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1

Most fluorescent UV sources are:


1

High pressure xenon arc lamps
2

Low pressure xenon arc lamps
3

Low pressure argon lamps
4

High pressure tungsten lamps
5

Low pressure mercury vapor lamps
Q/Q(M)-474674 Report a Problem
Most fluorescent UV sources are:
5

Low pressure mercury vapor lamps
The mercury vapor in the fluorescent bulbs is excited by electric current. Then the mercury emits
radiation at 254 nm. This radiation is absorbed by the phosphor lining the bulb.
Q/Q(M)-474674 Report a Problem

A MED phototest should be read at:
1

2 hours
2

24 hours
3

48 hours
4

12 hours
5

96 hours
Q/Q(M)-478252 Report a Problem

A MED phototest should be read at:
2

24 hours
MED testing should be read 24 hours after delivery of the doses. An additional reading at 15 minutes is
important when solar urticaria is a consideration.
Q/Q(M)-478252 Report a Problem


What is the wavelength of a Wood's light?
1

290nm
2

311nm
3

330nm
4

365nm
5

410nm
Q/Q(M)-477451 Report a Problem



What is the wavelength of a Wood's light?
4

365nm
2

A Wood's light emits ultaviolet light at a wavelenth of 365nm and is produce by bassing light through a
Wood's filter which is composed of nickel oxide containing glass.
Q/Q(M)-477451 Report a Problem


All of the following are true about UVA radiation except:
1

10 times more abundant than UVB
2

penetrates to a greater depth in the dermis than UVB
3

responsible for phototoxic drug reactions
4

approximately 50% of exposure occurs in the shade
5

virtually all blocked by car window glass
Q/Q(M)-476963 Report a Problem

All of the following are true about UVA radiation except:
5

virtually all blocked by car window glass
The UVA band extends from 320 to 400 nm. This spectrum is further subdivided into UVA-2 (320 to
340 nm) and UVA-1 (340 to 400 nm). The UVA spectrum is recognized as a cause of immediate and
delayed tanning reaction of skin, and several other effects including photoaging, skin
photosensitization, and immunosuppression. The majority of the ultraviolet radiation at the earth's
surface is UVA (95 to 98%) with only 2 to 5% comprised of UVB. As UVC is completely absorbed by
the stratospheric ozone layer, it does not comprise ultraviolet radiation hitting the earth's surface. Much
of the UV radiation after reaching the atmosphere becomes scattered by the time it hits the earth's
surface. Due to this "sky radiation", it is possible to sunburn even if one is exposed only to the shade.
Notably, window glass filters out ultraviolet wavelengths shorter than 320 nm, so only UVB (290 to
320 nm) and UVC (200 to 290 nm) are effectively filtered by car window glass. Although UVA
penetrates deeper into the dermis than UVB, UVB radiation is much more erythmogenic. Finally, most
common photosensitizers have action spectrums in the UVA range, and, as a result, UVA radiation is
responsible for most phototoxic drug reactions.
Q/Q(M)-476963 Report a Problem

A watt is a measurement of:
1

Power
2

Fluence
3

Energy
4

Heat
5

Distance
Q/Q(M)-478225 Report a Problem

A watt is a measurement of:
1

Power
A watt is a measurement of power or irradiance of a UV source. Fluence and energy is measured in
joules. These are related by the formula Joules/cm2=Watts/cm2xseconds.
Q/Q(M)-478225 Report a Problem
3



Which of the following statements regarding hereditary PMLE of Native Americans is true?
1

It will remit in puberty
2

Specific HLA types predominate in Native Americans
3

5-10% of patients have a family history of this eruption
4

Cheilits and conjunctivitis are uncommon
5

Patients have an urticarial erupion.
Q/Q(M)-478266 Report a Problem

Which of the following statements regarding hereditary PMLE of Native Americans is true?
2

Specific HLA types predominate in Native Americans
Native Americans have a high rate of PMLE and there is some evidence of a genetic predisposition. It
tends to have a specific HLA predominance, continues through adulthood, and commonly presents as a
papular, excoriated, eczematous dermatitis predominantly on the face. Cheilitis and conjunctivitis are
common. Up to 75% of patients have a positive family history.
Q/Q(M)-478266 Report a Problem


The active spectrum for cutaneous vitamin D3 synthesis is:
1

220-290nm
2

290-320nm
3

320-400nm
4

400-410nm
5

Both First and Second Choice
Q/Q(M)-475864 Report a Problem

The active spectrum for cutaneous vitamin D3 synthesis is:
5

Both First and Second Choice
The source states that vitamin D3 synthesis occurs at wavelengths < 320 making choices 220-290nm
and 290-320nm correct.
Q/Q(M)-475864 Report a Problem


Treatment of this condition might include:
1

Azathioprine
2

Cytoxan
3

Cyclosporin
4

Antimalarials
5

All of these answers are correct
Q/Q(M)-474952 Report a Problem
4




Treatment of this condition might include:
4

Antimalarials
Sun avoidance, sunblocks, protective clothing, and topical steroids are sufficient for most patients with
PMLE. Other patients may require hardening with UVB or PUVA. Rare patients require antimalarials.
Q/Q(M)-474952 Report a Problem

The best location for phototesting patients suspected of photosensitivity is:
1

Affected skin of the buttock
2

Unaffected skin of the lower back
3

Affected skin of the ventral forearm
4

Unaffected skin of the upper back
5

Unaffected skin of the outer thighs
Q/Q(M)-478250 Report a Problem

The best location for phototesting patients suspected of photosensitivity is:
2

Unaffected skin of the lower back
Patients with suspected photosensitivity can be tested on unaffected skin of the buttocks, lower back or
ventral forearm. Effected skin should not be used for testing.
Q/Q(M)-478250 Report a Problem


A patient presents with signs of porphyria cutanea tarda. Porphyrin screens are negative. Which of the
following medications on the patient's medication list is your top choice for discontinuation?
1

Naproxen
2

Fenofibrate
3

Enalapril
4

Chloroquine
5

5

Multivitamin
Q/Q(M)-478258 Report a Problem

A patient presents with signs of porphyria cutanea tarda. Porphyrin screens are negative. Which of the
following medications on the patient's medication list is your top choice for discontinuation?
1

Naproxen
NSAIDs are a frequent offender in causing pseudoporphyria. The other listed medications are not
frequent causes of this type of skin reaction.
Q/Q(M)-478258 Report a Problem

Which of the following statements is correct regarding antigen presenting cells after UVR exposure?
1

Have increased ability to prime UV-irradiated mice to subcutaneously injected hapten
2

UV-irradiated mice have normal antigen presentation, allowing a normal delayed-type
hypersensitivity response
3

There is a decrease in the number of antigen presenting cells
4

APC's have increased ability to prime UV-irradiated mice to subcutaneously injected protein
5

APC's have increased ability to prime UV-irradiated mice to applied contact-sensitizing agents
Q/Q(M)-478243 Report a Problem
Which of the following statements is correct regarding antigen presenting cells after UVR exposure?
3

There is a decrease in the number of antigen presenting cells
APC's have depressed ability to prime UV-irradiated mice to subcutaneously injected hapten or protein
and to applied contact-sensitizing agents. UV-irradiated mice have defective antigen presentation,
preventing a normal delayed-type hypersensitivity response. There is a REDUCTION in number of
antigen presenting cells.
Q/Q(M)-478243 Report a Problem


Treatment of polymorphous light eruption includes all of the following EXCEPT:
1

Topical steroids
2

Antimalarials
3

PUVA therapy
4

Systemic corticosteroids
5

None of these answers are correct
Q/Q(M)-476085 Report a Problem



Treatment of polymorphous light eruption includes all of the following EXCEPT:
5

None of these answers are correct
Most patients with PMLE have mild disease that can be treated by sun avoidance and sun protection.
Topical steroids can be used to treat clinical lesions. For severe cases, hardening and desensitization
6

can be accomplished with UVB, UVB plus UVA, or PUVA. Antimalarials can be used for resistant
cases. A short course of prednisone (20-40 mg) is effective for brief, sunny vacations.
Q/Q(M)-476085 Report a Problem

A patient presents with erythematous pruritic papules on exposed areas that appear in the spring. They
appear between 2 hours and 2 days after exposure. Which of the following statements is NOT correct?
1

This is an idiopathic disease that appears in the first three decades of life
2

It is more common in fair-skinned females
3

The pathogenesis is unclear, but may be related to type IV hypersensitivity reactions
4

The diagnosis described above is solar urticaria
5

Vesicles and eczematous dermatitis is uncommon
Q/Q(M)-478260 Report a Problem

A patient presents with erythematous pruritic papules on exposed areas that appear in the spring. They
appear between 2 hours and 2 days after exposure. Which of the following statements is NOT correct?
4

The diagnosis described above is solar urticaria
The diagnosis described above is polymorphous light eruption. The time to development of lesions is
important in distinguishing between PMLE and solar urticaria. Solar urticaria usually develops 10-30
minutes after UVR exposure.
Q/Q(M)-478260 Report a Problem

The most helpful phototest to document this photosensitivity disorder would be:
1

Repeated doses of UVA and UVB
2

MEDBB
3

MEDNB
4

Photopatch tests
5

All of these answers are correct
Q/Q(M)-474951 Report a Problem



The most helpful phototest to document this photosensitivity disorder would be:
1

Repeated doses of UVA and UVB
7

Repeated doses of ultraviolet radiation can sometimes elicit lesions of PMLE. More patients react to
UVA radiation than to UVB radiation.
Q/Q(M)-474951 Report a Problem

Most bulbs used for PUVA have a peak output predominantly in the following range:
1

290 nm 320 nm
2

320 nm 340 nm
3

340 nm 400 nm
4

350 nm 360 nm
5

390 nm 410 nm
Q/Q(M)-474676 Report a Problem

Most bulbs used for PUVA have a peak output predominantly in the following range:
4

350 nm 360 nm
The UVA emitted by these bulbs is absorbed by psoralens, causing covalent bonding of psoralens to
DNA.
Q/Q(M)-474676 Report a Problem

A common cause of medication induced photoallergy is:
1

Psoralens
2

Acitretin
3

Ibuprofen
4

Naproxen
5

Piroxicam
Q/Q(M)-478089 Report a Problem

A common cause of medication induced photoallergy is:
5

Piroxicam
All of the listed medications are causes of photosensitivity, but only piroxicam is a cause of
photoallergy.
Q/Q(M)-478089 Report a Problem



Oxsoralen plus UVA results in the following except:
1

Forms monofunctional adducts
2

Binds to purine bases
3

Can form DNA crosslinks
4

Suppresses DNA synthesis
5

Has immunomodulating effects
Q/Q(M)-474694 Report a Problem
8


Oxsoralen plus UVA results in the following except:
2

Binds to purine bases
Oxsoralen, in the presence of UVA, forms covalent bonds to pyrimidine bases on DNA.
Q/Q(M)-474694 Report a Problem
Ultraviolet radition has been shown to do all of the following in in vitro and in vivo studies EXCEPT:
1

Alter the ability of antigen-presenting cells to present antigen
2

Suppress the induction of delayed-type hypersensitivity
3

Increase circulating levels of IL-6
4

Decrease circulating levels of IL-1
5

Induce suppressor T-cells
Q/Q(M)-476079 Report a Problem

Ultraviolet radition has been shown to do all of the following in in vitro and in vivo studies EXCEPT:
4

