CME Quiz

AAFP members and other physicians and health care professionals who
receive the print version of AFP in their own name can submit responses for
CME credit at https://www.aafp.org/afpquiz. Quiz questions are featured below
for your convenience. This issue is approved for up to 6 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.

Articles Intrapartum Fetal Monitoring (p. 158)

Neck Pain:​Initial Evaluation Q4. Continuous electronic fetal monitoring has become
and Management (p. 150) standard practice for most patients in labor. Which one of
Q1. Which one of the following physical examination the following outcomes has resulted from using continu-
findings is consistent with myelopathy? (check one) ous electronic fetal monitoring? (check one)
l A. Positive upper limb tension test. l A. Statistical decrease in fetal death.
l B. Increased muscle tone and fasciculations. l B. Reduction in operative vaginal delivery rates.
l C. Absent Babinski reflex. l C. Increase in cesarean delivery rates.
l D. Absent Hoffmann sign. l D. Increase in neonatal seizures.

Q2. Which one of the following statements about imag-
ing in patients with neck pain is correct? (check one)
l A. Radiography should be ordered for every patient
with neck pain.
l B. Computed tomography is recommended for
patients with progressive neurologic symptoms.
l C. The use of validated clinical tools, such as the
Canadian C-Spine Rule, can help guide imaging
decisions.
l D. Magnetic resonance imaging rarely detects
abnormalities in the cervical spine of asymptom-
atic patients.
Q3. Which one of the following statements about the
treatment of mechanical neck pain is correct? (check
one)
l A. There is no evidence supporting the use of
acupuncture.
l B. Up to 90% of patients will have significant pain
relief in four weeks regardless of treatment.
l C. Strong evidence supports early administration of
oral steroids to speed recovery.
l D. Narcotics can provide long-term benefits.
Q5. Structured intermittent auscultation is considered an
appropriate alternative for certain patients in labor. Which
one of the following statements about structured inter-
mittent auscultation is correct? (check one)
l A. It increases cesarean delivery rates.
l B. It decreases operative vaginal delivery rates.
l C. It should be considered for high-risk labor.
l D. It increases the chance of switching to continu-
ous electronic fetal monitoring for the duration
of labor.
Q6. Which one of the following findings on a Category II
tracing requires immediate intervention during labor?
(check one)
l A. Provoked accelerations.
l B. Moderate variability.
l C. Mild variable decelerations.
l D. Recurrent deep decelerations.
Acute Pyelonephritis in Adults:​
Rapid Evidence Review (p. 173)
Q7. Which one of the following oral antibiotics is an
appropriate choice for outpatient treatment of acute
pyelonephritis when an additional parenteral agent is not
indicated? (check one)
l A. Nitrofurantoin.
l B. Fosfomycin (Monurol).
l C. Trimethoprim/sulfamethoxazole.
l D. Ceftriaxone (Rocephin).

Downloaded
August from
1, 2020 the American
◆ Volume 102, Family
NumberPhysician
3 website at www.aafp.org/afp.  © 2020 American Academy of Family
Copyright
www.aafp.org/afp American Family
Physicians. ForPhysician 143
the private, non-
commercial use of one individual user of the website. All other rights reserved. Contact copyrights@aafp.org for copyright questions and/or permission requests.
Downloaded for Ahmed Hemaid (aihmaid@seha.ae) at Abu Dhabi Health Services Co from ClinicalKey.com by Elsevier on
September 16, 2022. For personal use only. No other uses without permission. Copyright ©2022. Elsevier Inc. All rights reserved.
 CME QUIZ

