ABLS Trial Exam

PLEASE REVIEW THESE INSTRUCTIONS CAREFULLY

This is the ABLS Trial Exam on Laser Biophysics, Tissue Interaction and Safety. There are also a few questions on Cosmetic Laser Procedures, for a total of 12 knowledge questions.

This short exam is designed to explore your knowledge with a few critical questions that the Board believes you should know to maximize efficacy and safety for your patients. To the extent you are unsure of some answers, the Board suggests consideration of the certification process.

Question 1 captures your contact information - name, location and email, but not street address or phone number. We will contact you only by email about your Trial Exam result and this will be kept confidential.

Questions 2 through 7 relate to fundamental laser science and tissue interaction. Questions 8 and 9 relate to key aspects of laser safety. Questions 10 through 13 concern cosmetic laser procedures. If you practice in another discipline, please skip these.

Question 14 asks how you think you did and for any comments you may have.

You must answer each question in order to be able to complete the Trial Exam. If you are not sure of the answer, please make your best guess. You may back up to check or change any answers. However after you click the "DONE" button at the end of the exam, you cannot change your answers.

When you have completed the exam, your score will show. A score indicating a very good understanding would be 85% of all possible points.  There are 55 total points available for all 12 knowledge questions so a score of 47 is at the 85% level. For the first 8 questions (non-cosmetic) the maximum possible points are 46.

Questions that contain ONLY ONE right answer will only allow you to select one answer - these questions have circular DOTS. If you change your answer, the dot with the check mark will change accordingly. Questions which may have MORE THAN ONE right answer will allow you to make more than one selection - these questions have square BOXES. If you change your answer, you must click on a box to uncheck it, and then click on a new box to check it.

Below please provide your name, degree, specialty, location and email address. We will only contact you by email. Your answers will be confidential.

The Board wishes you success!


* 1. Please provide the following information:

* 2. Laser light has three unique properties. Select each choice that denotes one of these properties.

* 3. To determine the length of each laser pulse and prevent the temperature of adjacent tissue from exceeding a level at which irreversible damage occurs, it is important to understand and calculate the thermal relaxation time (TRT) of the tissue that is being irradiated. The value of this time is dependent on (check any that are correct):

* 4. A Gaussian laser beam has maximum power density at the axis, and its intensity falls asymptotically toward zero with increasing radial distance from the axis, theoretically requiring an infinite distance to reach zero. Hence there is no concentric circle of finite diameter which encompasses all the radiant power of such a beam. It is, therefore, convenient to define an effective diameter: the diameter of a concentric circle within which most of the power of the beam is transmitted. In the list of statements below, check each one that is correct regarding the effective diameter:  

* 5. When a ray of laser light strikes the first surface of living tissue, some of its intensity will be reflected from that surface. The major effect of this reflection is to diminish the intensity of the ray penetrating into the tissue. The reflectance of soft tissue is characterized by some of the statements listed below. Check each correct statement:

* 6. When the beam of a continuous-wave Nd:YAG laser is delivered to tissue by a quartz fiber that does not touch the tissue, it is not very effective for vaporizing or cutting until some free carbon has formed by thermal breakdown of the tissue. However, it can be used for effective cutting of soft tissue if the distal end of the fiber is contoured into the shape of a needle with a small radius at the distal tip, or a conical tip of sapphire is attached to the distal end of the quartz fiber, and this tip is put in contact with the tissue. These terminations of the fiber enable the Nd:YAG laser to cut tissue effectively because…(check each correct statement):  

* 7. In the list of laser types below, select the one OR two major biophysical process(es) for each type - coded by number - which are effective in soft tissue at that wavelength, and at the power densities usually employed for that laser. Processes are:

1.  PhotoCHEMolysis
2. PhotoPYRolysis
3. PhotoVAPORolysis
4. PhotoPLASMolysis

* 8. Accidental laser beam trauma to unintended targets has been a major cause of injury and death during laser surgery. In the list of four possible trauma events below, check just ONE of the options A, B, C, or D for each event to denote the relative risk of that event, with A denoting the lowest risk and D the highest risk:

* 9. Smoke is an inevitable byproduct of surgery with any device that thermally dehydrates tissue and heats it to combustion temperatures. Denote each statement below as either true (T) or false (F) by selecting either a (T) or an (F) option for each:

* 10. Fractional lasers remove pigments by which mechanism?

