Cutaneous Laser

CME Quiz
You can take this test online, or print the page and mail the completed form to:
 

Boston University School of Medicine
715 Albany Street, A-305
Boston, MA 02118
 
Part I: General Information
 

You must fill all the requested data under the first section in order for test results to be properly credited. There is only one correct answer for each of the following questions.
Part II: Quiz Your Knowledge
 

I. Laser Physics & Safety
 

1. Class 4 lasers require the following protective measure(s):
 

A. The elimination of reflective surfaces in the treatment area
 

B. The use of appropriate laser safety eyewear
 

C. Covering windows and potential viewing ports
 

D. All of the above
 

2. Selective photothermolysis requires the selection of:
 

A. Appropriate wavelength
 

B. Pulse duration and spot size
 

C. Chromophore
 

D. All of the above
 

3. Laser light is a form of non-ionizing electromagnetic radiation which cannot:
 

A. Induce changes in cellular DNA
 

B. Ablate tissue
 

C. Be absorbed by a chromophore
 

D. Induce a shock wave to destroy a lesion
 

4. Laser components include:
 

A. A medium such as a solid, liquid or gas
 

B. An electrical, flashlamp or additional laser power source
 

C. Delivery systems which utilize a combination of waveguides, fibers, handpieces and lenses
 

D. All of the above
 
5. Laser treatment parameters do not include:
 

A. Fluence
 

B. Spot size
 

C. Pulse width
 

D. Topical anesthesia
 
6. Visible (400-760 nm) wavelength lasers produce light which is well absorbed by the:
 

A. Cornea
 

B. Retina
 

C. Iris
 

D. Sclera
 

II. Laser Hair Removal
 
1.The target chromophore for most laser hair removal devices is:
 

