WorksheetsNephro/Cardio/Gastro/Pulmo
Total questions: 75
Worksheet time: 1hrs 15mins
The kidney has an outer layer, the cortex, which contains the following, except?
glomeruli
proximal and distal convoluted tubules
collecting ducts
loops of Henle
Each kidney contains approximately (each consisting of a glomerulus and associated tubules) how many nephrons?
1 million nephrons
3 million nephrons
500 hundred thousands
750 thousands
Kidney function is best measured by?
serum Creatinine
BUN
glomerular filtration rate
urine output
It is created by the gradient between the high concentration of plasma proteins within the capillary and the almost protein-free ultrafiltrate in Bowman’s space?
glomerular capillary hydrostatic pressure
glomerular capillary oncotic pressure
glomerular
plasma flow
ultrafiltrate
The GFR may be estimated by measurement of the this and is derived from muscle metabolism?
seum BUA
GFR
serum BUN
serum creatinine
In this clinical setting, serum creatinine is an insensitive measure of decreased renal function because its level does not rise above normal until GFR falls by?
30-40%
50-60%
40-50%
20-30%
The GFR is optimally measured by the clearance of?
creatinine
inulin
insulin
BUN
These are examples of Mesangial cell diseases, except?
IgA nephropathy
mesangio-proliferative glomerulonephritis
class II lupus nephritis
Infection-associated glomerulonephritis
The infections from this organism are common in children and can lead to the postinfectious complication of acute glomerulonephritis
(GN)?
Group A β-hemolytic streptococcal
Group A α-hemolytic streptococcal
Group B β-hemolytic streptococcal
Group B α-hemolytic streptococcal
These serotypes are assocaited with epidemics of nephritis in association
with throat, except?
M1
M12
M25
M49
The most common small vessel vasculitis in childhood?
idiopathic thrombocytopenic purpura
henoch-schönlein purpura
Systemic lupus erythematosus
Polyarteritis nodosa
It s characterized by pulmonary hemorrhage and glomerulonephritis. The disease results from attack on organs by antibodies directed against certain epitopes of type IV collagen?
Henoch-Schönlein purpura
Goodpasture disease
Hemolytic-uremic syndrome
Systemic lupus erythematosus
Spontaneous bacterial peritonitis presents with fever, abdominal pain, and peritoneal signs. The most common causative organism is?
Streptococcal
Fungal
Staphylococcal
Pneumococcus
Relapse of nephrotic syndrome is defined as, except?
urine protein : creatinine ratio of >2
≥3+ protein on urine dipstick testing for 3 consecutive days
failure to achieve remission after 6 wk of corticosteroid therapy
triggered by upper respiratory or gastrointestinal infections.
A disease state characterized by a normal anion gap (hyperchloremic) metabolic acidosis in the setting of normal or near-normal glomerular filtration rate?
Nephrogenic diabetes insipidus
Nephrotic syndrome
Bartter syndrome
Renal tubular acidosis
The biochemical features including hypokalemic metabolic alkalosis with hypercalciuria, resemble those seen with chronic use of loop diuretics?
Bartter syndrome
Gitelman syndrome
Fanconi syndrome
Dent disease
It is called the diluting segment.
Collecting ducts
Proximal tubule
Distal tubule
Thick ascending limb of the loop of Henle
In a person having metabolic acidosis, the following are expected outcomes, except?
Overproduction or ingestion of fixed acid
Increased HCO3 − concentration causes a decrease in blood pH
hyperventilation (Kussmaul breathing)
increased excretion of the excess fixed H+
Which of the following substances has the highest renal clearance?
Para-aminohippuric acid (PAH)
Inulin
Glucose
Na+
Which of the following is a cause of metabolic alkalosis?
Chronic renal failure
Diarrhea
Hyperaldosteronism
Ethylene glycol ingestion
The mainstay of therapy in all forms of RTA is?
adequate hydration based on BSA
bicarbonate replacement
KCL tablet
dialysis
Stressed volume is found on what blood vessels?
veins
arteries
arterioles
venules
It contains the highest proportion of blood in the cardiovascular system?
capillaries
arteries
veins
venules
The highest arterial pressure during a cardiac cycle?
