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CME examination for volume 26
IOURNAL Of t h e
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In the June and December issues each year, C M E questions based on articles in the preceding volume of the JOURNAL appear. Two hours of Category I C M E credit can be earned by reading the text material, reporting the answers on the perforated answer sheet, and following instructions for Category I C M E credit. Editor
CME examination for volume 26* Identifleatlon No. 892-312
Instructionsfor CategoryI CME credit and answersto this examinationappear in the front advertisingsection. See last page of Contentsfor page number.
Directions for questions 1-25: Give single best response. 1. A high incidence of xeroderma pigmentosum occurs in Japan and in (the) a. Southeast Asia b. Middle East c. Central Africa d. Tibet and Western China e. Australia 2. The Gianotti-Crosti syndrome is caused by a. hepatitis B virus in the majority of cases b. herpes simplex virus in the majority of cases e. hepatitis B virus or cytomegalovirus, but only rarely by Epstein-Barr virus d. hepatitis B virus or Epstein-Barr virus, but only rarely by cytomegalovirus e. either hepatitis B virus, cytomegalovirus, or Epstein-Barr virus in the majority of cases 3. Features often present in cases of dermatopathia pigmentosa reticularis include each of the following
except a. adermatoglyphia b. reticulate hyperpigmentation e. palmoplantar hyperkeratosis d. eicatricial alopecia e. onychodystrophy 4. Eachofthe foUowingis a component ofthePOEMS syndrome excep~ a. polyarthropathy b. organomegaly c. endocrinopathy d. M protein e. skin changes
*Includesentirevolumewiththe exceptionof CME articles.
5. Each of the following statements regarding Castleman's disease is correct except a. most patients complain of malaise and symptoms related to anemia b. either a polyelonal or a monoclonal increase in circulating immunoglobulins may be present c. cutaneous manifestations may be present d. lesional lymphoid tissue changes are usually limited to the mediastinum e. histologically, lesional lymphoid tissue shows follicle-like structures and marked capillary proliferation 6. Actinic prufigo occurs most commonly in a. Orientals b. Pacific Islanders c. Amerindians d. African-Americans e. the Middle East 7. The most common site of cutaneous lesions in Wegener's granulomatosis is the a. face b. neck c. arms d. trunk e. legs 8. The most important diagnostic finding in herpes gestationis is a. deposition of IgG in a linear band along the cutaneous basement membrane zone b. deposition of IgA in a linear band along the cutaneous basement membrane zone c. deposition of IgM in a linear band along the cutaneous basement membrane zone d. deposition of C3 in a linear band along the cutaneous basement membrane zone e. deposition of IgG in a discontinuous array along the cutaneous basement membrane zone 9. Infants of mothers in whom herpes gestationis developed are at greatest risk for a. stillbirth b. premature birth c. small size for gestational age at birth d. heart block e. pemphigus
Continued on page 33A
30A
December, Part 1, 1992
Volume 27 Number 6, Part 1 December 1992
10. Urticarial vasculitis occurs most commonly in association with a. Sj6gren's syndrome b. rheumatoid arthritis c. progressive systemic sclerosis d. systemic lupus erythematosus e. dermatomyositis 11. Erythema gyratum repens most commonly occurs in association with a. gastric carcinoma b. colon carcinoma c. breast carcinoma d. bronchogenic carcinoma e. pulmonary tuberculosis 12. Lesions of erythema elevatum diutinum most commonly occur on the a. palms and soles b. extensor surfaces of the extremities c. flexor surfaces of the elbows and knees d. scalp e. face and neck 13. The most common cause of erythema nodosum is infection with
a. Staphylococcus epidermidis b. Staphylococcus aureus c. Group B streptococci d. Group A/~-hemolytic streptococci e. Yersinia enterocolitica 14. Sneddon syndrome consists of livedo reticularis and (a) a. subacute lupus erythematosus b. carcinoma of the lung c. carcinoma of the stomach d. cerebrovascular accident e. cardiac anomaly 15. The sign of Leser-Trrlat consists of (a) a. sudden eruption of palmar and plantar erythema with hyperkeratosis b. sudden eruption of palmar and plantar erythema without hyperkeratosis c. acquired ichthyosis of the extensor surfaces of the extremities d. sudden increase in size and number of seborrheic keratoses e. sudden increase in size and number of lentigines 16. Current statistics from the National Cancer Institute indicate that the type of cancer that has increased most rapidly during the past 15 years is a. melanoma of the skin b. melanoma of the eye c. prostate cancer d, breast cancer e. non-Hodgkin's lymphoma
C M E examination f o r volume 26
33A
17. The most common primary tumor to cause metastatic disease in the skin in women is a. carcinoma of the breast b. carcinoma of the ovary c. carcinoma of the colon d. carcinoma of the cervix e. malignant melanoma 18. Cylindromas are least likely to occur on the a. face b. scalp c. neck d. preauricular region e. axillae 19. Epithelioid hemangioendothelioma occurs mainly in a. infants b. small children c. adolescents d. pregnant women e. adults 20. The majority (75%) of epithelioid sarcomas stain" immunohistochemically for a. myoglobin b. common leukocyte antigen c. cytokeratin d. factor VIII-related antigen e. none of the above 21. Fibrous histiocytomas are least likely to react with a. stains for lipid b. stains for iron c. anti-S- 100 and anti-HMB-45 specific monoclonal antibodies d. virnenfin and al-antitrypsin e. common leukocyte antigen 22. The neoplastic cells in malignant proliferative angioendotheLiomatosis are most commonly a. endothelial cells b. perithelial cells c. B lymphocytes d. T lymphocytes e. monocytes
23. The treatment of choice for secondary erythromelalgia is a. splenectomy b. phlebotomy c. cyclosporine d. rnethotrexate e. aspirin 24. The most common major adverse complication of cyclosporine is a. hepatotoxicity b. nephrotoxicity c. bone marrow suppression d. pulmonary fibrosis
Continued on page 34A
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C M E examination f o r volume 26
e. Schulman's disease 25. Psoriasis is most likely to be exacerbated or precipitated by administration of a. penicillin b. tetracyclines c. acetaminophen d. lithium carbonate e. tricyclic antidepressive agents
Directions for questions 26-29: Select the one lettered item most closely related to each numbered item.
