CME Information, Posttest, and Evaluation

Information

To receive an acknowledgment of participation for this CME activity, please complete this CME posttest and evaluation summary, then click the <SUBMIT> button below or click the <PRINT> button and fax to (201) 617-7333 or mail to Projects In Knowledge. Please provide the following information to ensure receipt of your CME acknowledgment:

CME Posttest

Release date: July 7, 1998

Documentation of Participation for CME

To receive documentation of your participation for CME credit complete the following steps:

1. View the online presentations and review the transcripts.
2. Complete this posttest, selecting the single best answer to each question.
3. Complete the evaluation form that follows the posttest.
4. Submit the form electronically by pressing the <SUBMIT> button, or click the <PRINT> button and fax to (201) 617-7333 or mail your posttest and evaluation forms to Projects In Knowledge.

Projects In Knowledge will mail an acknowledgment of your participation in this activity. Please note: You must score 70% or better on the posttest. If you score lower than 70%, you will be given another chance to take the posttest.

Question 1 - True or False

A 6-month course of interferon/ribavirin reduces relapse rates even more than does a 12- to 18-month course of interferon monotherapy in treatment-naive patients.

True
False

Question 2 - Single Best Answer

Ribavirin monotherapy:

Lowers ALT levels temporarily and has no effect on HCV RNA levels
Produces a sustained decrease in ALT levels, but only transitory decreases in HCV RNA
Has no effect on ALT levels, but produces a temporary decrease in HCV RNA levels
Reduces both ALT and HCV RNA levels, but the decreases are not sustained
Produces sustained decreases in both ALT and HCV RNA levels, but in fewer patients than interferon/ribavirin

Question 3 - True or False

In a 1998 study by Reichard, interferon/ribavirin produced a greater response rate than interferon in treatment-naive patients with viral genotypes 2 or 3, but not genotype 1.

True
False

Question 4 - Single Best Answer

Side effects of combination therapy are similar to those of interferon alone with the addition of an increased risk of:

Retinal hemorrhage and headache
Hemolytic anemia and teratogenesis
Sexual dysfunction
Arthralgias and myalgias
All of the above

Question 5 - True or False

According to a study by Davis, in patients who relapse after treatment with interferon, 6 months of interferon/ribavirin results in high initial and sustained ALT, HCV RNA, and histologic responses compared with retreatment with interferon monotherapy.

True
False

Question 6 - Single Best Answer

Which of the following is false regarding HCV and liver transplantation?

A second transplantation is needed in 5% to 15% of HCV-infected liver transplant recipients
The cost of a second transplant generally is double the cost of the first
Short-course interferon monotherapy after liver transplantation produces a good rate of sustained virologic response
Short courses of combination interferon/ribavirin reduced HCV RNA levels, serum ALT levels, and hepatic inflammation/fibrosis following liver transplantation in early studies

Question 7 - Single Best Answer

Investigations by Lam in patients who respond to therapy showed that following a single 3 MU dose of interferon:

HCV RNA levels decline within 24 hours, and this decline is generally sustained as long as interferon is administered at least three times per week
HCV RNA levels decline within 24 hours but begin to rise again within 48 hours
The initial decline in HCV RNA levels is confirmed to be as great as with higher doses
None of the above

Question 8 - Single Best Answer

Investigational dosing regimens described in this CME activity include all of the following except:

Daily administration with high doses (5 or 10 MU) of interferon for 4 to 12 weeks followed by less intense therapy
Long-term suppressive therapy with interferon
Once-weekly administration of PEGylated interferon
Sequential therapy with ribavirin for 6 weeks followed by interferon for 6 months

Question 9 - True or False

Recent evidence suggests that patients who are treated with interferon who do not have a sustained response nonetheless experience an improvement in liver histology with a decrease in hepatic necroinflammation with long-term therapy.

True
False

Question 10 - Single Best Answer

Which of the following specific antiviral or molecular therapies is currently being explored for the treatment of HCV?

Therapies targeted to the internal ribosomal entry site
Therapies targeted to the RNA-dependent RNA polymerase
Antisense oligonucleotides
Ribozymes
All of the above

Evaluation

a. Formulate state-of-the-art treatment strategies for patients with chronic hepatitis C virus (HCV) infection and recognize how thinking regarding these patients has changed over the past year

b. Compare the safety and efficacy of combination therapy (interferon/ribavirin) to interferon monotherapy in HCV-infected patients who have experienced a relapse after response to interferon alone

c. Evaluate the possible role of combination therapy in the following HCV-infected patient groups: treatment-naive patients, patients who fail to respond to interferon monotherapy, and posttransplant patients

d. Describe the possible role of interferon therapy to prevent the development of cirrhosis and hepatocellular carcinoma in HCV-infected patients

e. Adjust doses, dosing frequencies, and duration of treatment to optimize a patient's sustained response to control chronic HCV infection

f. Describe the scientific basis for new developments in antiviral agents in the management of hepatitis C

Knowledge and expertise
(a)

Teaching skill
(b)

Relevance of content to objectives
(c)

Overall quality of teaching
(d)

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a. I will apply the knowledge/skills I learned

b. Course fulfilled the description in the brochure

c. Written materials were valuable

d. Course format enhanced achievement of learning objectives

e. Course was free from commercial bias

a. Written syllabus materials

b. Didactic lecture

c. Examples/case studies

d. Videotaped demonstrations

e. Small group discussions/round tables

a. Audioconference

b. Videoconference

c. Enduring materials (audiocassettes, videotapes, monographs)

d. Internet (online discussions with experts, online educational activities)

e. Multimedia (online, CD-ROM)

As part of our ongoing continuous quality-improvement effort, we conduct postactivity follow-up surveys to assess the impact of our CME courses on professional practice. Please indicate your willingness to participate in such a survey:

Yes, I would be interested in participating in a follow-up survey.

No, I'm not interested in participating in a follow-up survey.

Thank you for your participation.

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