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 ropy of your answers so that they can be compared with the correct answers that will be sent to you later.
3. TVpe 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 S 1 8 made out to PEDIATRIC ANNALS CME CENTER, 0900 Grove Road, Thorofare, NJ 08086.
5. Your answers will be graded, and you will be ¿idvised 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 CMiI 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 acci edited for continumy medical education, the Lenox Hill Hospital of Nevv York designates this continuing medical education activity as meeting the criteria for rhree credit hours in Category I For Educational Materials for the Physician's Recognition Award oí the American Medical Association, provideo it has been completen according to instructions
1 . The most common type of headaches seen in adolescent patients are:
A. acute recurrent headaches.
B. chronic-nonprogressive headaches.
C. chronic-progressive headaches.
D. mixed pattern headaches.
2. All of the following are common clinical features of migraine (seen in more than 50% of cases) in adolescent patients except:
A. paroxysmal pounding headache.
B. relief after sleep.
C. nausea, vomiting, or abdominal pain.
D. aura preceding the headache.
3. In a large consulting child neurology practice, the pattern of headache types seen in adolescents approximates:
A. 15% have migraine, 35% have muscle contraction or tension headaches, and 50% have other forms.
B. 25% have migraine, 25% have muscle contraction or tension headaches, and 50% have other forms.
C. 40% have migraine, 45% have muscle contraction or tension headaches, and 15% have other forms.
D. 50% have migraine, 25% have muscle contraction or tension headaches, and 25% have other forms.
4. Adolescent patients with chronicnonprogressive headaches:
A. usually are able to describe their symptoms precisely and specifically.
B. rarely complain of fatigue, dizziness, or fainting.
C. usually describe their pain as bilatéral and often as band-like.
D. rarely have daily headaches that wax and wane.
5. The most likely cause of recurring chest pain in adolescents is:
6. Management of recurrent chest pain in adolescents requires a detailed explanation of findings because:
A. the reasons are often quite complex.
B. adolescents' minds think concretely, and detailed explanations need to be repeated.
C. adolescents are cognitively immature.
D. many laboratory tests are needed to diagnose the problem.
7. All of the following statements about hyperventilation are true except:
A. hyperventilation can cause chest pain itself due to respiratory alkalosis.
B. hyperventNation is most commonly found to be an accompanying finding of costochondritis because the chest pain causes anxiety about possible death.
C. hyperventilation itself is not uncommon among adolescent females.
D. hyperventilation accounts for less chest pain in adolescents than does serious pathology.
8. Dysfunctional chronic abdominal pain (CAP) is almost never associated with:
A. loss of daily (unctioning.
B. a relationship with physiological events.
C. growth failure.
D. headache and dizziness.
9. Nonulcer dispepsia is never associated with:
A. Helicobacler pylori.
C. emotional stress.
D. Meckel's diverticulum.
10. Organic chronic abdominal pain (CAP) is more commonly:
B. associated with a long history of abdominal complaints.
C. related to stressful précipitants.
D. found in females.
11. Recurrent abdominal pain is usually associated with:
A. nocturnal episodes.
B. alternating diarrhea/constipation.
C. persistent abdominal distention.
D. fixed location.
12. All of the following statements about infectious mononucleosis are true except:
A. it is usually an acute, self-limiting, benign Iy m phoprol iterative disorder.
B. it is generally readily recognized in adolescents by its classic presentation.
C. it usually represents primary EpsteinBarr Virus (EBV) infection.
D. its communicability is very high.
13. The best statistically significant predictor of the duration of illness in patients with infectious mononucleosis is:
A. the time from onset of symptoms to the time specific diagnosis is established.
B. the percentage of atypical lymphocyles on blood smear at the time of peak illness.
C. the magnitude of the serologie response.
D. the presence of abnormal liver chemistries at time of diagnosis.
14. Corticosteroids are indicated in the treatment of infectious mononucleosis when:
A. there is concern for spienic rupture.
B. the presentation is consistent with the glandular type of infectious mononucleosis.
C. there are signs of upper airway obstruction.
D. the illness will affect athletic abilities in competition.
15. Guidelines for resumption of activities in patients with infectious moñón ucleosis should include:
A. isolation of the patient from family and friends during acute illness.
B. resumption of full activities including athletic training 14 days after onset of illness.
C. strict bedrest during the first week of illness.
D. careful evaluation of splenic size, including use of ultrasound, prior to participation in contact sports or strenuous training.
16. The primary cause of anterior knee pain in adolescent patients is:
A. patella subluxation.
B. abnormal patella tracking.
C. patella femoral osteoarthritis.
17. The majority of patients with anterior knee pain:
A. will be managed by conservative therapy.
B. willpresentwiththeirsymptomsth rough- B. out their life,
C. will require early surgery, C.
D. will respond quickly to a regimen of D. exercise therapy.
18. Strength training for the patient significant patellofemoral synwith drome requires:
A. a slowly progressive program.
B. the early use of knee extensionflexion exercises.
C. an expectation of significant improvement at less than 10 pounds of resistance.
D. a rapid progression to higher resistances.
19. All of the following are true statements of the natural history of low back pain except:
A. it is almost always a self-limited disorder.
B. it is statistically difficult to demonstrate that any one of the many treatment modalities are more effective than others.
C. without any treatment, 80% of patients will have recovered by 1 week.
D. radiologie studies are rarely indicated in the typical case.
20. An intense exercise program should always be recommended following recovery of an adolescent's initial episode of acute low back pain.
ANSWERS TO THE JANUARY QUI2 SEIZURES