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Volume 19, Number 1—January 2013

CME ACTIVITY - Research

Pneumocystis jirovecii Genotype Associated with Increased Death Rate of HIV-infected Patients with Pneumonia

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:
Pneumocystis jirovecii Genotype Associated with Increased Death Rate of HIV-infected Patients with Pneumonia

CME Questions

1. You are seeing a 30-year-old man with HIV infection and a new diagnosis of Pneumocystis jirovecii pneumonia (PCP). You are concerned regarding the possibility of genetic mutations in this organism. What was the overall rate of dihydropteroate synthase (DHPS) mutations among cases of PCP in the current study?

A. 4%

B. 33%

C. 74%

D. 83%

2. DHPS mutations were most associated with which of the following patient characteristics in the current study?

A. CD4 count less than 50 cells/mL

B. Age over 40 years

C. Male sex

D. Diagnosis of PCP after 1995

3. You initiate treatment with trimethoprim-sulfamethoxazole. Which of the following variables was most associated with sulfa resistance of P. jirovecii in the current study?

A. Need for mechanical ventilation at the time of PCP diagnosis

B. P. jirovecii type 10

C. P. jirovecii type 7

D. DHPS M2 mutation

4. Which of the following variables was most associated with a higher risk of death due to PCP in the current study?

A. DHPS M2 mutation

B. DHPS M3 mutation

C. P. jirovecii type 7

D. Older age

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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