Decrease circulating levels of IL-1
UV-irradiated mice have been shown to have defective antigen presentation and a decreased number of
antigen-presenting cells, which prevents a normal delayed-type hypersensitivity response. UVR causes
the release of immunosuppressive factors, with induction of suppressor T-cells and increases in
circulating levels of cytokines, including IL-1, IL-6, and TNF.
Q/Q(M)-476079 Report a Problem

This middle-aged man demonstrates infiltrated, dusky plaques on all sun-exposed areas. The most
likely diagnosis is:
1

PMLE
2

CAD
3

Actinic prurigo
4

Drug photosensitivity
5

Photoallergic contact dermatitis
Q/Q(M)-474955 Report a Problem


This middle-aged man demonstrates infiltrated, dusky plaques on all sun-exposed areas. The most
likely diagnosis is:
2

CAD
The thick, infiltrated plaques on sun-exposed areas are typical of the actinic reticuloid variety of CAD.
9

Q/Q(M)-474955 Report a Problem

The most common cause(s) of topical phototoxicity today in the United States is(are):
1

Psoralens
2

Halogenated salicylanilides
3

Musk ambrette
4

6-methyl-coumarin
5

PABA and non-PABA sunscreen ingredients
Q/Q(M)-476092 Report a Problem

The most common cause(s) of topical phototoxicity today in the United States is(are):
1

Psoralens
Topical phototoxicity is most commonly caused by psoralens. Topical 8-methoxypsoralen is used
therapeutically to treated psoriasis, localized vitiligo, and hand/foot eczema. Psoralens in certain plants,
fruits, and vegetables can produce phytophotodermatitis. Topical photoallergy has in the past been
caused by halogenated salicylanilides, as well as musk ambrette and 6-methyl-coumarin in fragrances.
These compounds produced photoallergic contact dermatitis, and have been removed from marketed
products. PABA, its esters, and non-PABA sunscreen ingredients are the most common causes of
topical photoallergy, not topical phototoxicity
Q/Q(M)-476092 Report a Problem

In solar urticaria wheals may be brought on by:
1

UVA
2

UVB
3

UVC
4

Visible light
5

UVA, UVB and Visible light
Q/Q(M)-474683 Report a Problem

In solar urticaria wheals may be brought on by:
5

UVA, UVB and Visible light
Some patients react to visible light or UVA or UVB. Others react to combinations of visible light,
UVA, and UVB.
Q/Q(M)-474683 Report a Problem

The portion of the electromagnetic spectrum that produces a particular biologic effect is known as the:
1

Absorption spectrum
2

Action spectrum
3

Photobiologic spectrum
4

Minimal erythema dose
5

Active spectrum
Q/Q(M)-476078 Report a Problem
10


The portion of the electromagnetic spectrum that produces a particular biologic effect is known as the:
2

Action spectrum
The action spectrum is the portion of the electromagnetic spectrum that products a particular biologic
effect (e.g. erythema, delayed tanning). The absorption spectrum is the portion of the electromagnetic
spectrum that is absorbed by a particular absorbing molecule, or chromophore. The minimal erythema
dose is the dose of UV radiatino that produces barely perceptible erythema during phototesting.
Q/Q(M)-476078 Report a Problem

This disease can be brought on by:
1

Visible light
2

UVA II
3

UVA I
4

UVB
5

All of these answers are correct
Q/Q(M)-474949 Report a Problem


This disease can be brought on by:
5

All of these answers are correct
Solar urticaria can be brought on by UVB or UVA or visible light or combinations of those
wavelengths.
Q/Q(M)-474949 Report a Problem

A patient with a personal and family history of multiple fibrofolliculomas may have:
1

Birt-Hogg-Dube syndrome
2

Basal cell nevus syndrome
3

Muir-Torre syndrome
4

Gardner's syndrome
5

Tuberous sclerosis
Q/Q(M)-475876 Report a Problem

A patient with a personal and family history of multiple fibrofolliculomas may have:
1

Birt-Hogg-Dube syndrome
11

Fibrofolliculomas are small, benign, yellow or flesh colored papules that are usually inherited in an
autosomal dominant fashion and have a predilection for the face, neck and upper trunk. Birt-Hogg-
Dube syndrome is an autosomal dominant condition characterized by multiple fibrofolliculomas,
trichodiscomas, acrochordons, collagenomas. This condition is important to recognize due to its
association with renal cell carcinoma. In addition, lung cysts and bullous emphysema are also features
of the condition with spontaneous pneumothorax being a potential complication. Muir-Torre syndrome
is an autosomal dominant condition caused by a defect in hMSH2 gene. This condition is associated
with sebaceous neoplasms including sebaceous carcinoma, sebaceous hyperplasia, sebaceous
epithelioma, sebaceous adenoma as well as keratoacanthomas. These can be markers for underlying
malignancy in this condition; notably adenocarcinoma of the colon, breast, urinary tract, lung and
endometrium. Gardner syndrome is an autosomal dominant condition caused by a defect in the APC
familial adenomatous polyposis gene in which patients have multiple hamartomatous polyps of the
colon with a high rate of malignant transformation. Cutaneous clues to the diagnosis include multiple
epidermoid cysts, fibromas, and desmoid tumors. Other manifestations include osteomas, supernumary
teeth, and congential hypertrophy of the retinal pigment epithelium. Tuberous sclerosis, (TS),also
known as Bourneville's syndrome is caused by defects in hamartin and tuberin, found on chromosome 9
and 16, respectively. Patients with TS are at increased risk of muliple neoplasms including retinal
hamartomas, angiomyolipomas, and cardiac rhabdomyomas. Cutaneous manifestations include ash-leaf
macules, shagreen patchs, caf-au-lait macules, confetti macules, facial angiofibromas, and periungual
fibromas. As the name implies, basal cell nevus syndrome is associated with multiple basal cell
carcinomas. In addition palmoplantar pitting, multiple milia and epidermoid cysts are seen. It is
autosomal dominantly inherited and caused by a defect in the patched gene.
Q/Q(M)-475876 Report a Problem

Narrowband UVB bulbs emit predominantly at:
1

290-320 nm
2

311 nm
3

352 nm
4

305 nm
5

360 nm
Q/Q(M)-474675 Report a Problem

Narrowband UVB bulbs emit predominantly at:
2

311 nm
Narrowband UVB (311-312 nm) is more effective than broadband UVB for psoriasis, vitiligo, and
other skin disorders.
Q/Q(M)-474675 Report a Problem

UVB acts on what compound to form pre-Vitamin D3 ?
1

5-dehydrocholesterol
2

9-hydrocholesterol
3

7-deoxycholesterol
4

7-dehydrocholesterol
5

DNA
Q/Q(M)-474670 Report a Problem

12

UVB acts on what compound to form pre-Vitamin D3 ?
4

7-dehydrocholesterol
UVB converts 7-dehydrocholesterol in the skin to pre-Vitamin D3, which then thermally isomerizes to
form Vitamin D3.
Q/Q(M)-474670 Report a Problem

Blue-gray pigmentation of the lunulae:
1

Can be seen in patients on amiodarone
2

Occurs only after many years of treatment with chlorpromazine
3

Is seen in argyria and not in most medication photosensitivities
4

Is a rare side effect of treatment with tricyclic antidepressants
5

None of these answers are correct
Q/Q(M)-476094 Report a Problem

Blue-gray pigmentation of the lunulae:
3

Is seen in argyria and not in most medication photosensitivities
Blue-gray pigmentation on sun-exposed areas can be seen during treatment with amiodarone,
chlorpromazine, and tricyclic antidepressants. In these medication photosensitivities, there is no
involvement of the sclera, lunulae, or mucous membranes, as in argyria (prolonged contact with or
ingestion of silver salts).
Q/Q(M)-476094 Report a Problem

Which of the following statements about UVR and DNA is correct?
1

UVR alters DNA
2

UVA is much more efficient than UVB in inducing DNA damage
3

Cells from patients with actinic keratoses have more DNA repair capacity than controls
4

UVA is most effective in producing pyrimidine dimer
5

Pyrimidine dimers can not activate oncogenes
Q/Q(M)-478241 Report a Problem

Which of the following statements about UVR and DNA is correct?
1

UVR alters DNA
UVR alters DNA. UVB is much more efficient than UVA in inducing DNA damage. It can create
pyrimidine dimers that may activate oncogenes and lead to cancer. Cells from patients with actinic
keratoses have less DNA repair capacity than controls.
Q/Q(M)-478241 Report a Problem

Which of the following statements about electromagnetic radiation is MOST correct?
1

Electromagnetic radiation can be conceptualized as packets of power called photons
2

The energy of photons is proportional to the wavelength
3

The energy of photons is inversely proportional to the frequency
13

4

Longer wavelengths penetrate the skin more deeply
5

Electromagnetic radiation is measured in watts
Q/Q(M)-478223 Report a Problem

Which of the following statements about electromagnetic radiation is MOST correct?
4

Longer wavelengths penetrate the skin more deeply
Longer wavelengths penetrate the skin more deeply. Electromagnetic radiation can be conceptualized
as packets of ENERGY called photons. The energy of photons is proportional to the FREQUENCY and
inversely proportional to WAVELENGTH. Electromagnetic radiation is measured in wavelength.
Q/Q(M)-478223 Report a Problem


Hereditary PMLE of Native Americans:
1

Is more similar to PMLE than to actinic prurigo
2

Often presents with chelitis and conjunctivitis
3

Is not treated with thalidomide
4

Rarely persists into adulthood
5

All of these answers are correct
Q/Q(M)-476087 Report a Problem

Hereditary PMLE of Native Americans:
2

Often presents with chelitis and conjunctivitis
Hereditary PMLE of Native Americans is similar to actinic prurigo but persists much more frequently
into adulthood. 75% of patients have a positive family history. It presents with a papular, excoriated,
eczematous dermatitis that occurs predominantly on the face. Chelitis and conjunctivitis are common. It
may be treated with thalidomide.
Q/Q(M)-476087 Report a Problem
In solar urticaria wheals typically:
1

Begin at 45 minutes after exposure and last 2 hours (h.)
2

Begin at 1-2 h. and last 2-4 h
3

Begin at 15-30 minutes and last 1 h
4

Begin at 30-60 minutes and last 1-4 h
5

Begin at 15-30 seconds and last about 15 minutes
Q/Q(M)-474682 Report a Problem

In solar urticaria wheals typically:
3

Begin at 15-30 minutes and last 1 h
The wheals of solar urticaria begin 10-15 minutes after exposure and last for about an hour. Solar
urticaria is usually idiopathic. Rare cases are associated with EPP, SLE, and certain medications.
Q/Q(M)-474682 Report a Problem

14

Which of the following is NOT true regarding polymorphous light eruption?
1

Usually appears in the first three decades
2

May be a manifestation of a type IV hypersensitivity reaction
3

Vesicles and an eczematous dermatitis are a common presentation
4

Not all exposed areas show lesions
5

It may occur through windowglass, which filters out UVB
Q/Q(M)-476084 Report a Problem

Which of the following is NOT true regarding polymorphous light eruption?
3

Vesicles and an eczematous dermatitis are a common presentation
Polymorphous light eruption is the most common photodermatosis. It is an idiopathic disease that
usually appears in the first three decades. Pathogenesis is unclear but it may be related to a type IV
hypersensitivity reaction. Most lesions are erythematous, pruritic papules. The plaque form is less
common, and vesicles and an eczematous dermatitis are rare. Not all exposed areas show lesions, but
the same areas are affected year after year. It may improve as the summer progresses. It may occur
through windowglass, which filters out UVB.
Q/Q(M)-476084 Report a Problem

