AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. July 2003, Volume 5, Number 7.

Test Questions

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Test Questions: Medicine and Industry

July 2003, Volume 5, Number 6

1. According to one clinical case commentator, the most important reason why residency program director Dr. Matthews should not allow drug companies to provide lunch for his clinical conferences is:

A. Doing so sets a bad example for residents about proper physician-industry relations.
B. Residents may be exposed to misinformation about the sponsor's products.
C. Ultimately, patients end up paying for the lunch in the form of higher prices for prescription drugs.
D. None of the above.

2. "Conflict of interest," as used in this month's Virtual Mentor articles, describes:

A. An ethical dilemma in which one must decide between competing interests both of which have a presumptive claim to priority.
B. A situation in which professional judgment concerning one's primary interest may be unduly influenced by a secondary interest.
C. A circumstance in which a physician places his or her own financial interest above the well-being of the patient.
D. A and C.
E. None of the above.

3. The manufacturer of a new antidepressant offers internist Dr. Hoover $3,000 for each of his male patients that consents to enroll in the clinical trials of the company's new antidepressant. In return for the payment, Dr. Hoover will follow the patient without charging him during the 2-year trial period and report outcomes to the drug company. To comply with professional ethics, Dr. Hoover:

A. May refer patients so long as he tells them that he is receiving $3,000 from the drug company for each patient who enrolls.
B. Must recognize that the free care his patients receive while participating in the trial might constitute undue influence on their decisions.
C. Must decline the drug company's offer.
D. Can enroll patients only if he is confident that the trial antidepressant is a clear improvement over existing medications for the same symptoms.

4. According to the AMA PowerPoint® presentation "What You Should Know about Gifts to Physicians from Industry," 3 key factors that prompted the medical profession to reconsider interaction with industry at this time were:

A. The inappropriateness of the market model for industry-medicine relations, media coverage of pharmaceutical practices, belief that promotion of drugs to physicians adds to price patients pay for drugs.
B. Impact of direct-to-consumer advertising on prescribing practices; media coverage of pharmaceutical practices, belief that promotion of drugs to physicians adds to price patients pay for drugs.
C. The inappropriateness of the market model for industry-medicine relations, media coverage of pharmaceutical practices, impact of direct-to-consumer advertising on prescribing practices.
D. The inappropriateness of the market model for industry-medicine relations, belief that promotion of drugs to physicians adds to price patients pay for drugs, impact of direct-to-consumer advertising on prescribing practices.

5. According to the AMA PowerPoint® presentation "What You Should Know about Gifts to Physicians from Industry," the primary interest(s) of medicine (is)(are):

A. Peer recognition.
B. Patient welfare.
C. Developing new medical knowledge.
D. A and B.
E. B and C.

6. Which of the following statements about the federal "anti-kickback" regulation is false?

A. It does not apply to the referral of patients.
B. It relates to activities that affect the volume of business generated for a provider of service or a seller of products.
C. It relates to writing prescriptions for specific pharmaceuticals.
D. It applies to gifts, rewards, or payments that are more than trivial in value.

7. The Code adopted by the Pharmaceutical Research and Manufacturers of America (PhRMA) for governing their industry's relations with physicians and other health care professionals:

A. Is a series of rules designed to ensure that industry interactions with physicians and other health care professionals focus on informing them about products, providing scientific and educational information, and supporting medical research and education.
B. Has the endorsement of the Department of Health and Human Serices Office of Inspector General.
C. Allows companies to provide scholarships that pay for medical students, residents, and others in training to attend conferences.
D. All of the above.
E. A and B.

8. The ACCME's proposed new guidelines for standards of commercial support of continuing medical education (CME):

A. Recommend that physicians pay 100 percent of CME fees in order to avoid undue influence from industry.
B. Were drafted because more professionals and CME providers than ever before have relationships with industry.
C. Are based on the same 5 ethical standards as the existing guidelines adapted in 1992.
D. All of the above.
E. B and C.

9. Most patients with hypertension can normalize their blood pressure with one medication.

A. True
B. False

10. According to the JNC7 report, the systolic blood pressure range that indicates a pre-hypertension condition and should prompt physicians to urge that the patient adopt health-promoting lifestyle modifications such as weight reduction, dietary sodium reduction, and regular physical activity is:

A. 135 to 139 mm Hg
B. 130 to 139 mm Hg
C. 125 to 139 mm Hg
D. 120 to 139 mm Hg

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