TEST BANK FOR NEONATAL & PEDIATRIC RESPIRATORY CAR
d d d d d d d
E 5TH EDITION BY WALSH
d d d d
Chapter 1: Fetal Lung Development Test Bank
d d d d d d
MULTIPLEdCHOICE
5. WhatdisdthedpurposedofdthedsubstancedsecreteddbydthedtypedIIdpneumocyte?
a. Todincreasedthedgasdexchangedsurfacedarea
b. Todreducedsurfacedtension
c. Todmaintaindlungdelasticity
d. Todpreservedthedvolumedofdthedamnioticdfluid
ANS:dB
Thedprimarydroledofdmammaliandsurfactantdisdtodlowerdthedsurfacedtensiondwithindthedalveolus,dspeci
ficallydatdthedair–
liquiddinterface.dThisdallowsdtheddelicatedstructuredofdthedalveolusdtodexpanddwhendfilleddwithdair.dW
ithoutdsurfactant,dthedalveolusdremainsdcollapseddbecausedofdthe
highdsurfacedtensiondofdthedmoistdalveolardsurface.dSurfactantdisdcomposeddpredominantlydofdandintr
icatedblenddofdphospholipids,dneutraldlipids,danddproteins.
,REF:dp.d8
6. Whichdofdthedfollowingdtestsdofdthedamnioticdfluiddhavedbeendshowndtodbedsensitivedi
ndicatorsdofdlungdmaturity?
a. Levelsdofdprednisone
b. Levelsdofdepidermaldgrowthdfactor
c. Levelsdofdprostaglandins
d. Levelsdofdphosphatidylglyceroldanddphosphatidylcholine
ANS:dD
Ofdclinicaldrelevancedduringdlatedgestation,danalysisdofdamnioticdfluiddfordthedconcentrationdofdphos
phatidylglyceroldanddphosphatidylcholinedhasdbeendshowndtodbedadsensitivedindicatordofdthedstatedof
dfetaldlungdmaturity.
REF:dp.d8
Chapterd2:dFetaldGasdExchangedanddCirculationdTestdBank
1. Whichdofdthedfollowingdphasesdofdhumandlungddevelopmentdisdcharacterizeddbydthedf
ormationdofdadcapillarydnetworkdarounddairwaydpassages?
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS:dD
Thedcanaliculardphasedfollowsdthedpseudoglandulardphase,dlastingdfromdapproximatelyd17dweeksdto
d26dweeksdofdgestation.dThisdphasedisdsodnameddbecausedofdthedappearancedofdvasculardchannels,
,ordcapillaries,dwhichdbegindtodgrowdbydformingdadcapillarydnetworkdarounddthedairdpassages.dDuring
dthedpseudoglandulardstage,dwhichdbeginsdatddayd52danddextendsdtodweekd16dofdgestation,dthedairway
dsystemdsubdividesdextensivelydanddthedconductingdairwaydsystemddevelops,dendingdwithdthedtermi
naldbronchioles.dThedsacculardstagedofddevelopment,dwhichdtakesdplacedfromdweeksd29dtod36dofdgest
ation,disdcharacterizeddbydtheddevelopmentdofdsacsdthatdlaterdbecomedalveoli.
Duringdthedsacculardphase,dadtremendousdincreasedindthedpotentialdgas-
dexchangingdsurfacedareadoccurs.dTheddistinctiondbetweendthedsacculardstagedanddthedalveolardstaged
isdarbitrary.dThedalveolardstagedstretchesdfromd39dweeksdofdgestationdtodterm.dThisdstagedisdrepresen
teddbydthedestablishmentdofdalveoli.
REF:dpp.d3-5
2. Regardingdpostnataldlungdgrowth,dbydapproximatelydwhatdageddodmostdofdthedalveolidthatd
willdbedpresentdindthedlungsdfordlifeddevelop?
a. 6dmonths
b. 1dyear
c. 1.5dyears
d. 2dyears
ANS:dC
Mostdofdthedpostnataldformationdofdalveolidindthedinfantdoccursdoverdthedfirstd1.5dyearsdofdlife.dAtd2dye
arsdofdage,dthednumberdofdalveolidvariesdsubstantiallydamongdindividuals.dAfterd2dyearsdofdage,dmale
sdhavedmoredalveolidthanddodfemales.dAfterdalveolardmultiplicationdends,dthedalveolidcontinuedtodincr
easedindsizeduntildthoracicdgrowthdisdcompleted.
