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 guestions in the quiz bellow. 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 $18 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 correa 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. All of the following statements about low-birth-weight infants are true except:
A. They are the single most important factor in neonatal mortality in the United States today.
B. Maternal age is a risk factor for premature delivery but not for low-birthweight infants.
C. They are 50 times more likely to die in the neonatal period than normalweight infants.
D. Approximately, 25% of all low-birthweight infants born in the United States are bom to teenage mothers.
2. Approximately what number of young women under the age of 20 (teenagers) currently become pregnant each year in the United States?
A. 250 000 teenagers.
B. 500 000 teenagers.
C. 750 000 teenagers.
D. 1 000 000 teenagers.
3. Compared with other developed countries in the world:
A. Adolescent childbearing rates are significantly higher.
B. Age of initiation of sexual activity is earlier.
C. The percentage of both younger and older teenagers engaging in sexual activity is higher.
D. The rate of elective abortions to women under 20 is about equal.
4. All off the following statements relating to teenage pregnancies are true except:
A. Inadequate contraceptive use is the primary reason for the high pregnancy rate in the United States compared with other developed countries of the wortd.
B. Over the last two decades, the trend in adolescent childbearing continues to show a slow steady downward movement.
C. 15% to 20% of US adolescents are sexually active by age 15.
D. 70% or greater of US adolescents are sexually active by age 19.
5. All of the following are true statements about abortion trends in adolescent pregnancies except:
A. The proportion of pregnant black and white adolescents who obtain abortions are comparable.
B. Unmarried pregnant adolescents are much more likely to seek an abortion than those married during pregnancy.
C. The population of all pregnancies to adolescents 15 to 19 years of age ending in abortion is currently approximately 40% to 45% in the United States.
D. Racial differences in abortion rates are due to higher pregnancy rates among black adolescents.
6. An adolescent medicine rotation:
A. Is generally an optional/rotation in pediatric residency programs.
B. Is currently under review by the Residency Review Committee.
C. Is required by the Residency Review Committee.
D. Need not include reproductive health training during pediatric residency.
7. It is generally recommended that pediatricians "shift gears" and spend time alone with patients at health maintenance evaluations:
A. When the patient reaches Tanner stage 2.
B. At age 15-16.
C. When the parent(s) request it.
D. After puberty is completed.
8. The injectable methods of contraception (Norplant and Depo-Proveraf are:
A. Contraindicated in adolescence.
B. Not yet approved by the FDA.
C. Not likely to cause change in menstruation.
D. Currently available for use in teenage girls.
9. Postponing Sexual Involvement, an innovative program for early adolescents, developed in Atlanta and now in use in Cincinnati and many other cities:
A. Emphasizes abstinence until marriage.
B. Depends on the training and skills of the classroom teacher.
C. Emphasizes abstinence until the teenager is mature enough to make responsible decisions about sexual behavior.
D. Has the same philosophy as Sex Respect and Teen-Aid.
10. Good nutrition for normalweight adolescents during pregnancy includes all of the following except: A. Weight gain of 24 to 28 lbs.
B. Caloric intake between 2400 and 2700 calories/day.
C. Protein intake of 60 to 75 g/day.
D. Iron intake of 75-100 g/day.
11. All of the following statements about nutrition in pregnant adolescents are true except:
A. Early inadequate weight gain is often indicative of a risk for poor pregnancy outcome.
B. The very young pregnant adolescent who is less than 15 years of age is at higher risk of giving birth to an SGA growth-retarded infant.
C. Adolescents who are thinner before pregnancy tend to have babies equal in size to those of their heavier counterparts with the same gestational weight gain.
D. The nutritional needs of pregnant adolescents are the greatest at the time in their lives when it is most difficult to meet them.
12. All of the following statements about vitamin and mineral requirements in adolescent pregnancy are true except:
A. 35% to 50% of pregnant adolescents will be iron deficient unless appropriate supplementation is assured.
B. Zinc is essential in pregnancy for normal protein synthesis.
C. Alcohol users and cigarette smokers in pregnancy need greater than average vitamin C supplements.
D. Both vitamin D and vitamin E supplementation are recommended for pregnant adolescents regardless of age or local habitat.
13. All of the following statements about American students are true except.
A. Currently about 4 million of our nation's 30 million 7th to 12th grade students drink alcohol almost weekly.
B. Twice as many young white students smoke as compared to young black students.
C. The average age of first intercourse for American girls is 16 years of age.
D. The average age of first intercourse for American boys is 15.7 years of age.
14. Approaches to help youth manage their participation in sexual behaviors include all of the following except:
D. Delay of onset.
15. The kind of programmatic intervention that appears to show the most promise in reducing teenage pregnancy is:
A. Abstinence-only education.
B. Education aimed at increasing knowledge, including detailed instruction about birth control use.
C. Abstinence education with support for use of birth control.
D. School-based health services.
16. A knowledgeable 13 year old who has had appropriate sex education courses in the school setting is:
A. More likely to use contraceptives than is an uninformed 13 year old.
B. Less likely to use contraceptives than is an uninformed 13 year old.
C. No more or no less likely to use contraceptives than is an uninformed 13 year old.
17. The percentage of all females who become pregnant before they turn 20 is approximately:
18. All of the following are known newborn consequences of teenage pregnancies except:
A. Increased incidence of low-birthweight infants.
B. Increased mortality in the first 2 years of life.
C. Increased admission frequency to pediatric intensive care units.
D. Increased incidence of congenital heart disease.
19. Girls born to teenage mothers are no more likely to become pregnant during adolescence themselves than children of older mothers.
Answers to the November Quiz Eating Disorders in Adolescents