Pediatric Annals

CME QUIZ

Abstract

INSTRUCTIONS

Pediatricians may receive three credit hours in Category 1 for the Physician's Recognition Award of the American Medical Association by reading the material in this issue and successfully answering the questions in the quiz below. To obtain credits, follow these instructions.

1. Read each of the articles carefully. Do not neglect the tables and other illustrative materials, as they have been selected to enhance your knowledge and understanding.

2. The following questions have been designed to provide a useful link between the articles in the issue and your everyday practice. Read each question, choose the correct answer, and record your answer on the CME Registration Form at the end of the quiz. Retain a copy of your answers so that they can be compared with the correct answers that will be sent to you later.

3. Type or print your full name and address and your Social Security number in the spaces provided on the CME Registration Form.

4, Send the completed form, with your check or money order for $10 made out to PEDIATRIC ANNALS CME CENTER, 6900 Grove Road, Thorofare, N.J. 08086.

5. Your answers will be graded, and you will be advised that you have passed (or failed). An answer sheet containing all correct answers will be mailed ?? you. Review the parts of the articles dealing with any questions you have missed, and read the supplemental material on this aspect of the subject listed in the references in this issue.

6. Be sure to mail the form on or before the deadline listed on the CME Registration Form, so that credit can be awarded. (After that date, the quiz will close, and correct answers will appear in the magazine.) Unanswered questions will be considered incorrect and so scored. A minimum score of 70 must be obtained in order for credits to be awarded.

CERTIFYING INSTITUTION

As an organization accredited for continuing medical education, the Lenox Hill Hospital of New York designates this continuing medical education activity as meeting the criteria for three credit hours in Category 1 for Educational Materials for the Physician's Recognition Award of the American Medical Association, provided it has been completed according to instructions.

CME QUIZ: PEDIATRIC GASTROENTEROLOGY

1. The best single index of growth failure secondary to malnutrition is:

A. The triceps skin-fold for thickness.

B. The patient's mid-arm circumference.

C. The patient's weight loss.

D. The patient's weight and height.

2. If a patient has chronic diarrhea:

A. Hemorrhages in the skin may indicate vitamin B deficiency.

B. Enlargement of the liver and spleen may be seen with protein malnutrition.

C. The presence of fat droplets in the stool may indicate a deficiency of vitamin K.

D. All of the above (A, B and C).

3. Infants intolerant to cow's milk protein should be changed to:

A. Skimmed milk.

B. Goat's milk.

C. Nutramigen.

D. Any of the above (A, B or C).

4. The most common cause of chronic diarrhea in a two-year-old child who does not show any evidence of malnutrition is:

A. Chronic non-specific diarrhea of infancy (CNSD).

B. A persistent viral infection.

C. Irritable bowel syndrome.

D. Salmonella or Shigella infectio'n.

5. Celiac disease in children living in the United States:

A. Is rarer than it is in Europe.

B. Usually manifests between one and three years of age.

C. Responds to a gluten-free diet within one or two weeks.

D. All of the above (A, B and C).

6. Ulcerative colitis in children under the age of 18:

A. Is rare.

B. Is unlike Cronn's disease in children.

C. Always requires a proctosigmoidectomy.

D.…

INSTRUCTIONS

Pediatricians may receive three credit hours in Category 1 for the Physician's Recognition Award of the American Medical Association by reading the material in this issue and successfully answering the questions in the quiz below. To obtain credits, follow these instructions.

1. Read each of the articles carefully. Do not neglect the tables and other illustrative materials, as they have been selected to enhance your knowledge and understanding.

2. The following questions have been designed to provide a useful link between the articles in the issue and your everyday practice. Read each question, choose the correct answer, and record your answer on the CME Registration Form at the end of the quiz. Retain a copy of your answers so that they can be compared with the correct answers that will be sent to you later.

3. Type or print your full name and address and your Social Security number in the spaces provided on the CME Registration Form.

4, Send the completed form, with your check or money order for $10 made out to PEDIATRIC ANNALS CME CENTER, 6900 Grove Road, Thorofare, N.J. 08086.

5. Your answers will be graded, and you will be advised that you have passed (or failed). An answer sheet containing all correct answers will be mailed ?? you. Review the parts of the articles dealing with any questions you have missed, and read the supplemental material on this aspect of the subject listed in the references in this issue.

6. Be sure to mail the form on or before the deadline listed on the CME Registration Form, so that credit can be awarded. (After that date, the quiz will close, and correct answers will appear in the magazine.) Unanswered questions will be considered incorrect and so scored. A minimum score of 70 must be obtained in order for credits to be awarded.

CERTIFYING INSTITUTION

As an organization accredited for continuing medical education, the Lenox Hill Hospital of New York designates this continuing medical education activity as meeting the criteria for three credit hours in Category 1 for Educational Materials for the Physician's Recognition Award of the American Medical Association, provided it has been completed according to instructions.

