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  Vol. 9 No. 7, July 2000 TABLE OF CONTENTS
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The Archives of Family Medicine Continuing Medical Education Program

Arch Fam Med. 2000;9:639-641.

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.


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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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; tel: (312) 419-0400, ext 225; fax: (312) 269-1636.


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.


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.


Questions for July 2000

Parents and Adults Who Want Antibiotics for Cold Symptoms (SEE ARTICLE)

Q1. The following is a characteristic or experience more likely to be reported among people who want antibiotics for cold symptoms than among other symptomatic adults:

A. Having milder cold symptoms.
B. Being unsure about how to treat a cold.
C. Believing that too many people take antibiotics for a cold.
D. Believing that their symptoms have lasted too long.

Family Physicians' Role in Recruitment of Organ Donors (SEE ARTICLE)

Q2. Regarding the recruitment of organ donors:

A. There is uniformity of opinion among physicians regarding their role in the recruitment of organ donors.
B. Roughly two thirds of potential organ donors actually contribute organs for transplantation.
C. Most patients disapprove of organ donation.
D. A simple intervention by family physicians can increase the commitment of patients to organ donation.

Demographic Predictors of Melanoma Stage at Diagnosis (SEE ARTICLE)

Q3. Regarding melanoma:

A. The lifetime risk of acquiring melanoma is now estimated to be about 1 in 400 individuals.
B. The prognosis of malignant melanoma is not dependent on the stage at which it is detected.
C. Understanding the determinants of late-stage melanoma diagnosis is an important objective in controlling cancer.
D. Factors predictive of later stages at diagnosis and poor prognosis in previous studies have included female sex and younger age.

Q4. A sociodemographic group more likely to be diagnosed as having melanoma at a late stage is:

A. Women.
B. Married persons.
C. Nonsmokers.
D. Persons residing in communities with low-median educational attainment.

Child Reports of Daily Functioning and Identification of Psychosocial Problems (SEE ARTICLE)

Q5. Regarding psychosocial problems in children:

A. Epidemiologic studies indicate that between 15% and 20% of children experience psychosocial problems.
B. Many of the children with psychosocial problems are treated exclusively by mental health professionals.
C. Children with untreated psychosocial problems are unlikely to have problems that are severe and persist over time.
D. Primary care physicians are not asked to identify and treat these children.
E. Previous research has found that physicians are unlikely to identify children as having psychosocial problems when parents disclose concerns about their child's functioning.

Does Influenza Vaccination Exacerbate Asthma? (SEE ARTICLE)

Q6. Regarding asthma in children:

A. Asthma is not the most common cause of hospitalization in children.
B. Asthma may be precipitated by viral infections of the upper respiratory tract.
C. Health authorities do not recommend annual influenza vaccination for patients with asthma.
D. Most children with asthma receive an annual influenza vaccination.
E. Concern about possible exacerbation of asthma is a valid reason to not vaccinate children with asthma against influenza.

National Patterns of Physician Activities Related to Obesity Management (SEE ARTICLE)

Q7. Regarding obesity:

A. The prevalence of obesity has decreased in the United States over the last 4 decades.
B. In recent years, obesity has been defined as a body mass index of 40 kg/m2 or greater.
C. Research has shown that behavior modification provides the worst results for weight reduction and maintenance.
D. Physicians may be overreporting and overtreating obesity.
E. Office-based physicians may be providing obesity treatment at inadequate levels.

Emergency Contraception (SEE ARTICLE)

Q8. Regarding emergency contraception:

A. Emergency contraception is not indicated after sexual assault.
B. Emergency contraception does not interrupt an established pregnancy.
C. Combination contraceptive pills used as emergency contraception reduce pregnancy by 20%.
D. Progestin-only regimens are estimated to be less effective.
E. Hormonal emergency contraception is indicated for up to 24 hours after unprotected intercourse.

Q9. Regarding emergency contraception dosing regimens:

A. The traditional Yuzpe regimen consists of 3 doses of combination contraceptive pills.
B. Products combining ethinyl estradiol and levonorgestrel cannot be used.
C. A levonorgestrel-only product (plan B) has just been approved by the Food and Drug Administration.
D. Levonorgestrel alone is not as well tolerated as combination oral contraceptives.
E. A copper-containing intrauterine device is not effective.

Amylophagia Presenting as Gestational Diabetes (SEE ARTICLE)

Q10. In the United States, gravid women considered to be at high risk for pica include:

A. Whites.
B. Those who reside in an urban area.
C. Those of higher socioeconomic strata.
D. Those with weak social support networks.
E. Those who live in the Pacific Northwest.

Q11. Amylophagia:

A. Should be considered in any pregnant woman who presents with gestational diabetes, especially if refractory to initial dietary management.
B. Is an entity distinct from the specific phenomenon of pica.
C. Refers to the practice of compulsive consumption of ice.
D. Is easily elicited by history.
E. Is known to be caused by a nutritional deficiency of magnesium.

Pyomyositis in a 5-Year-Old Child (SEE ARTICLE)

Q12. Regarding pyomyositis:

A. It is a purulent infection of striated muscle.
B. It does not respond to antibiotics.
C. It is common in healthy individuals.
D. It has not been found to lead to life-threatening complications.
E. Secondary pyomyositis is felt to be the result of hematogenous spread of an occult source.

© 2000 American Medical Association. All Rights Reserved.