JAAPA CME Post-Test July 2020

Seeking a Balanced Approach to Implementing Sepsis Guidelines
Sepsis, a life-threatening condition caused by an imbalanced response to infection, is a common diagnostic and therapeutic consideration for clinicians in acute care setting. The Surviving Sepsis Campaign (SSC) guidelines have increased awareness of sepsis and reduced mortality over the past 20 years. The Centers for Medicaid and Medicare Services created the SEP-1 core measure to ease and encourage implementation of the sepsis guidelines through financial incentives to hospitals. Still, the lack of clarity in sepsis diagnosis remains a concern. Many hospitals mandate sepsis care, forcing clinicians to provide treatment even if they consider it clinically unnecessary or harmful to the patient. This activity describes a balanced approach to sepsis guideline implementation using clinical decision tools and educates clinicians on sepsis diagnosis and management.

Kawasaki Disease: Shedding Light on a Mysterious Diagnosis
Kawasaki disease is an acute systemic febrile vasculitis of medium and small arteries, most often occurring in children under age 5 years. This condition is the most common cause of acquired heart disease in children in the developed world. The cause is unclear but is thought to be a hyperimmune reaction to an infectious agent. Diagnosis is clinical; the classic presentation includes persistent fever, lymphadenopathy, oral mucosal changes, conjunctivitis, and rash. Although the disease technically is self-limiting, treatment with IV immunoglobulin (IVIG) and high-dose aspirin is necessary to prevent cardiac complications, such as coronary artery aneurysm, pericarditis, or myocarditis. This activity reviews the pathophysiology, clinical presentation, diagnosis, and treatment of Kawasaki disease.

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