Kumar: Robbins and Cotran Pathologic Basis of Disease, 9th Edition

Chapter 10: Pediatric

Test Bank

MULTIPLE CHOICE

1. Which hormone can suppress surfactant production in fetal lungs?

a. Cortisol
b. Estrogen
c. Insulin
d. Glucagon
e. Androgens

ANS: C, Insulin is known to suppress surfactant production in fetal lungs. High levels of
insulin in diabetic mothers, who are resistant to insulin action, are an important cause of fetal
pulmonary immaturity, predisposing premature infants of diabetic mothers to neonatal
respiratory distress syndrome.

2. Which disease is caused by prolonged exposure of premature infants to oxygen at a high

concentration?
a. Retrolental fibroplasia
b. Coloboma
c. Retinitis pigmentosa
d. Blepharitis
e. Keratomalacia

ANS: A, Retrolental fibroplasia is a well-known ocular complication of prolonged exposure

of neonates to a high concentration of oxygen in incubators.

3. Neonatal vomiting and diarrhea and failure to thrive, combined with jaundice,
hepatomegaly, early development of cataracts, and mental retardation, suggest the diagnosis
of
a. Hunter syndrome
b. Hurler syndrome
c. cystic fibrosis
d. Marfan syndrome
e. galactosemia

ANS: E, Galactosemia, a mutation of the gene encoding galactose-phosphate-uridyl

transferase, is characterized by growth retardation and digestive problems, as well as
pathologic changes in the liver, eyes, and brain.

4.

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Test Bank 10-2

5. Most teratomas in infants are located in the

a. cranium
b. mediastinum
c. gonads
d. retroperitoneum
e. sacrococcygeal region

ANS: E, Most congenital teratomas are located in the sacrococcygeal region, and appear as
masses attached to the “rump.”

6. Overall, which of the following is the most common malignancy found in children
younger than 4 years of age?
a. Retinoblastoma
b. Neuroblastoma
c. Leukemia
d. Wilms’ tumor
e. Medulloblastoma

ANS: C, Leukemia, which most often occurs in the form of acute lymphoblastic leukemia, is
the most common form of malignancy in infants and in children younger than 4 years of age.

7. Which is the most common solid malignant tumor in children younger than the age of 1
year?
a. Retinoblastoma
b. Neuroblastoma
c. Hepatoblastoma
d. Wilms’ tumor
e. Medulloblastoma

ANS: B, Neuroblastomas represent the most common solid malignant tumor in children
younger than 1 year of age. Approximately 500 new cases are diagnosed each year in the
United States.

8. Which one of the following parameters portends a good prognosis in patients with
neuroblastoma?
a. Young age (less than 1 year)
b. Near-diploid, rather than hyperdiploid or near-tetraploid, karyotype
c. Chromosome 1 deletion
d. Amplification of n-myc
e. Presence of double minutes or homogenously staining regions on chromosome 1

ANS: A, Young age is a good prognostic factor and is associated with high curability of
neuroblastomas. All patients younger than 1 year of age have an excellent prognosis,
irrespective of the stage of the tumor. All other parameters listed have adverse prognostic
implications.

Copyright © 2015 by Saunders, an imprint of Elsevier Inc. All rights reserved.

Test Bank 10-3

9. The soft core of an aortic atheroma consists primarily of

a. triglycerides
b. cholesterol
c. free fatty acids
d. fibrin
e. pus

ANS: B, The soft core of atheromas consists predominantly of cholesterol. Cholesterol

crystals in routine histologic sections appear like empty narrow rhomboid clefts, because
alcohol and xylene used during processing dissolve and remove cholesterol from the tissues.

Copyright © 2015 by Saunders, an imprint of Elsevier Inc. All rights reserved.