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Chapter 40: Alterations of Renal and Urinary Tract Function in Children

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Pathophysiology: The Biologic Basis for Disease in Adults and Children 8th Edition
Emily Doyle
Quiz by Emily Doyle, updated more than 1 year ago
Emily Doyle
Created by Emily Doyle almost 5 years ago
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Resource summary

Question 1

Question
The functional kidney is associated with which embryonic organ?
Answer
  • Metanephros
  • Mesonephros
  • Pronephros
  • Endonephros

Question 2

Question
When does urine formation and excretion begin?
Answer
  • At birth
  • By 3 months’ gestation
  • By 6 months’ gestation
  • By 8 months’ gestation

Question 3

Question
Compared with an adult, an infant has a greater content of extracellular fluid, as well as a greater rate of fluid exchange. What effect does this have on the fluid balance of a child compared with that of an adult?
Answer
  • Edema development is less of a problem.
  • Overhydration is not difficult to manage.
  • Daily fluid requirements are greater.
  • The control of dehydration is more difficult.

Question 4

Question
What term is used to identify the condition that exists when the urethral meatus is located on the undersurface of the penis?
Answer
  • Hypospadias
  • Epispadias
  • Hyperspadias
  • Chordee

Question 5

Question
What initiates inflammation in acute poststreptococcal glomerulonephritis?
Answer
  • Lysosomal enzymes
  • Endotoxins from Streptococcus
  • Immune complexes
  • Immunoglobulin E (IgE)–mediated response

Question 6

Question
Acute glomerulonephritis (AGN) may be accompanied by a positive throat or skin culture for which bacteria?
Answer
  • Staphylococcus aureus
  • Streptococcus
  • Pseudomonas aeruginosa
  • Haemophilus

Question 7

Question
A child with acute poststreptococcal glomerulonephritis is voiding smoky, brown-colored urine and asks the healthcare professional to explain what causes it. What explanation by the professional is best?
Answer
  • Presence of red blood cells
  • Presence of urobilinogen
  • Slough from the collecting tubules
  • Protein in the urine

Question 8

Question
In immunoglobulin G (IgG) nephropathies such as glomerulonephritis, IgG is deposited in which location?
Answer
  • Juxtamedullary nephrons
  • Glomerulus basement membranes
  • Mesangium of the glomerular capillaries
  • Parietal epithelium

Question 9

Question
What is the pathophysiologic process responsible for the autoimmune disorder of hemolytic-uremic syndrome (HUS)?
Answer
  • Immunoglobulin A (IgA) coats erythrocytes that are destroyed by the spleen, and remnants are excreted through the kidneys.
  • Verotoxin from Escherichia coli is absorbed from the intestines and damages erythrocytes and endothelial cells.
  • Endotoxins from E. coli block the erythropoietin produced by the kidneys, which reduces the number of erythrocytes produced by the bone marrow.
  • Failure of the nephron to filter urea increases the blood urea nitrogen, which binds to erythrocytes that are subsequently destroyed by the spleen.

Question 10

Question
What is the first indication of nephrotic syndrome in children?
Answer
  • Periorbital edema
  • Scrotal or labial edema
  • Frothy urine
  • Ascites

Question 11

Question
Bacteria gain access to the female urinary tract by which means?
Answer
  • Systemic blood that is filtered through the kidney
  • Bacteria traveling from the lymph adjacent to the bladder and kidneys
  • Bacteria ascending the urethra into the bladder
  • Colonization of the bladder when urine is static

Question 12

Question
What causes vesicoureteral reflux to occur in children?
Answer
  • Children do not ask for help in urinating in a timely manner, and urine is forced up into the ureters.
  • The submucosal segment of a child’s ureter is short, making the antireflux mechanism inefficient.
  • The trigone lying between the opening to the ureters and the urethra is underdeveloped in children.
  • As the bladder fills in infants and children, it pulls the smooth lining of the transitional epithelium away from the ureters, making the reflux valves ineffective.

Question 13

Question
What is the mechanism for developing Wilms tumor?
Answer
  • It involves tumor-suppressor genes located on chromosome 11.
  • Development involves an autosomal dominant inheritance pattern.
  • Wilms tumor is an autoimmune disorder
  • The development of a Wilms tumor is a congenital anomaly.

Question 14

Question
Which anomaly is often associated with Wilms tumor?
Answer
  • Renal anaplasia
  • Aniridia
  • Anemia
  • Hypothyroidism

Question 15

Question
A healthcare professional has taught a parent group about the causes of enuresis. What statement by a parent indicates the professional needs to give more information?
Answer
  • A maturational lag may cause enuresis
  • Enuresis may be related to increased light sleep.
  • Obstructive sleep apnea may be a symptom of enuresis.
  • Elevated nocturnal levels of vasopressin may cause enuresis.

Question 16

Question
When does an individual have their full complement of renal nephrons?
Answer
  • At birth
  • At 6 months of age
  • At puberty
  • Between the ages 18 and 21 years
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