PHYSICIANS WHO read selected articles in this issue of Archives of Family Medicine, answer the Self-assessment Quiz, complete the CME Evaluation, and mail in the Answer Card are eligible for category 1 credit toward the American Medical Association (AMA) Physician's Recognition Award (PRA). There is no charge to subscribers or nonsubscribers.
The AMA is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. The AMA designates this education activity for up to 3 hours of category 1 credit per issue toward the AMA PRA. Each physician should claim only those hours of credit that he or she actually spent in the educational activity.
In addition, Archives of Family Medicine has been approved by the American Academy of Family Physicians (AAFP) as having educational content acceptable for Prescribed credit hours. This issue has been approved for up to 3 Prescribed credit hours. Credit may be claimed for 1 year from date of individual issue.
EARNING CREDIT
To earn credit, read the articles designated for CME credit carefully and take the following Self-assessment Quiz. Mark your responses on the accompanying Answer Card and complete the CME Evaluation. Then fax your Answer Card to the Blackstone Group at (312)269-1636 or mail it to the address on the back of the card. Answers are provided in Figure 1 so that you can immediately assess your performance.
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Answers to This Issue's Self-assessment Quiz
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Answer Cards must be submitted within 1 year of the issue date. The AMA maintains no permanent record of individual quiz scores. A certificate specifying the total amount of credit received for this educational activity will be returned to you by mail or fax. Please allow up to 4 weeks for your certificate to arrive. Questions about CME processing should be directed to the Blackstone Group; fax: (312)269-1636.
CME EVALUATION
Our goal is to continually assess the educational needs of our readership for the purpose of enhancing the educational effectiveness of the Archives of Family Medicine. To achieve this goal, we need your help. You must complete the CME Evaluation on the Answer Card to receive credit. Participants are encouraged to reply within 2 months of the issue date, to facilitate the assessment of its educational value.
STATEMENT OF EDUCATIONAL PURPOSE
The Archives of Family Medicine is devoted to strengthening the science, practice, and art of family medicine. Its emphasis is on original research that is clinically practical and academically sound. A flexible curriculum of article topics is developed annually by the journal's editorial board and is then supplemented throughout the year with information gained from readers, authors, reviewers, and editors.
Readers of the Archives of Family Medicine should be able to attain the following educational objectives: (1) use the latest information on diagnosis and treatment of diseases commonly seen in clinical practice to maximize patient health; (2) recognize uncommon illnesses that present with common symptoms to the family physician and treat or refer as appropriate; (3) use practical tools for health promotion and disease prevention; and (4) learn the clinical indications and adverse effects of pertinent new drugs or new uses for available drugs.
SELF-ASSESSMENT QUIZ
Questions for September/October 1999
Chromium: Friend or Foe? (SEE ARTICLE)
Q1. Chromium:
A. In its various valence states can be inert, of potential therapeutic value, or a carcinogen.
B. Is provided most frequently in the average US diet by eggs.
C. Is readily absorbed.
D. Improves the level of low-density lipoprotein cholesterol in diabetic patients.
E. Has a recommended daily allowance of 200 µg/d.
Creighton Model Natural Family Planning (SEE ARTICLE)
Q2. The Creighton Model Natural Family Planning system:
A. Is based on counting calendar days.
B. Can be used for pregnancy prevention as well as achievement of pregnancy.
C. Results in method-related pregnancy rates of about 9 per 100 women per year.
D. Does not work in women who are breast-feeding.
E. Should not be used after birth control pill use for at least 3 months.
Prepubertal Girls Evaluated for Sexual Abuse (SEE ARTICLE)
Q3. Concerning physical findings in prepubertal girls:
A. A large transhymenal diameter is diagnostic of sexual abuse with or without other physical findings.
B. The transhymenal diameter should be measured with traction.
C. A notch in the hymen is a strong indicator of sexual abuse.
D. The transhymenal diameter increases with age.
E. Hymenal penetration is required for the diagnosis of sexual abuse.
Quality of Papanicolaou Smears (SEE ARTICLE)
Q4. In obtaining Papanicolaou smears:
A. More endocervical cells are obtained in older women.
B. The rate of "adequate" Papanicolaou smears is correlated with the rate of abnormalities.
C. In the United States, family physicians perform more Papanicolaou smears on young women than obstetricians or gynecologists do.
D. Air-drying of the slide leads to an increased rate of reported abnormalities.
E. Use of the cytobrush is associated with a higher rate of abnormal smears.
Congestive Heart Failure (SEE ARTICLE)
Q5. In congestive heart failure, diastolic dysfunction is:
A. Readily determined on echocardiography.
B. Primarily a disease found in men rather than women.
C. Associated with better functional status than systolic dysfunction.
D. Primarily treated by angiotensin-converting enzyme inhibitors.
E. More common in either family practice or cardiology offices than systolic dysfunction.
Dementia and Life-Sustaining Procedures (SEE ARTICLE)
Q6. Which of the following is felt by the highest percentage of elderly patients to be a health problem worse than death?
A. Losing one's mental faculties.
B. Vegetative state.
C. Constant pain or being a burden to friends or family.
D. Losing one's independence.
Q7. In the study of Gjerdingen et al, most elderly patients with intact cognitive function believed that if they were to develop mild dementia and become ill, they would want:
A. Tube feedings.
B. Hospitalization.
C. Assisted ventilation.
D. Cardiac resuscitation.
Antibiotics for Upper Respiratory Tract Infections (SEE ARTICLE)
Q8. Concerning the treatment of respiratory infections:
A. Antibiotics are indicated for the treatment of upper respiratory tract infections that lead to significant acute functional deterioration, such as lost work or school time.
B. Antibiotics are indicated for the treatment of bronchitis in nonsmokers.
C. Antibiotics are currently prescribed slightly more than 50% of the time during first visits to family practice offices for upper respiratory tract infections.
D. Those who receive an antibiotic on the first visit for an upper respiratory tract infection are more likely to get a more expensive antibiotic if they return for a second visit.
E. Prescribing antibiotics for upper respiratory tract infections reduces the rate of repeat visits to the office during the same infectious episode by about one half.
Physician Mental Health and Substance Abuse (SEE ARTICLE)
Q9. Mental health conditions of physicians:
A. May become public through state medical board actions.
B. May currently become public through the National Practitioner Data Bank records of medical liability actions.
C. Are rare.
D. Are asked about on initial licensure application by 3 of 50 states.
E. Should only be reported on licensure application if formal treatment was obtained.
Psychosocial Functioning of Children (SEE ARTICLE)
Q10. About how many children have psychosocial problems?
A. 2%.
B. 5%-8%.
C. 15%-20%.
D. 25%-30%.
E. 35%-40%.
Q11. Family psysicians are most likely to indicate awareness of children's behavior problems when:
A. The parent is distressed.
B. The child reports it to the physician.
C. The children are of the same race as the physician.
D. The children are of high intelligence.
E. The family is insured.
Chondrodermatitis Nodularis Chronica Helicis (SEE ARTICLE)
Q12. Chondrodermatitis nodularis chronica helicis:
A. Is fatal if untreated.
B. Is painless.
C. Should be treated with low-dose steroids first.
D. Is most commonly located on the right ear helix.
E. Has a low recurrence rate after treatment.
