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Volume 16, Number 6—June 2010

CME ACTIVITY - Dispatch

Invasive Aspergillosis after Pandemic (H1N1) 2009

Earning CME Credit

To obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following, related, multiple-choice questions. To complete the questions and earn continuing medical education (CME) credit, please go to www.medscapecme.com/journal/eid. Credit cannot be obtained for tests completed on paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user on Medscape.com. If you are not registered on Medscape.com, please click on the New Users: Free Registration link on the left hand side of the website to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you will be able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider, CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association’s Physician’s Recognition Award (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further information on this award, please refer to http://www.ama-assn.org/ama/pub/category/2922.html. The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits™. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit is acceptable as evidence of participation in CME activities. If you are not licensed in the US and want to obtain an AMA PRA CME credit, please complete the questions online, print the certificate and present it to your national medical association.

Article Title: Invasive Aspergillosis after Pandemic (H1N1) 2009

CME Questions

Mr. Washington is a 35-year-old patient with a 2-day history of high fever, malaise, and cough. His son was diagnosed with infection with H1N1 influenza last week. None of the family was vaccinated against H1N1 influenza. He receives supportive care only for his symptoms. However, he presents to the emergency department the following week. He has experienced significant shortness of breath, and a chest x-ray reveals bilateral infiltrates. Mr. Washington is started on antibiotics but decompensates and develops ARDS.

  1. Which of the following diagnostic strategies in this case is most appropriate if invasive aspergillosis (IA) is suspected?

    A. The potential influenza infection does not influence the risk for IA in this immunocompetent patient, and further assessment for IA is not indicated

    B. Bronchoscopy and culture for aspergillosis

    C. Bronchoscopy with direct smear for aspergillosis

    D. Serum galactomannan assay

  2. Mr. Washington is diagnosed with IA. On the basis of this activity, which of the following strategies should be considered?

    A. Aggressive early treatment with antiviral medications

    B. Rapid diagnosis of fungal infection after the initial bronchoscopy

    C. Treatment with corticosteroids

    D. Initial treatment with voriconazole

Activity Evaluation

1. The activity supported the learning objectives.
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1 2 3 4 5
2. The material was organized clearly for learning to occur.
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3. The content learned from this activity will impact my practice.
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4. The activity was presented objectively and free of commercial bias.
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