The UVC portion of the electromagnetic spectrum extends from:
1

10-200 nm
2

200-290 nm
3

290-320 nm
4

400-760 nm
5

None of these answers are correct
Q/Q(M)-476731 Report a Problem

The UVC portion of the electromagnetic spectrum extends from:
2

200-290 nm
Ultraviolet C does not reach the earth's surface. It is filtered out by the ozone layer. It extends from
200-290 nm.
Q/Q(M)-476731 Report a Problem

Medication photosensitivity is caused by all except:
1

Thiazides
2

Cephalosporins
3

Phenothiazenes
4

Quinolones
5

Doxycycline
Q/Q(M)-474690 Report a Problem
Medication photosensitivity is caused by all except:
2

Cephalosporins
15

Cephalosporins do not cause drug photosensitivity. Neither do the penicillins.
Q/Q(M)-474690 Report a Problem

Which of the following is true regarding immediate pigment darkening?
1

Contributes to constitutive skin color
2

Caused by UVA radiation
3

Prominent in lightly pigmented individuals
4

Requires the synthesis of new melanin
5

Becomes prominent 48 hr after exposure
Q/Q(M)-477381 Report a Problem

Which of the following is true regarding immediate pigment darkening?
2

Caused by UVA radiation
Tanning develops in two phases, early (transitory) and late (stable). The immediate darkening is in
response to UVA and is related to photo-oxidation of pre-existing melanin.
Q/Q(M)-477381 Report a Problem

Photoonycholysis has been attributed to:
1

Amiodarone
2

Chlorpromazine
3

Quinine
4

Furosemide
5

Tricyclic antidepressants
Q/Q(M)-476093 Report a Problem

Photoonycholysis has been attributed to:
3

Quinine
Photoonycholysis is a manifestation of medication photosensitivity that has been attributed to
quinolones, tetracyclines, psoralens, and quinine.
Q/Q(M)-476093 Report a Problem

A joule is a measurement of:
1

Energy
2

Power
3

Irradiance
4

Wavelength
5

Distance
Q/Q(M)-478224 Report a Problem

A joule is a measurement of:
1

Energy
A joule is a measurement of energy dose or fluence. Power or irradiance is measured in watts. These
are related by the formula Joules/cm2=Watts/cm2xseconds.
16

Q/Q(M)-478224 Report a Problem

Which of the following statements about the light sources for phototesting/phototherapy is correct?
1

The most common light sources are incandescent bulbs
2

Phototherapy bulbs are low-pressure sulfur vapor lamps with the inner surface coated by a
specific phosphor
3

The mercury vapor is excited by electric current and emits a line spectrum of 254 nm
4

The phosphor emits a discoherent spectrum of various wavelengths
5

Broadband UVB bulbs emit throughout the UVB range and also include some UVC
Q/Q(M)-478249 Report a Problem

Which of the following statements about the light sources for phototesting/phototherapy is correct?
3

The mercury vapor is excited by electric current and emits a line spectrum of 254 nm
Fluorescent bulbs are commonly used for phototherapy. These bulbs are low-pressure mercury vapor
lamps with the inner surface coated by a specific phosphor. The phosphor emits a continuous spectrum
of various wavelengths. The mercury vapor is excited by electric current and emits a line spectrum of
254 nm. Broadband UVB bulbs emit throughout the UVB range and also include some UVA, not UVC.
Q/Q(M)-478249 Report a Problem

All of the following statements regarding chronic actinic dermatitis are true EXCEPT:
1

The MEDB on phototesting is markedly diminished in patients with this condition
2

Many cases begin as photoallergic contact dermatitis or drug photosensitivity
3

Fluorescent bulbs are safer for these patients than are incandescent bulbs
4

Azathioprine has been used successfully to treat this disorder
5

Many patients have a lowered threshold to shorter wavelength visible light
Q/Q(M)-476089 Report a Problem
All of the following statements regarding chronic actinic dermatitis are true EXCEPT:
3

Fluorescent bulbs are safer for these patients than are incandescent bulbs
Chronic actinic dermatitis (CAD) usually occurs in middle-aged to elderly males who present with a
chronic, eczematous dermatitis in a photodistribution, though there is no history of current exposure to
a photosensitizer. Phototesting is very helpful in diagnosing CAD. The MEDB is markedly diminished,
and the MEDB site may show an eczematous or infiltrated appearance. Many of the patients have a
lowered MEDA as well, and may have a lowered threshold to shorter wavelength visible light in the
blue-violet end of the spectrum. Many cases of this idiopathic disorder are thought to have begun as
photoallergic contact dermatitis or as a drug photosensitivity with broadening of the photosensitivity to
include the UVB range. It is unclear why photosensitivity persists when the photosensitizer is no longer
present. Treatment includes strict sun avoidance and sun protection. Incandescent bulbs with longer
wavelengths, far from the blue-violet end of the visible spectrum, should be used instead of fluorescent
bulbs, which have significant blue-violet radiation. Topical and oral steroids, oral azathioprine and
cyclosporine, and PUVA have all been used to treat patients with CAD.
Q/Q(M)-476089 Report a Problem

A patient that rarely burns and usually tans is which of the following skin types?
1

Type I
2

Type II
17

3

Type III
4

Type IV
5

Type V
Q/Q(M)-478248 Report a Problem

A patient that rarely burns and usually tans is which of the following skin types?
3

Type III
Skin type I always burns and never tans Skin type II usually burns and rarely tans Skin type III rarely
burns and usually tans Skin type IV never burns and alway tans Skin types V,VI are highly pigmented
individuals
Q/Q(M)-478248 Report a Problem

Which spectrum of UV is responsible for the conversion of 7-dehydrocholesterol in the skin to pre-
vitamin D3?
1

200-290 nm
2

290-320 nm
3

320-340 nm
4

340-400 nm
5

10-200 nm
Q/Q(M)-478227 Report a Problem
Which spectrum of UV is responsible for the conversion of 7-dehydrocholesterol in the skin to pre-
vitamin D3?
2

290-320 nm
Ultraviolet B with the spectrum of 290-320 nm is responsible for the conversion of 7-
dehydrocholesterol in the skin to pre-vitamin D3.
Q/Q(M)-478227 Report a Problem

The UVAII portion of the electromagnetic spectrum extends from:
1

200-290 nm
2

290-320 nm
3

320-400 nm
4

320-340 nm
5

None of these answers are correct
Q/Q(M)-476732 Report a Problem
The UVAII portion of the electromagnetic spectrum extends from:
4

320-340 nm
UVA extends from 320-400nm. UVA is further subdivided into UVAII (320-340nm) and UVA1 (340-
400nm).
Q/Q(M)-476732 Report a Problem

The most common presentation of a patient with medication photosensitivity is:
18

1

Photoonycholysis
2

Lichenoid eruptions
3

Diffuse erythema in sun-exposed areas
4

Pseudoporphyria
5

Fixed erythematous patch
Q/Q(M)-478256 Report a Problem

The most common presentation of a patient with medication photosensitivity is:
3

Diffuse erythema in sun-exposed areas
Most patients with medication photosensitivity present with diffuse erythema in sun-exposed areas. In
some patients, the eruption is eczematous and covered areas are spared. Photoonycholysis, lichenoid
eruptions and pseudoporphyria do occur with mediation photosensitivity, but are not the most common
presentation. Fixed erythematous patch is not seen with this type of reaction.
Q/Q(M)-478256 Report a Problem

Which of the following is a manifestation of dermatoheliosis?
1

Hydroa vacciniforme
2

Actinic prurigo
3

Chronic actinic dermatitis
4

Brachioradial pruritis
5

Cutis rhomboidalis nuchae
Q/Q(M)-482563 Report a Problem

Which of the following is a manifestation of dermatoheliosis?
5

Cutis rhomboidalis nuchae
Dermatoheliosis, also known as photoaging, is induced by chronic sun exposure. Clinical variants
include cutis rhomboidalis nuchae, which appears as leathery skin on the posterior neck with
exaggerated skin markings. Other variants include striated beaded lines (small yellowish papules and
plaques along the sides of the neck), Dubreuilh elastoma (translucent papule which may mimic a basal
cell carcinoma), and Favre-Racouchot syndrome (nodular elastoidosis with cysts and comedones).
Hydroa vacciniforme, actinic prurigo, chronic actinic dermatitis, and brachioradial pruritis are
photosensitivity disorders.
Q/Q(M)-482563 Report a Problem


Which of the following is the most likely cause of photosensitivity?
1

Quinolones
2

Sulfonamides
3

Doxycycline
4

Minocycline
5

Penicillin V
Q/Q(M)-478091 Report a Problem

Which of the following is the most likely cause of photosensitivity?
19

3

Doxycycline
Doxycycline is the tetracycline derivative most likely to cause photosensitivity. Quinolones and
sulfonamides will also cause this with ingestion. Minocycline is the least photosensitizing of the
tetracycline derivatives. Penicillin is not a common cause of photosensitivity.
Q/Q(M)-478091 Report a Problem
Which medication reactivates UVB- and PUVA-induced erythema?
1

Dacarbazine
2

5-FU
3

Vinblastine
4

Methotrexate
5

None of these answers are correct
Q/Q(M)-476736 Report a Problem

Which medication reactivates UVB- and PUVA-induced erythema?
4

Methotrexate
Methotrexate reactivates UVB- and PUVA-induced erythema.
Q/Q(M)-476736 Report a Problem

The best definition for a MED is:
1

The dose of ultraviolet radiation that produces barely perceptible erythema that completely fills
the test square
2

The dose of ultraviolet radiation that produces a easily visible "sunburn"
3

The dose of ultraviolet radiation that is one step below the first visible erythema
4

The dose of ultraviolet radiation that produces pronounced erythema that completely fills the test
square
5

The dose of ultraviolet radiation that produces bullae that completely fills the test square
Q/Q(M)-478251 Report a Problem

The best definition for a MED is:
1

The dose of ultraviolet radiation that produces barely perceptible erythema that completely fills
the test square
An MED is the dose of ultraviolet radiation that produces barely perceptible erythema that completely
fills the test square. The remaining options are incorrect.
Q/Q(M)-478251 Report a Problem


Phototesting of PMLE patients reveals:
1

Normal MEDB, reduced MEDA.
2

Normal MEDB, elevated MEDA.
3

Normal MEDB, normal MEDA.
4

Lowered MEDB, lowered MEDA.
5

Lowered MEDB, normal MEDA.
Q/Q(M)-474680 Report a Problem
20


Phototesting of PMLE patients reveals:
3

Normal MEDB, normal MEDA.
The MEDB and MEDA are normal in PMLE patients. Only with multiples of the MEDB or MEDA can
one often reproduce the lesions.
Q/Q(M)-474680 Report a Problem

A patient presents with onycholysis after sun exposure. Which of the following medications would be
least likely as a cause of this presentation?
1

Quinolones
2

Tetracyclines
3

Psoralens
4

Quinine
5

Chlorpromazine
Q/Q(M)-478254 Report a Problem

A patient presents with onycholysis after sun exposure. Which of the following medications would be
least likely as a cause of this presentation?
5

