Case Based Webinar 3: Application of CPG in Real-World Settings, CME/MOC 2 Questions

Please complete the following quiz. You can view your score at the end of this quiz. If you do not earn a score of 75% or higher, please review the presentation and submit the quiz again. CME and MOC points will be awarded on a 30-day basis. If you have any questions, please contact obesity@aap.org.

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* 1. Please provide the following information to receive CME credit, following successful completion of the knowledge change survey.

First and Last Name

AAP ID

Credential (MD, DO, RN)

Email Address

City/Town

State/Province

ZIP/Postal Code

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* 2. American Board of Pediatrics (ABP) ID# (REQUIRED for pediatricians seeking part 2 MOC)

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* 3. Month and date of birth (MM/DD) (REQUIRED for pediatricians seeking part 2 MOC)

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* 4. Were the individual learning objectives of this CME activity achieved?

Yes

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* 5. A 14 year old girl whose BMI is at the 98th%ile for age and sex is establishing care and would like to talk about treatment options for her weight. She has experienced bullying at school related to her body size and endorses occasional depressed mood. Blood pressure, hemoglobin A1c, fasting lipid panel, and alanine aminotransferase are all normal. According to the 2023 American Academy of Pediatrics Clinical Practice Guideline for pediatric obesity, is she a candidate for obesity pharmacotherapy?

No, she should first complete lifestyle treatment before being offered obesity medications.

Yes, concurrent with lifestyle treatment.

Yes, either by itself or concurrent with lifestyle therapy following shared decision making.

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* 6. A 16 year old boy with severe obesity (BMI ≥ 99th%ile), prediabetes, gastroesophageal reflux, and uncontrolled hypertension is engaged in lifestyle treatment and is interested in trialing obesity medications. Assuming he has access to all options, what is the best obesity medication to start with for this patient?

Metformin

Phentermine/Topiramate

Semaglutide

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* 7. A 15 year old girl with anxiety, binge eating (in psychotherapy for both with good stability), and obesity with prediabetes and obstructive sleep apnea is started on phentermine/topiramate in combination with lifestyle treatment by her primary care provider. Which of the following monitoring plans best supports a model of comprehensive, longitudinal obesity care in the medical home?

Primary care provider follows changes in BMI and associated comorbidities and defers mood and disordered eating screening to the patient’s therapist.

Primary care provider partners with the therapist to coordinate monitoring for mood and disordered eating in both settings.

Primary care provider schedules a routine medical follow-up in 1 year or sooner if concerns arise on the medication.

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* 8. A 17 year old boy with severe obesity on weekly injectable semaglutide for 2 years in combination with nutrition and physical activity modifications has had a 10% BMI reduction with normalization of hemoglobin A1c and significant improvement in triglycerides and alanine aminotransferase. He says that he would like to come off the phentermine/topiramate to see if he can maintain these improvements on his own. As part of a shared decision making discussion, what do you tell him based on current evidence?

For most, stopping semaglutide is associated with significant weight regain.

For most, stopping semaglutide results in weight loss maintenance as long as lifestyle treatment is continued.

For most people, stopping semaglutide results in ongoing weight loss as long as lifestyle treatment is continued.

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* 9. A 16 year old boy with severe intellectual disability and severe complicated obesity (BMI ≥ 99th%ile, type 2 diabetes) presents with his mom who would like to know what treatment you recommend for his weight. Which of the following should be offered as potential treatment options?

Lifestyle interventions only

Lifestyle interventions and obesity pharmacotherapy

Lifestyle interventions, obesity pharmacotherapy, and metabolic bariatric surgery

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* 10. Based on what you learned in this activity, do you plan to change:
The strategies you implement in practice (e.g., how you diagnose/manage patients, coordinate care, etc.)?

Yes

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* 11. Based on what you learned in this activity, do you plan to change:
What you do in practice (e.g., how you perform exams, instruct, counsel patients/families, etc.)?

Yes

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* 12. If YES to either of the above questions, please identify any changes in practice that you plan to make:

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* 13. If NO and you do not plan to make changes in practice, other than lack of time and resources, why not? (select all
that apply)

Systems-related barriers internal to your organization

The activity reinforced what I am already doing in practice

No practice changes were recommended

Other (please specify)

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* 14. Do you feel the educational content contributed to stereotypes and/or biases which could negatively impact patients, colleagues, or trainees?

Yes - if yes, please comment

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* 15. Do you feel a commercial product, device, or service was inappropriately promoted in the educational content?

Yes - If yes, please comment

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* 16. On a scale of 1 to 7, what was the return on your investment of time/effort for participating in this activity?

	1 - Low Return	2	3	4 - Medium Return	5	6	7 - High Return
Scale	Scale 1 - Low Return	Scale 2	Scale 3	Scale 4 - Medium Return	Scale 5	Scale 6	Scale 7 - High Return

Question Title

* 1. Please provide the following information to receive CME credit, following successful completion of the knowledge change survey.

Question Title

* 2. American Board of Pediatrics (ABP) ID# (REQUIRED for pediatricians seeking part 2 MOC)

Question Title

* 3. Month and date of birth (MM/DD) (REQUIRED for pediatricians seeking part 2 MOC)

Question Title

* 4. Were the individual learning objectives of this CME activity achieved?

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* 9. A 16 year old boy with severe intellectual disability and severe complicated obesity (BMI ≥ 99th%ile, type 2 diabetes) presents with his mom who would like to know what treatment you recommend for his weight. Which of the following should be offered as potential treatment options?

Question Title

* 10. Based on what you learned in this activity, do you plan to change:The strategies you implement in practice (e.g., how you diagnose/manage patients, coordinate care, etc.)?

Question Title

* 11. Based on what you learned in this activity, do you plan to change:What you do in practice (e.g., how you perform exams, instruct, counsel patients/families, etc.)?

Question Title

* 12. If YES to either of the above questions, please identify any changes in practice that you plan to make:

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* 13. If NO and you do not plan to make changes in practice, other than lack of time and resources, why not? (select all that apply)

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* 14. Do you feel the educational content contributed to stereotypes and/or biases which could negatively impact patients, colleagues, or trainees?

Question Title

* 15. Do you feel a commercial product, device, or service was inappropriately promoted in the educational content?

Question Title

* 16. On a scale of 1 to 7, what was the return on your investment of time/effort for participating in this activity?

* 10. Based on what you learned in this activity, do you plan to change:
The strategies you implement in practice (e.g., how you diagnose/manage patients, coordinate care, etc.)?

* 11. Based on what you learned in this activity, do you plan to change:
What you do in practice (e.g., how you perform exams, instruct, counsel patients/families, etc.)?

* 13. If NO and you do not plan to make changes in practice, other than lack of time and resources, why not? (select all
that apply)