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Volume 19, Number 5—May 2013

CME ACTIVITY

Transmission of Mycobacterium tuberculosis Beijing Strains, Alberta, Canada, 1991–2007

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:
Transmission of Mycobacterium tuberculosis Beijing Strains,
Alberta, Canada, 1991–2007

CME Questions

1. You are seeing family of 5 who emigrated from China one year ago. The father of the family was recently diagnosed with pulmonary tuberculosis (TB), and you are worried about the potential spread of the infection, particularly with virulent strains of Mycobacterium tuberculosis. What should you consider in general regarding the epidemiology of the Beijing lineage of M. tuberculosis?

A. It accounts for 13% of all TB strains globally

B. It accounts for less than 2% of cases of TB in immigrant-receiving countries with low rates of infection

C. It is rarely resistant to treatment

D. The Beijing strain is less virulent compared with other TB strains in animal models

2. Which of the following characteristics was most associated with TB infection with the Beijing strains in the current study?

A. Higher proportion of foreign-born patients

B. Younger age

C. More likely to have a positive sputum smear

D. Higher rates of drug resistance

3. What should you consider regarding the transmission of Beijing vs non-Beijing strains of TB in the current study?

A. The Beijing strains were associated with higher rates of clustered cases

B. The Beijing strains were associated with similar rates of clustered cases compared with non-Beijing strains

C. The Beijing cases were only more likely to be clustered among foreign-born patients

D. The Beijing cases were only more likely to be clustered among drug-resistant strains

4. Which of the following factors was most positively associated with a higher rate of secondary cases of TB in the current study?

A. Beijing lineage

B. Age over 64 years in the index case

C. Positive sputum smear in the index case

D. Foreign-born patient in the index case

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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