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 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 $ 1 8 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 Lenox Hill Hospital of New York designates this continuing medical education activity as meeting the 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.
1 . For an athlete with best corrected vision of 20/1 OO in one eye, appropriate eye protection devices should be required when participating in all of the following sports except.
2. Participation in contact/collision sports is contraindicated for all of the following except:
A. A 17-year-old female with hypertensive retinopathy.
B. A 10-year-old male with hypertrophic cardiomyopathy.
C. A 15-year-old girl with epilepsy (last seizure generalized tonic-clonic 14 months ago).
D. A 12-year-old boy with a single horseshoe kidney.
3. The most appropriate management of a football player who has experienced two Grade 2 concussions (retrograde amnesia, brief confusion, no loss of consciousness) early in the season is:
A. Return to football once asymptomatic both at rest and with exertion.
B. No participation for at least 1 month postinjury and with no symptoms at rest or with exertion.
C. Terminate participation for the remainder of this season.
D. Permanent disqualification for all contact/collision sports.
4. All of the following statements are true except:
A. Male athletes with a single testicle can have adequate protection with the use of a hard athletic supporter cup, and with such use may participate in contact/collision sports.
B. Athletes with indirect inguinal hernias should not be allowed to participate in sports, as there is evidence that sports participation is likely to lead to incarceration of a hernia.
C. Splenic rupture has not been reported with infectious mononucleosis after an athlete has been asymptomatic at least 4 full weeks and with no clinical splenomegaly.
D. Inhalation of either albuterol or cromolyn prior to exercise will effectively prevent the occurrence of exerciseinduced asthma for approximately 2 to 4 hours.
5. In detecting significant abnormalities that will require modification of sports participation, the traditional medical-oriented sports physical examination is:
A. Of high value (greater than 10% detection).
B. Of moderate value (approximately 3% to 5% detection).
C. Of limited value (about 1% detection).
D. Of no significant value (less than 0.1% detection).
6. If an orthopedic musculoskeletal assessment is included in a sports physical, the incidence rate for detecting abnormalities can be increased to:
7. Posttraumatic joint instability of the ankle does not lead to:
A. Shin splints.
B. Knee strains.
C. Recurrent ankle sprains.
D. Osteoarthritis of the ankle.
8. Of the following, the high school sport with the highest injury rate is:
9. Sudden death from commotio cordis (concussion of the heart) seems to occur most often in youth in:
B. Ice hockey.
10. A true statement about sports injuries in general is that:
A. Rule changes in football have made the sport safer.
B. Catastrophic injuries in football are rapidly increasing.
C. Cervical spine injuries in ice hockey do not appear to be preventable.
D. Soccer has the highest overall injury rate of all interscholastic sports.
11. The best agent to use for cryotherapy following injury is:
B. Chemical ice packs.
C. Frozen gels.
D. Ethyl chloride spray.
12. A true statement about the use of anti-inflammatory medications (NSAIDs) in the treatment of minor soft tissue injury is:
A. They are an accepted part of early therapy for injury.
B. They speed recovery.
C. Research has proven them to be safe and efficacious.
D. They may cause increased bleeding following injury.
13. Possible adverse effects of cryotherapy Include all of the following except.
A. Delay in early ambulation postinjury.
B. Increase swelling if used for 30 minutes or more.
C. Damage to superficial tissues from freezing.
D. Triggering of Raynaud's disease.
14. All of the following statements about acute soft tissue injuries are true except.
A. It is usually the amount of bleeding and edema rather than the severity of the underlying lesion that determines the amount of time lost from participation after a sports injury.
B. Injury to the posterior talo-fibular ligament is the most frequent injury in an inversion (lateral) ankle sprain.
C. Avoidance of weight bearing with the early use of crutches is usually the most effective means of resting the ankle after an acute sprain.
D. With acute ankle sprains, an appropriate rehabilitation program is needed, and the return to normal should always be slow and gradual.
15. Behavioral toxicity to anabolicandrogenic drugs include all of the following except:
A. Psychological dependency.
B. Heightened aggression.
C. Diminished pain threshold.
D. Increased self-confidence.
16. Side effects of anabolic-androgenic compounds may include all of the following except:
A. Gynecomastia in males.
B. Decrease in breast size in females.
C. Cholestatic jaundice.
D. Decreased low-density lipoprotein cholesterol concentration.
17. The most compelling reason for adolescents to abstain from anabolicandrogenic steroid usage is:
A. The moral issue of fair play.
B. A high probability of medically significant side effects.
C. A high probability of psychologically significant side effects.
D. The probability of significant addictive potential.
18. The approximate incidence of sudden unexpected cardiac death in young athletes is:
A. 1:10 000.
B. 1:100 000.
C. 1:200 000.
D. 1:500 000.
19. The most common cardiac cause of sudden unexpected death in the apparently healthy young athlete is:
A. Marfan syndrome.
B. Hypertrophic cardiomyopathy.
C. Coronan/ artery anomalies.
D. Dysplastic right ventricle.
20. The most appropriate means of routine preparticipation screening for cardiovascular abnormalities in young athletes is:
A. The history and physical examination.
D. Treadmill stress testing.
Answers to the December Quiz Transplantation Medicine