Chapter 37- Alterations of Renal and Urinary Tract Function in Children

Question 1

Poststreptococcal glomerulonephritis in children:

a. is a post infectious renal disease
b. causes hypotension
c. causes dehydration
d. both B & C are correct

Answer 1

a. is a post infectious renal disease

Question 2

Infants cannot concentrate urine because of:

a. shorter tubular length
b. increase tubular weight
c. increased blood flow to the kidneys
d. both a & c are correct
e. a, b, c are correct

Answer 2

d. both a & c are correct

Question 3

Vesicoureteral reflux causes urine to ____ up the ureters and places the young child at risk for ______

a. retrograde, glomerulonephritis
b. regrade, nephrotic syndrome
c. retrograde, pyelonephritis
d. regrade, cystitis

Answer 3

c. retrograde, pyelonephritis

Question 4

IgA nephropathy:

a. occurs in the presence of other systemic immunologic disease
b. has no other immunoglobulin present
c. damages the glomerulus irreversibly
d. manifests as recurrent gross hematuria

Answer 4

d. manifests as recurrent gross hematuria

Question 5

Organic causes of enuresis may include:

a. congenital abnormalities of the urinary tract
b. a neurologic origin
c. diabetes insipidus
d. all of the above are correct

Answer 5

d. all of the above are correct

Question 6

Which clinical manifestations suggests hemolytic uremic syndrome?

a. polyuria
b. pallor and bruising
c. hypotension
d. all of the above are correct

Answer 6

b. pallor and bruising

Question 7

Childhood urinary tract infection results from:

a. bacteria ascending up the ureter in cystitis
b. bacteria ascending up the urethra in pyelonephritis
c. detrusor muscle hypoactivity
d. a pathogenic strain of e. coli

Answer 7

d. a pathogenic strain of e. coli

Question 8

Wilms tumor is characterized by:

a. hypotension
b. diagnosis in early teens
c. loss or inactivation of both copies of Wilms tumor suppressor genes
d. transmission in an autosomal recessive fashion for inherited cases

Answer 8

c. loss or inactivation of both copies of Wilms tumor suppressor genes

Question 9

Childhood nephrotic syndrome is characterized by

a. having peak incidence during the teen years
b. increased glomerular permeability to protein
c. hypolipidemia
d. injured renal interstitial tissue

Answer 9

b. increased glomerular permeability to protein

Question 10

1. Which of the following is NOT a complication of the horseshoe kidney?
A. Hydronephrosis
B. Hypospadias
C. Infection
D. Stone formation

Answer 10

B. Hypospadias

Question 11

2. A 2-month-old male infant presents with the urethral opening on the dorsal surface of the penis. Which of the following is the correct name for this anomaly?
A. Hypospadias
B. Epispadias
C. Exstrophy
D. Ureteropelvic junction

Answer 11

B. Epispadias

Question 12

3. A person is born with abnormal differentiation of renal tissues. Which of the following medical terms describes this condition?
A. Renal aplasia
B. Hypoplastic kidney
C. Renal dysplasia
D. Renal agenesis

Answer 12

C. Renal dysplasia

Question 13

4. A person presents with wide-set eyes, “parrot beak” nose, low-set ears, and receding chin. What is the renal manifestation associated with this presentation?
A. Potter syndrome
B. Polycystic kidney disease
C. Minimal change neuropathy
D. Hemolytic-uremic syndrome

Answer 13

A. Potter syndrome

Question 14

5. A 6-year-old has just recovered from streptococcal pharyngitis. Which of the following is TRUE regarding acute poststreptococcal glomerulonephritis?
   A. Antibody-antigen complexes of IgM, IgG, and IgA are deposited.
   B. The exact mechanism of immune complexes is unknown.
   C. There is decreased vascular permeability.
   D. There are no signs of inflammation.

Answer 14

B. The exact mechanism of immune complexes is unknown.

Question 15

6. An individual presents with hematuria, proteinuria, and abdominal pain. There are also skin lesions. Which of the following diseases does this represent?
A. Henoch-Schönlein purpura
B. Hemolytic uremic syndrome
C. Primary nephrotic syndrome
D. Minimal change nephropathy

Answer 15

A. Henoch-Schönlein purpura

Question 16

7. What is the cause of minimal change nephropathy?
   A. Fusion of the glomerular foot processes
   B. Verotoxin of Escherichia coli
   C. IgA deposition
   D. Inflammation of the glomeruli

Answer 16

A. Fusion of the glomerular foot processes

Question 17

Urine formation and excretion begin by the _________ month of gestation.

Answer 17

third

Question 18

Genetically, the ________ plays an important role at all stages of kidney development.

Answer 18

Wilms tumor gene 1

Question 19

During the first year of life, infant’s GFR is about ______ of adult levels.

Answer 19

30-50%

Question 20

The primitive glomeruli and uriniferous tubules develop from the _______.

Answer 20

metanephrogenic blastema

Question 21

An infant has a lower threshold for bicarbonate reabsorption and limited acid excretion, this increases the risk for developing _________.

Answer 21

metabolic acidosis

Question 22

When a child has had and then loses bladder control, it is know as ________.

Answer 22

secondary enuresis

Question 23

A __________ kidney is a small but normal functioning organ.

Answer 23

dysplastic

Question 24

__________ is blockage where the renal pelvis joins the ureter.

Answer 24

Utereropelvic junction obstruction

Question 25

_______ exhibits a urethral meatus on the ventral surface of the penis.

Answer 25

Hypospadias

Question 26

Urine seepage onto the abdominal wall from the ureter can observed in ________.

Answer 26

exstrophy of the bladder

Question 27

Polycystic kidney disease is an autosomal ______ disorder.

Answer 27

dominant

Question 28

Bilateral renal agenesis is usually ________.

Answer 28

fatal

Question 29

Congenital malpositioning of a ureter or ureters into the bladder causes _______.

Answer 29

primary vesicoureteral reflux

Question 30

________ is responsible for most school-aged children who require dialysis and kidney transplantation.

Answer 30

Chronic glomerulonephritis

Question 31

Common childhood glomerular disease include glomerulonephritis, hemolytic uremic syndrome, and _______.

Answer 31

nephrotic syndrome