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Volume 18, Number 11—November 2012

CME ACTIVITY - Research

Coccidioidomycosis-associated Deaths, United States, 1990–2008

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 (with a minimum 70% passing score) and earn continuing medical education (CME) credit, please go to www.medscape.org/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.org. If you are not registered on Medscape.org, 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 may be acceptable as evidence of participation in CME activities. If you are not licensed in the US, please complete the questions online, print the certificate and present it to your national medical association for review.

Article Title:
Coccidioidomycosis-associated Deaths, United States, 1990–2008

CME Questions

1. You are seeing a 45-year-old man with a 4-week history of cough and fever. He was visiting a cousin in the southwestern United States last month, and you consider whether he might have coccidioidomycosis. What should you consider regarding the epidemiology of coccidioidomycosis?

A. Coccidioides spp. are usually found at high elevations

B. Coccidioides spp. are usually found in wet climates

C. Up to 50% of people in endemic areas have been exposed to Coccidioides spores

D. Coccidioides spp. are found on the surface of the soil

2. What should you consider regarding the transmission and clinical course of coccidioidomycosis?

A. Livestock frequently transmit coccidioidomycosis to humans

B. Person-to-person transmission accounts for most cases of coccidioidomycosis

C. One quarter of patients with coccidioidomycosis develop extrapulmonary disease

D. The rate of disseminated disease is higher among men vs women

3. The patient is diagnosed with coccidioidomycosis. What should you consider regarding the demographics of fatal cases of coccidioidomycosis in the current study?

A. There was no sex-based difference in the risk of mortality

B. The highest rate of death was among children and adolescents

C. Race and ethnicity did not affect the risk of mortality

D. Native Americans experienced the highest rate of mortality compared with other racial/ethnic groups

4. The patient has an extensive past medical history. Which of the following comorbid illnesses was most associated with a higher risk of death among patients with coccidioidomycosis in the current study?

A. Rheumatoid arthritis

B. Congestive heart failure

C. Chronic obstructive pulmonary disease

D. Recurrent dental abscesses

Activity Evaluation

1. The activity supported the learning objectives.

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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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