Society for Pediatric Pain Medicine
Better Care for Children in Pain

{“questions”:{“rre6v”:{“id”:”rre6v”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”When discussing patients with Ehlers Danlos Syndrome (EDS), which of the following statements is FALSE?”,”desc”:””,”hint”:””,”answers”:{“cvwlg”:{“id”:”cvwlg”,”image”:””,”imageId”:””,”title”:”A. EDS patients have decreased efficacy to local anesthetic medications when local infiltration is performed”},”p8wsv”:{“id”:”p8wsv”,”image”:””,”imageId”:””,”title”:”B. Many patients with EDS also have concurrent chronic pain “},”96vy1”:{“id”:”96vy1″,”image”:””,”imageId”:””,”title”:”C. The response of larger peripheral nerve bundles to local anesthetic medications is similar to the response following local infiltration analgesia”,”isCorrect”:”1″},”rj04o”:{“id”:”rj04o”,”image”:””,”imageId”:””,”title”:”D. EDS is a hereditary disease that results in impaired connective tissue integrity”}}}},”results”:{“sux24”:{“id”:”sux24″,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2024\/02\/SPPM-QOM-February-2024.pdf”}}}

{“questions”:{“urvgd”:{“id”:”urvgd”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 17-year-old female cheerleader presents for right shoulder anthroscopy. She has a history of rotator cuff injury with lingering pain for 4 months. Which of the following is not a risk factor for persistent postoperative opioid use (PPOU) in children and adolescents?”,”desc”:””,”hint”:””,”answers”:{“y2ge4”:{“id”:”y2ge4″,”image”:””,”imageId”:””,”title”:”A. Past or current opioid use”},”958h0″:{“id”:”958h0″,”image”:””,”imageId”:””,”title”:”B. Older age”},”lef5t”:{“id”:”lef5t”,”image”:””,”imageId”:””,”title”:”C. Family history of Substance Use Disorder”},”1n2ph”:{“id”:”1n2ph”,”image”:””,”imageId”:””,”title”:”D. Female sex”},”vyln3″:{“id”:”vyln3″,”image”:””,”imageId”:””,”title”:”E. All of the above are risk factors for persistent postoperative opioid use in children and adolescents.”,”isCorrect”:”1″}}}},”results”:{“dcce2”:{“id”:”dcce2″,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2024\/01\/SPPM-QOM-January-2024.pdf”}}}

{“questions”:{“0f30e”:{“id”:”0f30e”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 15-year-old, female, softball player presents for left knee ACL reconstruction with autograft, following a knee injury few weeks ago. The patient denies any numbness or weakness in her leg at this time, but active knee movement is limited by pain. Her past medical history and physical exam are otherwise unremarkable. Strength is perceived as 5\/5 in all muscles tested. Sensation was normal in the affected lower extremity. For pain management, left femoral nerve block is done with 0.2% ropivacaine (10 ml) under ultrasound guidance, and femoral catheter left in place, after anesthesia induction, prior to surgical incision. iPACK block is done at the end. GETA is otherwise uneventful and surgical tourniquet time is noted to be 92 minutes. In the recovery room, she is pain-free. She is discharged home with nerve catheter in place infusing 0.15% ropivacaine @8 ml\/hr with instructions for catheter care. She was followed by pain service while catheter is in place, and removal at home on postoperative day 3. Over this time there were no motor deficits reported. On routine post-surgical follow up 2 weeks after surgery in orthopedic clinic, she complains of persistent numbness in medial aspect of knee to foot. On exam, she also has weakness 3\/5 with knee extension and has been unable to participate in physical therapy. The orthopedic surgeon refers the patient to the anesthesiologist who performed the block for further assessment. After a thorough exam and discussion, referral to neurology is placed. Electromyography\/nerve conduction studies are conducted a week later which reveal neurapraxia. \r\n\r\nPlease select which of the following features will most help make the diagnosis of neurapraxia:”,”desc”:””,”hint”:””,”answers”:{“wzunp”:{“id”:”wzunp”,”image”:””,”imageId”:””,”title”:”A.\tNeurapraxia is associated with myelin damage to the peripheral nerve”,”isCorrect”:”1″},”r3ovl”:{“id”:”r3ovl”,”image”:””,”imageId”:””,”title”:”B.\tNerve conduction velocity testing reveals loss of conduction velocity and loss of continuity of axons”},”vjfyt”:{“id”:”vjfyt”,”image”:””,”imageId”:””,”title”:”C.\tEMG findings include fibrillations and loss of activation of larger motor unit potentials “},”xfdhu”:{“id”:”xfdhu”,”image”:””,”imageId”:””,”title”:”D.\tNeurapraxia is associated with a poor prognosis”}}}},”results”:{“irm93”:{“id”:”irm93″,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2023\/12\/SPPM-QOM-December-2023-REV.pdf”}}}

{“questions”:{“l9oig”:{“id”:”l9oig”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 3-month-old infant undergoes a Kasai procedure for biliary atresia. An epidural catheter was threaded from the caudal space to the thoracic level, and the position was confirmed by an epidurogram. On post-op day #1 the bedside nurse states that they do not think the epidural is working because the baby cries intermittently and sometimes appears uncomfortable. FLACC scores have been between 0-6. The baby has an NG tube in place, a right radial arterial line, and 2 peripheral IVs in the upper extremities. \r\n\r\nWhich of the following techniques is best for determining whether the epidural is functional or not?\r\n”,”desc”:””,”hint”:””,”answers”:{“8pq5v”:{“id”:”8pq5v”,”image”:””,”imageId”:””,”title”:”A. Confirm the position of the epidural with Ultrasound”},”ugy3t”:{“id”:”ugy3t”,”image”:””,”imageId”:””,”title”:”B. Use the Wong-Baker Faces Pain Scale in place of the FLACC”},”2lfyk”:{“id”:”2lfyk”,”image”:””,”imageId”:””,”title”:”C. Check dermatome levels by gently palpating along the chest and abdomen”,”isCorrect”:”1″},”10i1a”:{“id”:”10i1a”,”image”:””,”imageId”:””,”title”:”D. Stop the epidural and look for increased pain behavior”}}}},”results”:{“a5ls9”:{“id”:”a5ls9″,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2023\/11\/SPPM-QOM-November-2023-2.pdf”}}}

{“questions”:{“a28mf”:{“id”:”a28mf”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”A 66 kg 15-year-old male with a history of sickle cell disease on methadone maintenance therapy for back pain and adolescent idiopathic scoliosis presents for posterior spinal fusion with combination general and regional anesthesia. Which of the following characteristics may increase the likelihood of developing chronic post-surgical pain (CPSP) in this child?”,”desc”:””,”hint”:””,”answers”:{“bb95y”:{“id”:”bb95y”,”image”:””,”imageId”:””,”title”:”A. Male patient”},”psi6h”:{“id”:”psi6h”,”image”:””,”imageId”:””,”title”:”B. History of pre-operative pain “,”isCorrect”:”1″},”ifyvu”:{“id”:”ifyvu”,”image”:””,”imageId”:””,”title”:”C. Undergoing orthopedic surgery versus thoracic surgery”},”3eex7″:{“id”:”3eex7″,”image”:””,”imageId”:””,”title”:”D. Use of a regional anesthetic technique”}}}},”results”:{“fcqpu”:{“id”:”fcqpu”,”title”:””,”image”:””,”imageId”:””,”min”:”0″,”max”:”1″,”desc”:””,”redirect_url”:”https:\/\/pedspainmedicine.org\/wp-content\/uploads\/2023\/10\/SPPM-QOM-October-2023-REV.pdf”}}}