Pulse pressure
Diastolic pressure
Mean arterial pressure
Systolic pressure
It represents the entire period of depolarization and repolarization of the ventricles?
QT interval
PR interval
QRS complex
ST segment
Stroke volume × Heart rate?
Total volume
Stroke Volume
Ejection fraction
Cardiac output
What part of the cardiac cycle represents the beginning of the QRS complex, which represents electrical activation of the ventricles?
Rapid ventricular filling
Isovolumetric ventricular relaxation
Rapid ventricular ejection
Isovolumetric ventricular contraction
Baroreceptor reflex includes several fast neural mechanisms. The set point for mean arterial pressure in the vasomotor center is about how many mm Hg?
90mm Hg
110mm Hg
100mm Hg
95mm Hg
Three cardiovascular structures unique to the fetus are important for maintaining this parallel circulation, except?
ductus venosus
urachus
foramen ovale
ductus arteriosus
The placenta is not as efficient an oxygen exchange organ as the lungs. What vessel provides the highest level of oxygen to the fetus?
umbilical artery
urachus
vasa recta
umbilical vein
The foramen ovale is usually functionally closed by how many month/s of life?
1st
2nd
3rd
4th
Functional closure of the ductus arteriosus is usually complete by how long in a normal neonate?
18-24hr
5-9hr
1-2days
10-15 hr
The 1st heart sound is caused by closure of the?
mitral and tricuspid
aortic and pulmonary
aortic and mitral
tricuspid and pulmonary
This heart sound may be normal in an adolescent with a relatively slow heart rate, but in a patient with the clinical signs of heart failure and tachycardia, it may be heard as a gallop rhythm.
1st heart sound
2nd heart sound
3rd heart sound
4th heart sound
ACE inhibitors block the conversion of angiotensin I to angiotensin II. An example of which is?
Losartan
Amlodipine
Clonidine
Captopril
What type of congenital heart defect is most common in children?
ASD
VSD
TOF
PDA
What type of Congenital Heart Defect is seen in children with Down's Syndrome?
ASD
VSD
TOF
TGA
PDA is associated with the following except?
female patients (2:1)
maternal rubella infection
preterm
DM mother
It is involved in the regulation of blood pressure in response to hemorrhage, but not in minute-to-minute regulation of normal blood pressure.
Renin
Vasopressin
Atrial Natriuretic Peptide
Angiotensin
This substance is produced by endothelial cells that causes smooth muscle to relax. What is that substance?
Dopamine
Nitric Oxide
Serotonin
Calcium
The tendency for blood flow to be turbulent is increased by?
increased viscosity
increased hematocrit
partial occlusion of a blood vessel
(D) decreased velocity of blood flow
If the heart rate is 70 beats/min, then the cardiac output of this ventricle is closest to?
3.45 L/min
5.25 L/min
4.55 L/min
8.00 L/min
Tetralogy of Fallot is one of the conotruncal family of heart lesions in which the primary defect is an anterior deviation of the infundibular septum. The following are components of TOF, except?
pulmonary stenosis
overriding of aorta
ventricular septal defect
left ventricular hypertrophy
This accounts for ≈5% of all congenital heart disease. Chest x-rays may show mild cardiomegaly, a narrow mediastinum (the classic “egg-shaped heart”), and normal to increased pulmonary blood flow.
TOF
TGA
Ebstein Anomaly
TAPVR
In this CHD, the heart has no direct pulmonary venous connection into the left atrium. The pulmonary veins may drain above the diaphragm into the right atrium directly, into the coronary sinus, or into the superior vena cava via a “vertical vein,” A large supracardiac shadow can be seen, which together with the normal cardiac shadow forms a “snowman” appearance.
TOF
TGA
TAPVR
Ebstein Anomaly
Which of the following substances is released from neurons in the GI tract and produces smooth muscle relaxation?
Secretin
Gastrin
Cholecystokinin (CCK)
Vasoactive intestinal peptide (VIP)
Cholecystokinin (CCK) inhibits?
gastric emptying
pancreatic HCO3
− secretion
pancreatic enzyme secretion
contraction of the gallbladder
Which of the following substances must be further digested before it can be absorbed by specific carriers in intestinal cells?
Fructose
Sucrose
Alanine
Dipeptides
Infants show preferences to sweet and salty foods at what age?
