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Volume 18, Number 2—February 2012

CME ACTIVITY

Invasive Pneumococcal Disease and Pandemic (H1N1) 2009, Denver, Colorado, USA

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: Invasive Pneumococcal Disease and Pandemic (H1N1) 2009, Denver, Colorado, USA

CME Questions

1. You are admitting a 55-year-old woman with a history of chronic obstructive pulmonary disease, type 2 diabetes mellitus, and steatohepatitis. She has had fever and cough for 8 days, and it has grown worse in the last 2 days.

You consider whether this patient has influenza, invasive pneumococcal disease (IPD), or both. Which of the following statements regarding the relationship between pandemic (H1N1) 2009 and IPD in the current study is most accurate?

A. Fewer than 20% of cases of IPD featured positive testing for pandemic (H1N1) 2009

B. Most cases of IPD did not feature influenza-like illness (ILI)

C. More patients had positive testing for pandemic (H1N1) 2009 than for ILI

D. The sensitivity of rapid influenza testing approached 100%

2. Which of the following variables most characterized pandemic (H1N1) 2009–associated cases of IPD vs IPD cases during the nonpandemic period?

A. Younger age and black race

B. Younger age and higher rates of chronic obstructive pulmonary disease

C. Female sex and higher rates of diabetes

D. Older age and higher rates of liver disease

3. As you take this patient's history, what information from the current study should you consider regarding the use of pneumococcal vaccine and treatment of influenza?

A. Nearly all eligible patients had received the pneumococcal polysaccharide vaccine (PPV23) vaccine

B. All children had received the 7-valent pneumococcal conjugate (PCV7) vaccine

C. Fewer than 10% of patients received antiviral medications

D. The most common reason for not prescribing antiviral medications was fear of side effects

4. The patient is diagnosed with influenza (H1N1) and IPD. What was the difference in the severity of cases of IPD in the pandemic vs the nonpandemic periods in the current study?

A. Pandemic (H1N1) 2009 was associated with higher rates of hospitalization and mortality

B. Pandemic (H1N1) 2009 was associated with higher rates of hospitalization only

C. Pandemic (H1N1) 2009 was associated with higher rates of mortality only

D. Pandemic (H1N1) 2009 was not associated with higher rates of hospitalization or mortality

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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