A. Water
 

B. Melanin
 

C. Keratin
 

D. Hemoglobin
 

2. Laser hair removal is most effective in:
 

A. All skin types
 

B. Individuals with dark hair and fair skin
 

C. Vellus hair

D. Grey, blonde, red, or white hair
 
3. The most critical factor in protecting the skin during laser hair removal is:
 

A. Cooling
 

B. Topical anesthesia
 

C. Bleaching prior to treatment
 

D. Shaving
 
4. Management of darker skin types includes the selection of:
 

A. Longer pulse widths
 

B. Shorter pulse widths
 

C. Longer treatment intervals
 

D. Higher fluences
 
5. An advantage of using an Nd:YAG 1064nm laser includes:
 

A. Decreased absorption by epidermal melanin
 

B. Decreased discomfort during treatments
 

C. Increased efficacy when compared to similar devices
 

D. Increased absorption by epidermal melanin
 
6. A non-coherent broadband intense pulsed light source:
 

A. Induces less pain than a laser
 

B. Delivers a wavelength of 810 nm
 

C. Delivers a wavelength of 532nm
 

D. Uses a cut-off filters to target melanin in hair
 
III. Vascular Lesions
 
1. Successful damage to a vessel is based on the selection of a:
 

A. Wavelength that is preferentially absorbed by oxyhemaglobin
 

B. Pulse width that is greater than the thermal relaxation time of the vessel
 

C. Fluence which induces reversible damage to the entire vessel wall
 

D. All of the above
 
2. Laser(s) commonly used for the treatment of vascular lesions include:
 

A. 1.5 ms pulsed 585-600 nm dye laser
 

B. 400 ms pulsed 585-600 nm dye laser
 

C. 50 ns q-switched 755 nm alexandrite laser
 

D. 250 ms pulsed 10,640nm CO2 laser
 
3. A common tissue response noted when short pulse widths are utilized to treat vascular lesions is:
 

A. Hypopigmentation
 

B. Hyperpigmentation
 

C. Purpura
 

D. Blistering
 
4. Lasers used to treat vascular lesions in conjunction with integrated cooling devices will:
 

A. Require a decrease in fluence
 

B. Increase the risk of hypopigmentation
 

C. Reduce the risk of epidermal injury
 

D. Induce vasoconstriction
 

5. Small macular vascular lesions should respond to laser treatment by:
 

A. Clearing in an average of two treatments
 

B. Crusting and blistering
 

C. Requiring topical anesthesia
 

D. Leading to unexpected epidermal textural changes
 
6. The primary competing chromophore when treating a vascular lesion with a 532 KTP laser is:
 

A. Melanin
 

B. Keratin
 

C. Water
 

D. Bilirubin
 
IV. Pigmented Lesions
 
1. Multicolored tattoos are most effectively treated with a combination of the following lasers:
 

A. Q-switched Nd:YAG (1064 nm) and frequency - doubled Q-switched Nd:YAG (532nm)
 

B. Pulsed dye(585nm) and Q-switched Nd:YAG (1064nm)
 

C. Pulsed Er:YAG (2940) and Q-switched Alexandrite (755nm)
 

D. Frequency-doubled Q-switched Nd:YAG (532nm) and continuous CO2 (10600nm)
 
2. The following pigmented lesion(s) respond(s) best to the least number of laser treatments:
 

A. Lentigines
 

B Nevus of Ota
 

C. Melasma
 

D. Café au lait macules
 
3. Irreversible ink darkening may occur when the following tattoo(s) are treated with a laser:
 

A. Yellow tattoos
 

B. Permanent pink, white or flesh- toned cosmetic tattoos
 

C. Red tattoos
 

D. Green tattoos
 
4. The proposed mechanism(s) of action for laser tattoo removal includes:
 

A. Lymphatic elimination of micronized pigment particles
 

B. Phagocytosis of pigment particles
 

C. Elimination of pigment particles via an epidermal wound
 

D. All of the above
 
V. Resurfacing Lasers
 
1. The target chromophore for ablative lasers is:
 

A. Melanin
 

B. Oxyhemoglobin
 

C. Water
 

D. Wrinkles
 
2. Ablative laser resurfacing has traditionally been accomplished with:
 

A. Use of high peak power, short pulse duration CO2 and /or Er:YAG lasers
 

B. Removal of 400 microns of tissue per pass
 

C. Minimal postoperative wound care
 

D. Long pulse dye lasers
 
3. Which wavelength of light is used in an ablative laser?
 

A. 595nm
 

B. 800nm
 

C. 1,064nm
 

D. 10,640nm
 
4. Re-epithelialization occurs approximately how long after a two pass CO2 resurfacing procedure?
 

A. 24 hours
 

B. 48 hours
 

C. 1 week
 

D. 1 month
 
5. Moderate to severe photodamage and rhytids respond best to:
 

A. Microdermabrasion
 

B. Pulsed dye laser

C. CO2 and /or Er:YAG laser
 

D. Topical retinoids
 
VI. Lasers, Light and Acne
 
1. Which wavelength of light is most efficient at exciting porphyrins in the photodynamic reaction?
 

A. 410nm
 

B. 532nm
 

C. 595nm
 

D. 1,320nm
 
2. What is the target chromophore of infrared lasers?
 

A. Oxyhemoglobin
 

B. Melanin
 

C. Water
 

D. Porphyrin
 
3. What depth to infrared lasers heat?
 

A. Epidermis
 

B. Dermis
 

C. Deep dermis
 

D. Subcutaneous fat
 
4. Which wavelength of light is most likely to improve depressed white acne scars?
 

A. 523nm
 

B. 595nm
 

C. 694nm
 

D. 1,450nm
 
VII. Non-Ablative Rejuvenation
 
1. Which wavelength is not used in an infrared non-ablative laser?
 

A. 1,320nm
 

B. 1,450nm
 

C. 1,540nm
 

D. 2,900nm
 
2. Which laser can be used to improve skin texture?
 

A. 595nm pulsed-dye
 

B. 1,320nm
 

C. 1,450nm
 

D. All of the above
 
3. Which wavelength has the greatest absorption in water?
 

A. 595nm
 

B. 1,064nm
 

C. 1,450nm
 

D. 2,940nm
 
4. Which non-ablative laser utilizes absorption in oxyhemoglobin to induce collagen production?
 

A. 595nm
 

B. 1,064nm
 

C. 1,320nm
 

D. 1,450nm
 
5. Which type of cooling device is employed by most non-ablative lasers?
 

A. Air
 

B. Contact

C. Cryogen
 

D. Gel
 
6. What depth do infrared non-ablative lasers heat?
 

A. Epidermis
 

B. Dermis
 

C. Deep dermis
 

D. Subcutaneous fat

Evaluation

This section MUST be completed in order to receive CME credit.

1 ) Do you feel that the stated educational objectives were met? How would you rate this activity overall? (1 = poor, 5 = excellent,  please check one)

1) Poor 2) 3) 4) 5) Excellent
 

2)  In your opinion, did you perceive any commercial bias?
Yes No

If yes, please explain?

3) Do you plan on making any changes in your practice as a result of this activity?  
Yes No

If yes, please explain?

May we contact you in the future to determine if you made changes?

Yes No

4) Do you feel each of the following objectives was met?

 4a) Describe the basic physics behind modern cutaneous laser systems.

  Yes No  Partially  N/A

 4b) List the safety aspects and concerns of cutaneous laser systems. 

  Yes No  Partially  N/A

 4c) Discuss a wide variety of cutaneous laser treatments including hair removal lasers, vascular lasers, pigmented lesion lasers, as well as ablative and non ablative resurfacing lasers.

Yes No  Partially  N/A

5)  Do you feel that the information in this activity was based on the best evidence available?

Yes No

If no, please explain?
   

6. Please suggest topics for future activities.

7) Please rate the content of this activity?  (1 = poor, 5 = excellent, please check one)

1) Poor 2) 3) 4) 5) Excellent
Timely, up to date?
Relevant to your practice?

8)  General comments:

*Required fields

*Name:  
*Degree:   (For CME certificate)
DO MD RN, BSN NP Resident  Other
Specialty:
*Address:  
*City:  
*State  
Zip
Country:
Office Telephone:
*E-mail:  

*Would you like to receive information about upcoming Boston University School of Medicine Continuing Medical Education programs via e-mail? Yes   No
 
*Are you licensed to practice in the U.S.?   Yes   No
 
*Please indicate the amount of time spent on this activity?
 
 
How would you describe your profession?
 
What is your primary reason for using CME?