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 should you choose to request them.

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. Payment should be made in US dollars drawn on a US bank

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. Upon receiving your grade, you may request quiz answers. Contact our customer cervice department at (856) 848-1000 ext.581.

8. Be sure to mail the CME registration form on or before the deadline listed. After that date, the quiz will close.CME registration forms received after the date listed will not be processed.

CME ACCREDITATION

This CME activity is primarily targeted to pediatricians, osteopathic physicians, pediatric nurse practitioners, and others allied to the field.There are no specific background requirements for participants taking this activity. SLACK Incorporated is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

SLACK Incorporated designates this educational activity for a maximum of 3 category 1 credits toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

FULL DISCLOSURE POLICY

Current ACCME policies state that participants in CME activities should be made aware of a faculty member's significant financial or other relationships. Therefore, all faculty members participating in any SLACK Incorporated-sponsored activity are expected to disclose to the activity audience their relationships (1) with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial service(s) discussed in an educational presentation and (2) with any commercial supporters of the activity. (Such relationships can include grants or research support, employee, consultant, major stockholder, member of speakers bureau, etc.) The intent of this disclosure is not to prevent a presenter with a significant financial interest or other relationship from making a presentation, but rather to provide participants with information on which they can make their own judgments. It remains for the audience to determine whether the presenter's interests or relationships may influence the presentation with regard to exposition or conclusion.

In accordance with ACCME policies, the audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products orto products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such…

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 should you choose to request them.

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. Payment should be made in US dollars drawn on a US bank

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. Upon receiving your grade, you may request quiz answers. Contact our customer cervice department at (856) 848-1000 ext.581.

8. Be sure to mail the CME registration form on or before the deadline listed. After that date, the quiz will close.CME registration forms received after the date listed will not be processed.

CME ACCREDITATION

This CME activity is primarily targeted to pediatricians, osteopathic physicians, pediatric nurse practitioners, and others allied to the field.There are no specific background requirements for participants taking this activity. SLACK Incorporated is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

SLACK Incorporated designates this educational activity for a maximum of 3 category 1 credits toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

FULL DISCLOSURE POLICY

Current ACCME policies state that participants in CME activities should be made aware of a faculty member's significant financial or other relationships. Therefore, all faculty members participating in any SLACK Incorporated-sponsored activity are expected to disclose to the activity audience their relationships (1) with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial service(s) discussed in an educational presentation and (2) with any commercial supporters of the activity. (Such relationships can include grants or research support, employee, consultant, major stockholder, member of speakers bureau, etc.) The intent of this disclosure is not to prevent a presenter with a significant financial interest or other relationship from making a presentation, but rather to provide participants with information on which they can make their own judgments. It remains for the audience to determine whether the presenter's interests or relationships may influence the presentation with regard to exposition or conclusion.

In accordance with ACCME policies, the audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products orto products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage.

Questions 1 through 5 are taken from the article "Evaluation of Hearing Loss In Infants and Young Children" by John Jacobson, PhD; and Claire Jacobson, AuD (see pages 81 1-821).

1. Normal hearing in children is considered better than which of the following decibel levels?:

A. 3OdB.

B. 25 dB.

C. 2OdB.

D. 15 dB.

2. Behavioral observation audiometry (BOA) is most applicable to what age group?:

A. Birth to 6 months.

B. 6 months to 1 2 months.

C. 24 months to kindergarten age.

D. Preschool-age children.

3. The incidence of severe to profound hearing loss in newborns has been estimated to be in the range of:

A. 14 per 1,000 live births.

B. 1 to 6 per 1,000 live births.

C. 1 per 10,000 live births.

D. None of the above.

4. When you meet with a family for the first time, they report that their newborn daughter failed her hearing screen. They are scheduled for a re-screen in a week and ask what the chances are that their child will pass the second screen. Your response should include which of the following statements?:

A. It has been found that most infants (80% to 90%) who fail their first screening will pass when re-screened.

B. The chances of passing on re-screening fall by 20% for every week there is a delay in re-screening.

C. Re-screening should be performed with a different technique from the original screen to assure accurate results.

D. Screening is so accurate with current technology that a second screen is not necessary and the family should plan to see a skilled otolaryngologist immediately.

5. All of the following are true regarding distortion product otoacoustic emissions (DPOAEs) except:

A. DPOAEs use a click stimulus to elicit the response.

B. DPOAEs most commonly use octave band frequencies between 1,000 and 8,000 hertz.

C. DPOAEs are always present in a nonpathological ear with normal sensitivity.

D. DPOAEs have as a primary limiting factor the fact that they are not usually recorded as frequency regions that show hearing loss of greater than mild to moderate degrees.

Questions 6 through 10 are taken from the article "Evaluation and Management of Childhood Hearing Loss" by Margaret A. Kenna, MD (see pages 822-832).

