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 guestions in the quiz below. To obtain credits, follow these instructions.
1. Read each off 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 Sl 5 made out to PEDIATRIC ANNALS CME CENTER. 6900 Grove Road, Thorofare. NJ. 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 to 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.
As an organization accredited for continuing medical education, the Lexon Hill Hospital of New York designates this continuing medical education activity as meeting the entena for three credit hours in Category I for Educational Materials for the Physician's Recognition Award of the American Medical Association, provided it has been completed according to instructions'
Gastrointestinal Diseases of Children
1. To relieve rectal spasm in Infants one could:
A. Spread apart the rectal walls.
B. Use a rectal tube.
C. Use a stimulant suppository.
D. All of the above are correct.
2. The pharmacologic treatment of rectal spasm Is:
B. Achieved by using phenothiazine derivative.
C. Achieved by using ethanol in older children.
D. None of the above are correct.
3. Lactose restriction:
A. Usually causes relief in RAP
B. Is helpful in some children.
C. Should be used if one parent is known to suffer from lactose intolerance.
D. Should be used if both parents are known to suffer from lactose intolerance.
Which of the above Is false?
4. Bran is frequently used to relieve IBS. This treatment:
A. Is never useful.
B. May prove to be counterproductive.
C. Is useful as it causes increased bloating with evacuation,
D. Is useful as it causes increased flatus with evacuation.
5. The therapy for chronic retentive constipation includes:
A. Colonic evacuation and disimpaction.
B. Laxative therapy to achieve daily bowel movements.
C. Behavioral conditioning.
D. All of the above are correa.
6. The differential diagnosis of chronic constipation includes:
B. Lead poisoning.
C. Hirschsprung's disease.
D. All of the above are correct
7. All of the following statements are correct except:
A. The most frequent organic differential problem in patients with constipation is Hirschsprung's disease.
B. Children with chronic constipation require a barium enema to rule out Hirschsprung's disease.
C. The stool frequency in infants and toddlers seems to decrease with age.
D. Some children seem to have a genetic predisposition to constipation.
8. Medications that may cause constipation include:
D. All of the above.
9. Colic occurs in infants:
A. Three days to three months old.
B. Three weeks to three months old.
C. Three months to six months old.
D. Less than one month old.
10. Mean daily crying time in infants peaks at:
A. Two weeks.
B. Four weeks.
C. Six weeks.
D. Eight weeks.
11. All of the following statements about colic are correct except:
A. Colic is a self-limited disorder.
B. Colicky infants may go on to develop irritable colon of childhood.
C. No one therapy is universally accepted.
D. Changing formula is often helpful.
12. An unrestricted diet in infants and small children:
A. Never leads to normalization of bowel movements.
B. Always leads to normalization of bowel movements.
C. Leads to normalization of bowel movements in 80% of patients.
D. Should be used with drug therapy
13. The most common cause of chronic recurrent abdominal pain is:
A. Inflammatory bowel disease.
B. Peptic ulcer disease.
C. Functional abdominal pain.
D. Psychiatric disorder.
14. Which of the following statements about functional abdominal pain is least true?
A. Functional abdominal pain is believed to be related to IBS in adults.
B. The vast majority of patients with functional abdominal pain have lactose intolerance.
C. Functional abdominal pain is most commonly periumbilical in location.
D. The number of episodes and severity of functional abdominal pain is commonly increased by stress.
15. Functional recurrent abdominal pain is believed to result from:
A. Activation of stretch receptors in the intestinal wall.
B. Psychological disorders in the family.
C. Occult peptic ulcer disease.
D. Inflammatory bowel disease.
16. The initial evaluation of patients with functional abdominal pain should include all of the following except:
A. CBC, ESR.
B. Careful history and physical examination.
D. Stool guaiac cards for occult blood.
17. Symptoms in the irritable bowel syndrome may be:
B. Lower abdominal pain.
D. All of the above are correct.
18. The most efficient area of the gastrointestinal tract for fluid resorption Is:
A. The stomach.
B. The small intestine.
C. The very distal colon.
D. The rectum.
19. In Individuals with tendencies to constipation:
A. Drier stools result from stronger distal colonic muscle squeezing mechanisms.
B. There is a more efficient water membrane transport mechanism.
C. Stools stay in contact with the rectal mucosa for a longer period.
D. There is often a tight tectum on physical examination.
Which of the above Is false?
20. The. appearance of starch and vegetable fibers In the stool:
A. Is normally inversely related to the length of time the stool remains in contact with rectal bacteria.
B. Is normally related to the length of time the stool remains in contact with rectal bacteria.
C. Depends on the diet.
D. Depends on the amount of fluid one drinks.
ANSWERS TO THE JULY QUIZ
Current Trends in Pediatric Cardiology - Noninvasive Diagnosis