

In immunoglobulin A (IgA) nephropathy (Berger nephropathy), the IgA, IgM, and complement proteins are deposited in the:

A)juxtamedullary nephrons.
B)glomerular endothelium.
C)mesangium of the glomerular capillaries.
D)parietal epithelium.

Question 34

Vesicoureteral reflux occurs in children because:

A)they do not ask for help in urinating in a timely manner and urine is forced up into the ureters.
B)the submucosal segment of the ureter is short, making the antireflux mechanism inefficient.
C)the trigone lying between the opening to the ureters and the urethra is underdeveloped.
D)as the bladder in infants and children fill, it pulls the smooth lining of the transitional epithelium away from the ureters so that the reflux valves are ineffective.

Question 35

Which statement is false about the causes of enuresis?

A)Enuresis is caused by a maturational lag.
B)Enuresis may be related to nonrapid eye movement (NREM) sleep.
C)Enuresis may be a symptom of obstructive sleep apnea.
D)Enuresis may be caused by excessive antidiuretic hormone (ADH).