Chlorpromazine
Chlorpromazine is associated with blue-gray pigmentation on sun-exposed areas and is not associated
with photoonycholysis. Quinolones, tetracyclines, psoralens and quinine can cause photoonycholysis.
Q/Q(M)-478254 Report a Problem

Oral PUVA has been used to treat which of the following diseases:
1

CTCL
2

Mastocytosis
3

Graft-versus-host disease
4

Generalized granuloma annulare
5

All of these answers are correct
Q/Q(M)-474696 Report a Problem

Oral PUVA has been used to treat which of the following diseases:
5

All of these answers are correct
PUVA has been reported to have helped patients with all the diseases listed.
Q/Q(M)-474696 Report a Problem

Which of the following statements is true regarding UV radiation, erythema, and pigmentation?
1

UVB erythema reaches a maximum in 24-36 hours
2

The chromophores involved with UVB erythema are melanosomes
3

Immediate pigment darkening is brought on by UVA and visible light
4

Immediate pigment darkening fades within 12-24 hours after exposure
21

5

Delayed tanning, which becomes visible about 72 hours after exposure, is largely brought on by
UVA.
Q/Q(M)-476081 Report a Problem

Which of the following statements is true regarding UV radiation, erythema, and pigmentation?
3

Immediate pigment darkening is brought on by UVA and visible light
UVB in natural sunlight is the main contributor to erythema. UVB erythema reaches a maximum in 6-
24 hours. The chromophores involved with UVB erythema are not clear but appear to involve nucleic
acids. Immediate pigment darkening is brought on by UVA and visible light, and fades within minutes
after exposure. Delayed tanning becomes visible about 72 hours after UVB exposure. UVA contributes
to a lesser extent to delayed tanning.
Q/Q(M)-476081 Report a Problem

Ultraviolet radiation from the sun cause ALL of the following acute effects EXCEPT?
1

Epidermal thickening
2

Photosynthesis of vitamin D
3

Sunburning
4

Immediate pigment darkening
5

Increased immune surveillance
Q/Q(M)-478226 Report a Problem

Ultraviolet radiation from the sun cause ALL of the following acute effects EXCEPT?
5

Increased immune surveillance
UV radiation causes acute effects including: photosynthesis of vitamin D, sunburning, immediate
pigment darkening, delayed tanning, epidermal thickening and immunologic effects such as
DECREASED immune surveillance.
Q/Q(M)-478226 Report a Problem

Patients with chronic actinic dermatitis (CAD) typically show on phototesting:
1

Lowered MEDB, usually lowered MEDA, sometimes positive photopatch tests
2

Lowered MEDB, usually normal MEDA, sometimes positive photopatch tests
3

Normal MEDB, lowered MEDA, sometimes positive photopatch tests
4

Normal MEDB, normal MEDA, sometimes positive photopatch tests
5

None of the above
Q/Q(M)-474684 Report a Problem
Patients with chronic actinic dermatitis (CAD) typically show on phototesting:
1

Lowered MEDB, usually lowered MEDA, sometimes positive photopatch tests
The hallmark of CAD is a lowered MEDB. Often the patients have a lowered MEDA. It is felt that
many of CAD patients began with photoallergic contact dermatitis, so some have positive photopatch
tests.
Q/Q(M)-474684 Report a Problem
The action spectrum for photoallergy is mostly in which spectrum?
1

320-425nm
22

2

290-320nm
3

311-312nm
4

200-290nm
5

400-760nm
Q/Q(M)-479419 Report a Problem
The action spectrum for photoallergy is mostly in which spectrum?
1

320-425nm
The action spectrum for photoallergic dermatoses refers to the specific wavelengths of light that evoke
the photosensitive reaction. This falls mostly within the UVA region and may spill into the visible light
region for photoallergy (320-425nm). 200-290nm refers to the UVC region; 290-320nm refers to the
UVB region; 311-312nm refers to narrowband UVB region; and 400-769nm refers to the visible light
region.
Q/Q(M)-479419 Report a Problem
Rare cases of which photosensitivity disorder have been associated with erythropoietic protoporphyria?
1

Hydroa vacciniforme
2

Solar urticaria
3

Actinic prurigo
4

Polymorphous light eruption
5

Chronic actinic dermatitis
Q/Q(M)-476088 Report a Problem

Rare cases of which photosensitivity disorder have been associated with erythropoietic protoporphyria?
2

Solar urticaria
Rare cases of solar urticaria have been associated with erythropoietic protoporphyria (EPP), lupus
erythematosus (LE), and with certain drugs. Blood tests for LE and EPP should be performed in
patients with this diagnosis.
Q/Q(M)-476088 Report a Problem
Which of the following statements is true regarding pseudoporphyria?
1

Porphyrins may be normal
2

It has been associated with furosemide
3

Clinically it may be indistinguishable from porphyria cutanea tarda
4

All of these answers are correct
5

None of these answers are correct
Q/Q(M)-476096 Report a Problem
Which of the following statements is true regarding pseudoporphyria?
4

All of these answers are correct
Pseudoporphyria is a phototoxic reaction that clinically and histologically resembles porphyria cutanea
tarda. In pseudoporphyria, however, there is no porphyrin abnormality. It has been associated with
numerous medications, including nalidixic acid, tetracyclines, amiodarone, furosemide, and ketoprofen.
Q/Q(M)-476096 Report a Problem
Ultraviolet light spectrum most completely encompasses which of the following spectrums?
23

1

200 - 400 nm
2

290 - 400 nm
3

10 - 400 nm
4

400 - 700 nm
5

760 - 1200 nm
Q/Q(M)-478221 Report a Problem
Ultraviolet light spectrum most completely encompasses which of the following spectrums?
3

10 - 400 nm
The ultraviolet spectrum encompasses Vacuum UV from 10-200nm, UV-C from 200-290nm, UV-B
from 290-320nm and UV-A from 320-400nm. The visible light spectrum is from 400-700nm. 700-1200
nm is part of the infrared spectrum.
Q/Q(M)-478221 Report a Problem
Initial treatment of this disease should include:
1

Sun avoidance, sunblocks, beta carotene
2

Sun avoidance, sunblocks, desensitization
3

Hydroxychloroquine
4

Car UV filters, PUVA, sunblocks
5

Sun avoidance, sunblock, antihistamines
Q/Q(M)-474950 Report a Problem


Initial treatment of this disease should include:
5

Sun avoidance, sunblock, antihistamines
Treatment of solar urticaria is difficult. Sun avoidance is the most important aspect of treatment. A
broad-spectrum sunblock and antihistamines.
Q/Q(M)-474950 Report a Problem

Which of the following statements about UVR in vivo is correct?
1

induces skin cancers
2

normalizes Langerhans cell morphology and function
3

decreases circulating levels of cytokins (IL-1, IL-6 and TNF)
4

normalizes cell trafficking
24

5

normalizes proportions of lymphocyte subtypes in peripheral blood
Q/Q(M)-478247 Report a Problem

Which of the following statements about UVR in vivo is correct?
1

induces skin cancers
UVR can induce skin cancer. UVR in vivo INCREASES circulating levels of cytokins (IL-1, IL-6 and
TNF) and alters Langerhans cell morphology, cell trafficking, and the proportion of lymphocyte
subtypes in peripheral blood.
Q/Q(M)-478247 Report a Problem

Which patient most likely has chronic actinic dermatitis?
1

A 30-year old female with erythematous pruritic papules on the chest that recur each summer
2

A girl with excoriated papules and nodules on sun-exposed and non-sun-exposed areas with
cheilitis
3

A Native American adult with papules excoriated dermatitis on the face with cheilitis
4

A middle-aged male with recurring wheals that begin 20 min after sun exposure
5

An elderly man with persistent eczematous dermatitis in a photodistribution
Q/Q(M)-482245 Report a Problem

Which patient most likely has chronic actinic dermatitis?
5

An elderly man with persistent eczematous dermatitis in a photodistribution
Chronic actinic dermatitis typically affects middle-aged to elderly males and present as a chronic,
eczematous dermatitis in a photodistributed area with relative sparing of the upper lids, behind the ears,
and submental area. Occasionally non-sun-exposed areas are involved. These patients show histology
that resembles mycosis fungoides. Importantly, these patients also have altered phototesting, usually
with a diminished MEDb thought MEDa may also be decreased. Recurring erythematous pruritic
papules and less likely plaques can be seen in polymorphous light eruption. Children with excoriated
papules on sun-exposed and non-sun-exposed areas with cheilis is typical of actinic prurigo. Hereditary
polymorphous light eruption of Native Americans presents with an excoriated facial dermatitis. Solar
urticaria characteristically begin 10-30 min after exposure and last for about one hour.
Q/Q(M)-482245 Report a Problem
A normal MEDB on untanned Caucasian skin ranges from approximately:
1

2-6 mJ/cm2
2

15-40 mJ/cm2
3

20-70 mJ/cm2
4

70-140 mJ/cm2
5

140-200 mJ/cm2
Q/Q(M)-474698 Report a Problem

A normal MEDB on untanned Caucasian skin ranges from approximately:
3

20-70 mJ/cm2
The MEDB can vary from institution to institution. In one institution, it may range from 20-70 mJ/cm2.
In another institution, it may range from 30-90 mJ/cm2.
Q/Q(M)-474698 Report a Problem
25


Which of the following hypoglycemics is the most common cause of photosensitivity?
1

Insulin
2

Sulfonylureas
3

Metformin
4

Thiazolidinediones (i.e. rosiglitazone)
5

Piroxicam
Q/Q(M)-478088 Report a Problem

Which of the following hypoglycemics is the most common cause of photosensitivity?
2

Sulfonylureas
The sulfonylurea hypoglycemics for diabetes are the most common type of medication of this class of
medications. Piroxicam is not a hypoglycemic agent, but a common NSAID cause of photoallergy.
Q/Q(M)-478088 Report a Problem

Which of the following statements regarding phototesting is correct?
1

The UVB MED is performed using narrowband UVB light sources
2

The UVA MED is performed using a narrowband UVA source
3

To test for a visible light reaction, a slide projector is used as a light source
4

Repeated MEDs to UVB or UVA, given to different test sites over several days can be used to
reproduce lesions of polymorphous light eruption
5

A single large dose of visible light is the best way to reproduce lesions of polymorphous light
eruption
Q/Q(M)-478253 Report a Problem

Which of the following statements regarding phototesting is correct?
3

To test for a visible light reaction, a slide projector is used as a light source
Phototesting is done prior to initiating phototherapy or during provocative induction. To test for a
visible light reaction, a slide projector is used as a light source. The other choices are incorrect. The
UVB MED and UVA MED is performed using BROADBAND UVB and BROADBAND UVA light
sources respectively. Repeated MED's to UVB or UVA given to the SAME site may be used to
reproduce lesions of PMLE. Alternatively a single large dose of UVA or UVB can be used to reproduce
PMLE.
Q/Q(M)-478253 Report a Problem

The MPD of Oxsoralen plus UVA is:
1

Measured at 24 hours
2

Equal to one-half the patients MEDA
3

Tested on the patients calf or abdomen
4

Helpful in starting PUVA therapy
5

None of these answers are correct
26

Q/Q(M)-474693 Report a Problem

The MPD of Oxsoralen plus UVA is:
4

Helpful in starting PUVA therapy
MPD stands for the minimal phototoxic dose. For Oxsoralen plus UVA, the MPD is measured at 48-72
hours. Testing is done on the upper buttock or forearm.
Q/Q(M)-474693 Report a Problem