6. The most common nonsyndromic genetic abnormality associated with sensorineural hearing loss (SNHL) is:

A. Mutations of the Connexin 26 gene.

B. Mutations on the Pendrin gene.

C. Mutations in the Treacher Collins gene.

D. None of the above.

7. If congenital CMV infection is considered an etiology for hearing loss in the newborn period, the most definitive test is:

A. Serologic titers at birth.

B. Urine culture at birth.

C. Serologic titers at age 2.

D. None of the above.

8. Subgroups of children with SNHL that appear to be particularly at risk for progression include all of the following except:

A. Those with a history of congenital CMV infection.

B. Those with a history of aminoglycoside therapy.

C. Those with congenital abnormalities of the temporal bones.

D. Those with a history of management on extracorporeal membrane oxygenation.

9. The most common dominant genetic hearing loss syndrome is which of the following?:

A. Waardenburg syndrome.

B. Pendred syndrome.

C. Branchio-oto-renal syndrome.

D. Usher syndrome.

10. The most common genetic form of deafnessblindness is which of the following?:

A. Waardenburg syndrome.

B. Pendred syndrome.

C. Branchio-oto-renal syndrome.

D. Usher syndrome.

Questions 11 through IS are taken from the article "Appropriate Antibiotic Use for Otitis Media: Oral, Topical, or None?" by Richard M. Rosenfefd, MD, MPH (see pages 833-842).

11. Which child with acute otitis media is best suited for observation rather than immediate treatment with antibiotics?:

A. A 6-month-old with an oral temperature of 40 degrees C.

B. A 3-year-old with purulent middle-ear effusion, oral temperature of 37 degrees C, and mild otalgia.

C. An 18 month old with mild otalgia, oral temperature of 40 degrees C, and purulent middle ear effusion.

D. A 3 year old with cloudy middle ear effusion, oral temperature of 40 degrees C, and moderate otalgia.

12. Which of the following statements best describes the natural history of spontaneous resolution of otitis media?:

A. Only 20% of cases have symptomatic relief in 72 hours.

B. Approximately 60% of children have symptomatic relief within 24 hours.

C. Cases rarely resolve without the aid of oral antimicrobials.

D. 35% of cases have spontaneous relief in 12 hours.

13. After examining a 15-month-old for follow-up after another case of acute otitis media, you note a continued middle ear effusion. His parents ask how long the fluid will have to be in place before tubes are indicated. Your best answer should include which of the following statements?:

A. An effusion would have to be in place for at least 6 months before tubes would be indicated.

B. An effusion should be documented for at least 3 months in an otherwise healthy child before recommending tubes.

C. The duration of the effusion is not as important as the current age of the child.

D. None of the above.

14. The most common organism isolated in acute suppurative otitis media is which of the following?:

A. Haemophilus influenzae.

B. Streptococcus pneumoniae.

C. Moraxella catarrhalis.

D. Streptococcus pyogenes.

15. All of the following statements regarding topical antimicrobial drops for symptomatic tympanostomy tube otorrhea are true except:

A. Drops have a comparable clinical efficacy to oral antimicrobials.

B. Drops have an equivalent pathogen eradication rate.

C. Drops have fewer adverse effects.

D. Drops achieve middle ear drug levels that are much higher than those achievable by oral antimicrobial administration.

Questions 16 through 20 are taken front the article "Management of the Draining Ear In Children" by K. Ashley Schroeder, MD; and David H. Darrow, MD, DDS (see pages 843-853).

16. Bloody drainage from an ear with a tympanostomy tube:

A. Represents a serious condition that requires immediate evaluation.

B. Is usually secondary to granulation tissue adjacent to the tube.

C, Should be treated with oral antimicrobial therapy.

D. Indicates the tube has become dislodged.

17. Which of the following are true of Pseudomonas infection of the ear?:

A. It is more common during summer months.

B. It is usually responsive to ototopical therapy.

C. It is unlikely to become systematic.

D. All of the above.

18. The single most important intervention in initial management of a draining ear is which of the following?:

A. Debridement of the canal

B. Placement of an otowick.

C. Application of ear drops.

D. Administration of oral antibiotics.

19. Delayed referral to an otolaryngologist when an aural keratoma is suspected may lead to which of the following complications?:

A. Facial nerve paralysis.

B. Ossicular erosion.

C. Periosteal abscess.

D. All of the above.

20. While discussing swimming with pressure equalization tubes, a family inquires as to which factors would increase the risk of causing an "infection." Your best response would include all of the following statements except:

A. Large lumen tubes have an increased risk of otorrhea due to water exposure.

B. Swimming in any depth of water will increase the risk of tube otorrhea and should be actively discouraged.

C. Soapy water, which decreases surface tension, will increase the risk of tube otorrhea.

D. Lake water or contaminated water will increase the risk of tube otorrhea.

10.3928/0090-4481-20041201-11

Sign up to receive

Journal E-contents