1. Which one of the following is the most effective treatment option for melasma? (check one)

A. A cream consisting of fluocinonide 0.01%/hydroquinone 4%/tretinoin 0.05% (Tri-Luma).

B. Adapalene 0.3% gel (Differin).

C. Glycolic acid peel.

D. Tretinoin 0.1% cream (Retin-A).

 

 

2. Which one of the following statements about combined screening for fetal chromosomal abnormalities in the first trimester is correct? (check one)

A. It includes nuchal translucency measurement and quadruple screening.

B. It detects about 90 percent of cases of Down syndrome in women older than 35 years.

C. Low levels of pregnancy-associated plasma protein-A and human chorionic gonadotropin are not associated with adverse pregnancy outcomes.

D. It is less sensitive than quadruple screening at detecting Down syndrome in women younger than 35 years.

 

 

3. Which one of the following statements about nuchal translucency measurement is correct? (check one)

A. It is not gestational-age dependent.

B. It detects about 70 percent of cases of Down syndrome if used alone.

C. A measurement of less than 3 mm is associated with major congenital heart defects.

D. There is no improvement in the detection rate of Down syndrome if nuchal translucency measurement is performed with serum testing.

 

4. A patient presents with daytime fatigue and insomnia that has lasted for the past month, but the history and physical examination findings are unremarkable. Which one of the following would be the best initial advice to offer this patient? (check one)

A. Take daytime naps to alleviate fatigue.

B. Exercise during the morning or afternoon hours.

C. Try to vary bedtime each night.

D. Do nothing until the symptoms have persisted for longer than six weeks.

 

 

5. Which one of the following is a major principle of stimulus control in the treatment of insomnia? (check one)

A. Practicing meditation and relaxation techniques.

B. Associating the bedroom only with sleep and sexual activity.

C. Modifying the workday to get a nap in the afternoon.

D. Addressing sleep fears by purposely staying awake as long as possible.

 

 

6. Which one of the following conditions is best suited for treatment with a high-potency topical corticosteroid? (check one)

A. Psoriasis.

B. Diaper dermatitis.

C. Seborrheic dermatitis.

D. Perianal inflammation.

 

 

7. A patient presents with a thick, dry, hyperkeratotic lichen sclerosus lesion on his shin. Which one of the following topical corticosteroid vehicles is most appropriate for treating the lesion? (check one)

A. Ointment.

B. Cream.

C. Lotion.

D. Gel.

 

8. A patient who had been using a low-potency topical corticosteroid around her mouth for 12 weeks developed an eruption of erythema, papules, and pustules. After discontinuing the corticosteroid, she developed more severe erythema and pustules. Which one of the following is the most likely diagnosis? (check one)

A. Steroid-induced rosacea.

B. Type 1 herpesvirus infection.

C. Contact dermatitis.

D. Pustular acne.

 

 

9. Which one of the following statements about gastroesophageal reflux disease (GERD) is correct? (check one)

A. Proton pump inhibitors and histamine H2 receptor antagonists are equally effective treatment options.

B. Only 20 percent of persons with GERD have a relapse after discontinuing medication use.

C. Lifestyle modifications, such as avoiding coffee, mints, and dietary fat, are as effective as H2 receptor antagonists for reducing symptoms.

D. Patients with severe esophagitis may develop esophageal stricture or Barrett esophagus.

 

 

10. Which of the following is/are treatment options for solar lentigines? (check all that apply)

A. Cryotherapy.

B. Laser therapy.

C. Topical corticosteroids.

D. Hydroquinone (Eldoquin Forte).

 

 

11. Which of the following is/are treatment options for vitiligo? (check all that apply)

A. Retinoids, such as tretinoin (Retin-A).

B. Sun protection.

C. High-potency topical steroids.

D. Ultraviolet light therapy.

 

 

12. Which of the following statements about invasive testing for fetal chromosomal abnormalities is/are correct? (check all that apply)

A. Amniotic fluid is collected during amniocentesis.

B. There is a lower fetal loss rate with amniocentesis than with chorionic villus sampling.

C. There is an increase in limb reduction defects if chorionic villus sampling is performed before 10 weeks' gestation.

D. Amniocentesis is safest between 13 and 16 weeks' gestation.

 

 

13. Which of the following is/are possible secondary causes of insomnia? (check all that apply)

A. Anxiety.

B. Beta blocker use.

C. Depression.

D. Congestive heart failure.

 

 

14. According to the U.S. Preventive Services Task Force, which of the following is/are considered major risk factors for carotid artery stenosis? (check all that apply)

A. Male sex.

B. Hypertension.

C. Smoking.

D. High cholesterol.

 

 

 

 

 

 

 

 

 

Results:

 

1-      A

2-      B

3-      B

4-      B

5-      B

6-      A

7-      A

8-      A

9-      D

10-  A,B,D

11-  B,C,D

12-  A,B,C

13-  A,B,C,D

14-  A,B,C,D

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