Of the following which one is most characteristic of photoxocity rather than photoallergy?
1

Onset in hours to days
2

Eczematous dermatitis
3

Cross-reactivity to chemically similar agents
4

Often caused by furocoumarins
5

Relatively low incidence
Q/Q(M)-482244 Report a Problem

Of the following which one is most characteristic of photoxocity rather than photoallergy?
4

Often caused by furocoumarins
Furocoumarins may cause a phytophotodermatitis that is a phototoxic reaction. Such reactions occurs
with high frequency in the population, occur within minutes to hours from exposure, and appear like an
exaggerated sunburn. The other answers are common with photoallergy, such as seen with sunscreens,
fragrances, and various systemic medications like chlorpromazine.
Q/Q(M)-482244 Report a Problem

What is the most likely cause of these lesions on the cheek of this 8 year-old boy?
1

Acne
2

Herpes simplex
3

Varicella
4

Hydroa vacciniforme
5

Polymorphous light eruption
Q/Q(M)-476855 Report a Problem


What is the most likely cause of these lesions on the cheek of this 8 year-old boy?
4

Hydroa vacciniforme
Hydroa vacciniforme is a rare photodermatosis of childhood which occurs on areas of sun-exposed
skin. The lesions leave depressed and atrophic scars. The condition tends to spontaneously resolve in
27

adulthood.
Q/Q(M)-476855 Report a Problem
Which of the following genodermatoses is NOT worsened by sunlight?
1

Darier's disease
2

Kindler syndrome
3

Hartnup disease
4

Rothmund-Thompson syndrome
5

Job syndrome
Q/Q(M)-478324 Report a Problem
Which of the following genodermatoses is NOT worsened by sunlight?
5

Job syndrome
Many genodermatoses can be exacerbated by sunlight including Darier's, Kindler, Rothmund
Thompson, Hartnup (pellagra changes).
Q/Q(M)-478324 Report a Problem
Ultraviolet radiation from the sun causes all of the following acute effects in the skin EXCEPT:
1

Redistribution of melanosomes from a perinuclear position into dendrites
2

Epidermal thickening
3

Mast cell degranulation
4

Photooxidation of preexisting melanin
5

None of these answers are correct
Q/Q(M)-476076 Report a Problem
Ultraviolet radiation from the sun causes all of the following acute effects in the skin EXCEPT:
5

None of these answers are correct
All of these statements are acute effects of UV raditation on the skin. Immediate pigment darkening,
which fades within minutes after exposure, is brought on by UVA and visible light. It is caused by
photooxidation of preexisting melanin and a redistribution of melanosomes from a perinuclear position
into dendrites. Epidermal thickening is mainly a UVB-induced phenomenon. Mast cell degranulation,
with release of histamine and other mast cell products, also occurs as a result of UV radiation.
Q/Q(M)-476076 Report a Problem
As a result of ultraviolet radiation:
1

There is mast cell degranulation and release of histamine
2

Prostaglandins are increased
3

Epidermal thickening occurs
4

All of these answers are correct
5

None of these answers are correct
Q/Q(M)-476730 Report a Problem

As a result of ultraviolet radiation:
4

All of these answers are correct
28

Effects of ultraviolet radiation include mast cell degranulation with release of histamine and other mast
cell products, increases in certain prostaglandins and interleukins, and epidermal thickening, which is
mainly a UVB-induced phenomenon.
Q/Q(M)-476730 Report a Problem

Phytophotodermatitis can be seen with the following fruits / vegetables:
1

Potatoes and leeks
2

Tomatoes and bananas
3

Celery and radishes
4

Parsnips and limes
5

Lemons and pears
Q/Q(M)-474688 Report a Problem

Phytophotodermatitis can be seen with the following fruits / vegetables:
4

Parsnips and limes
Psoralens in certain plants, fruits, and vegetables can cause phytophotodermatitis. The most common
ones are limes, figs, parsley, parsnip, bergamot oranges, and celery.
Q/Q(M)-474688 Report a Problem

Currently the most common cause of photoallergic contact dermatitis is:
1

Halogenated salicylanilides
2

Musk ambrette
3

6-methylcoumarin
4

Sunscreens
5

Mercaptobenzothiazole
Q/Q(M)-474689 Report a Problem

Currently the most common cause of photoallergic contact dermatitis is:
4

Sunscreens
Halogenated salicylanilides, musck ambrette and 6-methylcoumarin used to cause most of the cases of
photoallergic contact dermatitis. They have been essentially eliminated from soaps and fragrances.
Sunscreen ingredients are now the most common cause.
Q/Q(M)-474689 Report a Problem

Narrow band UVB consists of what wavelength?
1

300-306nm
2

308-310nm
3

311-313nm
4

312-320nm
5

320-330nm
Q/Q(M)-478593 Report a Problem

Narrow band UVB consists of what wavelength?
29

3

311-313nm
Narrowband UVB is much less erythemogenic with regard to physical units (mJ/cm2) than broadband
UVB. Narrowband UVB is 311-313nm.
Q/Q(M)-478593 Report a Problem
Common side effects of PUVA include all of the following except:
1

Nausea
2

Hair loss
3

Painful erythema
4

Prolonged pruritus
5

Squamous cell carcinoma
Q/Q(M)-474697 Report a Problem

Common side effects of PUVA include all of the following except:
2

Hair loss
Alopecia is not a usual side effect of PUVA treatment.
Q/Q(M)-474697 Report a Problem

Which of the following statements about the hypothetical effect of UVR on cancer induction is correct?
1

UVR induces transformation of keratinocytes with expression of tumor-associated antigens
2

UVR alters APC function, by increasing the number of antigen-presenting cells
3

UVR inhibits the release of immunosuppressive factors
4

Suppressor T-cells are suppressed
5

UVR increases the ability of Langerhans cells to present antigen
Q/Q(M)-478246 Report a Problem
Which of the following statements about the hypothetical effect of UVR on cancer induction is correct?
1

UVR induces transformation of keratinocytes with expression of tumor-associated antigens
UVR induces transformation of keratinocytes with expression of tumor associated antigens. It alters
APC function by reducing the number of antigen presenting cells. It also promotes the release of
immunosuppressive factors, induce suppressor t-cells, and decreases the ability of Langerhans cells to
present antigen.
Q/Q(M)-478246 Report a Problem
The main contributor to erythema of the skin with exposure to the sun is:
1

UVC
2

UVB
3

UVA1
4

UVA2
5

Visible light
Q/Q(M)-478229 Report a Problem
The main contributor to erythema of the skin with exposure to the sun is:
30

2

UVB
UVB in natural sunlight is the main contributor to erythema. UVB erythema reaches a maximum in 6-
24 hours. UVA accounts for 15-20% of sunlight erythema despite that there is much more UVA than
UVB in sunlight.
Q/Q(M)-478229 Report a Problem

All of the following are true regarding actinic reticuloid except:
1

Affects elderly men
2

CD8+ T cells in lesional skin
3

Is a premalignant condition
4

Atypical dermal mononuclear cell infiltrate
5

Generalized lymphadenopathy common
Q/Q(M)-477231 Report a Problem

All of the following are true regarding actinic reticuloid except:
3

Is a premalignant condition
Actinic reticuloid is a type of chronic actinic dermatitis. Ive et al. introduced the disease as a severe
dermatosis with no apparent photoallergen. It generally affects elderly males and is characterized by
infiltrated erythematous plaques on an eczematous background in exposed sites with lymphadenopathy.
Histopathologically, it may resemble cutaneous T cell lymphoma. However, there is a trend towards a
lower CD4+/CD8+ ratio. It is not considered a premalignant condition.
Q/Q(M)-477231 Report a Problem

The portion of the electromagnetic spectrum that produces a particular biologic effect is called the:
1

Action Spectrum
2

Absorption Spectrum
3

Cutaneous Effect Spectrum
4

Effective Spectrum
5

Spectral Activity
Q/Q(M)-474669 Report a Problem

The portion of the electromagnetic spectrum that produces a particular biologic effect is called the:
1

Action Spectrum
The action spectrum is the wavelengths that produce a certain biologic effect. The action spectrum for
photosensitivity from exogenous chemicals is usually in the UVA range. The radiation that is absorbed
by those chemicals is called their absorption spectrum.
Q/Q(M)-474669 Report a Problem

Solar urticaria:
1

Is an idiopathic, type IV photosensitivity disorder
2

Can present with headache, nausea, and syncope
3

Rarely lasts for more than 6 months to 1 year
4

Usually occurs to only UVB radiation
31

5

Is not benefitted by antihistamines
Q/Q(M)-476090 Report a Problem

Solar urticaria:
2

Can present with headache, nausea, and syncope
Solar urticaria is an idiopathic, type I photosensitivity disorder. Mediator release during widespread
whealing may result in headache, nausea, wheezing, faintness, and syncope. It usually lasts for many
years. Some patients react with wheals to either visible light or UVA or UVB. Others react to both
UVA and visible radiation. Some react to both UVB and UVA, and some patients react to UVB, UVA,
and visible radiation. Treatment includes sun avoidance and protection, and H-1 antihistamines may be
of partial benefit.
Q/Q(M)-476090 Report a Problem

Which of the following drugs is commonly known to produce photosensitivity?
1

Quinidine
2

Sulfonylureas
3

Griseofulvin
4

All of these answers are correct
5

None of these answers are correct
Q/Q(M)-476734 Report a Problem

Which of the following drugs is commonly known to produce photosensitivity?
4

All of these answers are correct
Quinidine, sulfonlyureas, and griseofulvin are all known to cause photosensitivity.
Q/Q(M)-476734 Report a Problem

UVA II encompasses which wavelengths ?
1

290-320 nm
2

320-400 nm
3

400-450 nm
4

320-340 nm
5

340-400 nm
Q/Q(M)-474666 Report a Problem
UVA II encompasses which wavelengths ?
4

320-340 nm
UVA can be divided into UVA II (320-340 nm) and UVA I (340-400 nm).
Q/Q(M)-474666 Report a Problem

Which of the following statements about the spectrums of UVR that cause of solar urticaria is MOST
correct?
32

1

Visible light causes solar urticaria
2

UVA causes solar urticaria
3

UVB causes solar urticaria
4

Both UVA and UVB cause solar urticaria
5

Patients can react to visible light, UVA and/or UVB
Q/Q(M)-478268 Report a Problem

Which of the following statements about the spectrums of UVR that cause of solar urticaria is MOST
correct?
5

Patients can react to visible light, UVA and/or UVB
Some patients react with wheals to either visible light or UVA or UVB. Others react to both UVA and
visible radiation. Some react to both UVB and UVA, and some patients react to UVB, UVA and visible
light.
Q/Q(M)-478268 Report a Problem

Which of the following is the most common photodermatosis?
1

Hydroa vacciniforme
2

Chronic actinic dermatitis
3

Actinic prurigo
4

Polymorphous light eruption
5

Solar urticaria
Q/Q(M)-478259 Report a Problem

Which of the following is the most common photodermatosis?
4

Polymorphous light eruption
Polymorphous light eruption is the most common photodermatosis. It is a idiopathic disease that
usually appears in the first three decades of life and is more common in fair-skinned females. The
pathogenesis is unclear, but is believed to be related to a type IV hypersensitivity reaction. Most lesions
are erythematous pruritic papules, with the plaque form being less common. Lesions appear
symetrically on exposed areas after a delay of several hours to several days. Patients with mild disease
are treated with sun avoidance and a broad spectrum sunscreen. In more severe cases, hardening and
desensitization can be accomplished or antimalarials can be used for resistant cases. For brief, sunny
vacations, a short course of prednisone can be helpful. The other options are less common forms of
idiopathic photosensitivity disorders.
Q/Q(M)-478259 Report a Problem