REF:dp.d6
3. Thedrespiratorydtherapistdisdevaluatingdadnewborndwithdmilddrespiratoryddistressdduedtodt
rachealdstenosis.dDuringdwhichdperioddofdlungddevelopmentddiddthisdproblemddevelop?
a. Embryonal
b. Saccular
c. Canalicular
, d. Alveolar
ANS:dA
Thedinitialdstructuresdofdthedpulmonarydtreeddevelopdduringdthedembryonaldstage.dErrorsdinddevelop
mentdduringdthisdtimedmaydresultdindlaryngeal,dtracheal,dordesophagealdatresiadordstenosis.dPulmonar
ydhypoplasia,dandincompleteddevelopmentdofdthedlungsdcharacterizeddbydandabnormallydlowdnumber
dand/ordsizedofdbronchopulmonarydsegmentsdand/ordalveoli,dcanddevelopdduringdthedpseudoglandula
rdphase.dIfdthedfetusdisdborndduringdthedcanaliculardphased(i.e.,dprematurely),dseveredrespiratoryddistre
ssdcandbedexpecteddbecausedthedinadequatelyddevelopeddairways,dalongdwithdinsufficientdanddimmat
uredsurfactantdproductiondbydalveolardtypedIIdcells,dgivesdrisedtodthedconstellationdofdproblemsdknow
ndasdinfantdrespiratoryddistressdsyndrome.
REF:d p.d6
4. Whichdofdthedfollowingdmechanismsdisd(are)dresponsibledfordthedpossibledassociationd
betweendoligohydramniosdanddlungdhypoplasia?
I. Abnormaldcarbohydratedmetabolism
II. Mechanicaldrestrictiondofdthedchestdwall
III. InterferencedwithdfetaldbreathingdIV.d Failuredtodproducedfetaldlungdliquid
a. IdanddIIIdonly
b. IIdanddIIIdonly
c. I,dII,danddIVdonly
d. II,dIII,danddIVdonly
ANS:dD
Oligohydramnios,dadreduceddquantitydofdamnioticdfluiddpresentdfordandextendeddperioddofdtime,dwit
hdordwithoutdrenaldanomalies,disdassociateddwithdlungdhypoplasia.dThedmechanismsdbydwhichdamni
oticdfluiddvolumedinfluencesdlungdgrowthdremaindunclear.dPossibledexplanationsdfordreduceddquanti
tydofdamnioticdfluiddincludedmechanicaldrestrictiondofdthedchestdwall,dinterferencedwithdfetal
d d d d d d d
E 5TH EDITION BY WALSH
d d d d
Chapter 1: Fetal Lung Development Test Bank
d d d d d d
MULTIPLEdCHOICE
5. WhatdisdthedpurposedofdthedsubstancedsecreteddbydthedtypedIIdpneumocyte?
a. Todincreasedthedgasdexchangedsurfacedarea
b. Todreducedsurfacedtension
c. Todmaintaindlungdelasticity
d. Todpreservedthedvolumedofdthedamnioticdfluid
ANS:dB
Thedprimarydroledofdmammaliandsurfactantdisdtodlowerdthedsurfacedtensiondwithindthedalveolus,dspeci
ficallydatdthedair–
liquiddinterface.dThisdallowsdtheddelicatedstructuredofdthedalveolusdtodexpanddwhendfilleddwithdair.dW
ithoutdsurfactant,dthedalveolusdremainsdcollapseddbecausedofdthe
highdsurfacedtensiondofdthedmoistdalveolardsurface.dSurfactantdisdcomposeddpredominantlydofdandintr
icatedblenddofdphospholipids,dneutraldlipids,danddproteins.
,REF:dp.d8
6. Whichdofdthedfollowingdtestsdofdthedamnioticdfluiddhavedbeendshowndtodbedsensitivedi
ndicatorsdofdlungdmaturity?
a. Levelsdofdprednisone
b. Levelsdofdepidermaldgrowthdfactor
c. Levelsdofdprostaglandins
d. Levelsdofdphosphatidylglyceroldanddphosphatidylcholine
ANS:dD
Ofdclinicaldrelevancedduringdlatedgestation,danalysisdofdamnioticdfluiddfordthedconcentrationdofdphos
phatidylglyceroldanddphosphatidylcholinedhasdbeendshowndtodbedadsensitivedindicatordofdthedstatedof
dfetaldlungdmaturity.
REF:dp.d8
Chapterd2:dFetaldGasdExchangedanddCirculationdTestdBank
1. Whichdofdthedfollowingdphasesdofdhumandlungddevelopmentdisdcharacterizeddbydthedf
ormationdofdadcapillarydnetworkdarounddairwaydpassages?
