Pediatric Annals

CME QUIZ

Abstract

Instructions

1. As an organization accredited for continuing medical education, the Lenox Hill Hospital certifies that this continuing medical education activity meets the criteria for three credit hours in Category I of the Physician's Recognition Award of the American Medical Association, provided it is used and completed as designed.

2. Read every question carefully. Answers to allquestions will be found in the articles in this issue of Peojatric Annals. Select only one letter next to each of the numbers listed on the answer form.

3. Type or print your full name and address (including zip code) and your social security number in the spaces provided.

4. Send check or money order ($10) made out to Pediatric Annals CME Quiz. Mail with your answer form to:

PEDIATRIC ANNALS

CME Center

501 Madison Avenue

New York, N.Y. 10022

5. After your answers are graded, you will be advised of your score and the answers to any incorrect or missed questions. Unanswered questions will be considered incorrect and so scored. A minimum score of 70 per cent must be obtained in order for credits to be awarded.

6. All replies and results are confidential. Answer sheets, once graded, will be returned and no record of scores will be maintained. The Department of Pediatrics at Lenox Hill Hospital will keep only a record of participation, indicating the completion and awarding of three hours of Category 1 to individual physicians.

CME Quiz: Cancer in Children

1. A seven-year-old child has developed a ½″ × 1″ mass in the right eyelid. Excisional biopsy indicated a malignant tumor. The most likely diagnosis would be

A. Retinoblastoma.

B. Rhabdomyosarcoma.

C. Wilms' tumor with metastasis.

D. None of the above.

2. Retinoblastoma is a fairly common tumor during childhood. This statement is

A. True.

B. False.

C. True among children of Jewish descent in Asia Minor.

D. True among American Indians.

3. If a retinoblastoma is found in a child, one can expect involvement of the

A. Kidney.

B. Lungs.

C. Eye.

D. None of the above.

4. In cases of retinoblastoma the primary aim should

A. Preservation of useful vision.

B. Preventing further spread of tumor.

C. Preservation of life by whatever means.

D. Enucleation of the uninvolved eye to prevent metastasis.

5. The mortality from retinoblastoma is higher in developing nations than in England or the United States. This can be attributed to

A. More radical treatment in the U.S. and England.

B. More spontaneous regression among members of the white race.

C. Greater use of photocoagulation and cryotherapy in the U.S. and England.

D. An earlier diagnosis in the U.S. and England than in developing countries.

6. A nine-year-old boy has an orbital tumor causing pro ptosis. A rhabdomyosarcoma is suspected because of three of the following. Mark the statement that does not belong:

A. More than 70 per cent of the cases occur before the age of 10.

B. This tumor occurs more frequently in males than in females.

C. This tumor occurs very infrequently in children.

D. The location of this tumor is frequently in the head.

7. The orbital tumor of the child in question 6 is most likely of the

A. Embryonal type.

B. Alveolar type.

C. Botryoid type.

D. Pleomorphic type.

8. If rhabdomyosarcoma is found in the child in question 6, and on operation the surgeon leaves "microscopic" residual tumor, as judged by histologic examination of the margins of the excised tumor, which of the following conclusions should be reached?

A. A second operation should be performed immediately.

B. A second resection may not be required if chemotherapy and radiation…

Instructions

1. As an organization accredited for continuing medical education, the Lenox Hill Hospital certifies that this continuing medical education activity meets the criteria for three credit hours in Category I of the Physician's Recognition Award of the American Medical Association, provided it is used and completed as designed.

2. Read every question carefully. Answers to allquestions will be found in the articles in this issue of Peojatric Annals. Select only one letter next to each of the numbers listed on the answer form.

3. Type or print your full name and address (including zip code) and your social security number in the spaces provided.

4. Send check or money order ($10) made out to Pediatric Annals CME Quiz. Mail with your answer form to:

PEDIATRIC ANNALS

CME Center

501 Madison Avenue

New York, N.Y. 10022

5. After your answers are graded, you will be advised of your score and the answers to any incorrect or missed questions. Unanswered questions will be considered incorrect and so scored. A minimum score of 70 per cent must be obtained in order for credits to be awarded.

6. All replies and results are confidential. Answer sheets, once graded, will be returned and no record of scores will be maintained. The Department of Pediatrics at Lenox Hill Hospital will keep only a record of participation, indicating the completion and awarding of three hours of Category 1 to individual physicians.

CME Quiz: Cancer in Children

1. A seven-year-old child has developed a ½″ × 1″ mass in the right eyelid. Excisional biopsy indicated a malignant tumor. The most likely diagnosis would be

A. Retinoblastoma.

B. Rhabdomyosarcoma.

C. Wilms' tumor with metastasis.

D. None of the above.

2. Retinoblastoma is a fairly common tumor during childhood. This statement is

A. True.

B. False.

C. True among children of Jewish descent in Asia Minor.

D. True among American Indians.

3. If a retinoblastoma is found in a child, one can expect involvement of the

A. Kidney.

B. Lungs.

C. Eye.

D. None of the above.

4. In cases of retinoblastoma the primary aim should

A. Preservation of useful vision.

B. Preventing further spread of tumor.

C. Preservation of life by whatever means.

D. Enucleation of the uninvolved eye to prevent metastasis.

5. The mortality from retinoblastoma is higher in developing nations than in England or the United States. This can be attributed to