Which of the following statements is true regarding ultraviolet carcinogenesis?
1

Mid-range ultraviolet radiation is less efficient in inducing neoplasia in mice that is long wave
UVR
2

Suppressor T-cells arise in UV-irradiated hosts only after tumors have developed
3

Cells from patients with actinic keratoses have normal DNA repair capacity
4

UVA, when added to UVB, may accelerate carcinogenesis
5

UVA is most effective in producing pyrimidine dimers, which may activate oncogenes
Q/Q(M)-476080 Report a Problem
33


Which of the following statements is true regarding ultraviolet carcinogenesis?
4

UVA, when added to UVB, may accelerate carcinogenesis
Mid-range UVR (280-320 nm) is more efficient in inducing neoplasia in mice, but long wave UVA,
when added to UVB, may accelerate carcinogenesis. Suppressor T-cells induce susceptibility to tumors,
and appear to arise in UV-irradiated hosts prior to tumors developing, thus playing a role in
carcinogenesis. Cells from patients with AKs have less DNA repair capacity than controls. UVB is
most effective in producing pyrimidine dimers, which may activate oncogenes, particularly in the
formation of BCCs and SCCs.
Q/Q(M)-476080 Report a Problem

UVB is about how many times more erythermogenic than UVA ?
1

10
2

100
3

1000
4

10000
5

5
Q/Q(M)-474671 Report a Problem

UVB is about how many times more erythermogenic than UVA ?
3

1000
Though UVB is 1000 times more erythermogenic than UVA, UVA is much more plentiful in sunlight.
Therefore, UVA does contribute to sunlight erythema.
Q/Q(M)-474671 Report a Problem

A patient presents with solar urticaria. What tests should be considered initially?
1

ANA
2

ANCA
3

Urinalysis
4

CXR
5

ESR
Q/Q(M)-478267 Report a Problem

A patient presents with solar urticaria. What tests should be considered initially?
1

ANA
Solar urticaria is an idiopathic, type I photosensitivity disorder. Rare cases have been associated with
erythropoietic protoporphyria (EPP) and lupus erythematosus (LE). Blood tests for LE and appropriate
screening for EPP should be performed including ANA, Ro/La, Urine & Stool porphyrins.
Q/Q(M)-478267 Report a Problem

The highest energy visible photons are in which portion of the visible spectrum?
1

Green
34

2

Blue-violet
3

Red-Orange
4

Yellow
5

All of these answers are correct
Q/Q(M)-474667 Report a Problem

The highest energy visible photons are in which portion of the visible spectrum?
2

Blue-violet
In the visible spectrum, the blue-violet portion has the shortest wavelength and the highest energy. The
red-orange portion has the longest wavelength and the lowest energy.
Q/Q(M)-474667 Report a Problem

The xenon arc solar simulator, whose spectrum is in this slide, is useful for:
1

MED-B testing
2

MED-A testing
3

Photopatch testing
4

MED-B testing and MED-A testing
5

MED-B testing, MED-A testing, and Photopatch testing
Q/Q(M)-474961 Report a Problem



The xenon arc solar simulator, whose spectrum is in this slide, is useful for:
4

MED-B testing and MED-A testing
Solar simulator radiation contains both UVB and UVA in sufficient quantities to be useful for MED-B
and MED-A testing. The field size is too small for photopatch testing.
Q/Q(M)-474961 Report a Problem

Which of the following conditions would be least likely to be photo-exacerbated?
1

Herpes simplex
2

Pellagra
3

Transient acantholytic dermatosis
4

Psoriasis
5

Pyridoxine deficiency
Q/Q(M)-478323 Report a Problem
35


Which of the following conditions would be least likely to be photo-exacerbated?
4

Psoriasis
Psoriasis is improved by phototherapy, especially at the wavelengths of 311-312 nm in most cases.
Photosensitive psoriasis can occur, but is the least likely choice to be photo-exacerbated. The other
listed conditions are worsened by UV/sunlight exposure.
Q/Q(M)-478323 Report a Problem

A patient presents with blue-gray pigmentation on sun-exposed areas but does not have involvement of
the sclerae, lunulae or mucous membranes. Which of the following medications is could be causing this
pigmentation?
1

Clindamycin
2

Chlorpromazine
3

Ciprofloxacin
4

Fluoxetine
5

Sertraline
Q/Q(M)-478255 Report a Problem

A patient presents with blue-gray pigmentation on sun-exposed areas but does not have involvement of
the sclerae, lunulae or mucous membranes. Which of the following medications is could be causing this
pigmentation?
2

Chlorpromazine
Amiodarone, chlorpromazine and tricyclic antidepressants all are capable of causing blue-gray
pigmentation on sun-exposed areas without involvement of the sclerae, lunulae or mucous membranes.
Q/Q(M)-478255 Report a Problem


The potent photosensitizer, 5-methoxypsoralen, is contained in which of the following contact
allergens?
1

Oil of Bergamot
2

Balsam of Peru
3

Tuliposide A
4

Usnic acid
5

Eugenol
Q/Q(M)-479420 Report a Problem

The potent photosensitizer, 5-methoxypsoralen, is contained in which of the following contact
allergens?
1

Oil of Bergamot
Oil of Bergamot contains 5-methoxypsoralen and may cause of 'Berloque dermatitis,' an intense post-
inflammatory hyperpigmentation due to an antecedent phytophotodermatitis that may be subclinical.
Q/Q(M)-479420 Report a Problem

36

Absorption of UV radiation generates singlet oxygen in the skin by which chromophore?
1

Melanin
2

Urocanic acid
3

Keratin
4

Hemoglobin
5

Water
Q/Q(M)-477228 Report a Problem

Absorption of UV radiation generates singlet oxygen in the skin by which chromophore?
2

Urocanic acid
Urocanic acid and DNA are biologically important chromophores. DNA absocrbs uVB directly
inducing changes between adjacent pyrimidine bases on one strand of DNA. Cyclopyrimidine dimers,
particularly thymine dimers or less commonly (6-4) photoproducts may be generated. Urocanic acid is
a second biologically important chromophore in the skin and is a by-product of filaggrin breakdown.
One photon of light contains enough energy to generate singlet oxygen.
Q/Q(M)-477228 Report a Problem

The following compound exerts immunosuppressive effects in the skin following exposure to UV-
radiation:
1

Cis-urocanic acid
2

7-dehydrocholesterol
3

IL-12
4

Delta aminolevulinic acid
5

Amino-levulinic acid
Q/Q(M)-478146 Report a Problem


The following compound exerts immunosuppressive effects in the skin following exposure to UV-
radiation:
1

Cis-urocanic acid
Trans-urocanic acid is an epidermal chromophore that isomerizes to cis-urocanic acid following
exposure to UV radiation. Cis-urocanic acid has been shown to be immunosuppressive, for example, by
impairing the induction of contact allergy in mouse models. The mechanism of this immunosuppressive
effect is unclear.
Q/Q(M)-478146 Report a Problem

Actinic prurigo (AP) differs from PMLE in all of the following except:
1

The lesions of AP begin in childhood
2

The lesions of AP occur on all sun-exposed areas
3

Lesions of AP may occur on non-sun exposed areas
4

Cheilitis is rare in AP and common in PMLE
5

Outbreaks of AP are not as clearly related to sun exposure
Q/Q(M)-474681 Report a Problem
37


Actinic prurigo (AP) differs from PMLE in all of the following except:
4

Cheilitis is rare in AP and common in PMLE
Cheilitis is common in actinic prurigo and not a usual accompaniment in PMLE.
Q/Q(M)-474681 Report a Problem

Advantages of narrowband UVB over PUVA therapy are the following EXCEPT:
1

No need for protective eyewear
2

No nausea
3

Safe in childhood
4

Safe in pregnancy
5

More effective in treating thick plaques of CTCL
Q/Q(M)-474692 Report a Problem


Advantages of narrowband UVB over PUVA therapy are the following EXCEPT:
5

More effective in treating thick plaques of CTCL
UVB, both narrowband and broadband, is less penetrating into the skin than UVA. Therefore, PUVA is
more effective for thick plaques of CTCL. The UVB does not reach to the bottom of the plaques.
Q/Q(M)-474692 Report a Problem
UVB converts 7-dehydrocholesterol in the skin to pre-vitamin D3. What is the catalyst of the next step,
the conversion to vitamin D3?
1

Thermal isomerization
2

Enzymatic conversion in the skin
3

Cell mediated conversion
4

No catalyst is needed
5

Enzymatic conversion in the liver
Q/Q(M)-478228 Report a Problem

UVB converts 7-dehydrocholesterol in the skin to pre-vitamin D3. What is the catalyst of the next step,
the conversion to vitamin D3?
1

Thermal isomerization
7-dihydrocholesterol is present in the skin and is converted to previtamin D3 by UV in the spectrum of
290-315 nm. The Previtamin D3 then thermally isomerizes to form vitamin D3 which enters the
circulation. 1-hydroxylation occurs in the liver and 25-hydroxylation in the kidney resulting in the final
form of 1,25-dihydroxyvitamin D3.
Q/Q(M)-478228 Report a Problem

Which of the following cell types induce susceptibility to tumor growth?
1

Suppressor T-cells
2

NK cells
3

Helper T-cells
38

4

Mast cells
5

Langerhans cells
Q/Q(M)-478242 Report a Problem

Which of the following cell types induce susceptibility to tumor growth?
1

Suppressor T-cells
The suppressor T-cells induce susceptibility to tumor. These cells appear to arise in UV-irradiated hosts
prior to tumor developing, and play a role in carcinogenesis.
Q/Q(M)-478242 Report a Problem

The irradiance of a UV source is measured in:
1

Joules
2

Seconds
3

Watts
4

Millijoules
5

Centimeters
Q/Q(M)-474668 Report a Problem

The irradiance of a UV source is measured in:
3

Watts
The irradiance of a UV source in watts x the time in seconds equals the UV dose in joules.
Q/Q(M)-474668 Report a Problem

UVB converts 7-dehydrocholesterol in the skin to:
1

25-hydroxyvitamin D
2

1,25-dihydroxyvitamin D
3

Calcitriol
4

Previtamin D3
5

None of the above
Q/Q(M)-476729 Report a Problem

UVB converts 7-dehydrocholesterol in the skin to:
4

Previtamin D3
UVB converts 7-dehydrocholesterol in the skin to previtamin D3, which then thermally isomerizes to
form vitamin D3. It is hydroxylated in the liver and then in the kidney to form 25-hydroxyvitamin D
and 1,25-dihydroxyvitamin D, respectively.
Q/Q(M)-476729 Report a Problem

Actinic prurigo (AP) differs from polymorphous light eruption (PMLE) in that:
1

Chelitis is more frequently seen in PMLE
39

2

Lesions of AP usually begin after puberty
3

Lesions of PMLE occur on all sun-exposed areas
4

Lesions of AP may persist for months, even into the winter
5

Lesions of PMLE may occur on non-sun-exposed areas
Q/Q(M)-476086 Report a Problem
Actinic prurigo (AP) differs from polymorphous light eruption (PMLE) in that:
4

