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ABFM HEALTH COUNSELING AND PREVENTIVE CARE questions and answers rated A+2025/2026
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ABFM HEALTH COUNSELING ANDPREVENTIVE CARE
You are counseling a forty five-12 months-antique male with improved LDL-ldl cholesterol.
When discussing nutritional modifications to promote wholesome lipid degrees, which one of
the following would be correct advice?
He have to minimize his intake of nuts
The Dietary Approaches to Stop Hypertension (DASH) weight-reduction plan advocated for
reducing hypertension will help decrease his LDL-cholesterol degree
Saturated fat need to comprise 15% or less of his caloric intake
He must goal for a fiber consumption of 25 g each day
He should document what he has eaten in a meals diary at the quit of each day - ANSB
In 2013, the American Heart Association (AHA) issued life-style control suggestions
designed to lessen cardiovascular risk. For person patients with accelerated LDL-levels of
cholesterol the AHA advises following weight-reduction plan plans such as the Dietary
Approaches to Stop Hypertension (DASH) weight loss plan, the AHA weight-reduction plan,
or the USDA Food Pattern. The AHA especially recommends decreasing the percentage of
calories from saturated fat, aiming for a goal of 6%-7% of energy from this source. The AHA
additionally recommends a diet that emphasizes the intake of end result, greens, and entire
grains, and which incorporates fish, rooster, low-fat dairy products, legumes, nontropical
vegetable oils, and nuts. Consumption of red meat, goodies, and sugar-sweetened liquids
must be discouraged.Although dietary fiber has been shown to have numerous beneficial
fitness outcomes, the common daily consumption for most Americans is 15 g day by day,
which is a good deal decrease than the advocated quantity. The recommended each day
fiber consumption for adult males age 14-50 is 38 g each day. For different populations the
endorsed quantity is decrease, and varies in keeping with age and intercourse. Several
randomized, controlled trials have shown a reduction of LDL-ldl cholesterol with higher fiber
consumption. A food diary is an crucial element of dietary conduct alternate however it is
maximum correct if entries are made right away after meals is consumed.
A 24-12 months-antique woman sees you for a preconception visit and elimination of her
IUD. This may be her first pregnancy and she or he tells you that she has smoked ¼-½ % of
cigarettes a day for the past 5 years.Which one of the following could be suitable
recommendation regarding the risks from smoking?
Smoking all through being pregnant increases the risk of attention-deficit/hyperactivity
disease
Smoking throughout being pregnant will increase the risk of clubfoot
Smoking throughout pregnancy will increase the chance of congenital atrial septal defects
Stopping smoking now will lessen the multiplied danger of orofacial defects in her infant
Reducing smoking now will reduce the risk of preterm delivery - ANSD
,There are many reproductive troubles associated with smoking, such as theory put off and
both number one and secondary infertility; an extended chance of ectopic pregnancy and
spontaneous abortion; an multiplied risk of abruption, preterm rupture of membranes,
placenta previa, and untimely delivery; and improved perinatal morbidity and mortality,
including stillbirth, low birth weight, and SIDS-associated deaths. The 2001 Surgeon
General's Report on ladies and smoking makes it clean that stopping smoking throughout
pregnancy reduces and once in a while eliminates lots of these consequences.Small for
gestational age (SGA) infants are a dose-established final results of maternal smoking, with
an odds ratio (OR) of 2.11 when ladies smoke during being pregnant. Risks for prematurity
(OR 1.15) and fetal dying (OR 1.15) are also improved. The threat of having an SGA infant is
prevented if smoking is decreased, but the risks for prematurity and accelerated fetal loss of
life aren't.In 2014 the U.S. Surgeon General issued a brand new file on the fitness results of
smoking that referred to that the proof turned into robust enough to infer a causal hyperlink
between maternal smoking and orofacial clefts. This changed into nevertheless true while
the Surgeon General issued a report on smoking cessation in 2020. No hyperlink will be
inferred, however, among smoking and other congenital defects, together with clubfoot,
gastroschisis, and atrial septal defects. There is not any evidence that maternal smoking
results in multiplied costs of childhood attention-deficit/hyperactivity ailment.
