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  Vol. 9 No. 3, March 2000 TABLE OF CONTENTS
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THE Archives of Familly Medicine Continuing Medical Education Program

Arch Fam Med. 2000;9:267-269.

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 March 2000

A Call for Active Listening (SEE ARTICLE)

Q1. Which of the following would be an example of active listening in a physician-patient relationship?
A. "Tell me more."
B. "What do you think may be causing your problem?"
C. "You said your baby was lethargic. Are you concerned your baby is very sick?"
D. "What else . . . ?"
E. "Do you have any vomiting, diarrhea, constipation, or bloody stools?"

Family Dinner and Diet Quality Among Children and Adolescents (SEE ARTICLE)

Q2. For school-age children and adolescents:
A. A higher proportion of energy and key nutrients is obtained with snacks than with any regular meal.
B. School health courses, rather than parents, provide the most information on diet.
C. Eating family meals is a daily occurrence in almost all American households.
D. The rate of eating family meals is similar for all age groups.
E. Higher rates of eating family meals were associated with higher intake of fruits and vegetables and several beneficial nutrients.

Fluoride and Bacterial Content in Both Bottled and Tap Water (SEE ARTICLE)

Q3. Concerning fluoridation of drinking water:
A. Most brands of bottled water do not contain much fluoride.
B. Bottled water is required to have labels indicating the amount of fluoride per serving.
C. Fluorosis is excess mineralization of the dental enamel.
D. Carbon and charcoal home-filtration products remove most fluoride.

Supplemental Insurance and Mortality in Elderly Americans (SEE ARTICLE)

Q4. For elderly Medicare beneficiaries:
A. Out-of-pocket expenses averaged about 5% of an elderly individual's income.
B. Out-of-pocket expenses have increased in recent years.
C. Out-of-pocket expenses are higher for elderly individuals from higher socioeconomic groups.
D. Higher out-of-pocket expenses are associated with lower levels of disability and mortality.
E. Recent withdrawals of health maintenance organizations from Medicare contracts make it easier for Medicare beneficiaries to obtain prescription drugs.

Vitamin and Mineral Supplement Use in the United States (SEE ARTICLE)

Q5. The US Public Health Service currently recommends folic acid supplementation for:
A. Women capable of becoming pregnant.
B. Women in the second or third trimester of pregnancy.
C. Men with a family history of heart disease.
D. Patients with anemia caused by chronic disease.
E. Patients who drink alcohol.

Pharmacotherapy of Smoking Cessation (SEE ARTICLE)

Q6. Within 1 year of quitting, former smokers reduce their risk of developing coronary heart disease by:
A. 100%.
B. 75%.
C. 50%.
D. 25%.
E. 10%.

Q7. Concerning patients successfully quitting smoking:
A. Brief physician advice has no effect.
B. Follow-up letters or telephone calls after counseling have no effect.
C. Nicotine replacement products with higher acute levels of nicotine, such as the gum and the inhaler, should not be used for patients with known stable heart disease.
D. At any specific time, most smokers state they would like to quit.
E. All nicotine replacement products are available without prescription.

An Unusual Cause of Postpartum Vomiting (SEE ARTICLE)

Q9. A patient with Addison disease is at increased risk for:
A. Chronic obstructive pulmonary disease.
B. Ehlers-Danlos syndrome.
C. Hypothyroidism.
D. Polycystic kidney disease.
E. Heart valve abnormalities.

Q10. In Addison disease, usual laboratory abnormalities include:
A. Normal baseline cortisollevel.
B. Corticotropin stimulation of cortisol.
C. Normal corticotropin level.
D. Elevated plasma renin level.
E. Normal electrolyte levels.

Avascular Necrosis (SEE ARTICLE)

Q11. Which of the following is the most sensitive and acceptable standard diagnostic method for avascular necrosis of the humeral head?
A. Physical examination.
B. Plain film radiographs.
C. Computed tomographic scan.
D. Bone scan.
E. Magnetic resonance imaging.

Q12. The most common risk factor for avascular necrosis of the humeral head is:
A. Chemotherapy.
B. Gaucher disease.
C. Corticosteroid therapy.
D. Sickle cell disease.
E. Trauma.

© 2000 American Medical Association. All Rights Reserved.