JAAPA CME Post-Test September 2019

Managing Gestational Diabetes
Gestational diabetes is diabetes diagnosed in the second or third trimester of pregnancy in a patient who was not diagnosed with diabetes before pregnancy. Timely identification and management of gestational diabetes is important to prevent fetal, infant, and maternal complications. Physical activity and dietary changes remain the hallmark of treatment, with insulin becoming the medication of choice if further intervention is needed. This activity reviews the steps clinicians can take to screen for patients with gestational diabetes, recommendations for future type 2 diabetes screening, and how to manage gestational diabetes during the course of a patient’s pregnancy based on the American Diabetes Association’s current standards of care.
HPV-Associated Oropharyngeal Cancer
Exposure of the oral cavity and oropharynx to human papillomavirus (HPV) often results in an asymptomatic, transient oral infection that is cleared by the body’s immune system; however, a small percentage of these oral infections can persist in a dormant state. Depending on the HPV genotype, a persistent oral infection may lead to benign or malignant disease. High-risk HPV types 16 and 18, which cause most cervical and anal cancers, also are the cause of the rising rate of oropharyngeal squamous cell carcinoma (SCC) in the United States. This activity focuses on the epidemiology, transmission, risk factors, and clinical presentation of HPV-associated oropharyngeal SCC, and provides an update on HPV vaccination in the context of the new head and neck cancer epidemic.

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