Pediatric Annals

CME QUIZ

Abstract

INSTRUCTIONS

Pediatricians may receive up to 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 succesfully 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 correa 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. 1 1 7 Old Alumni Ctr. DCO 345.00. Columbia. MO 65212.

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 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 correa 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.

CME ACCREDrTATION

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

Asthma

1. You have chosen to use magnesium sulfate In a patient with a refractory asthma attack. Which of the following routes of administration provides the most therapeutic benefit:

A. Oral.

B. Intravenous.

C. Aerosol.

D. Intramuscular.

2. All of the following are true with regards to the Intravenous administration of magnesium sulfate in children except:

A. The currently recommended dose is 75 mg/kg infused over 20 minutes.

B. Repeated dosing every 6 hours as necessary with routinely monitored serum magnesium levels.

C. A target serum magnesium level of >8 mg/dL.

D. Expected onset of action within minutes of the start of the infusion.

3. Expected side effects of magnesium sulfate infusions include:

A. Dry mouth.

B. Flushing.

C. Both A and B.

D. Neither A nor B.

4. When administering magnesium sulfate by infusion. It Is Imperative that which of the following be closely monitored:

A. Respiratory rate.

B. Urine output.

C. Deep tendon reflexes.

D. All of the above.

5. You receive the results of a routine serum magnesium level drawn on a patient you have elected to treat with a MgS04 Infusion. The level Is 15 mg/dL. Which of the following symptoms would you expect to find:

A. Absent deep tendon reflexes.

B. Respiratory depression.

C. Both A and B.

D. Neither.

6. Primary factors governing the severity of airway obstruction In exercise-Induced bronchospasm Include all of the following except:

A. The climate in…

INSTRUCTIONS

Pediatricians may receive up to 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 succesfully 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 correa 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. 1 1 7 Old Alumni Ctr. DCO 345.00. Columbia. MO 65212.

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 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 correa 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.

CME ACCREDrTATION

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

Asthma

1. You have chosen to use magnesium sulfate In a patient with a refractory asthma attack. Which of the following routes of administration provides the most therapeutic benefit:

A. Oral.

B. Intravenous.

C. Aerosol.

D. Intramuscular.

2. All of the following are true with regards to the Intravenous administration of magnesium sulfate in children except:

A. The currently recommended dose is 75 mg/kg infused over 20 minutes.

B. Repeated dosing every 6 hours as necessary with routinely monitored serum magnesium levels.

C. A target serum magnesium level of >8 mg/dL.

D. Expected onset of action within minutes of the start of the infusion.

3. Expected side effects of magnesium sulfate infusions include:

A. Dry mouth.

B. Flushing.

C. Both A and B.

D. Neither A nor B.

4. When administering magnesium sulfate by infusion. It Is Imperative that which of the following be closely monitored:

A. Respiratory rate.

B. Urine output.

C. Deep tendon reflexes.

D. All of the above.

5. You receive the results of a routine serum magnesium level drawn on a patient you have elected to treat with a MgS04 Infusion. The level Is 15 mg/dL. Which of the following symptoms would you expect to find:

A. Absent deep tendon reflexes.

B. Respiratory depression.

C. Both A and B.

D. Neither.

6. Primary factors governing the severity of airway obstruction In exercise-Induced bronchospasm Include all of the following except:

A. The climate in which the patient is exercising.

B. The level of ventilation required to meet the demands of the activity.

C. Both A and B.

D. Neither.

7. In the pharmacological management of a patient with exerciseinduced bronchospasm, beta2-agonlsts should:

A. Be used just before exercising.

B. Be of the short-acting variety.

C. Have a rapid onset of action.

D. All of the above.

8. Which of the following statements Is most correct? Patients with exerciseInduced bronchospasm should be educated to:

A. Avoid all exercise in the winter months.

B. Exercise in warm, humid environments.

C. Avoid preparticipation warm-up routines.

D. Participate only in activities that require short bursts of effort.

9. Management of a patient with exercise-Induced bronchospasm using the long-acting beta2-agonlst salmeterol (Serevent) Is:

A. Not currently recommended for children under 12 years of age.

B. Useful for adolescents who exercise several times a day.

C. Useful for adolescents who exercise for prolonged periods of time.

D. All of the above.

10. Which of the following beta2 -agonists Is NOT a short-acting compound:

A. Salmeterol.

B. Terbutaline.

C. Metaproterenol.

D. Albuterol.

11. Instructions to patients with exercise-Induced bronchospasm should include all of the following except:

A. If breakthrough occurs during exercise, exercise should be stopped immediately.

B. Inhaled, short-acting beta -agonists should be kept on hand For breakthroughs.

C. Patients may exercise alone if shortacting beta2-agonists are readily available.

D. Exercise should be undertaken in as pollutant-free environment as possible.

12. Which of the following physical findings Is not useful In Identifying a child at risk for life-threatening asthma attacks:

A. Episodes of monosyllabic speech.

B. Prior intubation.

C. Previous oxygen requirement.

D. Episodes of nighttime wheezing.

13. Which of the following pairs of PEFR (peak expiratory flow rate) and levels of severity Is false:

A. PEFR=70% to 90% predicted: mild asthma.

B. PEFR=<50% predicted: severe asthma.

C. PEFR=50% to 70% predicted:moderate asthma.

D. None of the above.

14. Your office pulse oximeter has Just returned a value of 92% on your young asthmatic panent. This finding Indicates which level of severity:

A. Mild.

B. Moderate.

C. Severe.

D. Life threatening.

15. A typical arterial blood gas In an acute uncomplicated case of asthma reveals which of the following:

A. Normal Pao2, normal Paco2, respiratory acidosis.

B. Normal PaO2, normal Paco2, respiratory alkalosis.

C. Normal PaO2, decreased Paco2, respiratory alkalosis.

D. Normal PaO2, decreased PaCO2, respiratory acidosis.

16. In following serial arterial blood gases In an acutely III Intubated asthmatic patient, you note an alkalotlc pH, depressed Pco2, and elevated Po2. This Is an Indicator of:

A. Improving air exchange.

B. Over ventilation.

C. Both A and B.

D. Neither.

17. A patient with a history of constant throat clearing, a sensation of secretions In the posterior nasopharynx, and a çranul»r appearance to the posterior pharyngeal wall most likely suffers from:

A. Postnasal drip syndrome.

B. Gastroesophageal reflux disease.

C. Asthmatic bronchitis

D. None of the above.

18. You suspect a patient who presents with a chronic cough to have underlying gastroesophageal reflux disease. Which of the following tests will best delineate the presence of this disorder:

A. Gastroesophageal endoscopy.

B. Esophageal pH probe study.

C. Barium swallow.

D. Esophageal manometry.

19.WhICh of the following Is true regarding a psychogenic cough:

A. Cough usually occurs at night.

B. Cough decreases when attention is paid to it.

C. Responds well to prescription antitussives.

D. Is seen most frequently in females.

20. A 10-year-old child with known asthma develops a chronic cough. Your history reveals poor compliance with medications. You educate the family on the correct use of your therapeutic regimen. Which of the following medications could be Included In this plan:

A. Inhaled albuterol.

B. Inhaled cromolyn sodium.

C. Inhaled corticosteroids.

D. All of the above.

Answers to the December Quiz

Environmental Health

1.C

2.C

3.A

4.D

5.A

6.C

7. B

8.D

9.D

10. B

11. A

12. C

13. A

14. A

15. A

16. C

17. D

18. C

19. B

20. D

10.3928/0090-4481-19960301-10

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