CME QUIZ: PEDIATRIC GASTROENTEROLOGY

1. The best single index of growth failure secondary to malnutrition is:

A. The triceps skin-fold for thickness.

B. The patient's mid-arm circumference.

C. The patient's weight loss.

D. The patient's weight and height.

2. If a patient has chronic diarrhea:

A. Hemorrhages in the skin may indicate vitamin B deficiency.

B. Enlargement of the liver and spleen may be seen with protein malnutrition.

C. The presence of fat droplets in the stool may indicate a deficiency of vitamin K.

D. All of the above (A, B and C).

3. Infants intolerant to cow's milk protein should be changed to:

A. Skimmed milk.

B. Goat's milk.

C. Nutramigen.

D. Any of the above (A, B or C).

4. The most common cause of chronic diarrhea in a two-year-old child who does not show any evidence of malnutrition is:

A. Chronic non-specific diarrhea of infancy (CNSD).

B. A persistent viral infection.

C. Irritable bowel syndrome.

D. Salmonella or Shigella infectio'n.

5. Celiac disease in children living in the United States:

A. Is rarer than it is in Europe.

B. Usually manifests between one and three years of age.

C. Responds to a gluten-free diet within one or two weeks.

D. All of the above (A, B and C).

6. Ulcerative colitis in children under the age of 18:

A. Is rare.

B. Is unlike Cronn's disease in children.

C. Always requires a proctosigmoidectomy.

D. Always requires a barium enema.

7. Betalactoglobulin, an antigen found in cow's milk:

A. Is not found in breast milk.

B. Has its antigenicity partially inactivated by heating.

C. Can lead to intolerance to cow's milk in children.

D. All of the above (A, B and C).

8. Children with cow's milk and soy milk protein intolerance (CMPSPI):

A. Will often be intolerant to other proteins as well.

B. Will be intolerant to the milk or soy protein until adolescence.

C. Will continue to have the original mucosal injury even if the allergen is eliminated.

D. All of the above (A, B and C).

9. The unifying features of psychosomatic gastrointestinal complaints are:

A. The constancy about the localization of pain.

B. The vagueness about the seventy of the problem.

C. The willingness of the patient to wait for an answer until all the tests are completed.

D. The constancy of gastrointestinal symptoms.

10. Vomiting in childhood may be due to gastrointestinal conditions as well as:

A. Central nervous system disease.

B. Genito-urinary disease.

C. Endocrine disease.

D. All of the above (A, B and C).

11. Clear liquid feedings have been used in nonspecific diarrhea.

A. Recent experimental work has confirmed this treatment.

B. Recent experimental work has shown that clear liquids may perpetuate thesymptoms.

C. Recent experimental work has shown that clear liquids should never be used.

D. Recent experimental work has shown that fats should not be used in the diet.

12. If a child has chronic constipation it must be differentiated from Hirschsprung's disease.

A. In Hirschsprung'sdisease the rectal examination may disclose occasional stool in the rectal ampulla.

B. In Hirschsprung's disease there is infrequent passage of hard stools.

C. Bulky hard stools in a well baby usually means aganglionosis.

D. Three suction biopsies to look for ganglion cells 3-4 cm from the anal verge is oneof the , most reliable diagnostic tests to differentiate the two conditions.

13. Mineral oil has been used for treatment of chronic constipation.

A. A starting dose would be two teaspoons twice a day.

B. If there is leakage of mineral oil there should be a decrease of the dosage.

C. The child should continue to take mineral oil regularly for two months following the establishment of a normal stooling pattern.

D. There is evidence to support that mineral oil promotes purgative dependency.

14. Recurrent abdominal pain in a child in whom no organic etiology is found:

A. Usually has the pain localized near the umbilicus.

B. Rarely has symptoms not related to the Gl tract.

C. Is more frequent in boys than girls.

D. All of the above (A, B and C).

15. Below one year of age, frequent vomiting in infant children may be due to gastroesophageal reflux. This may result in:

A. Failure to gain weight.

B. Constipation.

C. Diarrhea alternating with constipation,

D. All of the above (A, B and C).

16. Treatment of gastroesophageal reflux can include:

A. Upright positioning.

B. Thickened feedings.

C. Surgical therapy.

D. All of the above (A, B and C).

17. Diarrhea and colitis following the use of antibiotics is usually caused:

A. By a toxin produced by a specific bacteria.

B. By direct invasion of a specific bacteria.

C. By invasion of the mucosa by bacteria.

D. By a toxin produced by a virus.

18. E. coil and Salmonella are capable of causing acute infectious gastroenteritis (AGE):

A. By toxins produced by the bacteria in the small bowel.

B. By direct invasion of colonie mucosa.

C. Through both mechanisms simultaneously.

D. Through neither of the above mechanisms (A nor B).

19. Children with AGE who are vomiting but do not appear severely dehydrated should be offered:

A. As much clear fluid as they will take.

B. Frequent small volumes of a rehydration solution.

C. Milk and milk formula feedings.

D. Solids and a milk formula in small amounts but frequently.

20. Simple acute infectious gastroenteritis (AGE) due to Salmonella:

A. Should always be treated with ampicillin.

B. Should always be treated with chloramphenicol.

C. Should be treated with quinacrine,

D. Should not be treated with antibiotics.

ANSWERS TO THE OCTOBER CME QUIZ

Ethical Problems In Pediatrics

1. C

2. B

3. C

4. C

5. B

6. A

7. C

8. B

9. C

10. A

11. B

12. C

13. C

14. A

15. A

16. C

17. C

18. D

19. B

20. A

10.3928/0090-4481-19820101-12

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