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Volume 18, Number 12—December 2012

CME ACTIVITY

Enterovirus 71–associated Hand, Foot, and Mouth Disease, Southern Vietnam, 2011

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:
Enterovirus 71–associated Hand, Foot, and Mouth Disease, Southern Vietnam, 2011

CME Questions

1. You are seeing a 3-year-old girl with a two-day history of fever. She developed oral ulcers this morning, and you suspect that she has hand, foot, and mouth disease (HFMD). In the current study, what virus type was associated with the majority of cases of HFMD requiring hospitalization?

A. Enterovirus 71

B. Coxsackievirus A16

C. Echovirus 13

D. Poliovirus 2

2. The patient is treated with supportive care but returns to your clinic the next day when her mother notes myoclonus in her fingers. While the patient still has fever and a rash, there are no other symptoms or physical signs. According to the clinical grading system used in the current study, what grade of HFMD does this patient now have?

A. Grade 1

B. Grade 2

C. Grade 3

D. Grade 4

3. What should you consider regarding the clinical presentation of cases of HFMD in the current study?

A. Most children were over 5 years old

B. The mortality rate exceeded 10%

C. The average time for progression to most severe illness was 5 days

D. Children with caregiver-reported myoclonus had a low rate of clinical progression

4. The patient goes on to develop multiple complications of HFMD. What treatments were used for the associated complications in the current study?

A. Myoclonus — diazepam

B. Seizures — carbamazepine

C. Fever unresponsive to antipyretics — IVIg

D. Hypertension — beta blockers

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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