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Nephro/Cardio/Gastro/Pulmo

Total questions: 75

Worksheet time: 1hrs 15mins

Name
Class
Date
1.

The kidney has an outer layer, the cortex, which contains the following, except?

a)

glomeruli

b)

proximal and distal convoluted tubules

c)

collecting ducts

d)

loops of Henle

2.

Each kidney contains approximately (each consisting of a glomerulus and associated tubules) how many nephrons?

a)

1 million nephrons

b)

3 million nephrons

c)

500 hundred thousands

d)

750 thousands

3.

Kidney function is best measured by?

a)

serum Creatinine

b)

BUN

c)

glomerular filtration rate

d)

urine output

4.

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?

a)

glomerular capillary hydrostatic pressure

b)

glomerular capillary oncotic pressure

c)

glomerular

plasma flow

d)

ultrafiltrate

5.

The GFR may be estimated by measurement of the this and is derived from muscle metabolism?

a)

seum BUA

b)

GFR

c)

serum BUN

d)

serum creatinine

6.

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?

a)

30-40%

b)

50-60%

c)

40-50%

d)

20-30%

7.

The GFR is optimally measured by the clearance of?

a)

creatinine

b)

inulin

c)

insulin

d)

BUN

8.

These are examples of Mesangial cell diseases, except?

a)

IgA nephropathy

b)

mesangio-proliferative glomerulonephritis

c)

class II lupus nephritis

d)

Infection-associated glomerulonephritis

9.

The infections from this organism are common in children and can lead to the postinfectious complication of acute glomerulonephritis

(GN)?

a)

Group A β-hemolytic streptococcal

b)

Group A α-hemolytic streptococcal

c)

Group B β-hemolytic streptococcal

d)

Group B α-hemolytic streptococcal

10.

These serotypes are assocaited with epidemics of nephritis in association

with throat, except?

a)

M1

b)

M12

c)

M25

d)

M49

11.

The most common small vessel vasculitis in childhood?

a)

idiopathic thrombocytopenic purpura

b)

henoch-schönlein purpura

c)

Systemic lupus erythematosus

d)

Polyarteritis nodosa

12.

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?

a)

Henoch-Schönlein purpura

b)

Goodpasture disease

c)

Hemolytic-uremic syndrome

d)

Systemic lupus erythematosus

13.

Spontaneous bacterial peritonitis presents with fever, abdominal pain, and peritoneal signs. The most common causative organism is?

a)

Streptococcal

b)

Fungal

c)

Staphylococcal

d)

Pneumococcus

14.

Relapse of nephrotic syndrome is defined as, except?

a)

urine protein : creatinine ratio of >2

b)

≥3+ protein on urine dipstick testing for 3 consecutive days

c)

failure to achieve remission after 6 wk of corticosteroid therapy

d)

triggered by upper respiratory or gastrointestinal infections.

15.

A disease state characterized by a normal anion gap (hyperchloremic) metabolic acidosis in the setting of normal or near-normal glomerular filtration rate?

a)

Nephrogenic diabetes insipidus

b)

Nephrotic syndrome

c)

Bartter syndrome

d)

Renal tubular acidosis

16.

The biochemical features including hypokalemic metabolic alkalosis with hypercalciuria, resemble those seen with chronic use of loop diuretics?

a)

Bartter syndrome

b)

Gitelman syndrome

c)

Fanconi syndrome

d)

Dent disease

17.

It is called the diluting segment.

a)

Collecting ducts

b)

Proximal tubule

c)

Distal tubule

d)

Thick ascending limb of the loop of Henle

18.

In a person having metabolic acidosis, the following are expected outcomes, except?

a)

Overproduction or ingestion of fixed acid

b)

Increased HCO3 − concentration causes a decrease in blood pH

c)

hyperventilation (Kussmaul breathing)

d)

increased excretion of the excess fixed H+

19.

Which of the following substances has the highest renal clearance?

a)

Para-aminohippuric acid (PAH)

b)

Inulin

c)

Glucose

d)

Na+

20.

Which of the following is a cause of metabolic alkalosis?

a)

Chronic renal failure

b)

Diarrhea

c)

Hyperaldosteronism

d)

Ethylene glycol ingestion

21.

The mainstay of therapy in all forms of RTA is?

a)

adequate hydration based on BSA

b)

bicarbonate replacement

c)

KCL tablet

d)

dialysis

22.

Stressed volume is found on what blood vessels?

a)

veins

b)

arteries

c)

arterioles

d)

venules

23.

It contains the highest proportion of blood in the cardiovascular system?

a)

capillaries

b)

arteries

c)

veins

d)

venules

24.

