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CME examination
CME examination
IdentificationNo. 884-t06
See "Instructions for Category 1 CME Credit" on page 27A of the front advertising section. Questions 1-33, Wong RC, Ellis CN: J AM ACAD DERMATOL 10:929-940, 1984.
Directions for questions 1-13: Give single best response. 1. All of the following are thought to be safe for use during pregnancy, except a. hydroxyzine b. diphenhydramine c. tripelennamine d. pheniramine e. chlorpheniramine 2. Which of the following cutaneous changes observed during pregnancy is most commonly found? a. Hyperpigmentation b. Melasma c. Spider angiomas d. Palmar erythema e. Varicosities 3. Which of the following cutaneous changes observed during pregnancy is the first to disappear postpartum? a. Hyperpigmentation b. Melasma c. Spider angiomas d. Palmar erythema e. Varicosities 4. All of the following statements regarding melasma are correct, except a. it occurs in about two thirds of pregnant women b. it occurs in about one third of nonpregnant women c. clinically, the centrofacial pattern is by far the most common d. histologically, the epidermal type is by far the most common e. the Wood's light-inapparent type occurs in very lightly pigmented individuals 5. Montgomery's tubercles are found on the a. areolae of the breasts b. nipples c. lips d. vulva e. hands 6. The most common site of pruritus during pregnancy is the a. vulva b. perineum
c. buttocks d. abdomen e. hands and feet 7. Hirsutism, during pregnancy, is most pronounced on the a. face b. arms c. legs d. back e. suprapubic region of the abdomen 8. In pregnancy, spider angiomas are most frequently found on the a. face b. neck c. arms d. legs e. abdomen 9. The cause of spider angiomas observed in pregnancy is thought by many to be due to a. alterations in liver function b. alterations in renal function c. circulating growth hormone d. circulating estrogens e. circulating androgens 10. Most investigators believe that the physiologic hyperpigmentation of pregnancy is due to some combination of elevated a. ovarian hormones b. pituitary hormones c. placental hormones d. ovarian and placental hormones e. ovarian, pituitary, and placental hormones 11. The pregnancy tumor of the gums is histologically indistinguishable from a a. glomangioma b. granular cell tumor c. fibroma d. granuloma pyogenicum e. hemangioendothelioma 12. The molluscum fibrosum gravidarum clinically and histologically resembles the a. acrochordon (skin tag) b. glomangioma c. granuloma pyogenicum d. hemangioendothelioma e, capillary hemangioma 941
942
Journal of the American Acaderny of Dermatology
C M E examination
13. Prominent generalized hypermelanosis pregnancy should suggest a diagnosis of a. acromegaly b. hyperadrenalism c. hyperthyroidism d. adrenogenital syndrome in the fetus e. panhypopituitarism in the fetus
during
Directions for questions 14-18: Select the one lettered item that is most closely related to each numbered item. Each lettered item may be used once, more than once, or not at all. a. Onset during the first trimester of pregnancy b. Onset during the second trimester of pregnancy c. Onset during the second half o f pregnancy d. Onset immediately postpartum e. Onset several weeks to months postpartum 14. Melasma 15. Physiologic hyperpigmentation 16. Palmar erythema 17. Montgomery's tubercles 18. Pregnancy gingivitis Directions for question ] 9-23: For each numbered item choose the appropriate lettered item. a. Apocrine gland activity b, Eccrine gland activity c, Both d. Neither 19. Increases during pregnancy 20. Decreases during pregnancy a. Chadwick's sign b. Goodell's sign c. Both d. Neither 21. Bluish hue of the vagina 22. Bluish hue of the cervix 23. Occurs early during pregnancy Directions for questions 24-33: Indicate correct answers. All, some, or none o f the choices may be corFect, 24. In melasma a. the centrofacial type is more likely to be of the dermal type histologically than the malar type b. the centrofacial type is more likely to be of the dermal type histologically than the mandibular type e. the malar type is more likely to be of the dermal type histologically than the mandibular type d. the malar type is more likely to be of the dermal type histologically than the centrofacial type e. the mandibular type is more likely to be of the
