Pediatric Annals

CME QUIZ

Abstract

INSTRUCTIONS

Pediatricians may receive up to three credit hours in Category I for the Physician's Recognition Award of the American Medicai 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 «ach 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 rhe 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 $25 made payable to PEDIATRIC ANNALS CME CENTER, 117 Old Alumni Ctr, DCO 345.00, Columbia, MO 652 12.

5. Your answers wlH 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 mall 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 journal.) Unanswered questions will be considered incorrect and so scored. A minimum score of 70 must be obtained in order for credits to be awarded.

CMC ACCREDITATION

The office of Continuing Education, School of Medicine, University of Missouri-Columbia is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME programs for physicians. This activity is designated for up to 3 hours of credit for the Physician's Recognition Award.

CME Quiz

Pain Management

1. All of the following are benefits of assessing a child's pain except:

A. Assessment helps to establish a correct clinical diagnosis.

B. Assessment provides a baseline for objectively determining the effectiveness of different analgesics.

C. Assessment enables us to answer relevant research questions, but doesn't add to our clinical management of children's pain.

D. Assessment enables us to identify the factors that affect a child's pain processing.

2. All of the following are practical and efficient methods for assessing children's pain In clinical practice except:

A. Behavioral pain scales.

B. Structured interviews.

C. Analog pain scales.

D. Standardized questionnaires.

3. All of the following can Intensify a child's pain from an Invasive procedure except:

A. Lack of control.

B. Knowledge about what will happen.

C. Overt behavioral distress.

D. Anxiety and fear.

4. PaIn sydromes that are common In children and adolescents Include:

A. Recurrent abdominal pain.

B. Chronic daily headaches.

C. Chest pain.

D. All of the above.

5. The assessment of chronic pain should Include:

A. Interview of patient and family members.

B. Thorough physical examination.

C. Eliciting the meaning of pain.

D. All of the above.

6. With regards to trkyclte antidepressant therapy for chronic pédiatrie pain:

A. Analgesic effects may be independent of alterations in mood.

B. They are typically prescribed in a single night-time dose.

C. Amitriptyline is often a drug of first choice.

D. All of the above.

7.…

INSTRUCTIONS

Pediatricians may receive up to three credit hours in Category I for the Physician's Recognition Award of the American Medicai 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 «ach 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 rhe 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 $25 made payable to PEDIATRIC ANNALS CME CENTER, 117 Old Alumni Ctr, DCO 345.00, Columbia, MO 652 12.

5. Your answers wlH 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 mall 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 journal.) Unanswered questions will be considered incorrect and so scored. A minimum score of 70 must be obtained in order for credits to be awarded.

CMC ACCREDITATION

The office of Continuing Education, School of Medicine, University of Missouri-Columbia is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME programs for physicians. This activity is designated for up to 3 hours of credit for the Physician's Recognition Award.

CME Quiz

Pain Management

1. All of the following are benefits of assessing a child's pain except:

A. Assessment helps to establish a correct clinical diagnosis.

B. Assessment provides a baseline for objectively determining the effectiveness of different analgesics.

C. Assessment enables us to answer relevant research questions, but doesn't add to our clinical management of children's pain.

D. Assessment enables us to identify the factors that affect a child's pain processing.

2. All of the following are practical and efficient methods for assessing children's pain In clinical practice except:

A. Behavioral pain scales.

B. Structured interviews.

C. Analog pain scales.

D. Standardized questionnaires.

3. All of the following can Intensify a child's pain from an Invasive procedure except:

A. Lack of control.

B. Knowledge about what will happen.

C. Overt behavioral distress.

D. Anxiety and fear.

4. PaIn sydromes that are common In children and adolescents Include:

A. Recurrent abdominal pain.

B. Chronic daily headaches.

C. Chest pain.

D. All of the above.

5. The assessment of chronic pain should Include:

A. Interview of patient and family members.

B. Thorough physical examination.

C. Eliciting the meaning of pain.

D. All of the above.

6. With regards to trkyclte antidepressant therapy for chronic pédiatrie pain:

A. Analgesic effects may be independent of alterations in mood.

B. They are typically prescribed in a single night-time dose.

C. Amitriptyline is often a drug of first choice.

D. All of the above.

7. Significant pain often accompanies:

A. Otitis externa.

B. Otitis media.

C. All of the above.

D. None of the above.

8. Although Inadequately studied, treatments that often are used for pain due to oral ulcérations and which appear effective Include:

A. Topical local anesthetics.

B. Magic mouthwashes.

C. All of the above.

D. None of the above.

9. Signicant pain often accompanies:

A. Upper urinary tract infections.

B. Lower urinary tract infections.

C. All of the above.

D. None of the above.

10. The Ideal Intramuscular Injection site In children Is:

A. Glutea! muscle.

B. Deltoid muscle.

C. Vastus lateralis muscle.

D. None of the above.

11. Conscious sedation:

A. Allows protective airway reflexes to be maintained.

B. Retains the patient's ability to maintain a patent airway independently and continuously.

C. Permits appropriate response by the patient to physical Stimulation or verbal command.

D. All of the above.

12. Chloral hydrate:

A. Is an effective analgesic.

B, Has been shown to cause liver tumors in children.

C. Has a very short duration of effect.

D. Is not suitable as a primary agent for painful procedures.

13. Fentanyl:

A. Is not as potent as morphine.

B. Has a longer duration of effect than meperidine.

C. May cause chest wall rigidity resulting in impaired breathing.

D. Should not be used in children.

14. Midaxolam:

A. Is a short-acting benzodiazepine.

B. May cause respiratory depression when combined with fentanyl.

C. May have a prolonged duration of effect when given to children taking erthromycin.

D. All of the above.

15. Propofol:

A. Is safe in patients allergic to egg products.

B. Accumulates after prolonged exposure.

C. Causes pain on injection.

D. Does not lead to deep sedation or general anesthesia.

16. EMLA Cream:

A. Is a combination of lidocaine and prilocaine.

B. Is safe in infants younger than 3 months old.

C. Becomes effective after 45 minutes.

D. Both A and C.

17. Undertreatment of pain In Infants, children, and adolescents Is due to factors that Include:

A. Knowledge deficits.

B. Inadequate assessment.

C. Fear of side effects and addiction.

D. All of the above.

18. Oplolds:

A. Are not well tolerated by children.

B. Are the mainstay of treatment for severe pain.

C. Are best given intramuscularly if patenterai analgesia is needed.

D. Are to be avoided, but if needed meperidine is preferred.

19. Patient-controlled analgesia:

A. Is unreliable in children.

B. May overwhelm children due to its "high-tech" nature.

C. Can be used to treat postoperative pain in children older than 5 years.

D. Meperidine is the drug of choice.

20. Epidural analgesia:

A. Provides excellent, selective postoperative pain relief in adults and children.

B. Routinely requires intensive care nursing for maintenance.

C. Although effective in children, it is still experimental.

D. Cannot be performed in children younger than 10 years of age.

Answers to the December Quiz Community Pediatrics

1. D

2. B

3. C

4. B

5. A

6. D

7. C

8. C

9. D

10. A

11. A

12. B

13. D

14. B

15. C

16. D

17. B

18. A

19. A

20. C

10.3928/0090-4481-19950301-11

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