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 May 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: Puukka K, Hietala J, Koivisto H, Anttila P, Bloigu R, Niemelä O. Additive effects of moderate drinking and obesity on serum -glutamyl transferase activity. Am J Clin Nutr 2006;83:1351–4.

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 defines serum -glutamyl transferase (GGT)?
   1. A liver enzyme that is induced by ethanol and participates in its metabolism.
      
   2. A liver enzyme that is increased during alcoholism or obesity-related oxidative stress.
      
   3. A liver enzyme that is released from necrotic liver cells.
      
   4. A liver enzyme that accurately predicts the severity of alcoholic liver disease.
      
   
   
2. Which of the following statements is true regarding the elevation of serum GGT in an obese person?
   1. The increase in serum GGT is proportional to the increase in body mass index.
      
   2. An increase in serum GGT implies that the obese person is also actively drinking alcohol.
      
   3. Women are more likely to have higher GGT concentrations than are men.
      
   4. An increase in serum GGT is predictive of nonalcoholic steatohepatitis.
      
   
   
3. A reasonable conclusion from the observation that GGT is increased in an additive fashion by both the daily amount of alcohol consumed and the severity of obesity is that
   1. Both alcohol consumption and increased obesity promote identical mechanisms of liver damage.
      
   2. Obese persons are at an increased risk of liver disease induced by alcohol consumption.
      
   3. GGT elevation is a reliable marker of cytochrome P450 metabolism of toxic substances.
      
   4. Similar to liver disease associated with obesity, alcoholic liver disease is characterized by fat accumulation in the liver.
      
   
   

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 (please explain)
      
   2. No
      
   
   
4. Was the information presented in this article objective, balanced, and free of commercial bias?
   1. Yes
      
   2. No
      
   
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