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. Oo noi neglect the tabfes 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 SI5 made out to PEDIATRIC ANNALS CME CENTER. 6900 Grove Road. Thorofare, NJ 08080.
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 malerial on this aspect of the subject listed in the references in this issue.
6. Be sure to mall the form on or before the deadline listed on the CME Registration Form, so that credit can be awarded. iAfter 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 lot continuing medical education, the Lenox Hill Hospital of New York designates this continuing medical education activity as meeting [he criteria 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.
Emergencies in Pediatrics I
1. The leading cause of death In children older than 1 year of age Is:
C. traumatic injuries.
2. Children have a higher death rate In prehospltal situations than do adults.
3. The most common underlying condition In children that leads to emergent life-threatening conditions are:
A. cardiac disorders.
B. respiratory illnesses.
C. neurologic illnesses.
D. metabolic disorders.
4. All of the following statements are true except:
A. The majority of emergency pediatrie conditions are neither preventable nor reversible if treated urgently and appropriately.
B. Accidents and Injuries are the major cause of morbidity and mortality of children after infancy.
C. Each year, more than 10000 children die from accidental causes.
D. for each childhood mortality, four other children sustain severe morbidity.
5. The outcome for cardlopulrnonary resuscitation In Infants and children:
A. depends on the location of the event.
B. is better in the emergency department than in the prehospital setting.
C. is generally good, with a 50% survival rate.
D. is generally very poor.
6. Minute ventilation is:
A. the product of the respiratory rate and expiratory volume.
B. the amount of air that remains in the lungs after one minute of deep breathing.
C. is the product of the tidal volume and respiratory rate.
D. is the product of the tidal volume and residual volume.
7. Grunting Is caused by:
A. secretions in the airway.
B. partial closure of the glottis during expiration.
C. obstruction at the level of the vocal cords.
D. lower airway obstruction.
8. The clinical assessment of the child In shock Includes all of the following except:
A. general appearance and color.
B. the heart rate and character of the pulses.
C. the blood pressure and capillary refill time.
D. careful fundoscopic examination.
9. Shock may be defined as:
B. cardiac failure.
C. failure to supply enough oxygen and metabolites to meet the metabolic demands of the tissues.
D. always a retrospective diagnosis.
10. The preferred solution for Initial resuscitation following significant trauma In children Is:
A. 5% albumin.
B. packed red blood cells.
C. normal saline.
D. Ringer's lactate.
11. All of the following statements regarding pediatrie trauma are true except!
A. Child abuse must always be considered.
B. A urinary catheter is not necessary for monitoring urine output.
C. The secondary survey is a head-totoe evaluation with "look, listen, feel" techniques,
D. The psychological needs are of great importance.
12. Ensuring an adequate airway In a multiple trauma patient includes all except:
A. a chin lift/jaw thrust maneuver.
B. cleaning debris and secretions.
C. supplemental oxygen.
D. tilting of the head dorsally.
13. As compared with adult trauma, pediatric trauma is characterized by:
A. a greater incidence of cervical spine injuries.
B. a greater likelihood of cerebral mass lesions.
C. more tolerance of hemoperitoneum.
D. poor healing of wounds and fractures.
14. Initial fluid management for moderate to severe dehydration should be:
A. 20 mL/kg of normal saline as lactated Ringer's solution run in over 1 5 to 20 minutes.
B. 10 mL/kg of normal saline DIOW run in over I hour.
C. 5 mL/kg of normal saline run in as rapidly as possible.
D. rapid transfusion of packed red blood cells.
15. All of the following statements about hypertonic dehydration are true except:
A. Most patients have a deficit of free water associated with the ingestion of boiled milk or excessive salt.
B. The degree of dehydration is clearly evident to the observer.
C. Slow rehydration over 48 hours or greater should be done, as too rapid fluid shifts often result in serious neurologic complications.
D. Hypotonic IV fluid (D5W 0.33% normal saline) should be used except if shock and poor perfusion exists.
16. All of the following signs and symptoms are generally found in infants presenting with meningitis except:
B. Kernig's or Brudzinskis.
D. poor feeding.
17. Which of the following bacteria would be an unusual pathogen in an otherwise normal 18month-old child presenting with signs and symptoms of cellulitis?
A. Escherichia coli.
B. Streptococcus pneumoniae.
C. Hemophilus influenzae.
D. Staphylococcus aureus.
18. All of the following are ominous signs or symptoms in a child presenting with art overwhelming infection except:
C. capillary refill of 3 seconds.
19. The highest priority in the management of an unstable child presenting with an overwhelming Infection is:
A. establishing airway, breathing, and circulation.
B. obtaining blood, spinal, and urine cultures.
C. beginning antibiotics immediately.
D. immediate transfer to a tertiary care center.
20. The most significant risk factor in an immunocompromised child presenting with signs and symptoms of an overwhelming infection is:
A. degree of fever.
B. duration of fever.
C. specific clinical findings.
ANSWERS TO THE JULY QUIZ AIDS IN CHILDREN I