Pediatric Annals

CME quiz

Abstract

INSTRUCTIONS

1. Review the stated learning objectives of the CME articles and determine if these objectives match your individual learning needs.

2. Read the articles carefully. Do not neglect the tables and other illustrative materials, as they have been selected to enhance your knowledge and understanding.

3. The following quiz questions have been designed to provide a useful link between the CME 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 published later.

4. Type or print your full name and address and your date of birth in the space provided on the CME REGISTRATION FORM.

5. Complete the Evaluation portion of the CME Registration Form. Forms and quizzes cannot be processed if the Evaluation portion is incomplete. The Evaluation portion of the CME Registration Form will be separated from the quiz upon receipt at PEDIATRIC ANNALS. Your evaluation of this activity will in no way affect the scoring of your quiz.

6. Send the completed form, with your $25 payment (check, money order, or credit card information) to: PEDIATRIC ANNALS CME Quiz, PO Box 36, Thorofare NJ 08086.

7. Your answers will be graded, and you will be advised whether you have passed or failed. Unanswered questions will be considered incorrect. A score of at least 80% is required to pass. Answers to the quiz will be published 3 months after the article appears. You should review your answers at that time, noting your incorrect answers, and referring to the article and its supplemental bibliography for additional information and clarification.

8. Be sure to mail the CME Registration Form on or before the deadline listed. After that date, the quiz will close and correct answers will appear in the Journal. CME Registration Forms received after the date listed will not be processed.

CME ACCREDITATION

SLACK Incorporated, publisher of PEDIATRIC ANNALS, is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. SLACK Incorporated designates this educational activity for a maximum of three (3) hours in category 1 toward the AMA Physicians Recognition Award. Each physician should only claim those hours of credit that he or she actually spent in the educational activity.

EPISODIC DISORDERS IN CHILDHOOD

Questions 1 through 7 are taken from the article, "Complicated Migraine Syndromes and Migraine Variants," by Colette Parker, MD.

1. Which of the following features is more characteristic of seizures and not complicated migraines:

A. Rapid evolution of symptoms.

B. Memory of the event.

C. Associated nausea and vomiting.

D. None of the above.

2. A 6-year-old girl with a history of typical migraines presents with ipsilateral ophthalmoplegia during an attack. On examination, she has ptosis, strabismus, and pupillary dilatation. Which of the following best describes this event:

A. Retinal migraine.

B. Ophthalmoplegic migraine.

C. Hemiplegic migraine.

D. Basilar artery migraine.

3. Which of the following is true of hemiplegic migraines:

A. More often involves the lower extremities.

B. Almost always associated with a precipitating event.

C. If hemiplegia is not transient, acute stroke must be considered.

D. Weakness always precedes the headache.

4. A 15 year old presents with acute-onset ataxia, dysarthric speech, vertigo, and tinnitus. Family history is positive for migraines. Which of the following migraine types best describe this case:

A. Retinal migraine.

B. Basilar artery migraine.

C. Hemiplegie migraine.

D. Acute confusional migraine.

5. Which of the following is true of benign paroxysmal…

INSTRUCTIONS

1. Review the stated learning objectives of the CME articles and determine if these objectives match your individual learning needs.

2. Read the articles carefully. Do not neglect the tables and other illustrative materials, as they have been selected to enhance your knowledge and understanding.

3. The following quiz questions have been designed to provide a useful link between the CME 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 published later.

4. Type or print your full name and address and your date of birth in the space provided on the CME REGISTRATION FORM.

5. Complete the Evaluation portion of the CME Registration Form. Forms and quizzes cannot be processed if the Evaluation portion is incomplete. The Evaluation portion of the CME Registration Form will be separated from the quiz upon receipt at PEDIATRIC ANNALS. Your evaluation of this activity will in no way affect the scoring of your quiz.

6. Send the completed form, with your $25 payment (check, money order, or credit card information) to: PEDIATRIC ANNALS CME Quiz, PO Box 36, Thorofare NJ 08086.

7. Your answers will be graded, and you will be advised whether you have passed or failed. Unanswered questions will be considered incorrect. A score of at least 80% is required to pass. Answers to the quiz will be published 3 months after the article appears. You should review your answers at that time, noting your incorrect answers, and referring to the article and its supplemental bibliography for additional information and clarification.

8. Be sure to mail the CME Registration Form on or before the deadline listed. After that date, the quiz will close and correct answers will appear in the Journal. CME Registration Forms received after the date listed will not be processed.

CME ACCREDITATION

SLACK Incorporated, publisher of PEDIATRIC ANNALS, is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. SLACK Incorporated designates this educational activity for a maximum of three (3) hours in category 1 toward the AMA Physicians Recognition Award. Each physician should only claim those hours of credit that he or she actually spent in the educational activity.

EPISODIC DISORDERS IN CHILDHOOD

Questions 1 through 7 are taken from the article, "Complicated Migraine Syndromes and Migraine Variants," by Colette Parker, MD.