26. 27. 28. 29.
a. Anti-Sm autoantibody b. Anti-DNA topoisomerase I autoantibody c. Anti-RNA synthetase autoantibody d. Anti-Ro (SS-A) autoantibody e. Anti-La (SS-B) autoantibody Present in many cases of polyrnyositis Present in many cases of systemic scleroderma Present almost exclusively in cases of lupus erythematosus Crosses the placenta and is associated with neonatal lupus erythematosus
Journal of the American Academy of Dermatology
Directions.for questions 30 and 31: For each numbered item choose the appropriate lettered item. a. Pruritic papular eruption of the acquired immunodeficiency syndrome b. Ofuji's disease c. Both d. Neither 30. Papules and pustulesthat coalesceto form polycyclic plaques 3 I. Mixed-cell pcrifollicularinfiltratecontaining cosinophils seen histologically
Directions f o r questions 32 and 33."For each numbered item choose the appropriate lettered item. a. Discoid lupus erythematosus b. Chronic cutaneous lupus erythematosus c. Both d. Neither 32. Atrophy and scarring 33. Follicular plugging with keratin
Amemcar
AcaDemY
OF
DerMaTOLOGY I
I'
'
inll ii
In the June and December issues each year, C M E questions based on articles in the preceding volume of the JOURNAL appear. Two hours of Category I C M E credit can be earned by reading the text material, reporting the answers on the perforated answer sheet, and following instructions for Category I C M E credit. Editor
CME examination for volume 26* Identifleatlon No. 892-312
Instructionsfor CategoryI CME credit and answersto this examinationappear in the front advertisingsection. See last page of Contentsfor page number.
Directions for questions 1-25: Give single best response. 1. A high incidence of xeroderma pigmentosum occurs in Japan and in (the) a. Southeast Asia b. Middle East c. Central Africa d. Tibet and Western China e. Australia 2. The Gianotti-Crosti syndrome is caused by a. hepatitis B virus in the majority of cases b. herpes simplex virus in the majority of cases e. hepatitis B virus or cytomegalovirus, but only rarely by Epstein-Barr virus d. hepatitis B virus or Epstein-Barr virus, but only rarely by cytomegalovirus e. either hepatitis B virus, cytomegalovirus, or Epstein-Barr virus in the majority of cases 3. Features often present in cases of dermatopathia pigmentosa reticularis include each of the following
except a. adermatoglyphia b. reticulate hyperpigmentation e. palmoplantar hyperkeratosis d. eicatricial alopecia e. onychodystrophy 4. Eachofthe foUowingis a component ofthePOEMS syndrome excep~ a. polyarthropathy b. organomegaly c. endocrinopathy d. M protein e. skin changes
*Includesentirevolumewiththe exceptionof CME articles.
