Book Reviews -- TPJ Fall 2007

Site Index

••Fall 2007/Vol. 11, No. 4

CME Evaluation Form --
Complete this form and submit it to earn CME credits online.

Physicians may earn up to 4 AMA PRA Category 1 credits for reading and analyzing the four designated articles. Other clinicians for whom CME is acceptable in meeting educational requirements may report up to four hours of attendance.
Select the most appropriate answer to the questions below, and complete the evaluation form. You must complete all sections to receive credit. (Acknowledgement will be mailed within two months after receipt of form.)
The Kaiser Permanente National Continuing Medical Education Program (KPNCMEP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The KPNCMEP designates this educational activity for 4 AMA PRA Category 1 credits. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. All authors in this issue report no conflict of interest.

The Permanente Journal has been reviewed and is acceptable for up to 8 Prescribed credits by the American Academy of Family Physicians. AAFP accreditation begins 01/01/07. Term of approval is for one year from this date. This issue is approved for 2 Prescribed credits. Credit may be claimed for one year from the date of this issue.

The Permanente Journal - Vol. 11, No. 4 - Fall 07

Article 1. A Multidisciplinary Approach to Transition Care: A Patient Safety Innovation Study

In the review of the medication reconciliation records after discharge from a skilled nursing facility what percentage contained at least one drug-related problem?

a. 25%

b. 45%

c. 50%

d. 75%

e. >90%

Which of the following was NOT one of the four factors associated with improved outcomes after discharge?

a. follow-up in primary care within 24 hours

b. assistance with medication self management

c. a patient-centered record owned and maintained by the patient to facilitate information transfer

d. timely follow-up with primary or specialty care

e. a list of red flags indicative of condition worsening

Article 2. Fetal Heart Rate Pattern Notification Guidelines and Suggested Management Algorithm for Intrapartum Electronic Fetal Heart Rate Monitoring

Which fetal heart rate pattern is significantly associated with fetal acidemia?

a. tachycardia with moderate variability

b. repetitive late decelerations with moderate variability

c. repetitive variable decelerations with moderate variability

d. marked variability

e. minimal variability

This article encourages all of the following except:

a. SBAR

b. NICHD terminology

c. collaborative practice

d. independent MD management

e. RN diagnosis

Article 3. The Argument for Use of Epidural Steroid Injections in Management of Acute Radicular Pain

A man, age 37 years, presents with a six-week history of low back pain radiating to the right foot. He reports a pins-and-needles-like sensation extending to the sole of the right foot and a dragging sensation of his right foot with walking. MRI of the lumbosacral spine reveals a right L5/S1 disc herniation causing impingement on the right S1 nerve root. Despite treatment with ibuprofen 600 mg orally three times daily and cyclobezaprine 10 mg orally three times daily, he has ongoing pain. Which statement best summarizes the role for epidural injection of steroids for treating his ongoing pain? Use of epidural steroid injections will:

a. reduce the likelihood that he will need surgical discectomy

b. hasten resolution of his pain

c. hasten resolution of his weakness

d. hasten resolution of his numbness

e. reduce the likelihood that he will have a recurrent disc herniation

Epidural injection of steroids is most beneficial for the treatment of which of the following conditions?

a. neurogenic claudication associated with lumbar spinal stenosis

b. chronic low back pain associated with failed back surgery syndrome

c. chronic low back pain associated with lumbar degenerative disc disease

d. acute lumbar radicular pain associated with lumbar intervertebral disc herniation

e. chronic lumbar radicular pain associated with chronic radiculopathy

Article 4. Anal Fissure: A Common Cause of Anal Pain

The most common cause of anal pain is:

a. cancer

b. crohn’s disease

c. herpes

d. fissure

e. hemorrhoids

Treatment for anal fissure includes all the following except:

a. fiber supplementation

b. diltiazem 2% ointment

c. xylocaine 2% gel

d. lateral internal sphincterotomy

e. hemorrhoidectomy

Objectives

1) to inculcate the use of evidence based medicine as part of the science of medicine.

2) to stress the art of medicine via enhanced patient physician communication, improved care experience for patients, and more satisfying care giving experience for physicians and staff through better teamwork.

3) to review appropriate updates on the diagnosis and treatment of clinical conditions.

4) to describe infrastructure and systems improvements that lead to improvements in outcomes and patient care experiences.

Referring to the CME articles and the stated objectives,
please choose your level of agreement next to each statement as appropriate

The article covered the stated objectives I learned something new that was important I plan to use this information as appropriate I plan to seek more information on this topic I understood what the author was trying to The article covered the statedsay

Article 1

Article 2

Article 3

Article 4

What change(s) (if any) do you plan to make in your practice as a result of reading these articles?

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Title:*
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