A. More radical treatment in the U.S. and England.

B. More spontaneous regression among members of the white race.

C. Greater use of photocoagulation and cryotherapy in the U.S. and England.

D. An earlier diagnosis in the U.S. and England than in developing countries.

6. A nine-year-old boy has an orbital tumor causing pro ptosis. A rhabdomyosarcoma is suspected because of three of the following. Mark the statement that does not belong:

A. More than 70 per cent of the cases occur before the age of 10.

B. This tumor occurs more frequently in males than in females.

C. This tumor occurs very infrequently in children.

D. The location of this tumor is frequently in the head.

7. The orbital tumor of the child in question 6 is most likely of the

A. Embryonal type.

B. Alveolar type.

C. Botryoid type.

D. Pleomorphic type.

8. If rhabdomyosarcoma is found in the child in question 6, and on operation the surgeon leaves "microscopic" residual tumor, as judged by histologic examination of the margins of the excised tumor, which of the following conclusions should be reached?

A. A second operation should be performed immediately.

B. A second resection may not be required if chemotherapy and radiation therapy follow.

C. Chemotherapy is usually sufficient.

D. Enucleation should be strongly considered.

9. A girl aged five years and a girl aged 12 years are both diagnosed as having rhabdomyosarcoma. Which would have the best prognosis?

A. The five-year-old girl.

B. The 12-year-old girl.

C. Neither will have a good prognosis.

D. The prognosis for each is likely to be the same.

10. A child has been treated for rhabdomyosarcoma and has shown no demonstrable lesions. Suddenly she develops lung metastasis in the right upper lobe. Which of the following would you advise?

A. Pneumonectomy.

B. Lobectomy.

C. Bilateral lung irradiation.

D. None of the above.

11. A one-year-old girl is brought to your office because of a resistant cradle cap. On examination you find a weeping scaly dermatitis as well as a fine, dry, scaly petechial rash of the upper trunk anteriorly and posteriorly, axially distributed. X-rays are taken. All but one of the following might be considered in your diagnosis. Which answer does noi belong?

A. Letterer-Siwe disease.

B. Atopic dermatitis.

C. Hand-Schüller-Christian disease.

D. Eosinophilic granuloma of bone.

12. Of the three diseases included in the histiocytosis syndrome, the most serious prognosis is in

A. Letterer-Siwe disease.

B. Hand-Schüller-Christian disease.

C. Eosinophilic granuloma of bone.

D. None of the above.

13. The child described in question 1 1 has been out of the country for two years and now is brought to your office. The parents tell you that this child still has an occasional rash, but for the past two days she has been very irritable, with a fever of 39° C. They have observed no sign of infection.

On physical examination, you find a generalized lymphadenopathy as well as hepatosplenomegaly. You suspect an infection, and the child is hospitalized. On laboratory examination the blood shows a W.B.C. of 2,700 and a Hb. of 8.4 gm. You decide to order all but one of the following tests. Which answer does not belong?

A. Blood culture.

B. Bone-marrow aspiration.

C. Fiberoptic bronchoscopy.

D. X-ray of lungs.

14. Even before the test results listed in question 13 are known to you, the child is started on empiric broad-spectrum antibiotics. This procedure is correct for which one of the following reasons?

A. The median survival of granulocytopenic-cancer patients with fever of unknown origin is less than three days.

B. Fungal infections are likely to be a cause of the fever, and they usually respond to broad-spectrum antibiotics.

C. Antibiotics are especially helpful in treating virus infections complicating a malignant disease.

D. No other method of treatment is really effective in treating febrile childhood cancer cases.

15. If studies prove that the child described in question 1 1 has Letterer-Siwe disease, the treatment of choice is

A. Surgery plus radiation.

B. Radiation plus antibiotics.

C. Chemotherapy plus local dermatologie therapy.

D. Chemotherapy plus surgery.

16. The prognosis of the child described in question 13 is poor because of all but one of the following reasons. Which answer does not belong?

A. Age ot the patient.

B. Nature of the underlying malignancy.

C. Possible presence of infection.

D. Dysfunction of the lungs.

17. If the child described in question 13 improves clinically in spite of negative cultures after one week, which one of the following is correct?

A. The antibiotics should be discontinued.

B. The antibiotics should be continued.

C. Other forms of therapy should take the place of antibiotics.

D. Live-virus vaccine should be used to prevent a new infection.

18. If the patient described in question 13 continues to have a further fall in white blood cells, granulocyte transfusion

A. Is too expensive to be tried.

B. Is usually of no help.

C. Might be tried if the WBC is less than 100/sq. mm. for more than two weeks.

D. Should be avoided because of severe side effects.

19. An eight-year-old boy has been diagnosed as having acute leukemia and is upset by the hospital treatment. You as his physician should

A. Withhold the information and deny the diagnosis to him.

B. Recommend psychologic studies.

C. Listen to the child and his family, and learn all of their reactions before giving reassurance and direction.

D. None of the above.

20. Mark the one best answer. The child described in question 19 is repeatedly hospitalized. This can have an effect on his four-year-old brother, who may conclude that

A. He is responsible for his brother's illness.

B. He will be next in line to have the same or a similar illness.

C. His brother is getting a great deal of attention, and he is jealous of it.

D. All of the above.

10.3928/0090-4481-19790101-10

Sign up to receive

Journal E-contents