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Volume 23, Number 10—October 2017

CME ACTIVITY - Synopsis

Fatal Rocky Mountain Spotted Fever along the United States–Mexico Border, 2013–2016

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Article Title:
Fatal Rocky Mountain Spotted Fever along the United States–Mexico Border, 2013–2016

CME Questions

1. You are advising a clinic located near the US–Mexico border regarding management of Rocky Mountain spotted fever (RMSF). According to the case series by Drexler and colleagues, which of the following statements about clinical presentation and diagnosis of RMSF in patients with recent exposure in northern Mexico is correct?

A. All 4 patients initially presented with rash

B. All 4 patients had several nonspecific findings at presentation, including fever, headache, nausea, vomiting, or myalgia

C. None of the patients had thrombocytopenia early during their illness

D. Two cases did not meet at least 1 laboratory criterion for a confirmed spotted fever rickettsiosis

2. According to the case series by Drexler and colleagues, which of the following statements about the clinical course and management of RMSF in patients with recent exposure in northern Mexico is correct?

A. Of the 4 patients, 2 had respiratory failure

B. Death occurred 2 to 3 months after the onset of illness

C. Cutaneous necrosis of the extremities was not reported

D. All patients received a nontetracycline-class antibiotic within the first week of illness, and only 1 patient received doxycycline at any time during their course

3. Which of the following statements about the clinical implications of analysis of this series of 4 fatal cases of RMSF in patients with recent exposure in northern Mexico is correct?

A. Doxycycline should be delayed until appearance of rash or availability of confirmatory laboratory testing

B. Clinicians on both sides of the US–Mexico border should consider RMSF in patients with rapidly progressing febrile illness and recent exposure in northern Mexico

C. Complete blood counts and hepatic function panels are not helpful in distinguishing RMSF from arboviral infections

D. RMSF diagnosis is straightforward based on characteristic features

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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