A 19-Year-Old Woman Comes to the Office for Evaluation of Chronic

question 176

Multiple Choice

A 19-year-old woman comes to the office for evaluation of chronic acne.  Over the last 6 months, the patient has tried several over-the-counter acne treatments without improvement.  She has a history of attention-deficit hyperactivity disorder and mild intellectual disability.  Her mother has a seizure disorder, and her maternal grandmother died of kidney failure.  Vital signs are within normal limits.  Facial examination findings are shown below. There are several elliptical, hypopigmented macules on the trunk.  Which of the following is the most likely underlying cause of this patient's condition?

• A)Congenital adrenal hyperplasia
• B)Fabry disease
• C)Neurofibromatosis type 1
• D)Tuberous sclerosis
• E)Von Hippel-Lindau disease

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Definitions:

Extrinsic Motivation

Motivation driven by external rewards such as money, praise, or avoiding negative consequences, rather than intrinsic satisfaction.

Intrinsic Motivation

A driving force that inspires individuals to engage in activities for their own sake, due to the personal satisfaction or pleasure they derive, rather than for external rewards.

Performance

Performance is the act of carrying out a task or function, often measured against preset known standards of accuracy, completeness, cost, and speed.

Quality Of Performance

The measure of how well a task or job is executed, often evaluated against a set of standards or objectives.