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  Vol. 8 No. 1, January 1999 TABLE OF CONTENTS
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The Archives of Family Medicine Continuing Medical Education Program

Arch Fam Med. 1999;8:23-25.

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


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 January/February 1999

Smoking Cessation (SEE ARTICLE)

Q1. Concerning implementation of a system to increase smoking cessation counseling in a typical family practice office:

A. Medical assistants uniformly volunteer to ask patients about smoking.
B. Physicians uniformly agree that it is reasonable to have medical assistants ask about smoking.
C. Many barriers to implementation decline with time.
D. No system has ever been shown to be significantly effective in increasing smoking cessation counseling.
E. 100% compliance can be achieved.

Trends in Primary Care (SEE ARTICLE)

Q2. Recent trends in medical office visits include:

A. Decreased rate of providing prevention services.
B. Decreased percentage of visits to primary care physicians referred by another physician.
C. Increased duration of average visit for an adult.
D. Increased percentage of total visits to generalists than specialists.
E. Increased percentage of total visits to family physicians in rural areas.

Q3. The most frequent medical diagnosis reported by family physicians is:

A. Hypertension.
B. Diabetes.
C. Asthma.
D. Obesity.
E. Sinusitis.

Patient Sexual Abuse (SEE ARTICLE)

Q4. Concerning sexual abuse and patient symptoms:

A. There is a positive but nonlinear relationship between a history of the severity of sexual abuse and the amount of patient impairment.
B. There is a positive, linear relationship between a history of the severity of sexual abuse and the amount of patient impairment.
C. Diagnosed psychiatric disorders account for the relationship between sexual abuse and physical symptoms.
D. Patients with a history of sexual abuse have symptoms primarily related to the female reproductive tract.

Definitions of Disability (SEE ARTICLE)

Q5. Which is true concerning the Americans With Disabilities Act of 1990?

A. Most physician offices are exempt because they employ fewer than 25 people.
B. Because of a loophole, the Americans With Disabilities Act permits discrimination on the basis of association with persons with known disabilities.
C. The cost for making public accommodations for disability is so high that Congress is reconsidering this part of the law.
D. Physicians should not require a driver's license for patients who pay by check, and should accept some alternate form of identification.
E. A physician must accept a patient, even if the patient represents a threat to the office staff.

Q6. Which of the following patients would not be considered to have a disability by the definition of the Americans With Disabilities Act of 1990?

A. Physical impairment not limiting any major life activity.
B. Mental impairment limiting 1 major life activity.
C. Physical impairment limiting life activities.
D. Mental impairment limiting life activities.
E. History of a physical impairment limiting 1 major life activity.

Papanicolaou Smears (SEE ARTICLE)

Q7. PAPNET:

A. Is a screening instrument for cervical, uterine, and ovarian cancer.
B. Is a computerized method to read Papanicolaou smears without human involvement.
C. Finds twice the rate of high-grade cervical intra-epithelial neoplasias as human screening.
D. Is approved by the US Food and Drug Administration as a primary screening device for cervical cytology smears.
E. Is less expensive than manual rescreening.

Depression in Primary Care (SEE ARTICLE)

Q8. Which of the following is most related to treatment of depression?

A. Physician specialty.
B. Presence of nearby mental health specialists.
C. Amount of capitated care in a practice.
D. Financial barriers.
E. Weekly practice volume.

Q9. Which of the following is the most common cue used by primary care physicians in recognizing depression?

A. Routine oral question about depression.
B. Routine screening for depression.
C. Past medical history.
D. Patient appearing depressed.
E. Family member providing information to the physician.

Otitis Media (SEE ARTICLE)

Q10. Which of the following is the least common cause of acute bacterial otitis media?

A. Staphylococcus aureus.
B. Streptococcus pneumoniae.
C. Haemophilus influenzae.
D. Moraxella catarrhalis.
E. Group A streptococci.

Q11. A 20-month-old child has otitis media without response to amoxicillin. In your area, there is little known pencillin-resistant Streptococcus pneumoniae. Which of the following would be the best choice at this time?

A. Erythromycin/sulfisoxazole.
B. Trimethoprim/sulfamethoxazole.
C. Azithromycin.
D. Cefuroxime.
E. Ventilating tubes.

Q12. A 20-month-old child has otitis media without response to amoxicillin. In your area, there is a substantial percentage of penicillin-resistant Streptococcus pneumoniae. Which of the following would be the best choice at this time?

A. Erythromycin/sulfisoxazole.
B. Trimethoprim/sulfamethoxazole.
C. Clarithromycin.
D. Cefuroxime.
E. Ventilating tubes.

Q13. The most common bacterial cause of concurrent acute otitis media and conjunctivitis is:

A. Staphylococcus aureus.
B. Streptococcus pneumoniae.
C. Haemophilus influenzae.
D. Moraxella catarrhalis.
E. Group A streptococci.






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