Pediatricians may receive three credit hours in Category I 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 Registranon 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 SI5 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 1 for Educational Materials for the Physician's Recognition Award of the American Medical Association, provided it has been completed according to instructions.
1. All of the following are reasonable diagnostic considerations for a painful hip in a 5-year-old child except:
A. Legg-Calvé-Perthes disease.
B. Septic arthritis.
C. Transient synovitis.
D. Slipped capital femoral epiphysis.
2. All of the following statements regarding bone scans are true except:
A. The bone scan may be normal in the first two days of osteomyelitis.
B. Needle aspiration will produce a false positive reading on a subsequent bone scan.
C. If osteomyelitis is obvious on plain x-rays, a bone scan is unnecessary.
D. The bone scan may be used to localize pathology before plain xrays become positive.
3. One should consider all of the following when a child presents with 'hip pain" except:
B. Iliopsoas abscess.
C. Chondromalacia patella.
D. Sacroiliac joint infection.
4. In Legg-Calvé-Perthes disease and slipped capital femoral epiphysis, the most significant loss of hip motion will be in:
A. Abduction and rotation.
B. Flexion and extension.
C. Extension and adduction.
D. Flexion and adduction.
5. The most appropriate management of the newborn with art unstable hip is:
A. Pavlik harness.
B. Triple diaper treatment.
C. Fredjka pillow splint.
D. Craig splint.
6. All but one of the following problems are associated with a higher than average likelihood of coexisting CDH:
B. Metatarsus adductus.
C. Cavus deformities.
D. Breech position.
7. Which of the following best describes the value of neonatal screening for congenital hip dysplasia:
A. Important but not definitive.
B. Little proven value, radiograph definitive.
C. Careful screening fulfills the physician's responsibility.
D. Not definitive; rely primarily on examination.
8. The best age for screening by radiography in high risk infants is:
A. At birth.
B. I month.
C. 2 to 3 months.
D. 4 to 6 months.
9. The most common joint affected in neonatal sepsis is the: A. Shoulder.
10. The best choice In initial antibiotic coverage of a bone or joint infection in the neonate should cover which of the following organisms:
A. Staphylococcus aureus. Beta streptococcus. Gram-negative coliforms.
B. Hemophilus influenzae. Staphylococcus aureus. Beta streptococcus.
C. Gonococcus, Staphylococcus aureus. Gram-negative coliforms.
D. Staphylococcus aureus.
11. Which of the following signs and symptoms may be seen in the neonate with a bone or joint infection:
A. A normal range of motion of all joints.
B. A normal body temperature.
C. Irritability lethargy, and poor feeding.
D. All of the above.
12. The best method for treating septic arthritis in the neonate is: A. Intravenous antibiotics and surgical drainage.
B. Intravenous antibiotics for one week, followed by oral antibiotics for four to six additional weeks.
C. Intravenous antibiotics, surgical drainage, and irrigation of the joint with antibiotic solution.
D. Oral antibiotics in sufficient concentration to kill the organisms.
13. In a neonate suspected of septic arthritis or osteomyelitis, the most useful test to confirm or disprove the diagnosis is:
A. Plain radiograph.
B. Technetium bone scan.
C. The clinical examination.
14. Which of the following symptoms or physical findings are most consistent with an osteosarcoma of the distal femur:
A. Knee stiffness.
B. Knee effusion.
C. Pain with joint motion.
D. Intraosseous night pain.
15. Which of the following is not the best diagnostic radiographic study for the corresponding problem:
A. Soft tissue mass - magnetic resonance imaging.
B. Intraosseous tumor - bone scan.
C. Soft tissue mass - ultrasound study D. All of the above.
16. Which of the following is not included in the category of small round blue cell tumors: A. Ewmg's sarcoma.
1 7. A dislocation of a child's elbow is: A. Usually a solitary injury B. Also called a pulled elbow C. Usually accompanied by a separa- tion of medial epicondyle.
D. Usually accompanied by brachial artery disruption.
18. An overlapping fracture of the distal radius: A. Can be reduced with anesthetic.
B. Should be reduced with a hema- toma block.
C. Usually requires open reduction.
D. Can be reduced closed or under general anesthesia.
19. Fractures of the femur in a 10- month-old child are: A. Common due to early attempts at walking.
B. Should be treated by soft dressing and early return to the orthopedic clinic.
C. Are difficult to diagnose clinically D. Should alert the physician to child abuse in a child of such a young age.
20. Supracondylar fractures of the humerus: A. Are benign injuries requiring no special treatment.
B. May cause deformity years after treatment due to growth abnor- malities.
C. Require closed reduction and may be augmented with percutaneous pinning. ANSWERS TO THE OCTOBER QUIZ Pediatric Otolaryngology 1. B 2. B 3. A 4. C 5. A
6. A 7. C 8. D 9. B 10. C
11. B 12. B 13. D 14. B 15. B
16. B 17. C 18. O 19. A 20. A