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  Vol. 8 No. 4, July 1999 TABLE OF CONTENTS
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The Archives of Family Medicine Continuing Medical Education Program

Arch Fam Med. 1999;8:291-293.

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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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.


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/August 1999

Over-the-Counter Medications (SEE ARTICLE)

Q1. Which of the following is not a criteria for Food and Drug Administration approval of a drug as available over the counter?

A. The condition the drug treats must be common.
B.The condition the drug treats must be benign.
C. The condition the drug treats must be self-diagnosable by the average consumer.
D. The drug must be cost-effective as compared with other alternatives.
E. The drug must be capable of effective use without the supervision of a licensed practitioner.

Q2. The most hazardous disadvantage for the availability of over-the-counter products for fungal vaginitis is:

A. The overall increase in health care costs.
B. The potential for delay in proper diagnosis and treatment of other types of vaginitis.
C. The decrease in the number of fungal vaginitis cases treated.
D. The shift in cost to the consumer from the insurance company.
E. The potential increase in the rates of resistant fungi.

Domestic Violence and Primary Care (SEE ARTICLE)

Q3. Concerning domestic violence, clinicians generally:

A. Overestimate the rate of occurrence of domestic violence in their individual practices.
B. Are more confident asking about domestic violence than about alcohol use.
C. Sometimes feel personally at risk when discussing domestic violence.
D. Feel confident in their ability to help victims of violence.
E. Have readily available information on the management of domestic violence.

Preparticipation Sports Examination (SEE ARTICLE)

Q4. Concerning the preparticipation sports examination:

A. Athletes often believe they can safely participate in athletics without undergoing a preparticipation examination.
B. Athletes are usually willing to pay a customary fee for a preparticipation examination.
C. Most athletes will have no other nonemergency contact with a physician within a year.
D. Most athletes are uncomfortable with physicians asking questions about non–sports-related items during the preparticipation examination.

Long-term Outcomes of Antidepressant Drug Choice (SEE ARTICLE)

Q5. As compared with depressed patients treated with desipramine or imipramine, depressed patients treated with fluoxetine:

A. Are more likely to continue any antidepressant.
B. Are more likely to switch to another antidepressant.
C. Have higher costs for antidepressant medication.
D. Have higher total medical costs.
E. Have better outcomes.

Treatment for Premenstrual Dysphoric Disorder (SEE ARTICLE)

Q6. In using sertraline in the late luteal phase for premenstrual dysphoric disorder:

A. The most common adverse effect is orgasmic dysfunction.
B. 50 mg and 100 mg work equally well for almost all patients.
C. Physical scores are not improved.
D. Behavioral scores are improved.

Prostate Cancer Screening (SEE ARTICLE)

Q7. Concerning male patients (age 45-70 years) and prostate cancer screening:

A. Most male patients have substantial knowledge of prostate cancer screening.
B. Videotaped instruction was no better than a routine physician office visit in increasing patient knowledge of prostate-specific antigen testing.
C. More than half of male patients desire a prostate-specific antigen test after extensive training on the advantages and disadvantages.
D. Extensive training on the advantages and disadvantages of prostate-specific antigen testing does not influence the percentage of men desiring the testing.

E. Few patients would recommend that other men review the videotape on prostate-specific antigen testing.

Alzheimer Disease (SEE ARTICLE)

Q8. Slowing of speech and comprehension, loss of train of thought in midsentence, forgetting to pay bills, getting lost while traveling, and awareness of loss of control is considered which stage of Alzheimer disease?

A. Stage 1.
B. Stage 2.
C. Stage 3.
D. Stage 4.

E. Stage 5.

Q9. Which of the following has been associated with delayed onset of Alzheimer disease?

A. Estrogen replacement therapy.
B. Calcium channel blockers.
C. Ipratropium.
D. Nitrates.
E. Vitamin D.

Health Care Plan Decisions Regarding Preventive Services (SEE ARTICLE)

Q10. Health maintenance organizations:

A. Routinely follow the US Preventive Services Task Force recommendations for prevention.
B. Routinely send reminder cards to patients to get the several prevention tests they recommend.
C. Often are in the forefront of recommending new preventive screening tests.
D. Rarely recommend abdominal aortic ultrasounds to screen for abdominal aortic aneurysms.
E. Consider evidence the most important factor in determining which new preventive rests to recommend.

© 1999 American Medical Association. All Rights Reserved.