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Volume 19, Number 12—December 2013

CME ACTIVITY

Potential Role of Deer Tick Virus in Powassan Encephalitis Cases in Lyme Disease–endemic Areas of New York, 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:
Potential Role of Deer Tick Virus in Powassan Encephalitis Cases in Lyme Disease–endemic Areas of New York, USA

CME Questions

1. You are seeing a 62-year-old man with several days’ history of fever and muscle weakness. You suspect that he might have encephalitis. What should you consider regarding the virology of Powassan virus (POWV)?

A. Both lineages feature tick vectors

B. Both lineages feature deer as the principal reservoir hosts

C. POWV is maintained by Ixodes scapularis

D. Deer tick virus (DTV) is maintained by I. cookei

2. Which of the following statements regarding the clinical presentation of POWV/DTV encephalitis in the current study is most accurate?

A. Most cases were diagnosed in the late fall

B. Most patients reported a history of tick bite

C. Subjective fever was the most common symptom

D. The incubation from tick bite to the onset of symptoms was 3 to 5 days

3. Which of the following was characteristic of laboratory and imaging data from patients in the current study?

A. Computed tomography of the brain was abnormal in over 90% of patients

B. Most patients had transaminitis

C. DTV was confirmed in 2 of 14 cases and was probably present in even more cases

D. Only 8% of patients experienced a substantial increase in POWV plaque reduction neutralization test titers between acute and convalescent sera

4. Which of the following statements regarding the outcomes of POWV/DTV encephalitis in the current study is most accurate?

A. 50% of patients were hospitalized

B. Most patients admitted to the hospital went to the intensive care unit

C. All deaths occurred in the hospital

D. Corticosteroid therapy was associated with a higher risk of 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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