CME Certificate Registration and Evaluation Form

To enable us to maintain the highest scientific and educational standards when planning future activities, we would appreciate your evaluation of this activity and its content. Please select the appropriate rating numbers and add your comments for the Evaluation. Please select the best answers to the posttest questions below, which are provided on the back of this page. Fax the completed form to 877-403-5765, or mail to TestosteroneUpdate, c/o CogniMed Inc., 70 South Orange Avenue, Suite 200, Livingston, NJ 07039.

Your certificate for continuing education credit (if applicable) will be issued from the following information.

*Last Name:

*First Name: MI:

Degree(s): Title:

Specialty: Endocrinology   Family medicine   Internal medicine   Primary Care   Urology

xOther (please specify)

Affiliation:

Practice Type:

Hospital-based   University-based   Private practice   Clinic
Home care          Long-term care      Other (please specify)

Address Type:

Business  Personal

*Address: *City: *State:

Select State/Province -- US States -- Alabama Alaska American Samoa Arizona Arkansas Armed Forces US Armed Forces EU Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota N. Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming -- Canada Provinces Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nunavut Nova Scotia Ontario Prince Edward Island Province du Quebec Saskatchewan Yukon

*ZIP:

*Day Phone: Ext.: Fax: *E-mail:

Date of Birth:

x(Used for record-keeping purposes only)

Because you have attended or shown interest in our programs, we may send you information on this and similar programs utilizing the e-mail address provided. You may unsubscribe at any time by clicking on the “unsubscribe” link on any e-mails sent from us.

Please do not send me information via e-mail.

We value the confidentiality of the information you choose to share with us and are committed to its protection. All personal information you provide is stored in a secure location and will never be sold or distributed to any third party.

EVALUATION

As a result of this activity, I am better able to:

		Agree			Disagree
		5	4	3	2	1
Recognize hypogonadism as a serious, chronic medical condition associated with obesity, metabolic syndrome, diabetes, dyslipidemia, hypertension, and cardiovascular disease
Recognize that low testosterone levels may be associated with future development of diabetes and cardiovascular disease and may be associated with increased morbidity
Describe current data on the relationship between the prostate and serum testosterone concentrations and data showing that a causal relationship between testosterone therapy and prostate cancer has not been established
Explain the importance of appropriate and continuous treatment of hypogonadism with testosterone therapy
Compare current and novel testosterone therapies based on efficacy, safety, dosing regimens, and consistency of serum testosterone levels within the eugonadal range
Differentiate between long- and short-acting testosterone formulations with respect to pharmacokinetics, ease of administration, and convenience
Identify obstacles and solutions to achieving patient adherence to and long-term persistence with testosterone therapy
This activity:
Met my expectations
Was relevant to my clinical practice
Was presented without commercial bias
After participating in this activity, I will change my clinical practice by:
Additional comments:
*I hereby certify that I have spent hour(s) on this educational activity.

POSTTEST

This activity was originally released July 31, 2009, and is eligible for credit through July 31, 2010. Please select the best answers to the posttest questions below.
1. Which of the following comorbidities has been associated with a higher prevalence of     hypogonadism than that in the general population?
	Diabetes
	Rheumatoid arthritis
	Hypertension
	Both diabetes and hypertension
	All of the above
2. Results of the Boston Area Community Health Survey suggest that, in men with T <300     ng/dL:
	The most common symptom of low testosterone levels is osteoporosis
	At least 40% will have 2 or more nonspecific symptoms
	The prevalence of symptoms is modified by free testosterone levels
	Low libido is much more common than erectile dysfunction
3. Which of the following reflects the best currently recommended definition of hypogonadism?
	Total testosterone levels <300 ng/dL
	Low or low-normal levels of testosterone in the presence of symptoms
	Loss of libido in men 65 years of age or older
	Both total and free testosterone concentrations below the lower limit of normal
4. In a study of 156 men with newly diagnosed prostate cancer, Schatzl demonstrated that:
	Two-thirds had a serum testosterone level in the high-normal range
	Higher-grade prostate cancer was significantly more common in the men with the highest testosterone levels
	Testosterone levels were significantly lower in men with the highest-grade cancers
	Testosterone levels were remarkably consistent, between 280 ng/dL and 410 ng/dL for the entire cohort
5. Which of the following statements is most accurate?
	Bringing testosterone levels up into the lower levels of normal with exogenous testosterone therapy will improve libido, bone mineral density, and insulin sensitivity
	The risks of testosterone therapy outweigh the benefits for most men
	Exogenous testosterone therapy has been shown to improve sexual function and body composition
	Testosterone therapy has been shown to improve hypogonadism-associated comorbidities such as diabetes and cardiovascular disease
6. In the Saturation Model of prostate-cancer growth, androgen receptors are:
	Not fully bound until total testosterone levels reach about 300 ng/dL
	Not very sensitive to changes in testosterone concentrations
	More responsive to dihydrotestosterone than to testosterone
	Fully bound at near-castration levels of testosterone
7. Which of the following is an appropriate goal of therapy according to Endocrine Society     Guidelines?
	Bringing testosterone levels into the normal eugonadal range
	Maintaining secondary sexual characteristics
	Relieving the symptoms associated with androgen deficiency
	All of the above
8. A urologic consultation is recommended before or during therapy if the patient’s:
	PSA is >4.0 ng/mL or increases rapidly during therapy
	PSA increases >1.4 ng/mL in any 1-year period
	PSA velocity is >0.4 ng/mL per year after >2 years of treatment
	American Urological Association prostate symptom score is >19
	All of the above
9. Which testosterone formulation is most likely to cause erythrocytosis, potentially due to     fluctuating testosterone levels?
	Injectable testosterone cypionate or testosterone enanthate
	Topical gel
	Transdermal patch
	Buccal tablet
10. What was the cause of a recent labeling change for topical gels?
	Application-site skin reactions
	Extreme testosterone peaks and nadirs and mood fluctuations
	Skin-to-skin transference to others
	All of the above
	None of the above