Q8. Which one of the following tests is not appropriate Smoking Cessation with Text Messaging
for the initial evaluation of uncomplicated acute pyelone- and App-Based Interventions (p. 148)
phritis? (check one)
Q11. A patient asks for your help to quit smoking. You
l A. Computed tomography of the abdomen and think text messaging and app-based (i.e., smartphone)
pelvis. interventions may be appropriate for this patient. Which
l B. Complete blood count. one of the following statements about these types of
l C. Basic metabolic panel. smoking cessation interventions is correct? (check one)
l D. Urine culture. l A. Smartphone interventions increase quit rates vs.
minimal smoking cessation support.
Q9. Which one of the following antibiotics has evidence l B. In combination with other smoking cessation
of safety in utero when treating pregnant patients with interventions, smartphone interventions improve
acute pyelonephritis? (check one) quit rates vs. other smoking cessation interven-
l A. Imipenem/cilastatin.
tions alone.
l C. Smartphone interventions have not been shown
l B. Trimethoprim/sulfamethoxazole.
to work better than lower intensity, non–
l C. Plazomicin (Zemdri). app-supported smoking cessation interventions,
l D. Ceftriaxone. such as printed educational materials.
l D. All of the above.

Cochrane for Clinicians

Heavy Menstrual Bleeding in Premenopausal Practice Guidelines
Patients and the Role of NSAIDs (p. 147) VTE in Patients with Cancer:​
Q10. Your 29-year-old patient reports symptoms of Guidelines from the American Society
menorrhagia without dysmenorrhea. Which one of the of Clinical Oncology (p. 188)
following statements about the treatment of this patient is Q12. A 57-year-old woman who recently completed
correct? (check one) chemotherapy for breast cancer is diagnosed with a pul-
l A. Nonsteroidal anti-inflammatory drugs (NSAIDs) monary embolism. According to the American Society of
have been shown to decrease the number of Clinical Oncology, what is the minimum recommended
patients who report heavy bleeding. duration of anticoagulation therapy? (check one)
l B. NSAIDs are more effective at reducing heavy l A. 45 days.
menstrual bleeding than tranexamic acid (Cyklo- l B. Three months.
l C. Six months.
kapron) and the levonorgestrel-releasing intra-
uterine system (Mirena).
l C. Guidelines from the National Institute for Health l D. Indefinitely.
and Care Excellence suggest that NSAIDs be
considered first-line therapy for heavy menstrual
bleeding.
l D. All of the above.

Answers to this issue’s quiz are on the inside back cover.

144 American Family Physician www.aafp.org/afp Volume 102, Number 3 ◆ August 1, 2020

Downloaded for Ahmed Hemaid (aihmaid@seha.ae) at Abu Dhabi Health Services Co from ClinicalKey.com by Elsevier on
September 16, 2022. For personal use only. No other uses without permission. Copyright ©2022. Elsevier Inc. All rights reserved.
 Advertiser Index
AAFP . . . . . . . . . . . . . . . . . . . . . . . 135*, 157*, 168*, 170*, 172, 183* FPM Subscription/AAFP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146

AAFP, ABFM, ADFM, AFMRD, Nexplanon/MERCK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2nd Cover

CFPC, NAPCRG, STFM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139*
Quillivant XR/QuilliChew ER/
AAFP CME/AAFP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3rd Cover Dyanavel/TRIS PHARMA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168*

AFP Podcast/AAFP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141

*DOES NOT APPEAR IN ALL COPIES.

ASTRAZENECA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183*

BAYER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157*
Answers to This Issue’s CME Quiz
Bayer Aspirin/BAYER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139* Q1:​ B Q4:​ C Q7:​ C Q10:​ A
Q2:​ C Q5:​ B Q8:​ A Q11:​ D
Cologuard/EXACT SCIENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135*
Q3:​ B Q6:​ D Q9:​ D Q12:​ C
FMX Virtual/AAFP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4th Cover

Choose the best. AAFP

CME
Choose AAFP CME.
Meet your CME needs with the AAFP’s expansive collection
of educational offerings featuring evidence-based education
in formats that fit your individual learning style. Key learnings
are easy to apply—improving both patient care and outcomes.

Learn, Apply, Improve with AAFP CME

Date xx, xxxx ◆ Volume xx, Number xx www.aafp.org/afp aafp.org/2020-cme American
• (800) Family274-2237
Physician C3

Downloaded for Ahmed Hemaid (aihmaid@seha.ae) at Abu Dhabi Health Services Co from ClinicalKey.com by Elsevier on
September 16, 2022. For personal use only. No other uses without permission. Copyright ©2022. Elsevier Inc. All rights reserved.