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 llustrative materials, as they have been selected to enhance your knowledge and understanding.
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This CME activity is primarily targeted to pediatricians, ostéopathie physicians, pediatrie 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 article.
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 Medical Education and SLACK Incorporated. Vindico Medical Education is accredited by the ACCME to provide continuing medical education for physicians.
Vindico Medical Education designates this educational activity for a maximum of 3 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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In accordance with the Accreditation Council forContinuing Medical Education's Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears at the beginning of each CME-accredited article in this issue.
UNLABELED AND ENVESTIGATIONAL USAGE
The audience is advised that this continuing medical education activity may contain references to u n labe led uses of PDA-approved products or to 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 3 are taken from the article "A Newborn Girl With a Large Red Plaque on Her Face" by Denise W. Metry, MD (see pages 423-426).
1.The port-wine stain of Sturge-Weber syndrome differs from a segmental hemangioma found in infancy if which of the following ways:
A. ls fully formed at birth.
B. Proliferates for a shorter period of time.
C. Expands for only 6 months at maximum before involuting.
D. Regresses typically after adolescence.
2. Other than the facial hemangioma, the most common features of PHACE are:
A. Structural and cerebrovascular anomalies of the brain.
C. Cardiovascular anomalies.
D. Ventral developmental defects.
3. Patient with PHACE who have cerebrovascular anomalies are most at risk for which of the following complications during infancy?:
A. Motor developmental delay.
B. Language delay.
C Acute arterial ischemie stroke.
D. Migraine headaches.
Questions 4 through 6 are taken from the article "An Byear-old Girl With an Enlarging Papule on the Eyelid" by Annette M. Wagner, MD (see pages 429-430).
4. Which of the following statements regarding pyogenic granulomas is not true?:
A. They are the most common acquired vascular tumor of the skin in children and adolescents.
B. After minor trauma and bleeding, regrowth without treatment is common.
C. Pyogenic granulomas commonly occur after a mild staphylococcal infection.
D. They are seen with increased frequency in women during pregnancy.
5. Treatment modalities used in the management of pyogenic granulomas include all of the following except:
A. Shave excision with electrodessication.
B. Topical application of mupirocin ointment.
C. Excision for lesions on the eyelids or mucosa.
D. Early use of pulsed dye laser.
6. The differential diagnosis for a pyogenicgranuloma includes which of the following:
A. Spitz nevus.
B. Amelanotic melanoma.
D. All of the above.
Questions 7 through 9 are taken from the article "A 4year-old Girl With Abnormal Fingernails" by Sapna Patel, MD; and Sarah L. Chamlin, MD (see pages 43 1 -432).
7. Nail matrix arrest can occur in all of the following settings except:
A. Systemic illness.
B. Local inflammatory process.
C Excessive nail biting.
D. Drug exposure.
8. Although commonly associated with the use of che motherapeutic agents, onychomadesis also has been described with which of the following?:
A. Antiepileptic agents.
D. All of the above.
9. Upon reaching the conclusion that a child with nail matrix arrest is suffering from a post-infectious phenomenon, his parents ask if the nails will return to normal. Your best answer is:
A. The nails will always have some ridging.
B. In the setting of infection, nail matrix arrest typically is transient, with normal re-growth.
C. It is highly likely the nails will be lost permanently.
D. None of the above.
Questions 10 through 12 are taken from the article "An Adolescent Girl With Tuberous Sclerosis Complex, Additional Skin Lesions" by Jonette E. Keri, MD1 PhD; and NidhiAvashia (see pages 433-435).
10. Which of the following are the most common skin findings in patients with tuberous sclerosis?:
A. Adenoma sebaceum and ash leaf macules.
B. Shagreen patches.
C. Periungual fibromas.
D. Café au lait spots.
11. Pulmonary involvement in tuberous sclerosis is most commonly seen in which group:
A. Men in their twenties.
B. Women in their thirties.
C. Boys in their teens.
D. Girls in the pre-ado lesee nt years.
1 2. Destructive methods used to treat adenoma sebaceum include all of the following except:
Questions 13 through IS are taken from the article "A 10-year-old Boy With Skin Lesions, Fever, and Hip Pain" by Melissa L. Abrams, MD; Ross M. Levy, MD; and Sarah L. Chamlin, MD (see pages 436-438).
13. Which of the following statements is true regarding Janeway lesions?:
A. They often are less than 2 mm in diameter.
B. They often are tender.
C. They occur on the palms and soles.
D. They are fleeting and often are gone in a few hours.
14. Osier's nodes are characteristically:
B. Located on the abdomen and back.
1 5. Bacterial endocarditis is associated with all of the following except:
C. Subungual hemorrhages.
D. Necrotic bullous lesions.
Questions 76 through 18 are taken from the article "A 6month-old Boy With an Enlarging Bruise on His Back" by Erin Mathes, MD; Marion Koerper, MD; and liona Frieden, MD (see pages 44 1 -443).
16. The diagnosis of Kasabach-Merritt phenomenon is based on all of the following except:
D. Enlarging vascular tumor.
1 7. Whkh of the following is characteristic of tufted angioma?:
A. Most common location is in the chest, neck,and retroperitoneum.
B. Misto pathologic features demonstrate tightly packed capillaries in a "cannonball" distribution.
C. Often involutes, leaving behind fibro fatty tissue.
D. Age of onset is almost universally birth to age 2 months.
18. First-line therapy for Kasabach-Merritt phenomenon includes:
A. Wide local incision.
B. Ticlopidine and aspirin.
D. High-dose steroids and vincristine.
Questions 79 and 20 are taken from the article "A 12Year-Old Girl With an Enlarging Nontender Nodule on the Arm" by Annette M. Wagner, MD (see pages 445-447).
19. All of the following are true regarding pilomatricomas except:
A. Occurs with a higher frequency in boys.
B. Most common location is the head and neck.
C. They are benign tumors of the hair follicle matrix cells.
D. More common in children.
20. The differential diagnosis of pilomatrkoma includes all of the following except:
A. Calcinosis cutis.
B. Foreign bodygranulomas.
C. Vascular malformations.
D. Spitz nevus.