February 9th, 2012 Conference Review Questions

Happy Valentine's Day!

Journal Club with Joelle, Gastroenteritis EBM with Kathy Brown and Theresa Walls, and NAT radiology with Dr. Shalaby-Rana

1. You are working to design a study comparing the mortality rates in pediatric trauma patients receiving pre-hospital fluid resuscitation with those who do not. Of the following, which is the LEAST accurate statement about study designs?

a) A cohort study starts with an exposure and assesses event status
b) When the outcome of interest is rare, a cohort design is most useful
c) A case control study starts with the outcome of interest and assesses exposure status
d) Relative risks cannot be calculated from case control studies

2. You are reviewing a randomized controlled trial comparing the efficacy of IVIG and aspirin compared with aspirin alone in the prevention of coronary artery aneurysms in patients with Kawasaki’s disease. The results show that the patients treated with aspirin alone had a 26% chance of having a coronary artery aneurysm within 30 days, compared to 4% in the group treated with both aspirin and 2gm/kg of IVIG. According to this study, what is best approximation of the number needed to treat (NNT) with IVIG and aspirin in order to prevent one patient from having a coronary artery aneurysm?

a) 22
b) 85
c) 5
d) 25
e) 7

3. A 3 year old M presents with 3 days of vomiting and diarrhea. Mom reports concern that he has not voided since last night and did not appear to have tears while crying. On exam, he is tired but non-toxic appearing. He has dry lips but his cap refill is <2 seconds and he has a benign abdominal exam. In your clinical assessment, you determine that he is moderately dehydrated from gastroenteritis and decide to initiate oral rehydration. Over the next 4 hours, you should aim for him to drink:

a) 40 cc/kg
b) 50 cc/kg
c) 60 cc/kg
d) 100 cc/kg

4. A 20 month old M is brought in for evaluation of swelling of his L leg noted over the last day with no history of trauma. A transverse femur fracture is found on xray, and a skeletal survey is ordered. Of the following, which is the least specific for non-accidental trauma?

a) Fracture inconsistent with stage of development
b) Clavicle fractures
c) Rib fractures
d) Metaphyseal corner fractures
e) Scapula fractures

5. The skeletal survey order has disappeared from cerner! The radiology tech asks you to order each of the films you need individually. In order to obtain a full skeletal survey, you order:

a) AP and lateral views of the skull, chest, spine, pelvis, bilateral humeri, forearms, hands, femurs, lower legs, and feet
b) AP and lateral views of the skull, spine, pelvis, bilateral humeri, forearms, hands, femurs, lower legs, and feet; and AP and bilateral oblique views of the chest
c) AP and lateral views of the skull and spine; AP views of the pelvis, bilateral humeri, forearms, hands, femurs, lower legs and feet; and AP and bilateral oblique views of the chest
d) AP views of the skull, spine, pelvis, bilateral humeri, forearm, hands, femur, lower legs, and feet; and AP and bilateral oblique views of the chest

Answers HERE