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Volume 19, Number 11—November 2013

CME ACTIVITY - Research

Possible Association between Obesity and Clostridium difficile Infection

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:
Possible Association between Obesity and Clostridium difficile Infection

CME Questions

1. You are seeing a 40-year-old woman with diarrhea and fever for the past 3 days. You are concerned regarding the possibility of Clostridium difficile infection (CDI). The patient also reports that she has had increasing abdominal pain for the past year, and you consider whether she has inflammatory bowel disease (IBD). Which of the following statements is most accurate regarding the relationship between IBD and CDI?

A. IBD is associated with increased morbidity and mortality associated with CDI

B. Most patients with IBD acquire CDI in inpatient settings

C. CDI generally develops more slowly after hospital admission among patients with IBD compared with patients without IBD

D. IBD does not affect the risk of antibiotic exposure

2. Which of the following factors was significantly more common in the healthcare-onset (HO) vs community-onset (CO) groups in the current study?

A. Obesity

B. Antibiotic use

C. Diabetes

D. End-stage renal disease

3. How did the CO cohort most differ from the CO–healthcare facility–associated (HCFA) cohort in the current study?

A. The CO cohort was older

B. The CO cohort was more likely to use acid suppressive medications

C. The CO cohort was more likely to be obese

D. The CO cohort was more likely to be male

4. Which group of patients had the highest rate of IBD in the current study?

A. CO

B. CO-HCFA

C. HO

D. CO-HCFA and HO

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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