dermal type histologically than the centrofacial type 25. Nail changes that are known to occur during pregnancy include a. transverse grooving b. increased brittleness c. softening d. distal onychoclasis e. subungual keratosis 26. Palmar erythema, occurring in normal pregnancies a. most commonly shows diffuse mottling b. is more common in blacks than in whites c. may be indistinguishable from the palmar erythema seen in hyperthyroidism d. may be indistinguishable from the palmar erythema seen in hepatic cirrhosis e. often occurs together with spider angiomas elsewhere 27. Regions that particularly show hyperpigmentation during pregnancy include a. areolae of the breasts b. axillae c. perineum d. genitalia e. perianal region 28. Late in pregnancy, a nonpitting edema tends to occur on the a. eyelids b. face c. hands d. ankles e. feet 29. The molluscum fibrosum gravidarum tends to occur on the a. lateral aspects of the face b. neck c. anterior aspect of the chest d. axillae e. feet 30. Proposed causes or partial causes for striae distensac of pregnancy include a. increased relaxin b. increased estrogen c. increased corticosteroids d. tearing of collagen e. tearing of elastic fibers 31. It is thought that high circulating levels of esta'ogen are causative factors in the development, during pregnancy, of a. cutis marmorata b. cavernous hemangiomas c. hemangioendotheliomas
Volume 10 Number 6 June, 1984 d. glomangiomas e. palmar erythema 32. Physiologic changes normally observed during the last trimester of pregnancy include a. marked hyperbilirubinemia b. increased serum alkaline phosphatase c. increased serum 5-nucleotidase d. increased serum leucine aminopeptidase e. enhanced clearance of Bromsulphalein
CME examihation
943
33.:Which of the following diseases tend to improve during pregnancy? a. Pompholyx (dyshidrosis) b. Miliaria c. Fox-Fordyce disease d. Hidradenitis suppurativa e. Acne vulgaris
IdentificationNo. 884-t06
See "Instructions for Category 1 CME Credit" on page 27A of the front advertising section. Questions 1-33, Wong RC, Ellis CN: J AM ACAD DERMATOL 10:929-940, 1984.
Directions for questions 1-13: Give single best response. 1. All of the following are thought to be safe for use during pregnancy, except a. hydroxyzine b. diphenhydramine c. tripelennamine d. pheniramine e. chlorpheniramine 2. Which of the following cutaneous changes observed during pregnancy is most commonly found? a. Hyperpigmentation b. Melasma c. Spider angiomas d. Palmar erythema e. Varicosities 3. Which of the following cutaneous changes observed during pregnancy is the first to disappear postpartum? a. Hyperpigmentation b. Melasma c. Spider angiomas d. Palmar erythema e. Varicosities 4. All of the following statements regarding melasma are correct, except a. it occurs in about two thirds of pregnant women b. it occurs in about one third of nonpregnant women c. clinically, the centrofacial pattern is by far the most common d. histologically, the epidermal type is by far the most common e. the Wood's light-inapparent type occurs in very lightly pigmented individuals 5. Montgomery's tubercles are found on the a. areolae of the breasts b. nipples c. lips d. vulva e. hands 6. The most common site of pruritus during pregnancy is the a. vulva b. perineum
c. buttocks d. abdomen e. hands and feet 7. Hirsutism, during pregnancy, is most pronounced on the a. face b. arms c. legs d. back e. suprapubic region of the abdomen 8. In pregnancy, spider angiomas are most frequently found on the a. face b. neck c. arms d. legs e. abdomen 9. The cause of spider angiomas observed in pregnancy is thought by many to be due to a. alterations in liver function b. alterations in renal function c. circulating growth hormone d. circulating estrogens e. circulating androgens 10. Most investigators believe that the physiologic hyperpigmentation of pregnancy is due to some combination of elevated a. ovarian hormones b. pituitary hormones c. placental hormones d. ovarian and placental hormones e. ovarian, pituitary, and placental hormones 11. The pregnancy tumor of the gums is histologically indistinguishable from a a. glomangioma b. granular cell tumor c. fibroma d. granuloma pyogenicum e. hemangioendothelioma 12. The molluscum fibrosum gravidarum clinically and histologically resembles the a. acrochordon (skin tag) b. glomangioma c. granuloma pyogenicum d. hemangioendothelioma e, capillary hemangioma 941