A fifty five-year-antique male expresses problem approximately his inability to keep an
erection that lets in for high-quality sexual intercourse along with his wife. He takes over the
counter diphenhydramine (Benadryl) at night time for sleep and takes a each day
multivitamin. He says he liquids one 12-ounce beer 2-3 instances in step with week. A bodily
examination is everyday, including his blood stress.Which one of the following might you tell
him?
Most instances of erectile disorder (ED) have a psychogenic etiology
Diphenhydramine has little impact on his ED
Abstaining from alcohol use will enhance his signs
Erectile disorder can be an early indication of vascular ailment
About five% of fellows his age enjoy ED - ANSD
Erectile disorder (ED) is not unusual, affecting an estimated 30 million men inside the United
States, and becomes extra not unusual with advancing age. The Health Professionals
Follow-up Study reported slight to severe ED in 12% of fellows more youthful than 59, 22%
of men ages 60-sixty nine, and 30% of fellows older than 69.It became formerly notion that
most of the people of cases of ED were as a result of psychogenic elements along with
family or occupational pressure. However, proof shows that about 80% of ED is because of
organic ailment, which may be divided into hormonal, vasculogenic, and neurogenic
reasons. Vasculogenic etiologies are the maximum commonplace, with arterial or "inflow"
problems accounting for extra problems than venous disorders. The patient need to be
advised that their ED is a chance component for underlying cardiovascular disease and that
further assessment may be appropriate. It is crucial to recall, however, that despite the fact
that the primary etiology of ED is most customarily organic, psychological factors regularly
coexist and play a position in the dysfunction.Many medicines can motive or make
contributions to ED. It is envisioned that as many as 25% of ED instances are due to
medication aspect consequences. This highlights the essential function of the primary care
,medical doctor in reviewing medicine lists and enhancing remedy regimens as a part of
addressing ED. Common offenders encompass antihistamines, antihypertensives and
diuretics consisting of hydrochlorothiazide and spironolactone, psychoactive medications
such as SSRIs, and anti-epilepsy medications. It isn't always clear whether or not low
quantities of alcohol reason erectile dysfunction.
A 42-yr-old female sees you for a routine fitness upkeep go to. Her neighbor was simply
identified with ovarian cancer and has endorsed her to have her CA-a hundred twenty five
degree checked. The affected person asks approximately ovarian most cancers risk
elements, prevention, and screening. Which one of the following would be appropriate
recommendation?
A beyond records of oral contraceptive use increases the danger for ovarian cancer
Hormone substitute therapy after menopause decreases the chance for next ovarian cancer
CA-one hundred twenty five has a false-wonderful fee of ninety eight% while used to display
screen for ovarian most cancers
Bimanual examinations are advocated to display screen for ovarian cancer
Transvaginal ultrasonography is usually recommended to display for ovarian cancer - ANSC
Ovarian most cancers is the 5th leading cause of most cancers demise amongst women
within the United States. Risk elements related to ovarian cancer consist of a fantastic family
records and having the BRCA1 or BRCA2 gene mutation. A first or second diploma relative
with ovarian cancer will increase the danger with the aid of about threefold. The use of oral
contraceptives in the course of the reproductive years, and being pregnant, especially after
age 35, lessen the risk of ovarian most cancers, however postmenopausal estrogen use can
also growth the threat.The U.S. Preventive Services Task Force does not currently suggest
screening for ovarian cancer, as it is likely to have a incredibly low yield (D
recommendation). Almost all ladies with a positive screening test for CA-a hundred twenty
five will now not have ovarian most cancers. In women at average hazard, the superb
predictive value of an strange CA-125 is about 2%, so 98% of women with positive check
effects will not have ovarian cancer. There aren't any current pointers for ovarian most
cancers screening through both transvaginal ultrasonography or pelvic examination.