The highest arterial pressure during a cardiac cycle?

a)

Pulse pressure

b)

Diastolic pressure

c)

Mean arterial pressure

d)

Systolic pressure

25.

It represents the entire period of depolarization and repolarization of the ventricles?

a)

QT interval

b)

PR interval

c)

QRS complex

d)

ST segment

26.

Stroke volume × Heart rate?

a)

Total volume

b)

Stroke Volume

c)

Ejection fraction

d)

Cardiac output

27.

What part of the cardiac cycle represents the beginning of the QRS complex, which represents electrical activation of the ventricles?

a)

Rapid ventricular filling

b)

Isovolumetric ventricular relaxation

c)

Rapid ventricular ejection

d)

Isovolumetric ventricular contraction

28.

Baroreceptor reflex includes several fast neural mechanisms. The set point for mean arterial pressure in the vasomotor center is about how many mm Hg?

a)

90mm Hg

b)

110mm Hg

c)

100mm Hg

d)

95mm Hg

29.

Three cardiovascular structures unique to the fetus are important for maintaining this parallel circulation, except?

a)

ductus venosus

b)

urachus

c)

foramen ovale

d)

ductus arteriosus

30.

The placenta is not as efficient an oxygen exchange organ as the lungs. What vessel provides the highest level of oxygen to the fetus?

a)

umbilical artery

b)

urachus

c)

vasa recta

d)

umbilical vein

31.

The foramen ovale is usually functionally closed by how many month/s of life?

a)

1st

b)

2nd

c)

3rd

d)

4th

32.

Functional closure of the ductus arteriosus is usually complete by how long in a normal neonate?

a)

18-24hr

b)

5-9hr

c)

1-2days

d)

10-15 hr

33.

The 1st heart sound is caused by closure of the?

a)

mitral and tricuspid

b)

aortic and pulmonary

c)

aortic and mitral

d)

tricuspid and pulmonary

34.

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.

a)

1st heart sound

b)

2nd heart sound

c)

3rd heart sound

d)

4th heart sound

35.

ACE inhibitors block the conversion of angiotensin I to angiotensin II. An example of which is?

a)

Losartan

b)

Amlodipine

c)

Clonidine

d)

Captopril

36.

What type of congenital heart defect is most common in children?

a)

ASD

b)

VSD

c)

TOF

d)

PDA

37.

What type of Congenital Heart Defect is seen in children with Down's Syndrome?

a)

ASD

b)

VSD

c)

TOF

d)

TGA

38.

PDA is associated with the following except?

a)

female patients (2:1)

b)

maternal rubella infection

c)

preterm

d)

DM mother

39.

It is involved in the regulation of blood pressure in response to hemorrhage, but not in minute-to-minute regulation of normal blood pressure.

a)

Renin

b)

Vasopressin

c)

Atrial Natriuretic Peptide

d)

Angiotensin

40.

This substance is produced by endothelial cells that causes smooth muscle to relax. What is that substance?

a)

Dopamine

b)

Nitric Oxide

c)

Serotonin

d)

Calcium

41.

The tendency for blood flow to be turbulent is increased by?

a)

increased viscosity

b)

increased hematocrit

c)

partial occlusion of a blood vessel

d)

(D) decreased velocity of blood flow

42.

If the heart rate is 70 beats/min, then the cardiac output of this ventricle is closest to?

a)

3.45 L/min

b)

5.25 L/min

c)

4.55 L/min

d)

8.00 L/min

43.

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?

a)

pulmonary stenosis

b)

overriding of aorta

c)

ventricular septal defect

d)

left ventricular hypertrophy

44.

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.

a)

TOF

b)

TGA

c)

Ebstein Anomaly

d)

TAPVR

45.

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.

a)

TOF

b)

TGA

c)

TAPVR

d)

Ebstein Anomaly

46.

Which of the following substances is released from neurons in the GI tract and produces smooth muscle relaxation?

a)

Secretin

b)

Gastrin

c)

Cholecystokinin (CCK)

d)

Vasoactive intestinal peptide (VIP)

47.

Cholecystokinin (CCK) inhibits?

a)

gastric emptying

b)

pancreatic HCO3

− secretion

c)

pancreatic enzyme secretion

d)

contraction of the gallbladder

48.

Which of the following substances must be further digested before it can be absorbed by specific carriers in intestinal cells?

a)

Fructose

b)

Sucrose

c)

Alanine

d)

Dipeptides

49.

Infants show preferences to sweet and salty foods at what age?

a)

1month

b)

2months

c)

3months

d)

4months

50.

Which of the following changes occurs during defecation?

a)

Intra-abdominal pressure is lower than when at rest

b)

External anal sphincter is contracted

c)

Rectal smooth muscle is relaxed

d)

Internal anal sphincter is relaxed

51.

