Society for Pediatric Pain Medicine
Better Care for Children in Pain

{“questions”:{“lo3qt”:{“id”:”lo3qt”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Studies have shown that animal assisted therapy can be a beneficial part of multimodal management of many various symptoms, ranging from depression and anxiety to acute and chronic pain. Animal-assisted interventions (AAI) have been known to improve discomfort, stress, anxiety, and overall well-being in children and adults. In addition to subjective reports from patients, biomarkers have been used to investigate a positive response to AAI. All of the following objective measures have been utilized indicating a positive response to AAI except:”,”desc”:””,”hint”:””,”answers”:{“11jb5”:{“id”:”11jb5″,”image”:””,”imageId”:””,”title”:”A.\tdecreased respiratory rate, heart rate, and blood pressure”},”ghemf”:{“id”:”ghemf”,”image”:””,”imageId”:””,”title”:”B.\tincreased oxytocin, endorphins, and serotonin”},”k46xc”:{“id”:”k46xc”,”image”:””,”imageId”:””,”title”:”C.\tdecrease cortisol levels”},”07yjs”:{“id”:”07yjs”,”image”:””,”imageId”:””,”title”:”D.\tincrease salivary alpha-amylase”,”isCorrect”:”1″}}}},”results”:{“jimik”:{“id”:”jimik”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2025\/03\/SPPM-QOM-March-2025.pdf”}}}

{“questions”:{“43c3d”:{“id”:”43c3d”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”An 8-year-old boy is brought to a local health post in rural Nepal by his parents with complaints of intense pain accompanied by swelling in his left wrist preceded by a fall on outstretched hand. The child is crying constantly and as per the Wong-Baker FACES Pain Rating Scale, he has a pain of \u201cHurts Worst\u201d. The wrist has a dinner fork like appearance. There are no imaging facilities in the health post and neither anesthesia consults or services. The nearest hospital is over eight hours drive away. Given the limited resources, what is the best pain management approach until he is transported to a higher center?”,”desc”:””,”hint”:””,”answers”:{“hmi4i”:{“id”:”hmi4i”,”image”:””,”imageId”:””,”title”:”A. Perform a closed reduction with hematoma block”},”hi4qo”:{“id”:”hi4qo”,”image”:””,”imageId”:””,”title”:”B. Perform a closed reduction with procedural sedation and analgesia”},”cxnk4″:{“id”:”cxnk4″,”image”:””,”imageId”:””,”title”:”C. Splint with available materials + NSAID”,”isCorrect”:”1″},”ch4kp”:{“id”:”ch4kp”,”image”:””,”imageId”:””,”title”:”D. Do nothing and just transport the patient “}}}},”results”:{“i66kd”:{“id”:”i66kd”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:” https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2025\/02\/SPPM-QOM-February-2025.pdf”}}}

{“questions”:{“l8xg3”:{“id”:”l8xg3″,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 30kg 8-year-old male with a history of Wilms tumor s\/p right nephrectomy at age 5, postoperative nausea and vomiting (PONV), and burning chronic post-surgical pain (CPSP) at right abdominal incision site with numbness, presents for an elective outpatient umbilical hernia repair. The patient had been requiring opioids and gabapentin for his pain until 8 months ago when it resolved. The anesthetic plan includes preoperative acetaminophen, a general anesthetic including 1mcg\/kg fentanyl, and post-induction, pre-incision bilateral rectus sheath blocks with 0.6mL\/kg of 0.2% ropivacaine with 1:200k epinephrine. Given the patient\u2019s history, which of the following preoperative medications is best suited to decrease postoperative pain and nausea \/ vomiting? “,”desc”:””,”hint”:””,”answers”:{“9x3dr”:{“id”:”9x3dr”,”image”:””,”imageId”:””,”title”:”A.\tKetorolac “},”b9d0o”:{“id”:”b9d0o”,”image”:””,”imageId”:””,”title”:”B.\tKetamine “},”je5ek”:{“id”:”je5ek”,”image”:””,”imageId”:””,”title”:”C.\tTramadol”},”2mnrq”:{“id”:”2mnrq”,”image”:””,”imageId”:””,”title”:”D.\tGabapentin “,”isCorrect”:”1″}}}},”results”:{“x65yr”:{“id”:”x65yr”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2025\/01\/SPPM-QOM-January-2025.pdf”}}}

{“questions”:{“yp0de”:{“id”:”yp0de”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 2-year-old child who weighs 15 kg, undergoes laceration repair of the right index finger in the operating room. The resident does a digital nerve block using 2% lidocaine with epinephrine (1:100,000) and uses 1 ml\/side. In the PACU, the anesthesiologists noticed the right index finger appeared pale and less perfused. Which of the following is the most likely cause of this finding?\t”,”desc”:””,”hint”:””,”answers”:{“3nihi”:{“id”:”3nihi”,”image”:””,”imageId”:””,”title”:”A.\tSurgical injury to artery”},”n1ebs”:{“id”:”n1ebs”,”image”:””,”imageId”:””,”title”:”B.\tUse of epinephrine in the block”,”isCorrect”:”1″},”8z957″:{“id”:”8z957″,”image”:””,”imageId”:””,”title”:”C.\tLocal Anesthesia Systemic Toxicity (LAST) “},”0zef3”:{“id”:”0zef3″,”image”:””,”imageId”:””,”title”:”D.\tHypothermia”}}}},”results”:{“hxeee”:{“id”:”hxeee”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2024\/12\/SPPM-QOM-December-2024.pdf”}}}

{“questions”:{“6kzcc”:{“id”:”6kzcc”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 30-week gestational age 1-day-old neonate with moderate neonatal opioid withdrawal syndrome (NOWS) is in the NICU showing signs of agitation, poor feeding, and sleep disturbances. The pain service is consulted for nonpharmacologic recommendations to help with her symptoms. According to available literature, which of the following techniques are recommended as first line therapy for the treatment of NOWS?\r\n\r\n”,”desc”:””,”hint”:””,”answers”:{“l3emx”:{“id”:”l3emx”,”image”:””,”imageId”:””,”title”:”A.\tStart around the clock morphine “},”5nvw2”:{“id”:”5nvw2″,”image”:””,”imageId”:””,”title”:”B.\tPrescribe as needed acetaminophen and avoid opioids”},”wzvy1″:{“id”:”wzvy1″,”image”:””,”imageId”:””,”title”:”C.\tUse the eat, sleep, console approach”,”isCorrect”:”1″},”uu15q”:{“id”:”uu15q”,”image”:””,”imageId”:””,”title”:”D.\tProvide acupressure\/acupuncture prior to other therapy”},”rvdl0″:{“id”:”rvdl0″,”image”:””,”imageId”:””,”title”:”E.\tPlace a clonidine patch and recommend as needed morphine”}}}},”results”:{“huuxx”:{“id”:”huuxx”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2024\/11\/November-2024-QOM.pdf”}}}