1. Which of the following features is more characteristic of seizures and not complicated migraines:

A. Rapid evolution of symptoms.

B. Memory of the event.

C. Associated nausea and vomiting.

D. None of the above.

2. A 6-year-old girl with a history of typical migraines presents with ipsilateral ophthalmoplegia during an attack. On examination, she has ptosis, strabismus, and pupillary dilatation. Which of the following best describes this event:

A. Retinal migraine.

B. Ophthalmoplegic migraine.

C. Hemiplegic migraine.

D. Basilar artery migraine.

3. Which of the following is true of hemiplegic migraines:

A. More often involves the lower extremities.

B. Almost always associated with a precipitating event.

C. If hemiplegia is not transient, acute stroke must be considered.

D. Weakness always precedes the headache.

4. A 15 year old presents with acute-onset ataxia, dysarthric speech, vertigo, and tinnitus. Family history is positive for migraines. Which of the following migraine types best describe this case:

A. Retinal migraine.

B. Basilar artery migraine.

C. Hemiplegie migraine.

D. Acute confusional migraine.

5. Which of the following is true of benign paroxysmal vertigo:

A. It is a disorder of older children and adolescents.

B. Loss of consciousness is common.

C. Complaints of head pain always occur.

D. Nausea and vomiting are usually absent.

6. Sandifer syndrome is best characterized by which of the following:

A. Torticollis.

B. Severe gastroesophageal reflux disease.

C. Cerebral palsy.

D. All of the above.

7. An adolescent experiencing distortion of body image and time as well as visual hallucinations has a negative toxicology screen but a positive family history for migraines. Which migraine syndrome best describes these findings:

A. Transient global amnesia.

B. Acute confusional migraine.

C. Alice-in-Wonderland syndrome.

D. None of the above.

Questions 8 through 13 are taken from the article, "The Diagnosis and Management of Syncope in Children and Adolescents," by David S. Braden, MD, FAAP, FACC, and Charles H. Gaymes, MD, FAAP, FACC.

8. Which of the following is not characteristic of neurally mediated syncope (NMS):

A. Concomitant pallor and diaphoresis.

B. Hypoventilation.

C. Bradycardia.

D. Hypotension.

9. Features suggestive of cardiac syncope include all of the following except:

A. Provocation of syncope during exercise.

B. Prodromal symptoms such as nausea and visual changes.

C. Associated symptoms such as chest pain and palpitations.

D. Occurrence of syncope in the recumbent position.

10. Initial evaluation of the child with an Isolated episode of syncope includes all of the following except:

A. History and physical examination.

B. Electrocardiogram.

C. Complete blood count and electrolytes.

D. Thyroid panel.

11. Which of the following is nof a first-line therapy for the prevention of recurrent syncope:

A. Flucocortisone and salt tablets.

B. Tricyclic antidepressants.

C. Beta blockers.

D. Pseudoephedrine.

12. Which of the following is true of Jervell-Lange-Nielsen syndrome:

A. Deafness.

B. Autosomal-dominant inheritance.

C. Both A and B.

D. Neither A nor B.

13. Which of the following medications used to treat neurally mediated syncope causes a prolonged QT interval:

A. Metoprolol.

B. Pseudoephedrine.

C. Disopyramide.

D. Sertraline.

Questions 14 through 20 are taken from the article, "Parasomnias in Children," by Merrill S. Wise, MD.

14. Which of the following is nof a disorder of arousal:

A. Confusional arousals.

B. Sleepwalking.

C. Sleep starts.

D. Sleep terrors.

15. Which of the following is true of sleepwalking:

A. Typical age of onset is less than 3 years of age.

B. Medications, such as chloral hydrate, decrease the incidence of sleepwalking.

C. The likelihood increases with febrile illnesses.

D. A familial tendency has not been demonstrated.

16. Sleep terrors:

A. Occur most commonly between 4 and 12 years of age.

B. Are somewhat more common in boys than girls.

C. Include prominent autonomic activity.

D. All of the above.

17. Which of the following pairs is incorrect:

A. Nightmares - characterized by vivid dream recall.

B. Sleep terrors - occur in the last third of the night.

C. Nightmares - rapid return to consciousness when awakened.

D. Sleep terrors - unresponsive to stimuli.

18. Parents of a 10-month-old child report repetitive head banging as their child is going to sleep. Your examination reveals a developmentally appropriate, healthy child. You can reassure the parents that:

A. Their child has a rhythmic movement disorder.

B. The disorder will likely spontaneously resolve by 4 years of age.

C. No precautions are necessary unless the child injures him- or herself.

D. All of the above.

19. A 15-year-old male presents with the complaint of temporary paralysis upon awakening. He is otherwise healthy, as his examination confirms. This scenario best fits which class of parasomnias:

A. Those associated with REM sleep.

B. Sleep-wake transition disorders.

C. Disorders of arousal.

D. None of the above.

20. Rhythmic movement disorders are more persistent in all of the following groups except:

A. Children with mental retardation.

B. Children with autism.

C. Children under 5 years of age.

D. Children with psychiatric disturbances.

10.3928/0090-4481-19970701-10

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