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Volume 19, Number 10—October 2013

CME ACTIVITY

Cryptococcus gattii Infections in Multiple States Outside the US Pacific Northwest

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:
Cryptococcus gattii infections in Multiple States Outside the US Pacific Northwest

CME Questions

1. You are asked to see a 40-year-old man with neurologic and pulmonary symptoms for the past several weeks. He had received treatment with azithromycin from an urgent care clinic, with no improvement. You consider whether this patient may have a fungal infection. Which of the following statements regarding Cryptococcus gattii infections is most accurate?

A. Transmission is primarily person-to-person

B. The incubation period is approximately 2 to 4 weeks

C. C. gattii primarily affects persons with HIV infection

D. There has been an outbreak of C. gattii in the Pacific Northwest United States

2. What should you consider regarding the presentation of patients with C. gattii infection in the current study?

A. Almost two-thirds of patients were healthy at the time of diagnosis

B. Half of patients were asymptomatic at the time of diagnosis

C. The average time from symptom onset to the diagnosis of C. gattii infection was 3 months

D. Cough and weight loss were the most common presenting symptoms

3. The patient is diagnosed with C. gattii infection of both the lungs and central nervous system. What should you consider regarding the management of patients with C. gattii infection in the current study?

A. Most patients did not require hospitalization

B. There were no admissions to the intensive care unit associated with C. gattii infection

C. Monotherapy with fluconazole was the most common treatment used

D. Over 35% of patients treated for C. gattii infection received corticosteroids

4. What should you consider regarding outcomes of patients with C. gattii infection in the current study?

A. The overall mortality rate exceeded 50%

B. All patients who died had underlying immunocompromised status

C. Nearly 40% of patients with follow-up data had cranial nerve palsies

D. Nearly all patients who died were men

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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