Lesions of AP may persist for months, even into the winter
Actinic prurigo (AP) may be a distinct entity, or an HLA-restricted subset of polymorphous light
eruption (PMLE). AP differs from PMLE in that the lesions of AP always begin in childhood and often
remit in puberty, the lesions of AP occur on all sun-exposed areas and may persist for months, even
into the winter, and the lesions of AP may occur on non-sun-exposed areas. In addition, outbreaks of
AP are not as clearly related to sun exposure, and chelitis is frequently seen in AP, not PMLE.
Q/Q(M)-476086 Report a Problem

Immediate pigment darkening:
1

Is associated with an increase in melanocyte number
2

Is predominately brought on by UVB
3

Start 45-60 minutes after exposure
4

Is predominately brought on by UVA and visible light
5

Is caused by an increase in tyrosinase activity
Q/Q(M)-474672 Report a Problem

Immediate pigment darkening:
4

Is predominately brought on by UVA and visible light
Immediate pigment darkening appears almost as soon as irradiation occurs. It is due to photo-oxidation
of preexisting melanin.
Q/Q(M)-474672 Report a Problem

Which of the following statements about ultraviolet C is incorrect?
1

UV-C does not reach the earth's surface
2

UV-C is absorbed by atmospheric ozone
3

UV-C has an electromagnetic spectrum from 200-290 nm
4

UV-C has higher energy than UV-B
5

UV-C has a higher wavelength than UV-B
Q/Q(M)-478222 Report a Problem

Which of the following statements about ultraviolet C is incorrect?
5

UV-C has a higher wavelength than UV-B
UV-C has wavelengths of 200 - 290 nm. UV-B has wavelengths of 290 - 320 nm. UV-C has a lower
wavelength, not higher. All of the other listed statements about UV-C are correct.
Q/Q(M)-478222 Report a Problem

40

Phototoxicity and photoallergy from exogenous agents typically involve absorption of:
1

UVA
2

UVB
3

UVB and UVA
4

UVA and visible light
5

UVB, UVA and visible light
Q/Q(M)-474686 Report a Problem

Phototoxicity and photoallergy from exogenous agents typically involve absorption of:
1

UVA
Topical and systemic agents that produce phototoxicity and/or photoallergy usually have action spectra
in the UVA range.
Q/Q(M)-474686 Report a Problem

A patient presents with purple polygonal pruritic papules on sun exposed areas. Which of the following
of his medication would not be suspect for causing this eruption?
1

Enalapril
2

Quinidine
3

Fenofibrate
4

Furosemide
5

Hydrochlorothiazide
Q/Q(M)-478257 Report a Problem
A patient presents with purple polygonal pruritic papules on sun exposed areas. Which of the following
of his medication would not be suspect for causing this eruption?
4

Furosemide
Furosemide (Lasix) is not a cause of lichenoid drug reactions, but can cause pseudoporphyria. The
others listed are causes of lichenoid drug reactions. Others are antimalarials, demethylchlortetracycline
and quinine.
Q/Q(M)-478257 Report a Problem

What mutation is responsible for this clinical presentation in a patient with thyroid dysfunction and
chronic candidal infections?
1

AIRE
2

PTEN
3

TRP1
4

fumarate hydratase
5

LYST
Q/Q(M)-476880 Report a Problem
41



What mutation is responsible for this clinical presentation in a patient with thyroid dysfunction and
chronic candidal infections?
1

AIRE
APECED syndrome named for the clinical features of autoimmune polyendocrinopathy, candidiasis,
ectodermal dystrophy and is caused by a mutation in AIRE (autoimmune regulator). 13% of these
patient have vitiligo.
Q/Q(M)-476880 Report a Problem

Photoexacerbated genodermatoses include all except:
1

Tuberous sclerosis
2

Cockayne's Syndrome
3

Hailey-Hailey Disease
4

Hartnup Disease
5

Darier's Disease
Q/Q(M)-474691 Report a Problem
Photoexacerbated genodermatoses include all except:
1

Tuberous sclerosis
Tuberous sclerosis is not associated with photosensitivity.
Q/Q(M)-474691 Report a Problem
Which of the following is true regarding actinic prurigo?
1

Lesions generally continue through late adulthood
2

Lesions persist for 1-2 days
3

Lesions never occur on non-sun-exposed areas
4

Cheilitis is frequently seen
5

Thalidomide has been ineffective for the majority of patients
Q/Q(M)-478264 Report a Problem

Which of the following is true regarding actinic prurigo?
4

Cheilitis is frequently seen
42

Actinic prurigo is an idiopathic photosensitivity disorder. Lesions are excoriated papules and nodules
that begin in childhood and remit in puberty. They can last for several months and may occur on non-
sun-exposed areas. Thalidomide has been very effective for treating the majority of patients with actinic
prurigo.
Q/Q(M)-478264 Report a Problem
Which of the following is not true about UVB radiation?
1

Responsible for sunburn
2

More intense in the summer than winter months
3

Peaks at noon
4

Decreased with high wind velocity
5

Virtually all blocked by car window glass
Q/Q(M)-475875 Report a Problem
Which of the following is not true about UVB radiation?
4

Decreased with high wind velocity
The UVB band extends from 290 to 320 nm. The UVB spectrum is recognized as the primary cause of
sunburn, skin cancer, and other harmful effects on human skin. The UVA band extends from 320 to
400 nm. This spectrum is further subdivided into UVA-2 (320 to 340 nm) and UVA-1 (340 to 400 nm).
The UVA spectrum is recognized as a cause of immediate and delayed tanning reaction of skin, and
several other effects including photoaging, skin photosensitization, and immunosuppression. UVC
radiation comprises wavelengths shorter than 290 nm (from 200 to 290 nm). Notably, window glass
filters out ultraviolet wavelengths shorter than 320 nm, so both UVB and UVC are effectively filtered
by car window glass. UVB radiation is more intense during summer months compared to winter
months and peaks during midday hours. It has been postulated that physical factors such as high
temperature, high humidity, and wind can all increase susceptibility to UV-induced carcinogenesis.
Q/Q(M)-475875 Report a Problem
A 40-year-old patient presents with widespread plaque-type psoriasis without arthritis. She had already
applied potent topical steroids, calcipotriene, and tazarotene. The treatment of choice would be:
1

PUVA
2

Cyclosporine
3

Narrowband UVB
4

Etretinate
5

Methotrexate
Q/Q(M)-474695 Report a Problem

A 40-year-old patient presents with widespread plaque-type psoriasis without arthritis. She had already
applied potent topical steroids, calcipotriene, and tazarotene. The treatment of choice would be:
3

Narrowband UVB
The other choices involve internal medications and therefore have the potential for more side effects
than with narrowband UVB. Phototherapy may be impractical for some patients, and therefore systemic
therapies should be offered.
Q/Q(M)-474695 Report a Problem

43

Lumisterol is an inactive epidermal reservoir of which vitamin?
1

A
2

C
3

D
4

E
5

K
Q/Q(M)-477189 Report a Problem

Lumisterol is an inactive epidermal reservoir of which vitamin?
3

D
Lumisterol and tachysterol are inert byproducts created during the biosynthesis of vitamin D. When
Previtamin D3 is exposed to light, it can result in photoisomerization of previtamin D3 to lumisterol
and tachysterol. If previatmin D3 is depleted, lumisterol and tachysterol can become converted back to
previtamin D3.
Q/Q(M)-477189 Report a Problem

Fluorescent UVA bulbs used for phototesting or PUVA therapy have a peak emission at:
1

254 nm
2

311 nm
3

312 nm
4

352 nm
5

468 nm
Q/Q(M)-476082 Report a Problem

Fluorescent UVA bulbs used for phototesting or PUVA therapy have a peak emission at:
4

352 nm
254 nm is the wavelength of the radiation emitted by mercury vapor lamps. Narrowband UVB emits
311-312 nm. Fluorescent UVA bulbs used for phototesting or PUVA therapy have a peak emission at
352 nm.
Q/Q(M)-476082 Report a Problem

When solar urticaria is a consideration for phototesting:
1

7 test squares of increasing UV doses should be exposed
2

The lower back should not be used for testing
3

An MED (B) and MED (A) should not be performed
4

An additional reading at 15 minutes after exposure should be performed
5

Visible light will not evoke the lesions
Q/Q(M)-476083 Report a Problem

When solar urticaria is a consideration for phototesting:
4

An additional reading at 15 minutes after exposure should be performed
44

When solar urticaria is a consideration, an additional reading at 15 minutes after exposure is important,
as wheals begin within 10-30 minutes after exposure and last for about one hour. The face and hands
may not show lesions as they are chronically exposed to sun. Some patients react to either visible light
or UVA or UVB. Others react to both UVB and UVA, both UVA and visible light, or all three.
Q/Q(M)-476083 Report a Problem

The differential diagnosis of this patient would include:
1

Photoallergic contact dermatitis
2

Airborne contact dermatitis
3

Chronic actinic dermatitis
4

Drug photosensitivity
5

All of these answers are correct
Q/Q(M)-474953 Report a Problem


The differential diagnosis of this patient would include:
5

All of these answers are correct
Photoallergic contact, airborne contact, chronic actinic dermatitis, and drug photosensitivity can all
result in erythema or eczematous patches in sun exposed areas. Subtle clues may help distinguish them
such as involvement of the submental area in a airborne contact dermatitis.
Q/Q(M)-474953 Report a Problem

All of the following are true regarding polymorphous light eruption except:
1

Pruritic
2

Abnormal metabolism of arachidonic acid
3

Hardening occurs with subsequent episodes
4

Lesions heal without scarring
5

Anti-Ro antibody positive
Q/Q(M)-477203 Report a Problem

All of the following are true regarding polymorphous light eruption except:
5

Anti-Ro antibody positive
Polymorphous light eruption is the most common photodermatosis that is characterized clinically by
the abnormal occurrence of pruritic, erythematous, edematous papules following exposure to UV
radiation. Lesions heal without scarring. It tends to affect women 2-3x more than men. Positive Anti-ro
antibodies should raise the suspicious for subacute cutaneous lupus erythematosus (tends also to be less
pruritic).
45

Q/Q(M)-477203 Report a Problem
This patient presented with hyperpigmented streaks after a vacation in the Caribbean. The most likely
diagnosis is:
1

PMLE
2

CAD
3

Melasma
4

Phytophotodermatitis
5

Actinic prurigo
Q/Q(M)-474959 Report a Problem


This patient presented with hyperpigmented streaks after a vacation in the Caribbean. The most likely
diagnosis is:
4

Phytophotodermatitis
Phytophotodermatitis requires exposure to certain plants or fruits followed by sunlight. Parsnips,
parsley, figs, limes, celery, bergamot oranges, and others contain psoralens that react with UVA.
Initially there is erythema and blistering followed by streaked hyperpigmentation.
Q/Q(M)-474959 Report a Problem

The solar simulator is not useful for phototherapy because of its:
1

High output of ultraviolet radiation
2

High output of infrared radiation
3

Low output of UVB
4

Low level of ionizing radiation
5

Small field size
Q/Q(M)-474677 Report a Problem

The solar simulator is not useful for phototherapy because of its:
5

Small field size
The coin-sized field of the solar simulator prevents this source from being useful for phototherapy. It is
46

useful in MED testing.
Q/Q(M)-474677 Report a Problem

Regarding renal transplant recipients, which of the following statements is correct:
1

