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 mateial 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 cor-rect 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 $25 made payable to PEDIATRIC ANNALS CME CENTER, 117 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 as~pect 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 qui/ 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 ob-tained in order for credits to be awarded.

CME 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

Advances In Perlnatology

1 . Which of the following pairings Is true wrth regards to omphalocele and gastrochlsls:

A. Omphalocele- karyotype abnormal 30% !9 40% of the time.

B, Gastroschisis - midline location.

C. Omphalocele - no membrane.

D. Gastroschisis- poor prognosis.

2. You are conducting a prenatal Interview for a prospective new family In your practice. They are Interested In having a prenatal ultrasound performed. Which of the following are Indications for a targeted ultrasound:

A. History of high or low maternal serum alpha fetoprotein.

B. History of maternal insulin-dependent diabetes mellitus.

C. History of previous child with a structural anomaly.

D. All of the above.

3. A fetal ultrasound reveals the presence of pulmonary sequestration. Other anomolles to look for Include:

A. Diaphragmatic hernia.

B. Tracheoesophageal atresia.

C. Both A and B.

D. Neither A nor B.

4. You have been told by an expectant mother that she has polyhydramnlos. Which of the following anomalies would not be In your differential:

A. Tracheoesophageal atresia.

B. Posterior urethral valves.

C. Duodenal atresia.

D. Gastroschisis.

5. A woman presents at 34 weeks In labor with ruptured membranes. The obstetrician on duty asks you If antibiotic prophylaxis Is warranted In this case should the mother go to delivery. Which of the following are currently considered justifications for the use of antibiotics:

A. The infant's gestational age (ie, preterm labor.)

B. Premature rupture of membranes.

C. Both A and B.

D.…

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 mateial 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 cor-rect 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 $25 made payable to PEDIATRIC ANNALS CME CENTER, 117 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 as~pect 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 qui/ 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 ob-tained in order for credits to be awarded.

CME 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

Advances In Perlnatology

1 . Which of the following pairings Is true wrth regards to omphalocele and gastrochlsls:

A. Omphalocele- karyotype abnormal 30% !9 40% of the time.

B, Gastroschisis - midline location.

C. Omphalocele - no membrane.

D. Gastroschisis- poor prognosis.

2. You are conducting a prenatal Interview for a prospective new family In your practice. They are Interested In having a prenatal ultrasound performed. Which of the following are Indications for a targeted ultrasound:

A. History of high or low maternal serum alpha fetoprotein.

B. History of maternal insulin-dependent diabetes mellitus.

C. History of previous child with a structural anomaly.

D. All of the above.

3. A fetal ultrasound reveals the presence of pulmonary sequestration. Other anomolles to look for Include:

A. Diaphragmatic hernia.

B. Tracheoesophageal atresia.

C. Both A and B.

D. Neither A nor B.

4. You have been told by an expectant mother that she has polyhydramnlos. Which of the following anomalies would not be In your differential:

A. Tracheoesophageal atresia.

B. Posterior urethral valves.

C. Duodenal atresia.

D. Gastroschisis.

5. A woman presents at 34 weeks In labor with ruptured membranes. The obstetrician on duty asks you If antibiotic prophylaxis Is warranted In this case should the mother go to delivery. Which of the following are currently considered justifications for the use of antibiotics:

A. The infant's gestational age (ie, preterm labor.)

B. Premature rupture of membranes.

C. Both A and B.

D. Neither A nor B.

6. Which of the following statements Is true:

A, Preterm births in the United States have decreased in the last decade.

B. The infant mortality rate for white infants has decreased less than that for black infants.

C. Prematurity is the leading cause of infant mortality.

D. None of the above.

7. While conducting a prenatal Interview with a mother-to-be, which of the following factors would point to an Increased risk of premature delivery:

A. History of vaginal bleeding.

B. History of poor weight gain.

C. History of poor fetal growth.

D. All of the above.

8. Therapy for asymmetric Intrauterine growth retardation should be directed at:

A. Improving fetal nutrient availability.

B. Prompt delivery of the infant as soon as pulmonary maturation is documented.

C. Strict maternal bed rest.

D. Prevention of maternal fluid overload.

9. While assessing a newborn Infant, which of the following are best used to characterize the child as asymmetrically Intrauterine growth retarded:

A. Birthweight.

B, Head circumference·, abdominal circumference ratio.

C. Length.

D. Head circumference.

10. Determining the optimal time for delivery of an asymmetrically Intrauterine growth retarded Infant Is best accomplished by:

A. Assessing changes in the biophysical profile.

B. Measuring a decrease in amniotic fluid volume.

C, Detecting changes in fetal heart rate pattern.

D. None of the above.

1 1 . While reviewing an lntrapartum history In the labor and delivery suite, which of the following would not Increase the risk of an adverse outcome:

A. Prolonged bradycardia.

B. Variable decelerations.

C. Tachycardia.

D. Thick meconium.

12. All of the following external fetal monitoring parameters are reassuring except:

A. Absent fetal heart rate accelerations.

B. Mild bradycardia.

C. Variable decelerations.

D. Fetal heart rate accelerations.

13. Evaluation of fetal well-being Includes which of the following parameters:

A. Presence or absence of meconium.

B. Fetal scalp pH.

C. Fetal heart rate.

D. All of the above.

14. Immediate delivery Is Indicated for:

A. Fetal scalp pH <7.25.

B. Presence of thick meconiumstained amniotic fluid.

C. Both A and B.

D. Neither A nor B.

15. Group B streptococcal cultures are most likely to be positive when obtained from which of the following sites:

A, Rectum.

B. Distal vagina.

C. Proximal vagina.

D. Cervix.

16. Each of the following specific risk factors have been associated with early onset neonatal sepsis except:

A. Low birth weight.

B. Prematurity.

C. Maternal fever in labor.

D. Twin pregnancy.

1 7. Which of the following are true of " carry onset" group B streptococcal sepsis:

A. Accounts for more than 60% of neonatal group B streptococcal sepsis.

B. The majority of infants with early onset disease become symptomatic approximately 48 to 72 hours after delivery.

C. Both A and B.

D. Neither A nor B.

18. Which of the following Is true regarding congenital malformations In Infants of diabetic mothers:

A. The rate of major malformations is three to five times higher than the general population.

B. Common defects seen in the genera) population occur at increased rates in infants of diabetic mothers.

C. The critical period for malformations Is usually over by the time pregancy becomes clinically apparent.

D. All of the above.

19. Infants of diabetic mothers are classically macrosomlc. Which of the following areas are dtsproportfonally large In these Infants:

A. Visceral organs.

B. Cerebral cortex.

C. Both A and B.

D. Neither A nor B.

20. Which of the following Is true with regards to Infants of diabetic mothers:

A. Measurements of lecithin/sphingomyelin ratios alone are helpful in predicting fetal Jung maturity.

B. The incidence of respiratory distress syndrome in infants of wellcontrolled diabetic mothers delivered at term is similar to that of the general population.

C. Maternal diabetes during pregnancy has no long-term effect on the development of an infant.

D. Hypoglycémie is the only metabolic abnormality seen in infants of diabetic mothers.

Answers to the January Quiz Poisoning

1.C

2.C

3.A

4.D

5.A

6.C

7.B

8.C

9.0

10. D

11. C

12. B

13. A

14. B

15. C

16. B

17. D

18. C

19. A

20. B

10.3928/0090-4481-19960401-13

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