Continuing Medical Education

After evaluating an article designated for Continuing Medical Education (CME) in the American Journal of Clinical Nutrition (AJCN), participants in the American Society for Nutrition (ASN) CME program should be able to show that their knowledge of clinical nutrition has increased. Participants should also be able to evaluate whether the clinical information provided in the CME-designated article is relevant to the provision of patient care.

Accreditation and credits

The ASN is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The ASN designates each CME program for 1 hour of category 1 credit toward the American Medical Association (AMA) Physician’s Recognition Award. Each physician should claim only those hours of credit that he or she actually spent on the education program.

Instructions

Each issue of the AJCN will usually include at least 2 articles designated for CME credit. After reading the CME-designated article, select the best answer to each exam question listed below and complete the evaluation. To receive CME credit, you should return the exam and evaluation pages along with the CME Participant Response Form by March 31, 2007. Please fax the pages to the ASN at 301-634-7351 or mail them to the following address: American Society for Nutrition, CME Program, 9650 Rockville Pike, Bethesda, MD 20814. Note that all responses must be prepaid. Answers to the questions will be mailed to all participants, and certificates of credit will be sent to participants who successfully complete each exam. Please be sure to make a photocopy of the exam for your records before submitting it to the ASN.

Article: Morley JE, Thomas DR, Wilson M-MG. Cachexia: pathophysiology and clinical relevance. Am J Clin Nutr 2006;83:735–43.

One hour of category 1 credit will be issued for successful completion of this entire exam.

CME exam

1. Which of the following statements best describes cachexia and its causes?

1. Voluntary restriction of food intake resulting in generalized weight loss.
   
2. Weight loss associated with chronic disease and disproportionate muscle wasting.
   
3. Postoperative catabolism resulting from hormonal imbalance.
   
4. All of the above.
   

2. Which of the following statements is true regarding mediators of cachexia?

1. Cachexia is an inflammatory state associated with increased circulating concentrations of cytokines, particularly tumor necrosis factor , which enhance muscle proteolysis.
   
2. Low concentrations of testosterone and insulin-like growth factor reduce appetite.
   
3. Low blood concentrations of testosterone and glucocorticoids are associated with increased metabolic rate.
   
4. None of the above.
   

3. Which of the following statements best describes disease-associated cachexia?

1. Only cancer and chronic infectious diseases are associated with cachexia.
   
2. Elevated cachexia cytokines are implicated in weight loss associated with congestive heart failure, renal failure, and chronic obstructive pulmonary disease.
   
3. Cachexia of chronic disease is usually caused by depression and inadequate dietary intake.
   
4. Elevated circulating concentrations of the appetite-suppressant hormone leptin are found in most chronic diseases associated with cachexia.
   

4. Which of the following statements best describes effective approaches for the treatment of cachexia?

1. Aggressive nutritional support by tube feeding or total parenteral nutrition.
   
2. Agents that block leptin and enhance ghrelin concentrations in the blood.
   
3. Cachexia can only be treated by eradication of the underlying disease.
   
4. Appetite-enhancing drugs such as megestrol acetate together with cytokine inhibitors.
   

CME exam evaluation

1. Were the CME program objectives successfully met?

1. Yes
   
2. No
   
3. Partially (please explain)
   

2. Did you find this article and its CME questions relevant to your practice?

1. Yes
   
2. No
   
3. Partially (please explain)
   

3. Will completion of this CME exam affect the way that you treat your patients?

1. Yes
   
2. No (please explain)
   

4. Was the information presented in this article objective, balanced, and free of commercial bias?

1. Yes
   
2. No
   

Comments

Related articles in AJCN:

Cachexia: pathophysiology and clinical relevance

John E Morley, David R Thomas, and Margaret-Mary G Wilson
AJCN 2006 83: 735-743. [Full Text]