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Rheumatology Clinical Vignette

Tracy Frech

Monique Hinchcliff

Jessica Gordon

Lori Chung

Flavia Castelino

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Course ID: 2358


Course Authors

Tracy Frech, MD
Internal Medicine-Pediatrics
Assistant Professor
University of Utah Health Care
Salt Lake City, UT

Monique Hinchcliff, MD
Assistant Professor
Northwestern University Feinberg School of Medicine
Chicago, IL

Jessica Gordon, MD
Assistant Attending Physician
Hospital for Special Surgery
New York, NY

Lorinda Chung, MD
Assistant Professorof Medicine (Immunology and Rheumatology)
Stanford University
Palo Alto, CA

Flavia Castelino, MD
Massachusetts General Hospital
Assistant Professor of Medicine
Harvard Medical School
Boston, MA 

Course Reviewer

Virginia Steen
Director of Rheumatology Fellowship Program
Georgetown University
Washington, DC

Learning Objectives

1. Identify the important clinical, laboratory, and cardiopulmonary testing features that best characterize patients with scleroderma spectrum disease who are at highest risk for pulmonary arterial hypertension

2. Describe cardiopulmonary complications that patients with scleroderma may also have and how they differs from those of patients with Group 1 pulmonary arterial hypertension

3. Recognize unique complications that occur in patients with scleroderma that are related to the presence and/or treatment of pulmonary hypertension

Release Date

April 2, 2014

Expiration Date

April 2, 2016

Accreditation and Credit

This enduring activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Washington University School of Medicine, Continuing Medical Education and the Pulmonary Hypertension Association. Washington University is accredited by the ACCME to provide continuing medical education for physicians.

Washington University designates this educational activity for a maximum of 1.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure Policy

It is the policy of Washington University School of Medicine, Continuing Medical Education, to ensure balance, independence, objectivity and scientific rigor in all its educational activities.  All planners, faculty and other persons who may influence content of this CME activity have disclosed all relevant financial relationships with commercial interests.  All disclosures have been reported and are indicated with their presentations. Any potential conflicts were addressed and resolved.

All members of the CME department have nothing to disclose.

Speakers are also expected to openly disclose inclusion of discussion of any off-label, experimental, or investigational use of drugs or devices in their presentations.

Presentations are expected to be based on evidence that is accepted within the profession of medicine as adequate justification for their indication in the care of patients.  All scientific research should conform to the generally accepted standards of experimental design, data collection and analysis.

These presentations are not an endorsement of any commercial interests.

The presenters’ views do not represent the policy or position of Washington University School of Medicine.  

Instructions for Earning Credit

This activity is a self-study program. Upon entering the activity, participants should read the text, examine any images and/or multimedia features, and review the content presented within all of the links provided. Once the course has been reviewed in its entirety, participants will be asked to complete a post-test and evaluation online. Participants must receive a test score of 100% in order to proceed to the course evaluation; the post-test can be repeated until all questions are answered correctly. All evaluation questions must be completed in order to receive a certificate of credit. If needed, participants may save their answers and complete the course at a later date. Saved courses can be found by using the "My Courses" link at the top of the page, and then click on "My Classes."

Faculty Disclosures

The Accreditation Council for Continuing Medical Education has standards and guidelines to ensure that individuals participating in CME activities are aware of relationships between authors and commercial companies that could potentially affect the information presented. To be disclosed to participants are all personal financial relationships with a commercial interest whose products are relevant to the content of this CME activity. It is the policy of Washington University School of Medicine, Continuing Medical Education, to ensure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty participating in this activity are expected to disclose to the audience any financial interest or other potential conflict. Each author was asked to complete a disclosure information form for this activity.

Disclosures are reported below:

Tracy Frech has no relevant personal financial relationships to disclose

Monique Hinchcliff has no relevant personal financial relationships to disclose

Jessica Gordon has no relevant personal financial relationships to disclose

Lorinda Chung has no relevant personal financial relationships to disclose

Flavia Castelino has no relevant personal financial relationships to disclose

Virginia Steen has served as a Consultant/Advisory Board/Steering Committee member for Actelion Pharmaceuticals, Gilead Sciences, United Therapeutics Corporation, bristol Meyers Squib


The information presented in this activity reflects the views of the faculty only and not necessarily those of the Pulmonary Hypertension Association (PHA), Washington University in St. Louis, or the educational grant providers. All participants should verify the information and data presented before treating patients or utilizing any therapies noted in these materials. No portion of this activity may be reproduced without the expressed written consent of PHA.

Estimated Time to Complete This Activity

10 - 15 minutes per clinical vignette 

Technical Requirements

This course requires an internet browser. For optimum display, please use Mozilla Firefox, Safari or Google Chrome.

Privacy Policy

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This activity is made possible through educational grants from Actelion, Gilead, Pfizer and United Therapeutics.


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