AAPA members should complete and submit posttests on the AAPA Web site by going to www.aapa.org and searching for keyword JAAPA post-tests. All others may complete and submit posttests online at no charge at www.myCME.com. To obtain 1 hour of AAPA Category I CME credit, PAs must receive a score of 70% or better on each test taken.

CLOSTRIDIUM DIFFICILE

1. A 3-fold increased risk of Clostridium difficile infection (CDI) has been associated with the widespread use of

a. Cephalosporins
b. Macrolides
c. Fluoroquinolones
d. Sulfonamides

2. Rates of CDI are higher and outcomes are worse in patients with

a. Peptic ulcer disease
b. Inflammatory bowel disease
c. Celiac disease
d. Ulcerative colitis

3. A typical initial manifestation of CDI is

a. Marked abdominal distension
b. Vomiting
c. Dyspepsia
d. Watery diarrhea

4. Fulminant and pseudomembranous colitis is associated with rising levels of

a. Creatinine
b. Potassium
c. Calcium
d. Albumin

5. The gold standard for diagnosing CDI is

a. A PCR test
b. A cell culture cytotoxic assay
c. Stool culture and sensitivity testing
d. Small bowel biopsy

6. Because of its associated neurotoxicity, repeated recurrences of CDI should not be treated with

a. Vancomycin
b. Amoxicillin
c. Metronidazole
d. Clarithromycin

ISCHEMIC STROKE

7. A frequent cause of embolic stroke is

a. Atrial fibrillation
b. Atrial septal defect
c. Patent foramen ovale
d. Myocardial infarction

8. A National Institutes of Health Stroke Scale (NIHSS) score of 8 to 15 reflects

a. Mild impairment
b. Moderate impairment
c. Major impairment
d. Severe impairment

9. The combined IV bolus dose and 60-minute infusion of alteplase is

a. 0.3 mg/kg
b. 0.6 mg/kg
d. 0.9 mg/kg
d. 1.2 mg/kg

10. Patients excluded from the expanded use of alteplase (from 3 hours to 4.5 hours) are those

a.Older than 65 years
b. With an NIHSS score greater than 10
c. With metabolic syndrome
d. Taking oral anticoagulants

11. An advantage of intra-arterial (IA) rtPA is that it

a. Can be given at any trauma center
b. Can be used within 6 hours of symptom onset
c. Is not associated with an increased risk of intracerebral hemorrhage
d. Takes less time to administer

12. Which of the following is an advantage of a mechanical thrombectomy device?

a. Greater efficacy in opening large-vessel occlusions
b. Potentially less risk of causing hemorrhage
c. Longer time window for treatment
d. All of the above