A male who became born in 1970 comes on your office for a preoperative exam for an
orthopedic method on his knee. He is in any other case healthy and does not take any
medications, but he has now not seen a physician for six years. He used illicit pills for a
quick period at age 23 but has now not done so on account that that time and has had 3
sexual companions, all of them woman. You use this opportunity to counsel him on
preventive health screenings, such as hepatitis C.Which one of the following is authentic
concerning screening for hepatitis C?
The high fee of treatment outweighs the ability benefit of screening
The CDC recommends checking out for hepatitis C virus each 3-five years in patients who
have a records of drug injection
The U.S. Preventive Services Task Force recommends recurring screening for hepatitis C
most effective for the ones born among 1945 and 1965
This patient ought to be screened with hepatitis C RNA polymerase chain response (PC -
ANSE
, In 2019 the U.S. Preventive Services Task Force (USPSTF) recommended screening all
sufferers 18-seventy nine years of age at least once for hepatitis C with the anti-HCV
antibody take a look at. Detection of hepatitis C virus (HCV) RNA by polymerase chain
reaction (PCR) checking out offers proof of lively HCV contamination, confirms the
diagnosis, and is utilized in monitoring the antiviral response to remedy. Quantitative PCR is
used to determine viral load. The CDC previously endorsed screening for human beings
born among 1945 and 1965, however that has been accelerated.HCV is the maximum
commonplace chronic bloodborne pathogen inside the United States and a main cause of
headaches from continual liver disorder. Before the COVID pandemic, HCV contamination
became associated with greater deaths than the pinnacle 60 different reportable infectious
illnesses blended, which include HIV. The most essential chance factor for HCV infection is
beyond or current injection drug use. In the USA an expected four.1 million people have past
or current HCV infection, based totally on a fine check for the anti-HCV antibody.
Approximately 2.Four million men and women with a high-quality antibody check have a
current contamination based on outcomes of molecular assays for HCV RNA and might be
ability applicants for treatment. Treatment results in very excessive ranges of virus
remission.Cases of acute HCV contamination accelerated about three.5-fold among 2010
and 2017. The improved incidence has in the main affected younger white people who inject
pills, especially those dwelling in rural areas. There has also been an increase inside the
wide variety of ladies age 15-forty four years with HCV infection. There is not any endorsed
testing frequency for high-hazard individuals presently.
You see a forty five-yr-old male who has smoked cigarettes for 25 years. He is very
inquisitive about quitting however has not been able to achieve this regardless of many tries.
He is interested by the use of medicines to assist.Which one of the following might probable
be only?
Calling the QUIT LINE and using over the counter nicotine patches
Bupropion (Wellbutrin SR, Zyban)
Nortriptyline (Pamelor)
Varenicline (Chantix)
Varenicline plus nicotine substitute remedy - ANSE
Not only are tobacco cessation remedies powerful clinically, they are also price-powerful in
contrast to treatments for different medical disorders (SOR A). Several analyses have found
that the value of treatment in line with patient who quits degrees from several hundred to a
few thousand bucks. Insurance insurance of medications and counseling to prevent smoking
will increase success charges (SOR A). Bupropion, varenicline, and 5 sorts of nicotine
alternative (gum, inhaler, lozenge, nasal spray, and patch) have all been shown to be
effective in helping adults quit smoking (SOR A).For each 10 smokers who give up at the
same time as taking a placebo nearly 30 may be predicted to stop when taking varenicline
as a single agent. Varenicline as a single agent has also been shown to help about 50%
greater human beings stop smoking in comparison to nicotine replacement remedy (NRT).
Varenicline has been proven to be more powerful than the nicotine patch (odds ratio [OR]
1.510), nicotine gum (OR 1.Seventy two), and different styles of NRT inclusive of inhalers,
sprays, tablets, or lozenges (OR 1.42). However, varenicline became no longer proven to be
greater effective than combination NRT (OR 1.06). Combination NRT the use of a nicotine
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