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ABPM BOARD QUESTIONS AND ANSWERS
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ABPM BOARD QUESTIONS AND ANSWERS
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ABPM BOARDQUESTIONS
AND ANSWERS
Which cancer causes the most deaths in the United States annually? - Answers-Lung
cancer is the leading cause of cancer death in the United States overall, followed by
colorectal cancer.
Prostate cancer and breast cancer are the second leading causes of cancer death in
men and women, respectively, (but not overall).
Which of the following individuals meet the current (2014) USPSTF criteria for
undergoing chest CT screening for lung cancer?
A) 60 year-old female who is a current smoker with a 25 pack-year history of smoking.
B) 65 year-old male former smoker with a 30 pack-year history of smoking who quit
smoking 15 years ago.
C) 55 year-old female former smoker with a 30 pack-year history of smoking who quit
smoking 10 years ago.
D) 50 year-old male who is a current smoker with a 30 pack-year history of smoking. -
Answers-Answer: C. In 2014, the USPSTF issued a "B" recommendation for screening
for lung cancer with low dose CT scans. The recommendation was based on the results
of the US National Lung Screening Trial (NLST), a large randomized clinical trial
published in 2011 showing a reduction of lung cancer deaths in the group undergoing
annual low dose CT scans for lung cancer screening over 3 years compared with the
group undergoing annual chest x-rays. The inclusion/exclusion criteria for the trial were
used as the basis for the recommended screening group in the new guideline: Current
,or former smoker ages 55-80 years with at least a 30 pack-year history of smoking and
who has quit less than 15 years ago.
A. does not have a long enough pack-year history of smoking;
B. quit smoking 15 or more years ago; and
D. is too young (age<55 years).
Screening modalities other than low dose CT are not recommended (I
recommendations for chest x-ray, etc.)
USPSTF (2013) lung cancer screening criteria in smokers: - Answers-Age 55-80
Min 30 pack-year hx
If quit, quit less than 15 years ago
(All Grade "B")
Annual breast self-examinations to screen for breast cancer:
A) Increase the number of breast biopsies performed.
B) Reduce all-cause mortality in women.
C) Reduce mortality due to breast cancer in women.
D) Reduce the use of mammography. - Answers-Answer: A.
A 58 year-old woman has a normal screening mammogram at her appointment today.
She has no family history of breast cancer and no symptoms. According to the U.S.
Preventive Services Task Force, her next mammogram would be due in:
A) 6 months.
B) 1 year.
C) 2 years.
D) 3 years. - Answers-Answer: C.
The U.S. Preventive Services Task Force recommends a biennial screening
mammogram from women age 50 to 74 years. While no studies have directly evaluated
the benefit of an annual versus biennial mammogram, a decision analysis projected that
70% to 99% of the benefit of annual screening would be obtained, with a significant
reduction in the number of mammograms required and therefore a decreased risk for
harms (49% of women who have 10 mammograms have a false positive, potentially
requiring a biopsy or surgery).
USPSTF recommendations for screening mammograms: - Answers-Grade "B" - Every
two years for women age 50 to 74
Grade "C" - Women age 40 to 49 at higher risk
,Grade "I" - Women age > 75 or women with dense breasts
According to the Joint National Committee on Prevention, Detection, Evaluation and
Treatment of High Blood Pressure VIII (JNC VIII) recommendations issued in 2014, the
goal treatment blood pressure for individuals without diabetes or chronic kidney disease
is less than:
A) 140/90 for all individuals.
B) 140/90 for individuals 60 years and older and 130/80 for individuals younger than 60
years.
C) 150/90 for individuals 60 years and older, 140/90 for individuals 30-59 years, and
130/80 for individuals younger than 30 years.
D) 150/90 for individuals 60 years and older and 140/90 for individuals younger than 60
years. - Answers-Answer: D.
The JNC VIII recommendations issued in 2014 cited strong evidence to support treating
hypertensive patients without diabetes or chronic kidney disease age 60 years or older
to a BP goal of less than 150/90 and ages 30-59 years to a treatment goal of less than
90 diastolic. Because the evidence for systolic pressure was less strong for the younger
age group and for treatment goals overall for individuals less than 30 years, the goal of
less than140/90 for all patients younger than 60 years was cited to be based on expert
opinion. The JNC VIII treatment goal for patients with diabetes or chronic kidney
disease is also less than 140/90. The JNC VIII recommendations replaced the JNC VII
recommendations, which had been in place for more than 10 years and had a lower
target BP treatment goal (140/90) for older adults.
JNC VIII (2014) recommendations for BP: - Answers-Without diabetes or CKD:
- Age > 60 goal less than 150/90
- Age < 60 goal less than 140/90
With diabetes or CKD:
- All ages goal less than 140/90
Two large studies conducted outside of the U.S. demonstrated no mortality benefit for
teaching self breast examinations. Additionally, teaching self breast examination
resulted in an increase in imaging studies and biopsies.
Routine aspirin is recommended by the U.S. Preventive Services Task Force for which
of the following groups, given that the risk of gastrointestinal hemorrhage is considered
to be low?
A) Men and women ages 50 to 79 years at average risk for colorectal cancer
, B) Men ages 45 to 79 years at risk for ischemic stroke
C) Women ages 55 to 79 years to prevent ischemic stroke
D) Women ages 55 to 79 years to prevent myocardial infarction - Answers-Answer: C.
The U.S. Preventive Services Task Force recommends the use of aspirin for women
age 55 to 79 years to prevent ischemic stroke when " the potential benefit due to a
reduction in ischemic stroke outweighs the potential harm due to an increase in
gastrointestinal hemorrhage " ("A" recommendation). Aspirin is also recommended for
men ages 45 to 79 years for reduction of myocardial infarction ("A" recommendation).
The U.S. Preventive Services Task Force recommends against use of aspirin for the
primary prevention of colorectal cancer in individuals at average risk
USPSTF routine aspirin recommendations: - Answers-Women:
Age 55-79 to prevent ischemic stroke
Men:
Age 45-79 to prevent MI
USPSTF recommends against aspirin use for prevention of colorectal cancer
---------------------------
2016 changes (in case boards are updated):
Grade "B" - Age 50-59 with a >=10% 10yr CVD risk
Grade "C" - Age 60-69 with a >=10% 10yr CVD risk
Grade "I" - Age > 70
A 52 year-old woman presents for preventive care. She had a total hysterectomy 4
years prior for benign disease. All of her Pap smears have been normal in the past and
she has been in a monogamous sexual relationship for the past 20 years. Which of the
following is the most appropriate recommendation?
A) A Pap smear every 3 years until the age of 65 years.
B) A Pap smear every year until the age of 65 years.
C) Annual Pap smears if she gets a new sexual partner, otherwise Pap smears are not
needed.
D) Further Pap smears are not indicated. - Answers-Answer: D.
Cervical cancer screening is recommended by the U.S. Preventive Services Task Force
for all women who have been sexually active and have a cervix. Routine screening can
be discontinued at age 65 years and after a total hysterectomy for benign disease.
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