Have rates of SCC similar to the general population
2

Have a 36-fold increased risk of BCC
3

Have a 36-fold increased risk of SCC
4

Should have skin cancer screening at the same rate as the general population
5

Have an decreased risk for melanoma
Q/Q(M)-478244 Report a Problem

Regarding renal transplant recipients, which of the following statements is correct:
3

Have a 36-fold increased risk of SCC
The rates of SCC in renal cell transplant recipients is increased at a rate of 36x. The rates of skin cancer
are higher than in the general population.
Q/Q(M)-478244 Report a Problem

The patient demonstrates a positive photopatch test to musk ambrette and a lowered MEDB. The
correct diagnosis is most likely:
1

PMLE
2

Solar urticaria
3

CAD
4

Actinic prurigo
5

Photoallergic contact dermatitis
Q/Q(M)-474954 Report a Problem

The patient demonstrates a positive photopatch test to musk ambrette and a lowered MEDB. The
correct diagnosis is most likely:
3

CAD
Only chronic actinic dermatitis (CAD) has a lowered MEDB. That finding helps distinguish CAD from
photoallergic contact dermatitis in which one sees a positive photopatch test also.
Q/Q(M)-474954 Report a Problem

Lichen planus like lesions on sun-exposed areas may be seen in patients receiving which medication?
1

Fenofibrate
2

Griseofulvin
3

Alprazolam
4

All of these answers are correct
5

None of these answers are correct
Q/Q(M)-476735 Report a Problem

Lichen planus like lesions on sun-exposed areas may be seen in patients receiving which medication?
47

1

Fenofibrate
LP-like lesions (which may be confluent) on sun-exposed areas have been seen in patients receiving
antimalarials, thiazides, demethylchlortetracycline, fenofibrate, enalapril, quinine, and quinidine.
Q/Q(M)-476735 Report a Problem
The main condition on the differential for polymorphous light eruption is lupus erythematosus. Which
of the following tests should NOT be performed to help make this distinction?
1

Antinuclear antibody
2

Anti-SSA
3

Anti-SSB
4

Skin biopsy for routine staining and direct immunofluorescence
5

SED rate
Q/Q(M)-478263 Report a Problem

The main condition on the differential for polymorphous light eruption is lupus erythematosus. Which
of the following tests should NOT be performed to help make this distinction?
5

SED rate
All of the listed tests are helpful in distinguishing between PMLE and lupus except a SED rate, which
is a non-specific marker of systemic inflammation.
Q/Q(M)-478263 Report a Problem

What range of ultraviolet radiation has been shown to be most efficient in inducing neoplasia in mice?
1

280-320nm
2

320-340nm
3

340-400nm
4

400-760nm
5

>760nm
Q/Q(M)-476733 Report a Problem

What range of ultraviolet radiation has been shown to be most efficient in inducing neoplasia in mice?
1

280-320nm
Midrange UVR 280-320nm (UVB range) has been shown to be most efficient in inducing neoplasia in
mice. Long-wave UVA, when added to UVB may accelerate carcinogenesis.
Q/Q(M)-476733 Report a Problem

Lesions of PMLE typically appear:
1

About one hour after exposure
2

Hours to days after exposure
3

Days to two weeks after exposure
4

15-30 minutes after exposure
5

Immediately
48

Q/Q(M)-475942 Report a Problem

Lesions of PMLE typically appear:
2

Hours to days after exposure
The history of a delay of several hours to several days after exposure is important to the diagnosis.
Q/Q(M)-475942 Report a Problem
Which of the following patients would be the most likely to present with chronic actinic dermatitis?
1

A 4 year-old Native American boy
2

A teenage girl
3

A 64 year-old farmer
4

A 32 year-old woman
5

A 32 year-old man
Q/Q(M)-478269 Report a Problem


Which of the following patients would be the most likely to present with chronic actinic dermatitis?
3

A 64 year-old farmer
Patients with chronic actinic dermatitis are usually middle-aged to elderly males who present with a
chronic eczematous dermatitis in a photodistribution without history of current exposure to a
photosensitizer.
Q/Q(M)-478269 Report a Problem
Lichen planus-like lesions on sun-exposed areas may be seen in patients being treated with:
1

Fenofibrate
2

Ketoprofen
3

Quinolones
4

All of these answers are correct
5

None of these answers are correct
Q/Q(M)-476095 Report a Problem

Lichen planus-like lesions on sun-exposed areas may be seen in patients being treated with:
1

Fenofibrate
Lichenoid medication photosensitivity, with LP-like lesions on sun-exposed areas has been associated
with treatment with antimalarials, thiazides, demethylchlortetracycline, fenofibrate, enalapril, quinine,
and quinidine.
Q/Q(M)-476095 Report a Problem

Most patients with PMLE require treatment with:
1

Sunscreen and sun avoidance between 11 am and 3pm
2

UVB hardening/desensitization
3

Chloroquine
4

Prednisone
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5

Cyclophosphamide
Q/Q(M)-478262 Report a Problem

Most patients with PMLE require treatment with:
1

Sunscreen and sun avoidance between 11 am and 3pm
Most patients have mild disease that can be treated by sun avoidance, especially between 11 am and
3pm; a broad spectum sunscreen and clothing with a tight weave. In more severe cases, UV hardening,
antimalarials or prednisone can be used. Cyclophosphamide is not used in PMLE.
Q/Q(M)-478262 Report a Problem

This malnourished individual presented with crusting and hyperpigmentation in a photodistribution.
The best diagnosis is:
1

CAD
2

Photoallergic contact dermatitis
3

Scurvy
4

Pellagra
5

PMLE
Q/Q(M)-474958 Report a Problem


This malnourished individual presented with crusting and hyperpigmentation in a photodistribution.
The best diagnosis is:
4

Pellagra
Pellagra is characterized by the triad of diarrhea, dermatitis, and dementia. The dermatitis begins as a
burning erythema in sun-exposed areas. There may be bullae and erosions. This is followed by a dry,
brittle, scaling and hyperpigmented phase. Pellagra is due to a deficiency of niacin and tryptophan.
Q/Q(M)-474958 Report a Problem

Treatment of CAD might include:
50

1

UV filters for car windows
2

Broad spectrum sunblock to which the patient is not allergic
3

Incandescent bulbs for home and office lighting
4

PUVA
5

All of these answers are correct
Q/Q(M)-474685 Report a Problem
Treatment of CAD might include:
5

All of these answers are correct
CAD patients are exquisitely sensitive to UVB, often sensitive to UVA, and sometimes sensitive to
visible light. Answers a, b, and c are correct because those treatments prevent UV and visible radiation
from reaching the patient. PUVA hardens and desensitizes the skin.
Q/Q(M)-474685 Report a Problem


Phototoxic reactions:
1

Are immunologically mediated
2

Occur only in predisposed individuals
3

Rarely occur on the first exposure to the chemical
4

Are called "photoreactive" if they produce damage through reactive oxygen species
5

Resolve with hyperpigmentation
Q/Q(M)-476091 Report a Problem

Phototoxic reactions:
5

Resolve with hyperpigmentation
A phototoxic reaction appears as a exaggerated sunburn with erythema and sometimes blistering,
resolving with hyperpigmentation. It is a nonimmunologic reaction that could occur in all individuals
given enough of the chemical and enough UVR. It can occur on the first exposure to the chemical and
the UVR. Phototoxic reactions that produce damage through reactive oxygen species are called
"photodynamic."
Q/Q(M)-476091 Report a Problem
The wavelength range that most effectively induces cutaneous immunosuppression is:
1

200-290nm
2

290-320nm
3

320-340nm
4

340-400nm
5

400-410nm
Q/Q(M)-478145 Report a Problem
The wavelength range that most effectively induces cutaneous immunosuppression is:
2

290-320nm
290-320nm (UVB) is most effective in suppressing cutaneous immunity; mechanisms include depletion
of Langerhans cells, induction of regulatory T cells, and keratinocyte secretion of such
51

immunosuppressive cytokines as IL-10 and TNF-alpha.
Q/Q(M)-478145 Report a Problem

Possible treatments for this patient with vitiligo include all of the following except:
1

Topical steroids
2

Narrowband UVB
3

Broadband UVB
4

Oral PUVA
5

Acitretin
Q/Q(M)-475943 Report a Problem
Possible treatments for this patient with vitiligo include all of
the following except:
5

Acitretin
Topical steroids and all the UV choices have been used to treat vitiligo. Soriatane does not benefit
vitiligo.
Q/Q(M)-475943 Report a Problem

Regarding the UVR effects on contact dermatitis and delayed-type hypersensitivity, which of the
following statements is correct?
1

Mice exposed to long-term, high-dose UVR demonstrate increased splenic APC function
2

There are increased delayed-type hypersensitivity responses
3

There are diminished contact hypersensitivity responses
4

Induction of sensitization is increased
5

There are increases in production of Th2 type cytokines
Q/Q(M)-478245 Report a Problem

Regarding the UVR effects on contact dermatitis and delayed-type hypersensitivity, which of the
following statements is correct?
3

There are diminished contact hypersensitivity responses
Mice exposed to short-term, high-dose UVR demonstrate decreased splenic APC function. There are
diminished delayed-type hypersensitivity and contact hypersensitivity responses. Induction of
sensitization is decreased. Th2 cytokines are not increased following UVR exposure.
Q/Q(M)-478245 Report a Problem

The immunologic effects of UVR include all of the following except:
52

1

Alteration of Langerhans cell morphology
2

Decrease in IL-1, IL-6, TNF-alpha
3

Suppression of delayed-type hypersensitivity
4

Alteration of lymphocyte population
5

Alteration of Langerhans cell function
Q/Q(M)-474673 Report a Problem

The immunologic effects of UVR include all of the following except:
2

Decrease in IL-1, IL-6, TNF-alpha
UVR causes an increase of circulating cytokines (IL-1, IL-6, TNF-alpha).
Q/Q(M)-474673 Report a Problem

The typical patients with polymorphous light eruption are:
1

Fair-skinned females in their 40s and 50s.
2

Type IV-skinned males in their 40s and 50s.
3

Type V-skinned females in their 20s and 30s.
4

Fair-skinned males in their 20s and 30s.
5

Fair-skinned females in their teens and 20s.
Q/Q(M)-474679 Report a Problem

The typical patients with polymorphous light eruption are:
5

Fair-skinned females in their teens and 20s.
PMLE most commonly appears in fair-skinned females during the first three decades of life. It may be
related to type IV hypersensitivity.
Q/Q(M)-474679 Report a Problem

Which of the following is true about UV light:
1

UVA radiation is 1000 times greater than UVB during midday hours
2

UVB radiation is 1000 times more erythrogenic than UVA
3

Sunlight early in the morning and late in the day contains relatively more UVB
4

UVAII light is 340-400nm
5

Clouds absorb most UVA light
Q/Q(M)-477445 Report a Problem

Which of the following is true about UV light:
2

UVB radiation is 1000 times more erythrogenic than UVA
UVA light is found b/w 320 and 400nm and is broken up into UVAI(340-400nm) and UVAII((320-
340nm). UVB light is found between 290 and 320nm. UVA radiation is 100 times greater than UVB
during midday hours and sunlight early in the morning and late in the day contains relatively more
UVA. UVB radiation is 1000 times more erythrogenic than UVA. Cloud cover is a poor UV absorber.
Q/Q(M)-477445 Report a Problem
53