Dupuytren’s Disease

CME Questions

1. 1. What is the proposed mode of inheritance for Dupuytren’s disease?

   1. A. Autosomal recessive.

   2. B. X-linked recessive.

   3. C. Autosomal dominant with variable penetrance.

   4. D. Trinucleotide repeat disorder.

2. 2. How many compartments are formed by the septa of Legueu and Juvara in the palm?

   1. A. 3.

   2. B. 7.

   3. C. 9.

   4. D. 4.

3. 3. What is the primary cell type contributing to the pathology of Dupuytren’s disease?

   1. A. Myofibroblast.

   2. B. Platelet.

   3. C. Monocyte.

   4. D. Osteoblast.

4. 4. A positive “table top test” as defined by Hueston correlates with what degree of contracture?

   1. A. 15°.

   2. B. 28°.

   3. C. 75°.

   4. D. 40°.

5. 5. Which of the following structures seen in the hand is not classically involved in diseased Dupuytren’s tissue?

   1. A. Cleland’s ligament.

   2. B. Grayson’s ligament.

   3. C. Pretendinous band.

   4. D. Natatory ligament.

6. 6. Alteration of collagen type and deposition are the basis for pathologic tissue formation in Dupuytren’s disease. What specific type of collagen is classically increased in diseased tissue?

   1. A. Type I.

   2. B. Type II.

   3. C. Type III.

   4. D. Type V.

7. 7. One study referenced mentioned complications following open fasciectomy of diseased tissue. What was the most common complication mentioned in this study?

   1. A. Nerve injury.

   2. B. Artery injury.

   3. C. Amputation.

   4. D. Wound healing issues.

8. 8. Which digit is the most commonly affected by primary Dupuytren’s disease in the non-diabetic patient?

   1. A. Small finger.

   2. B. Ring finger.

   3. C. Thumb.

   4. D. Index finger.

9. 9. What are the 4 classic components of a pathologic spiral cord?

   1. A. Spiral band, pretendinous band, Grayson’s ligament, lateral digital sheet.

   2. B. Spiral band, pretendinous band, Cleland’s ligament, natatory ligament.

   3. C. Spiral band, Grayson’s ligament, retrovascular band, pretendinous band.

   4. D. Spiral band, Grayson’s ligament, Cleland’s ligament, Grayson’s ligament.

10. 10. Numerous biochemical pathways are being studied to aid in the management of Dupuytren’s disease. Which of the following pathways plays an integral role in myofibroblast contraction?

    1. A. Oxidative phosphorylation.

    2. B. HMG-CoA reductase.

    3. C. Transforming growth factor beta.

    4. D. Porphyrin synthesis.