The most serious complication of oropharyngeal dysphagia is?

a)

Subcutaneous emphysema

b)

Aspiration

c)

Esophageal bleeding

d)

Halitosis

52.

Differential diagnoses for emesis seen in both infants and children except?

a)

Gastroenteritis

b)

Pertussis syndrome

c)

Otitis media

d)

Gastritis

53.

Bleeding that originates in the esophagus, stomach, or duodenum can cause?

a)

Melena

b)

Hematochezia

c)

Hematemesis

d)

all of the above

54.

The use of PPI in treatment of GERD is associated with these potential complications, except?

a)

Dysphagia

b)

Clostridium difficile infection

c)

Respiratory infection

d)

Hypomagnesemia

55.

The most common clinical association of pyloric stenosis?

a)

Elevated Amylase and Lipase

b)

Hyperbilirubinemia

c)

Hyperkalemia

d)

Hypocalcemia

56.

Criteria for diagnosis of pyloric stenosis include the following, except?

a)

Opening

b)

Thickness

c)

Diameter

d)

Length

57.

The surgical procedure of choice for pyloric stenosis is?

a)

Pylorophy

b)

Pylorochiloplasty

c)

Pylorotomy

d)

Pyloromyotomy

58.

Criteria for chronic constipation in infants and toddlers except?

a)

≥1 Episode of incontinence after the acquisition of toilet training

b)

History of painful or hard bowel movements

c)

≤3 Defecations per week

d)

none of the above

59.

At what weeks of gestation can a fetus can swallow amniotic fluid?

a)

12wks

b)

14wks

c)

16wks

d)

18wks

60.

Nutritive sucking in neonates develops at about what weeks of gestation?

a)

33wks

b)

34wks

c)

35wks

d)

36wks

61.

Indirect hyperbilirubinemia, which occurs commonly in normal newborns, tends to tint the sclerae and skin with what color?

a)

blackish yellow

b)

greyish yellow

c)

greenish yellow

d)

golden yellow

62.

Traditionally, lung volumes are measured with a?

a)

Spirometry

b)

Spirogram

c)

Gyroscope

d)

Gyrometer

63.

It is the amount of air moved in and out of the lungs during each breath?

a)

Vital Capacity

b)

Residual Volume

c)

Inspiratory Capacity

d)

Tidal Volume

64.

A decrease in Functional Residual Capacity is often encountered in alveolar interstitial diseases and thoracic deformities. The major pathophysiologic consequence of decreased FRC is?

a)

Hypoxemia

b)

Hypoxia

c)

Jaundice

d)

Cyanosis

65.

The adverse pathophysiologic consequences of decrease FRC are ameliorated by application of?

a)

Fio2

b)

PIP

c)

PEEP

d)

VR

66.

These fibers are slow-twitch, high-oxidative in nature, and have low contractility but are fatigue resistant

a)

Type 1

b)

Type 2

c)

Type 3

d)

Type 4

67.

It is a hallmark of extrathoracic airway obstruction.

a)

Suprasternal retractions

b)

Grunting

c)

Expiratory wheezing

d)

Inspiratory stridor

68.

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?

a)

Bezold-Jarisch reflex

b)

Cremasteric reflex

c)

Oropharyngeal reflex

d)

Hering-Breuer

reflex

69.

It remains the chief stimulus for ventilation, which is predominantly dependent on peripheral chemoreceptor stimulation?

a)

Hypercarbia

b)

Arterial hypoxemia

c)

Low Pco2

d)

Arterial hypoxia

70.

These sinuses are present at birth?

a)

frontal and sphenoid

b)

ethomoidal and frontal

c)

frontal and maxillary

d)

ethmoidal and maxillary

71.

What organism is the most common cause of pneumonia in a 3wk to 4yr old child?

a)

Mycoplasma pneumoniae

b)

Staphylococcus aureus

c)

Chlamydophila pneumoniae

d)

Streptococcus

pneumoniae

72.

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.

a)

bronchiectasis

b)

Löffler syndrome

c)

pneumothorax

d)

Goodpasture disease

73.

Catamenial pneumothorax, an unusual condition that is related to the following, except?

a)

Diaphragmatic defects

b)

Pleural blebs

c)

Tuberculosis

d)

Menses

74.

In the hemoglobin - o2 dissociation curve, the following conditions will shift the curve to the right, except?

a)

P50 is increased

b)

P50 is decreased

c)

affinity of hemoglobin for O2 is decreased

d)

Increase in 2,3-DPG concentration

75.

Which of the following is the site of highest airway resistance?

a)

Medium-sized bronchi

b)

Largest bronchi

c)

Alveoli

d)

Trachea