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS:dD
Thedcanaliculardphasedfollowsdthedpseudoglandulardphase,dlastingdfromdapproximatelyd17dweeksdto
d26dweeksdofdgestation.dThisdphasedisdsodnameddbecausedofdthedappearancedofdvasculardchannels,
,ordcapillaries,dwhichdbegindtodgrowdbydformingdadcapillarydnetworkdarounddthedairdpassages.dDuring
dthedpseudoglandulardstage,dwhichdbeginsdatddayd52danddextendsdtodweekd16dofdgestation,dthedairway
dsystemdsubdividesdextensivelydanddthedconductingdairwaydsystemddevelops,dendingdwithdthedtermi
naldbronchioles.dThedsacculardstagedofddevelopment,dwhichdtakesdplacedfromdweeksd29dtod36dofdgest
ation,disdcharacterizeddbydtheddevelopmentdofdsacsdthatdlaterdbecomedalveoli.
Duringdthedsacculardphase,dadtremendousdincreasedindthedpotentialdgas-
dexchangingdsurfacedareadoccurs.dTheddistinctiondbetweendthedsacculardstagedanddthedalveolardstaged
isdarbitrary.dThedalveolardstagedstretchesdfromd39dweeksdofdgestationdtodterm.dThisdstagedisdrepresen
teddbydthedestablishmentdofdalveoli.
REF:dpp.d3-5
2. Regardingdpostnataldlungdgrowth,dbydapproximatelydwhatdageddodmostdofdthedalveolidthatd
willdbedpresentdindthedlungsdfordlifeddevelop?
a. 6dmonths
b. 1dyear
c. 1.5dyears
d. 2dyears
ANS:dC
Mostdofdthedpostnataldformationdofdalveolidindthedinfantdoccursdoverdthedfirstd1.5dyearsdofdlife.dAtd2dye
arsdofdage,dthednumberdofdalveolidvariesdsubstantiallydamongdindividuals.dAfterd2dyearsdofdage,dmale
sdhavedmoredalveolidthanddodfemales.dAfterdalveolardmultiplicationdends,dthedalveolidcontinuedtodincr
easedindsizeduntildthoracicdgrowthdisdcompleted.
REF:dp.d6
3. Thedrespiratorydtherapistdisdevaluatingdadnewborndwithdmilddrespiratoryddistressdduedtodt
rachealdstenosis.dDuringdwhichdperioddofdlungddevelopmentddiddthisdproblemddevelop?
a. Embryonal
b. Saccular
c. Canalicular
, d. Alveolar
ANS:dA
Thedinitialdstructuresdofdthedpulmonarydtreeddevelopdduringdthedembryonaldstage.dErrorsdinddevelop
mentdduringdthisdtimedmaydresultdindlaryngeal,dtracheal,dordesophagealdatresiadordstenosis.dPulmonar
ydhypoplasia,dandincompleteddevelopmentdofdthedlungsdcharacterizeddbydandabnormallydlowdnumber
dand/ordsizedofdbronchopulmonarydsegmentsdand/ordalveoli,dcanddevelopdduringdthedpseudoglandula
rdphase.dIfdthedfetusdisdborndduringdthedcanaliculardphased(i.e.,dprematurely),dseveredrespiratoryddistre
ssdcandbedexpecteddbecausedthedinadequatelyddevelopeddairways,dalongdwithdinsufficientdanddimmat
uredsurfactantdproductiondbydalveolardtypedIIdcells,dgivesdrisedtodthedconstellationdofdproblemsdknow
ndasdinfantdrespiratoryddistressdsyndrome.
REF:d p.d6
4. Whichdofdthedfollowingdmechanismsdisd(are)dresponsibledfordthedpossibledassociationd
betweendoligohydramniosdanddlungdhypoplasia?
I. Abnormaldcarbohydratedmetabolism
II. Mechanicaldrestrictiondofdthedchestdwall
III. InterferencedwithdfetaldbreathingdIV.d Failuredtodproducedfetaldlungdliquid
a. IdanddIIIdonly
b. IIdanddIIIdonly
c. I,dII,danddIVdonly
d. II,dIII,danddIVdonly
ANS:dD
Oligohydramnios,dadreduceddquantitydofdamnioticdfluiddpresentdfordandextendeddperioddofdtime,dwit
hdordwithoutdrenaldanomalies,disdassociateddwithdlungdhypoplasia.dThedmechanismsdbydwhichdamni
oticdfluiddvolumedinfluencesdlungdgrowthdremaindunclear.dPossibledexplanationsdfordreduceddquanti
tydofdamnioticdfluiddincludedmechanicaldrestrictiondofdthedchestdwall,dinterferencedwithdfetal