942
Journal of the American Acaderny of Dermatology
C M E examination
13. Prominent generalized hypermelanosis pregnancy should suggest a diagnosis of a. acromegaly b. hyperadrenalism c. hyperthyroidism d. adrenogenital syndrome in the fetus e. panhypopituitarism in the fetus
during
Directions for questions 14-18: Select the one lettered item that is most closely related to each numbered item. Each lettered item may be used once, more than once, or not at all. a. Onset during the first trimester of pregnancy b. Onset during the second trimester of pregnancy c. Onset during the second half o f pregnancy d. Onset immediately postpartum e. Onset several weeks to months postpartum 14. Melasma 15. Physiologic hyperpigmentation 16. Palmar erythema 17. Montgomery's tubercles 18. Pregnancy gingivitis Directions for question ] 9-23: For each numbered item choose the appropriate lettered item. a. Apocrine gland activity b, Eccrine gland activity c, Both d. Neither 19. Increases during pregnancy 20. Decreases during pregnancy a. Chadwick's sign b. Goodell's sign c. Both d. Neither 21. Bluish hue of the vagina 22. Bluish hue of the cervix 23. Occurs early during pregnancy Directions for questions 24-33: Indicate correct answers. All, some, or none o f the choices may be corFect, 24. In melasma a. the centrofacial type is more likely to be of the dermal type histologically than the malar type b. the centrofacial type is more likely to be of the dermal type histologically than the mandibular type e. the malar type is more likely to be of the dermal type histologically than the mandibular type d. the malar type is more likely to be of the dermal type histologically than the centrofacial type e. the mandibular type is more likely to be of the
dermal type histologically than the centrofacial type 25. Nail changes that are known to occur during pregnancy include a. transverse grooving b. increased brittleness c. softening d. distal onychoclasis e. subungual keratosis 26. Palmar erythema, occurring in normal pregnancies a. most commonly shows diffuse mottling b. is more common in blacks than in whites c. may be indistinguishable from the palmar erythema seen in hyperthyroidism d. may be indistinguishable from the palmar erythema seen in hepatic cirrhosis e. often occurs together with spider angiomas elsewhere 27. Regions that particularly show hyperpigmentation during pregnancy include a. areolae of the breasts b. axillae c. perineum d. genitalia e. perianal region 28. Late in pregnancy, a nonpitting edema tends to occur on the a. eyelids b. face c. hands d. ankles e. feet 29. The molluscum fibrosum gravidarum tends to occur on the a. lateral aspects of the face b. neck c. anterior aspect of the chest d. axillae e. feet 30. Proposed causes or partial causes for striae distensac of pregnancy include a. increased relaxin b. increased estrogen c. increased corticosteroids d. tearing of collagen e. tearing of elastic fibers 31. It is thought that high circulating levels of esta'ogen are causative factors in the development, during pregnancy, of a. cutis marmorata b. cavernous hemangiomas c. hemangioendotheliomas
Volume 10 Number 6 June, 1984 d. glomangiomas e. palmar erythema 32. Physiologic changes normally observed during the last trimester of pregnancy include a. marked hyperbilirubinemia b. increased serum alkaline phosphatase c. increased serum 5-nucleotidase d. increased serum leucine aminopeptidase e. enhanced clearance of Bromsulphalein
CME examihation
943
33.:Which of the following diseases tend to improve during pregnancy? a. Pompholyx (dyshidrosis) b. Miliaria c. Fox-Fordyce disease d. Hidradenitis suppurativa e. Acne vulgaris