CME TEST QUESTIONS: FEBRUARY 2015
Examination available at http://learn.sirweb.org/. To take the online JVIR CME tests, please log into the SIR Learning Center with your SIR user name and password. Nonmembers: If you do not already have an SIR username and password, please click on “Create an Account” to gain access to the SIR Learning Center. Once in the Learning Center, click on the “Publication” activity type for a listing of all available JVIR CME Tests. Each test will be available online for 3 years from the month/date of publication. The CME questions in the February 2015 issue are derived from the article “Feasibility and Safety of Prophylactic Uterine Artery Catheterization and Embolization in the Management of Placenta Accreta” by Izbizky et al. 1. Placenta accreta (PA) is histopathologically defined as a. Invasion of the placental tissue into the myometrium, but not through it b. Invasion of the placental tissue through the entire myometrium c. Implantation of chorionic villi on the myometrium without an intervening deciduas basalis d. Invasion of the placental tissue specifically on the anterior wall after a cesarean section 2. According to the authors, management of PA requires a multidisciplinary approach, including a. Prenatal magnetic resonance imaging (MRI), counseling, scheduled delivery at approximately 36 weeks of gestation, coordinated perioperative management including bilateral uterine artery catheterization, surgical delivery of the fetus, and possible hysterectomy following uterine artery embolization (UAE) for confirmed PA b. Prenatal MRI, counseling, scheduled delivery at approximately 24 weeks of gestation, coordinated perioperative management including bilateral uterine artery catheterization, surgical delivery of the fetus, and possible hysterectomy following UAE for confirmed PA c. Prenatal MRI, counseling, scheduled delivery at approximately 36 weeks of gestation, and coordinated perioperative management including bilateral UAE in all patients prior to delivery
d. Prenatal MRI, counseling, and natural delivery at full-term following bilateral UAE 3. Based on the results of this study, prenatal imaging (ultrasound and MRI) can accurately diagnose the presence of PA in a. 100% of the cases b. 4 75% of the cases c. 4 50% of the cases d. 4 30% of the cases 4. Despite a multidisciplinary approach, scheduled delivery (nonemergent), and a technically successful UAE, what percentage of patients in the nonemergent group required a blood transfusion in this study? a. 4 90% b. 75% c. 60%–70% d. 40%–50% 5. According to the authors, although technically successful UAE did not completely eliminate the requirement of blood transfusion in this study, it did diminish a. The need for hysterectomy b. The number of units transfused to a mean of 1.4 units, with massive blood transfusion in o15% of patients c. Fetal mortality d. Maternal mortality