5. Each of the following statements regarding Castleman's disease is correct except a. most patients complain of malaise and symptoms related to anemia b. either a polyelonal or a monoclonal increase in circulating immunoglobulins may be present c. cutaneous manifestations may be present d. lesional lymphoid tissue changes are usually limited to the mediastinum e. histologically, lesional lymphoid tissue shows follicle-like structures and marked capillary proliferation 6. Actinic prufigo occurs most commonly in a. Orientals b. Pacific Islanders c. Amerindians d. African-Americans e. the Middle East 7. The most common site of cutaneous lesions in Wegener's granulomatosis is the a. face b. neck c. arms d. trunk e. legs 8. The most important diagnostic finding in herpes gestationis is a. deposition of IgG in a linear band along the cutaneous basement membrane zone b. deposition of IgA in a linear band along the cutaneous basement membrane zone c. deposition of IgM in a linear band along the cutaneous basement membrane zone d. deposition of C3 in a linear band along the cutaneous basement membrane zone e. deposition of IgG in a discontinuous array along the cutaneous basement membrane zone 9. Infants of mothers in whom herpes gestationis developed are at greatest risk for a. stillbirth b. premature birth c. small size for gestational age at birth d. heart block e. pemphigus
Continued on page 33A
30A
December, Part 1, 1992
Volume 27 Number 6, Part 1 December 1992
10. Urticarial vasculitis occurs most commonly in association with a. Sj6gren's syndrome b. rheumatoid arthritis c. progressive systemic sclerosis d. systemic lupus erythematosus e. dermatomyositis 11. Erythema gyratum repens most commonly occurs in association with a. gastric carcinoma b. colon carcinoma c. breast carcinoma d. bronchogenic carcinoma e. pulmonary tuberculosis 12. Lesions of erythema elevatum diutinum most commonly occur on the a. palms and soles b. extensor surfaces of the extremities c. flexor surfaces of the elbows and knees d. scalp e. face and neck 13. The most common cause of erythema nodosum is infection with
a. Staphylococcus epidermidis b. Staphylococcus aureus c. Group B streptococci d. Group A/~-hemolytic streptococci e. Yersinia enterocolitica 14. Sneddon syndrome consists of livedo reticularis and (a) a. subacute lupus erythematosus b. carcinoma of the lung c. carcinoma of the stomach d. cerebrovascular accident e. cardiac anomaly 15. The sign of Leser-Trrlat consists of (a) a. sudden eruption of palmar and plantar erythema with hyperkeratosis b. sudden eruption of palmar and plantar erythema without hyperkeratosis c. acquired ichthyosis of the extensor surfaces of the extremities d. sudden increase in size and number of seborrheic keratoses e. sudden increase in size and number of lentigines 16. Current statistics from the National Cancer Institute indicate that the type of cancer that has increased most rapidly during the past 15 years is a. melanoma of the skin b. melanoma of the eye c. prostate cancer d, breast cancer e. non-Hodgkin's lymphoma
C M E examination f o r volume 26
33A
17. The most common primary tumor to cause metastatic disease in the skin in women is a. carcinoma of the breast b. carcinoma of the ovary c. carcinoma of the colon d. carcinoma of the cervix e. malignant melanoma 18. Cylindromas are least likely to occur on the a. face b. scalp c. neck d. preauricular region e. axillae 19. Epithelioid hemangioendothelioma occurs mainly in a. infants b. small children c. adolescents d. pregnant women e. adults 20. The majority (75%) of epithelioid sarcomas stain" immunohistochemically for a. myoglobin b. common leukocyte antigen c. cytokeratin d. factor VIII-related antigen e. none of the above 21. Fibrous histiocytomas are least likely to react with a. stains for lipid b. stains for iron c. anti-S- 100 and anti-HMB-45 specific monoclonal antibodies d. virnenfin and al-antitrypsin e. common leukocyte antigen 22. The neoplastic cells in malignant proliferative angioendotheLiomatosis are most commonly a. endothelial cells b. perithelial cells c. B lymphocytes d. T lymphocytes e. monocytes
23. The treatment of choice for secondary erythromelalgia is a. splenectomy b. phlebotomy c. cyclosporine d. rnethotrexate e. aspirin 24. The most common major adverse complication of cyclosporine is a. hepatotoxicity b. nephrotoxicity c. bone marrow suppression d. pulmonary fibrosis
Continued on page 34A
34A
C M E examination f o r volume 26
e. Schulman's disease 25. Psoriasis is most likely to be exacerbated or precipitated by administration of a. penicillin b. tetracyclines c. acetaminophen d. lithium carbonate e. tricyclic antidepressive agents
Directions for questions 26-29: Select the one lettered item most closely related to each numbered item.
26. 27. 28. 29.
a. Anti-Sm autoantibody b. Anti-DNA topoisomerase I autoantibody c. Anti-RNA synthetase autoantibody d. Anti-Ro (SS-A) autoantibody e. Anti-La (SS-B) autoantibody Present in many cases of polyrnyositis Present in many cases of systemic scleroderma Present almost exclusively in cases of lupus erythematosus Crosses the placenta and is associated with neonatal lupus erythematosus
Journal of the American Academy of Dermatology
Directions.for questions 30 and 31: For each numbered item choose the appropriate lettered item. a. Pruritic papular eruption of the acquired immunodeficiency syndrome b. Ofuji's disease c. Both d. Neither 30. Papules and pustulesthat coalesceto form polycyclic plaques 3 I. Mixed-cell pcrifollicularinfiltratecontaining cosinophils seen histologically
Directions f o r questions 32 and 33."For each numbered item choose the appropriate lettered item. a. Discoid lupus erythematosus b. Chronic cutaneous lupus erythematosus c. Both d. Neither 32. Atrophy and scarring 33. Follicular plugging with keratin