Patient Management Problem—Preferred Responses

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Following are the preferred responses for the Patient Management Problem in this Continuum issue. The case, questions, and answer options are repeated, and the preferred response is given, followed by an explanation and a reference with which you may seek more specific information. You are encouraged to review the responses and explanations carefully to evaluate your general understanding of the material. The comment and references included with each question are intended to encourage independent study.
To obtain CME credits for this activity, subscribers must complete this Patient Management Problem online at
US Participants: Upon completion of the Patient Management Problem, US participants may earn up to 2 AMA PRA Category 1 Credits™. US participants have up to 3 years from the date of publication to earn CME credits. No CME will be awarded for this issue after August 31, 2020.
Canadian Participants: This program is an Accredited Self-Assessment Program (Section 3) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada and approved by the Office of Continuing Medical Education and Professional Development, University of Calgary, on April 1, 2017. Refer to the CME tab on for dates of accreditation. Canadian participants should visit MAINPORT ( to record learning and outcomes. Canadian participants can claim a maximum of 2 hours (credits are automatically calculated).
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