cme examination
TRANSCRIPT
CME examination Identification No. 886-101
Instructions for Category 1 CME credit appear in the front advertising section. See last page of Contents for page number.Questions 1-33, Truhan AP, Roenigk HH Jr: J AM ACAD DERMATOL 14:1-18, 1986.
Directions for questions 1-19: Give single bestresponse.
1. The most common cause of hypothyroidism inadults isa. primary idiopathic hypothyroidismb. Hashimoto's thyroiditisc. pituitary failured. hypothalamic failuree. ablative surgery
2. The second most common cause of hypothyroidismin adults isa. primary idiopathic hypothyroidismb. Hashimoto's thyroiditisc. pituitary failured. hypothalamic failuree. ablative surgery
3. In congenital hypothyroidism, myxedema is leastpronounced in which of the following sites?a. Neckb. Armsc. Legsd. Eyelidse. Genitalia
4. All of the following are signs of hypothyroidism,excepta. yellowish discoloration of the palms, soles, and
nasolabial foldsb. increased eccrine activityc. decreased sebaceous activityd. keratotic lesions on the elbows, knees, and
buttockse. eczema craquele
5. All of the following are characteristic of hypothyroidism, excepta. fine, silky texture of hairb. decreased rate of hair growthc. loss of scalp haird. loss of beard haire. loss of sexual hair
6. All of the following are signs of congenital hypothyroidism, except (a)a. cool, mottled, pale skinb. uniformly receding hairlinec. broad, flat nose with thickened lipsd. broad hands with stubby fingerse. short, thickened neck
7. Of the following, the latest change to appear incongenital hypothyroidism is usuallya. respiratory difficultiesb. sluggishnessc. feeding problemsd. myxedemae. unexplained prolongation of physiologic
jaundice8. Graves' disease is characterized by all of the fol
lowing, except (a)a. diffusely enlarged toxic goiterb. exophthalmiac. pretibial myxedemad. acropachye. decreased levels of serum long-acting thyroid
stimulator
9. Characteristics of the skin in Graves' disease include all of the following, except (a)a. soft and smooth textureb. vasodilatation and increased cutaneous per-
fusionc. rapidly growing nailsd. patchy hyperpigmentatione. exacerbation of acne
10. All of the following resolve following surgicaltreatment for Graves' disease, excepta. facial flushingb. palmar erythemac. pretibial myxedemad. dryness of the skine. alterations in hair texture
11. All of the following statements regarding pretibialmyxedema are correct, except ita. commonly arises after surgical therapy for thy
rotoxicosisb. commonly arises after radioactive iodine ther
apy for thyrotoxicosisc. can develop in the absence of hyperthyroidismd. may develop years following treatment for hy
perthyroidisme. is invariably asymptomatic
12. The overall incidence of pretibial myxedema inGraves' disease is approximatelya. 1%-10%b. 20%-30%c. 40%-55%
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d. 60%-75%e. 90%-100%
13. Among patients with Graves' disease with exophthalmos, the incidence of pretibial myxedema isapproximatelya. 1%-10%b. 20%-30%c. 40%-55%d. 60%-75%e. 90%-100%
14. Of the following, the most likely cause of scleromyxedema is (a)(an)a. plasma cell dyscrasiab. endocrine imbalancec. liver diseased. renal diseasee. genetic predisposition
15. The paraprotein isolated from patients with scleromyxedema is usuallya. IgAb. IgG, with kappa light chainc. IgG, with lambda light chaind. IgM, with kappa light chaine. IgM, with lambda light chain
16. Which of the following clinical presentations oflichen myxedematosis is most likely to be associated with a serum paraprotein?a. Generalized lichenoid papular eruptionb. Discrete papulesc. Localized lichenoid plaquesd. Urticarial plaquese. Nodular eruptions
17. All of the following sites are characteristic of involvement with scleromyxedema, except thea. handsb. elbowsc. superior aspect of the trunkd. facee. buccal mucosa
18. The most common site of the large-plaque eruptions of reticular erythematous mucinosis is thea. groin and lower part of the abdomenb. midline of the upper aspect of the back and chestc. lateral aspects of the neck and the axillaed. lateral aspects of the trunk and lateral aspects
of the thighse. flexor surfaces of the arms and legs
19. The most commonly affected area in follicular mucinosis is thea. scalp
Journal of theAmerican Academy of
Dermatology
b. face and neckc. axillae and groind. trunke. arms and legs
Directions for questions 20-23. Select the one lettered item that is most closely related to each numbered item.
a. Alcian blue, pH 0.5b. Alcian blue, pH 2.5c. Methylene blued. Mucicarminee. Colloidal iron
20. Stains mucin red2I. Stains dennal mucin blue22. Stains dennal mucin blue-green23. Metachromatic stain for dermal mucin
Directions for questions 24-33: Indicate correctanswers. All, some, or none of the choices maybe correct.24. Metachromasia of dennal. mucin (predominantly
hyaluronic acid) is demonstrated by which of thefollowing tissue stains?a. Toluidine blueb. Methylene bluec. Alcian blue, pH 0.5d. Alcian blue, pH 2.5e. Thiamine
25. Dermal mucin is stained bya. colloidal ironb. mucicarminec. periodic acid-Schiff reagent (PAS)d. alcian blue, pH 0.5e. alcian blue, pH 2.5
26. Which of the following fail to resolve readilyfollowing pharmacologic treatment for Graves'disease?a. Facial flushingb. Palmar erythemac. Dryness of the skind. Exophthalmose. Alterations in hair texture
27. Severe pretibial myxedema tends to occur in patients whoa. have exophthalmosb. develop their pretibial myxedema after surgical
treatmentc. develop their pretibial myxedema after radio
active iodine treatment
Volume 14Number 1January, 1986
d. develop hypothyroidism after surgical treatmente. develop hypothyroidism after radioactive iodine
treatment28. Sclerornyxedema may be caused by certain
a. drugsb. bacterial infectionsc. fungal infectionsd. environmental factorse. thyroid dysfunctions
29. Current therapeutic modalities considered appropriate for treatment of scleromyxedema includea. local radiation therapyb. electron beam treatmentc. dermabrasiond. melphalane. cyclophosphamide
30. Sc1eromyxedema has been found In associationwitha. esophageal aperistalsisb. peripheral neuropathyc. cardiovascular diseased. cerebrovascular disease
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e. no systemic disease (except for the sc1eromyxedema)
31. Which of the following is characteristically alteredin reticular erythematous mucinosis?a. Serum cholesterolb. Serum triglyceridesc. Serum gamma globulinsd. Serum bilirubin levelse. Serum lactate dehydrogenase (LDH)
32. Scleredema tends to occur in association witha. diabetes mellitusb. liver diseasec. intestinal malabsorptiond. monoclonal gammopathye. certain infections
33. Extensive deposition of hyaluronic acid in the dermis is sometimes present in lesional tissue ina. Degos' diseaseb. neurilemmomasc. neurofibromasd. nodular fasciitise. myxedema