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This CME activity is primarily targeted to pediatricians, osteopathic physfcians, pediatric nurse practitioners, and others allied to the field.
There are no specific background requirements for participants taking this activity. Learning objectives are found at the beginning of each CME artkle.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Vindico Medfcal Education and SLACK Incorporated. Vindfco Medfcal Education is accredited by the ACCME to provide continuing medfcal education for physfcians.
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UNLABELED AND INVESTIGATIONAL USAGE
The audience is advised that this continuing medfcal 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 7 through S are taken from the article "Recognition and Management of Pediatric Seizures" by Steven M. Wolf, MD; and Patricia Engel McGoldrick, NP (see pages 332-344).
1. All of the following are found in neurofibromatosis type 1 except:
A. Café-au-lait spots.
B. Lisch nodules.
D. High incidence of seizures.
2. Which of the following statements regarding death in patients with seizure is the most accurate?:
A. Mortality is higher in female patients than male patients.
B. Single unprovoked seizures have the highest mortality.
C. Mortality is increased in children with underlying neurological deficits.
D. Mortality is higher in childhood than in adulthood.
3. A 9-year-old foster child presents to your practice for an initial physical exam. You note gum hyperplasia, facial coarsening, and hirsuitism. Which of the following medications is best correlated with these findings?:
C. Valproic acid.
4. A 15-year-old girl with epilepsy complains that she has been feeling depressed since starting her latest seizure medication. Which of the following medications would best explain her depression?:
A. Lévite raceta m .
D. Valproic acid.
5. A 1 6-year-old previously healthy boy had a syncopal episode at school.Which of the following should be done immediately as part of the initial evaluation?:
C. Computed tomography (CT) of the head.
D. Magnetic resonance imaging (MRI) of the head.
Questions 6 through ?0 are taken from the article "Headaches in Children" by David H. Rubin, MD; Stacey A. Suecoff, MD; and Kelly G. Knupp, MD (see pages 345-353).
6. An 8-year-old boy presents to the emergency department with acute severe headache, maximal in the occipital area and accompanied by nausea and vomiting. Which of the following tests should be done first?:
B. Lumbar puncture.
7. The most common type of migraine is:
A. Migraine without aura.
B. Migraine with aura.
C Hemiplegie migraine.
D. Opthalmoplegic migraine.
8. A 4-year-old girl presents to her pediatrician with complaints of headaches for the past 2 weeks, worse in the morning and occasionally accompanied by vomiting. Growth parameters and vital signs are normal. The child is alert, oriented, and well appearing. Which of the following is the best next step in her evaluation and treatment?:
A. Send home with assurance and nonsteroidal anti-inflammatory medication.
B. Send home with neurology follow-up and schedule outpatient CT scan of the brain.
C. Arrange for immediate CT of the brain.
D. Perform a lumbar puncture.
9. Which of the following sets of clinical findings is associated with pseudo tumor cerebri?:
A. Obesity, abnormal cerebrospinal fluid (CSF) protein and glucose, normal neuroimaging, and opening pressure greater than 20 cm H20.
B. Obesity, normal CSF protein and glucose, abnormal neuroimaging, and opening pressure greater than 20 cm H20.
C. Obesity, normal CSF protein and glucose, normal neuroimaging, and opening pressure less than 20 cm H20.
D. Obesity, normal CSF protein and glucose, normal neuroimaging,and opening pressure greater than 20 cm H20.
10. Which of the following statements is false regarding the evaluation of headaches?:
A. If a mass lesion is suspected, a lumbar pucnture should precede radiographic evaluation.
B. Headache diaries can help the patient identify potential headache triggers.
C. Chronic progressive headaches may be secondary to systemic disease.
D. Treatment of primary headaches requires attention to initial pharmacologic management as well as reassurance.
Questions 11 through 15 are taken from the article "Management of Childhood Spasticity: A Neurosurgical Perspective" by Christopher E. Mandigo, MD; and Richard CE. Anderson, MD (see pages 354-362).
11. Which of the following is not displayed by children with spasticity?:
A. Decreased muscle tone.
B. Persistent primitive reflexes.
C. Delayed motor skills.
D. Joint subluxation.
12. Upper motor neuron injury can result in any of the following except:
A. Decrease cortical input to the reticulospinal pathway.
C. Hypoactive reflexes.
D. Loss of motor control.
13. All of the following medications have been used in patients with spasticity except:
14. Which of the following best describes the pharmacologic action of botulinum toxin in treating spasticity?:
A. Causes irreversible chemical neurotomy.
B. Inhibits the release of acetylcholine.
C. Has a direct effect on the muscle tissue.
D. Binds to acetyl Cholinesterase in the neuromuscular cleft.
15. Side effects of oral baclofen include all of the following except:
A. Respiratory depression.
Questions 16 through 20 are taken from the article "Pitfalls for the Pediatrician: Positional Molding or Craniosynostosis?" by Ricardo J. Komotar, MD; Brad E. lacharía, BS; Jason A. Ellis, BS; Neil A. Feldstein, MD; and Richard CE. Anderson, MD (see pages 365-375).
16.Which of the following is the most commonly involved suture in craniosynostosis?:
17. Which of the following is the most common reason for surgical correction of craniosynostosis in affected infants?:
A. Prevent later cognitive defects.
B. Prevent loss of language progression.
C. Intracranial hypertension.
D. Cosmetic and psychosocial issues.
18. All of the following statements concerning craniosynostosis are true except:
A. The best time for surgical correction is between ages 1 8 and 24 months.
B. Elected intracranial hypertension may be seen in a small number of cases.
C. Re-growth of removed bone may occur.
D. Surgical morbidity is less than 10%.
19. Following the institution of the American Academy of Pediatrics' "Back to Sleep" program, which of the following has been documented?:
A. Increased incidence of positional plagiocephaly.
B Increased incidence of SIDS.
C. Decreased incidence of ALTE.
D. Increased incidence of torticollis.
20. All of the following statements concerning positional plagiocephaly are correct except:
A. Occurs more frequently in males.
B. Occurs more commonly on the right side.
C. Incidence has increased with the "Back to Sleep" program.
D. Helmets are superior to repositioning techniques.