CME Questionaire

of the Kuwait Institute for Medical Specializationj

A Peer-reviewed Journal

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CME Questions - Volume 3; Number 2: 2004

Readers who submit answers to the questions that accompany the CME/CPD articles become eligible for CME/CPD credits in Category 1. To claim credit, the reader has to be registered in the MPC Program, the answers should be received by the CME Center before 31st December 2005, and all questions related to the article should have been attempted. Readers would then receive a certificate from the CME Center indicating the credit data.

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After you have completed reading the CME/CPD articles, take the test given. Check T (True) or F (False) to show the correct answer to each question.

Rheumatic diseases: knowledge update on scintigraphic assessment
D Shehab, A Elgazzar
(1 CME credit point)

1.	Tc99m polyclonal human immunoglobulin-G can be used to depict active inflammation in rheumatoid arthritis.	True False
2.	Tc99m-anti-E-selectin-Fab scintigraphy can be used successfully to image synovitis in rheumatoid arthritis patients.	True False
3.	Gouty arthritis is rare in children and premenopausal females and uncommon in males under 30 years of age.	True False
4.	In children, infectious (septic) arthritis is usually secondary to hematogenous seeding but can also be produced by direct extension of adjacent osteomyelitis.	True False
5.	The hip and knee joints are rarely affected in infectious arthritis in children.	True False
6.	Permanent loss of joint function occurs in up to 5% of patients with infectious arthritis.	True False
7.	There is no gold standard for the assessment of sinovitis activity.	True False
8.	Primary osteoarthritis is the most common type of non-inflammatory joint diseases.	True False
9.	There is no association between ankylosing spondylitis and HLA -B 27.	True False
10.	Trauma and repetitive physical rotation are common predisposing factors for soft-tissue inflammation.	True False

Pharmacotherapy of systolic heart failure
M Ridha, M Zubaid
(1 CME credit point)

11.	The New York Heart Association (NYHA) classification in heart failure is based on the relation between symptoms and the radiographic finding in heart failure patients.	True False
12.	Coronary angiography is indicated in all patients presenting with acute pulmonary edema.	True False
13.	Jugular venous pressure is always a reliable indicator of intravascular volume status in patients with cardiogenic shock.	True False
14.	An appropriate indication for intra-aortic balloon counterpulsation is cardiogenic shock refractory to proper medical therapy in patients with potentially reversible heart failure.	True False
15.	Intra-aortic balloon counterpulsation bump can be safely inserted in a patient with cardiogenic shock and history of aorto-bifemoral bypass grafts.	True False
16.	All patients with systolic heart failure should be placed on diuretic therapy.	True False
17.	Beta-blockers are contraindicated in patients with chronic heart failure.	True False
18.	Angiotensin receptor blockers (ARB) are superior to angiotensin converting enzyme inhibitors (ACEI) in patients with systolic heart failure.	True False
19.	ACEI are beneficial in patients with reduced left ventricular systolic function even if asymptomatic.	True False
20.	Cardiac resynchronization therapy is an acceptable treatment modality in patients with mild heart failure (NYHA class I/II).	True False

A patient with musculoskeletal (MSK) pains - clinical approach
AN Malaviya
(1 CME credit point)

21.	A clinical history of significant early morning stiffness is a feature that is specific for chronic inflammatory polyarthritis.	True False
22	The presence of joint deformity distinguishes chronic inflammatory from non-inflammatory categories of arthritis.	True False
23.	A positive test for rheumatoid factor in laboratory investigations in an adult patient with joint symptoms helps distinguish chronic inflammatory from non-inflammatory categories of arthritis.	True False
24.	Trauma that causes bleeding in the joints is a recognized etiological factor in the inflammation of joints.	True False
25.	X-ray of the affected joint usually establishes the diagnosis of acute inflammatory monoarthritis.	True False
26.	The most likely diagnosis of acute inflammatory monoarthritis in a male of over 40 years of age is crystal deposition arthritis (e.g. gout).	True False
27.	Refecoxib is an effective disease modifying agent (DMARD) for inflammatory polyarthritis.	True False
28.	Joint aspiration and examination of the joint fluid for infection, white cell count and crystals is mandatory immediate diagnostic investigation in acute inflammatory monoarthritis.	True False
29.	Inflammatory polyarthritis is classified as chronic if it is of 4 to 5 weeks’ duration.	True False
30.	Methotrexate is among the main DMARDs used for treating inflammatory polyarthritis.	True False

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