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Volume 19, Number 3—March 2013

CME ACTIVITY

Clinical and Therapeutic Features of Pulmonary Nontuberculous Mycobacterial Disease, Rio de Janeiro, Brazil

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:
Clinical and Therapeutic Features of Pulmonary Nontuberculous Mycobacterial Disease, Rio de Janeiro, Brazil, 1993–2011

CME Questions

1. You are seeing a 55-year-old man with a 4-month history of cough, night sweats, and weight loss. You suspect that he has pulmonary tuberculosis, but you also consider whether he has pulmonary nontuberculous mycobacterial (PNTM) disease. What should you consider regarding PNTM disease?

A. Immunosuppression affects the risk of pulmonary tuberculosis but not PNTM disease

B. The highest prevalence of PNTM disease in the United States is among men between the ages of 20 and 35 years

C. The prevalence of PNTM disease is higher in the United States compared with Brazil

D. Pulmonary infection with Mycobacterium kansasii has a clinical presentation very similar to that of pulmonary tuberculosis

2. Which of the following statements regarding the clinical presentation of PNTM disease among patients in the current study is most accurate?

A. Nearly all patients had significant comorbid illnesses

B. Most patients reported a history of smoking

C. Systemic symptoms were more common than respiratory symptoms

D. Less than 10% of patients had received prior treatment for tuberculosis

3. You order sputum cultures for this patient. Which of the following organisms were most common in cases of PNTM disease in the current study?

A. M. abscessus and M. fortuitum

B. M. abscessus and M. avium complex (MAC)

C. M. kansasii and MAC

D. M. kansasii and M. fortuitum

4. On further testing, the patient does appear to have PNTM disease. Which of the following organisms was associated with the LOWEST cure rate in the current study?

A. M. fortuitum

B. M. abscessus

C. MAC

D. M. kansasii

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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