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Volume 18, Number 9—September 2012

CME ACTIVITY - Research

Effectiveness and Timing of Vaccination during School Measles Outbreak

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: Evaluation of Diagnostic and Therapeutic Approaches for Suspected Influenza A(H1N1)pdm09 Infection, 2009–2010

CME Questions

1. You are seeing a 17-year-old young woman with a history of malaise, low-grade fever, sore throat, and frontal headache for 2 days. You suspect that this patient might have influenza. Based on the results of the current study, what should you consider regarding influenza testing?

A. 99% of patients with a positive test for influenza met CDC-defined criteria for influenza-like illness (ILI)

B. Children had higher rates of positive testing as outpatients compared with adults

C. All tested patients had some indication suggesting influenza infection

D. The rates of positive testing exceeded 50% among both children and adults in the outpatient setting

2. You decide to initiate treatment with oseltamivir as an outpatient. What does the current study demonstrate regarding the use of oseltamivir in the outpatient setting?

A. Adults were more likely than children to receive oseltamivir

B. Nearly half of patients with a positive rapid influenza diagnostic test (RIDT) were not treated according to CDC guidelines

C. Half of patients receiving oseltamivir had a negative RIDT

D. One quarter of patients received oseltamivir within 48 hours of the onset of symptoms

3. The patient returns to your clinic 2 days later with worsening cough, dyspnea, and fever. You decide to admit her to the hospital. What does the current study demonstrate regarding the management of influenza in the inpatient setting?

A. Over 90% of inpatients received oseltamivir

B. Over 90% of inpatients who received oseltamivir had positive influenza testing

C. Most patients prescribed oseltamivir received an incorrect dose or duration of therapy

D. The most common error in prescribing oseltamivir was extending the duration of therapy

4. What else should you consider regarding the management of influenza in the setting of lower respiratory tract infection (LRTI) in the current study?

A. All patients with cases of LRTI were admitted to the hospital

B. Most patients presented within 2 days of symptom onset

C. Two thirds of patients failed to receive appropriate treatment

D. The principal reason that patients failed to receive oseltamivir was the belief of physicians that the drug would not work

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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