* 11. Match each hair removal device with the most correct description, by selecting ONE letter for each device letter that denotes that description:   

A. Adequately damages non-pigmented hair at very high fluence, which makes it a good option in vellus hair removal.
B. High melanin absorption, best indicated in light skin (Fitzpatrick skin I - II), with high power consumption and a relatively slow repetition rate.  
C. Extremely high-powered device.  Permanent hair removal can be obtained in a significant percentage of patients. Its wavelength permits deeper penetration and treatment of darker skin types (Fitzpatrick skin III - IV).
D. Effective for a wide range of skin types due to the wide choice of different wavelengths, pulse durations and delay intervals. 

* 12. IPL devices are high-intensity, polychromatic light sources that emit pulsed light wavelengths between 400 nm and 1200 nm. Chromophore hemoglobin absorption peaks are at which of the following wavelengths: (there may be more than one correct answer) 

* 13. When using the 1320 nm Nd:YAG laser, what what dermal temperature is required for collagen denaturation and wound healing response?  

* 14. FINAL QUESTION: Please take a moment to review the special offer below for new applicants who take the Trial Exam, then indicate after that your thoughts about your score and Click DONE to see your score. Thank you for taking the ABLS Trial Exam. For more information, please email us at lasers1060@gmail.com.

We are also pleased to offer a discount on the Application Fee for candidates who apply within 30 days. Candidates may apply for just $50 US, saving $100 off of our standard $150 fee.  You may download our Application Form at http://americanboardoflasersurgery.org/contact.html.  Simply complete it and email it to us at lasers1060@gmail.com and reference this offer. The reduced $50 fee is easily remitted using the PayPal Misc. Fee Option S, or by sending a check to our Administrative Office. Any overseas checks should be dated with the month written out: example, 1 January, 2017. 

We also invite you to join our unique, email-based, List Serve knowledge network at no charge.  It is a great opportunity to tap the knowledge and expertise of other practitioners, and make new connections worldwide.  It is far more convenient that a traditional website forum! Instead, the knowledge sharing works by email.  Our List Serve is open exclusively to laser practitioners and not open to Industry.  For details please go to http://americanboardoflasersurgery.org/abls_list_serve.html.  We currently have over 425 List Members and growing.

The ABLS strongly believes that laser practitioners should have a solid understanding of laser biophysics, light-tissue interaction and safety for the most effective use of lasers and light, especially in the rapidly expanding fields of cosmetic procedures.  The ABLS Certification provides a valuable learning experience and promotes patient efficacy and safety.  Key reasons our Diplomates earned the Certification, whether as experienced or new practitioners:

·         Gain deeper knowledge of laser and light physics, tissue interactions and safety, to create better outcomes and minimize complications
·         Better understand tissue interactions at chomophore level, for using the most appropriate wavelengths and parameters
·         Differentiate with the Certificate and ABLS website listing, showing greater expertise and attracting patients
·         Augment medical and manufacturer training with in-depth, scientifically-validated information
·         Use flexible learning and testing formats to fit schedules and practice budgets
·         Help satisfy requirements for laser training from states, hospitals and ASC's

The Board was founded in 1984 to meet the need for a unique certification for lasers in medicine and surgery.  Hundreds of doctors and qualified practitioners worldwide have earned the Board’s Certificate.  The ABLS is the world’s only laser medical specialty board. The Board’s Certification includes:

·         Fundamental Laser Science, Biophysics, Laser and Light-tissue Interaction, Ethics and Laser Safety (for all practitioners).
·         Cosmetic Laser and Light Disciplines (for cosmetic practitioners), including ablative resurfacing, vascular lesions, leg veins, pigmented lesions and tattoos, scars, hair removal, non-ablative rejuvenation and skin tightening, photodynamic therapy (PDT), LED and IPL.
·         Laser density (for dental practitioners) including soft and hard tissue biophysics and safety; and procedures including endodontics, periodontics, restorative, implants and pediatrics.  

The ABLS Certification is a three-step process:

1.       Submit an Application for review and acceptance.
2.       Prepare for and pass the Board’s Written Examinations (provided online).
3.       Sit for the Oral Specialty Examination (provided by web conference).

Please visit www.americanboardoflasersurgery.org for more information.

Sincerely,

Edward M. Zimmerman, M.D.
President

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