Using a case-based approach, this CME activity will provide practical training on the management of congenital hypothyroidism. The course will address the initial diagnostic testing and initiation of treatment in infancy through childhood and adolescence.

The course will review the clinical signs of hypothyroidism, the initial work up, appropriate dosing and delivery of thyroid hormone replacement, the schedule of lab testing to monitor treatment and how to interpret results. The impact of congenital hypothyroidism on growth and development will be reviewed. Guidance on educating parents and patients to optimize adherence will be provided.

The course modules include short educational videos and role play videos of parent communication at each stage of diagnosis and management. Case-based testing and medication management scenarios provide the opportunity to assess your knowledge and learn from particular examples.

This course is designed for pediatricians, family practice physicians, and primary care physicians.

• Release Date: September 4, 2015
• Expiration Date: August 31, 2018
• Estimated Time to Complete: 1.25 hours
• CME Credits Offered: 1.25
• AAP Credits Offered: 1.25
• Registration Fee: FREE

• Review the information below and complete the entire activity.
• Complete the CME Post-test, CME Assessment Survey, and CME Activity Completion Statement at the end of the activity.
• You must receive a score of 75% or higher on the post-test in order to receive a certificate. You will have two attempts to answer each multiple-choice question (or one attempt for questions with only two options) to pass the post-test.
• Once you attest to completing the entire online activity and have scored 75% or higher on the post-test, your certificate will be generated automatically and will be available on your Dashboard page.
• Physicians will be awarded AMA PRA Category 1 Credits™. All other participants will receive a Certificate of Participation.

Only AAP Fellows and Candidate Members may claim AAP credit.

After completing all the necessary steps above and receiving your CME Certificate, visit http://pedialink.aap.org and log in using your AAP username and password.

Once logged in, click the CME tab and then go to the CME transcript page to claim your year-end credit.

At the conclusion of this activity, participants should be able to:

• Formulate a plan for the confirmatory retesting for congenital hypothyroidism.
• Prescribe and adjust treatment according to the American Academy of Pediatrics published guidelines (2006).
• Counsel and educate parents to address questions and concerns about congenital hypothyroidism and emphasize their responsibility in medication adherence.
• Interpret thyroid function tests.
• Distinguish which children warrant a trial off thyroid hormone replacement to determine if congenital hypothyroidism was transient.
• Monitor associated developmental challenges that affect children with congenital hypothyroidism.

1. Introduction
2. Why Screen for Congenital Hypothyroidism?
3. Initial Diagnosis
4. Interpreting Results and Starting Treatment
5. Long Term Care of CH Patients
6. Course Wrap-up
7. Resources and References
8. Help!

The following planners, speakers and authors have indicated that they have no relationships with industry to disclose relative to the content of this activity:

Laura K. Bachrach, MD
Professor of Pediatrics (Endocrinology)
Stanford School of Medicine
Course Director
Author/Presenter

Mary Rutherford, MD, FAAP, FACEP
Director of Clinical Quality
UCSF Benioff Children's Hospital Oakland
Speaker

Ning Rosenthal, MD, PhD
Senior Research Scientist
Genetic Disease Screening Program
California Department of Public Health
Planner

Mike McAuliffe
Stanford EdTech

Kimberly Walker, PhD
Stanford EdTech

Greg Bruhns
Stanford Online

Role Play Actors

Julie Pantaleoni, MD
Clinical Assistant Professor, Pediatrics

Rajiv B. Kumar, MD
Clinical Assistant Professor, Pediatrics
Endocrinology and Diabetes

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The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Stanford University School of Medicine designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This continuing medical education activity has been reviewed by the American Academy of Pediatrics and is acceptable for a maximum of 1.25 AAP credits. These credits can be applied toward the AAP CME/CPD Award available to Fellows and Candidate Members of the American Academy of Pediatrics.

This activity received no commercial support.

California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. It is the intent of the bill, which went into effect July 1, 2006, to encourage physicians and surgeons, CME providers in the State of California and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area. The Stanford University School of Medicine Multicultural Health Portal also contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.

You are encouraged to visit the portal: http://lane.stanford.edu/portals/cultural.html

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If you are having technical problems (video freezes or is unplayable, can't print your certificate, etc.) you can submit a Help Request to the OpenEdX Team. If you have questions related to CME credit, requirements (Pre-test, Post-test, Evaluation, Attestation) or course content, you can contact the CME Online support team at cmeonline@stanford.edu

American Academy of Pediatrics. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics. 2006; 117: 2290-2303

Leger J et al. European Society for Paediatric Endocrinology Consensus guidelines on Screening, diagnosis, and management of congenital hypothyroidism. HormRes Paediatr. 2014; 81: 80-103