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Volume 19, Number 3—March 2013

CME ACTIVITY - Research

Increasing Pneumocystis Pneumonia, England, UK, 2000–2010

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:
Increasing Pneumocystis Pneumonia, England, UK, 2000–2010

CME Questions

1. You are a public health official consulting with the World Health Organization regarding trends in Pneumocystis jirovecii pneumonia in England over the past decade. Based on findings from the database study by Dr. Maini and colleagues, which of the following statements about changes in incidence of P. jirovecii pneumonia in England from 2000–2010 would be most likely to appear in your report?

A. Between 2000 and 2010, laboratory-confirmed cases increased by an average of 3% per year

B. Between 2000 and 2010, death registrations increased by an average of 2% per year

C. Between 2000 and 2010, Hospital Episode Statistics (HES) cases increased by an average of 9% per year

D. Most of the increase in HES cases occurred in the first half of the decade

2. Based on findings from the database study by Dr. Maini and colleagues, which of the following statements about changes in risk factors associated with P. jirovecii pneumonia in England from 2000–2010 is most likely correct?

A. Rates of P. jirovecii pneumonia in adults with diagnosed HIV infection increased from 2000-2010

B. Patients with pre-existing renal disease were identified as a new risk group

C. The largest proportion of cases was patients who had undergone transplantation

D. A total of 17.5% of cases were associated with pre-existing lung disease

3. Which of the following statements about the clinical and public health implications of findings from the database study by Dr. Maini and colleagues is most likely correct?

A. The diagnosis of potentially preventable P. jirovecii pneumonia in non-HIV infected persons did not increase during the study period.

B. Earlier diagnosis of HIV was the only potential explanation for the significant reduction during the study period in P. jirovecii pneumonia infection among HIV-infected persons

C. There is no reason to suspect that P. jirovecii pneumonia ascertainment increased over the study period

D. The findings support enhanced P. jirovecii pneumonia surveillance for patients with chronic lung disease, systemic inflammatory diseases, and solid tumors

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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