CME Quiz

AAFP members and other physicians and health care professionals who
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CME credit at https://​w ww.aafp.org/afpquiz. Quiz questions are featured below
for your convenience. This issue is approved for up to 8 Prescribed and AMA PRA
Category 1 credits. The total credit for this issue is based on one credit for each
article included in the Quiz. Credits may be claimed for one year from the date
of this issue. Questions? Call 800-274-2237.

Q4. Which one of the following patients warrants an

Articles
Interventional Radiology:​Indications
and Best Practices (p. 547)
Q1. Which one of the following statements about central
venous catheters is correct? (check one)
l A. Placing ports surgically is not as expensive as
using interventional radiology.
l B. Nontunneled catheters have a lower infection
rate per catheter-day than tunneled catheters.
l C. Infections occur in about one-fifth of patients
with tunneled catheters.
l D. Subcutaneous ports cannot be placed using
interventional radiology.
Q2. A 29-year-old patient with long-standing pelvic pain
is diagnosed with a 5-cm uterine fibroid. Which one of
the following statements is correct? (check one)
l A. About one-third of patients receiving uterine
artery embolization for fibroids require surgical
treatment within two years.
l B. More than one-half of all women will have symp-
tomatic fibroids in their lifetime.
l C. Patients have higher satisfaction with uterine
artery embolization than with myomectomy.
l D. Uterine artery embolization should not be used in
women who wish to retain fertility.
Clinically Relevant Drug-Drug
Interactions in Primary Care (p. 558)
Q3. Which one of the following statements about the use
of antibiotics in patients receiving warfarin (Coumadin) is
correct? (check one)
l A. The empiric warfarin dosage should be reduced
25% to 50% upon initiation of rifampin.
l B. The precise effect on international normalized
ratio (INR) from any antibiotic is predictable.
l C. The patient’s INR should be checked soon after
initiating antibiotics and soon after finishing them.
l D. Metronidazole (Flagyl) has minimal influence on
INR.
empiric dosage adjustment? (check one)
l A. A patient receiving apixaban (Eliquis) being started
on ketoconazole.
l B. A patient receiving warfarin being started on pen-
icillin G benzathine.
l C. A patient receiving warfarin being started on ator-
vastatin (Lipitor).
l D. A patient receiving pravastatin (Pravachol) being
started on an azole antifungal.
Top 20 Research Studies of 2018
for Primary Care Physicians (p. 565)
Q5. Which one of the following statements about the
treatment of musculoskeletal pain is correct? (check one)
l A. Opioid and acetaminophen combination anal-
gesics relieve acute extremity pain better than
ibuprofen and acetaminophen combinations.
l B. Anticonvulsants are effective for the treatment of
low back pain with radiculopathy.
l C. Nonopioid medications are at least as effective
as opioid medications for improving pain-related
function in persons with chronic back, knee, or
hip pain.
l D. Anticonvulsants do not increase the risk of
adverse events.
Q6. Which one of the following statements about behav-
ioral medicine is correct? (check one)
l A. Two-thirds of patients with anxiety disorders will
relapse after discontinuation of antidepressant
therapy.
l B. Persons who participate in more than 150
minutes of at least moderate-intensity physical
activity per week have a lower risk of depression.
l C. There is no relationship between increased physi-
cal activity and a lower risk of depression.
l D. Nonbenzodiazepine hypnotics decrease the risk
of falls or fractures.

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Q7. Which one of the following statements about screen-
ing and prevention is correct? (check one)
l A. The fecal immunochemical test is less sensitive
and specific than guaiac-based fecal occult blood
tests for colorectal cancer screening.
l B. The initiation of statin therapy in patients 75
years or older without preexisting cardiovascular
disease or diabetes mellitus clearly reduces the
likelihood of developing cardiovascular disease.
l C. The benefits of aspirin for primary prevention
in patients with moderate risk of cardiovascular
disease clearly outweigh the harms.
l D. Exercise, with or without vision assessment/
treatment and environmental assessment/modi-
fication, reduces the risk of injurious falls in older
adults.
Cochrane for Clinicians
Saline Irrigation for Allergic Rhinitis (p. 544)
Q8. Which one of the following statements about using
nasal saline irrigation to treat the symptoms of allergic
rhinitis is correct? (check one)
l A. When used alone, it reduces the severity of
allergy symptoms vs. no treatment.
l B. When used alone, it does not yield better out-
comes than intranasal corticosteroids.
l C. When added to pharmacologic treatments, it
does not further improve symptoms.
l D. All of the above.
Aromatase Inhibitors Such as Letrozole
(Femara) vs. Clomiphene (Clomid) for Subfertile
Women with PCOS (p. 545)
Q9. When comparing letrozole with clomiphene for the
treatment of subfertility in women with polycystic ovary
syndrome (PCOS), which one of the following statements
is correct? (check one)
l A. Letrozole results in a higher incidence of live
birth.
l B. Letrozole results in a higher incidence of ovarian
hyperstimulation syndrome.
l C. Letrozole results in a higher risk of miscarriage.
l D. Letrozole results in a higher risk of a multiple
pregnancy.
542 American Family Physician
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CME QUIZ
Implementing AHRQ Effective Health Care Reviews
Psychological and Pharmacologic
Treatments for Adults with PTSD (p. 577)
Q10. Which one of the following statements about the
treatment of posttraumatic stress disorder (PTSD) is cor-
rect? (check one)
l A. Pharmacotherapy is superior to psychotherapy.
l B. Male veterans have lower rates of PTSD than the
general population.
l C. Fluoxetine, paroxetine, and venlafaxine reduce
PTSD symptoms.
l D. Individual trauma-focused psychotherapy is not
recommended.
Point-of-Care Guides
Applying a Clinical Decision Rule for CAD
in Primary Care to Select a Diagnostic Test
and Interpret the Results (p. 584)
Q11. Which one of the following is a positive clinical
predictor of a cardiovascular cause of chest pain based
on the INTERCHEST chest pain rule for coronary artery
disease (CAD)? (check one)
l A. Pain reproduced by palpating the chest wall.
l B. Age older than 50 years.
l C. Chest pain occurs at rest.
l D. Chest discomfort feels like pressure.
Practice Guidelines
Cholesterol Management:​ACC/AHA
Updates Guideline (p. 589)
Q12. According to the American College of Cardiology/Amer-
ican Heart Association (ACC/AHA) guideline, which of the fol-
lowing statements about statin therapy is correct? (check one)
l A. Patients with diabetes who have multiple ath-
erosclerotic cardiovascular disease risk factors
should be treated with high-intensity statin ther-
apy with a goal of reducing low-density lipopro-
tein cholesterol (LDL-C) levels by 50% or more.
l B. Patients 40 to 75 years without diabetes who are
at intermediate risk with LDL-C levels of 70 to 189
mg per dL should be treated with a high-intensity
statin to lower LDL-C levels by 50% or more.
l C. A nonfasting lipid measurement should be
repeated three to four weeks after starting a statin.
l D. LDL-C levels should initially be reduced with
moderate-intensity statin therapy in patients up to
75 years with atherosclerotic cardiovascular dis-
ease and a goal of lowering LDL-C levels by 30%.
Answers to this issue’s quiz are on the inside back cover.
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Answers to This Issue’s CME Quiz

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