1month
2months
3months
4months
Which of the following changes occurs during defecation?
Intra-abdominal pressure is lower than when at rest
External anal sphincter is contracted
Rectal smooth muscle is relaxed
Internal anal sphincter is relaxed
The most serious complication of oropharyngeal dysphagia is?
Subcutaneous emphysema
Aspiration
Esophageal bleeding
Halitosis
Differential diagnoses for emesis seen in both infants and children except?
Gastroenteritis
Pertussis syndrome
Otitis media
Gastritis
Bleeding that originates in the esophagus, stomach, or duodenum can cause?
Melena
Hematochezia
Hematemesis
all of the above
The use of PPI in treatment of GERD is associated with these potential complications, except?
Dysphagia
Clostridium difficile infection
Respiratory infection
Hypomagnesemia
The most common clinical association of pyloric stenosis?
Elevated Amylase and Lipase
Hyperbilirubinemia
Hyperkalemia
Hypocalcemia
Criteria for diagnosis of pyloric stenosis include the following, except?
Opening
Thickness
Diameter
Length
The surgical procedure of choice for pyloric stenosis is?
Pylorophy
Pylorochiloplasty
Pylorotomy
Pyloromyotomy
Criteria for chronic constipation in infants and toddlers except?
≥1 Episode of incontinence after the acquisition of toilet training
History of painful or hard bowel movements
≤3 Defecations per week
none of the above
At what weeks of gestation can a fetus can swallow amniotic fluid?
12wks
14wks
16wks
18wks
Nutritive sucking in neonates develops at about what weeks of gestation?
33wks
34wks
35wks
36wks
Indirect hyperbilirubinemia, which occurs commonly in normal newborns, tends to tint the sclerae and skin with what color?
blackish yellow
greyish yellow
greenish yellow
golden yellow
Traditionally, lung volumes are measured with a?
Spirometry
Spirogram
Gyroscope
Gyrometer
It is the amount of air moved in and out of the lungs during each breath?
Vital Capacity
Residual Volume
Inspiratory Capacity
Tidal Volume
A decrease in Functional Residual Capacity is often encountered in alveolar interstitial diseases and thoracic deformities. The major pathophysiologic consequence of decreased FRC is?
Hypoxemia
Hypoxia
Jaundice
Cyanosis
The adverse pathophysiologic consequences of decrease FRC are ameliorated by application of?
Fio2
PIP
PEEP
VR
These fibers are slow-twitch, high-oxidative in nature, and have low contractility but are fatigue resistant
Type 1
Type 2
Type 3
Type 4
It is a hallmark of extrathoracic airway obstruction.
Suprasternal retractions
Grunting
Expiratory wheezing
Inspiratory stridor
Stretch receptors decrease the respiratory rate due to an inhibition of inspiratory muscle activity and an increase in exhalation time. What do you call this reflex?
Bezold-Jarisch reflex
Cremasteric reflex
Oropharyngeal reflex
Hering-Breuer
reflex
It remains the chief stimulus for ventilation, which is predominantly dependent on peripheral chemoreceptor stimulation?
Hypercarbia
Arterial hypoxemia
Low Pco2
Arterial hypoxia
These sinuses are present at birth?
frontal and sphenoid
ethomoidal and frontal
frontal and maxillary
ethmoidal and maxillary
What organism is the most common cause of pneumonia in a 3wk to 4yr old child?
Mycoplasma pneumoniae
Staphylococcus aureus
Chlamydophila pneumoniae
Streptococcus
pneumoniae
It is characterized by irreversible abnormal dilation and anatomic distortion of the bronchial tree and represents a common end stage of a many nonspecific and unrelated antecedent events. Cystic fibrosis is the most common cause.
bronchiectasis
Löffler syndrome
pneumothorax
Goodpasture disease
Catamenial pneumothorax, an unusual condition that is related to the following, except?
Diaphragmatic defects
Pleural blebs
Tuberculosis
Menses
In the hemoglobin - o2 dissociation curve, the following conditions will shift the curve to the right, except?
P50 is increased
P50 is decreased
affinity of hemoglobin for O2 is decreased
Increase in 2,3-DPG concentration
Which of the following is the site of highest airway resistance?
Medium-sized bronchi
Largest bronchi
Alveoli
Trachea
