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ABFM health Assessment Guidance and counseling Essential Test Toolkit Exam Case Scenario Questions and Approved with Distinction Marking Scheme Latest 2024/2025
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ABFM health Assessment Guidance and counseling Essential Test Toolkit Exam Case Scenario Questions and Approved with Distinction Marking Scheme Latest 2024/2025
A 3-year-old male is brought to your office by his parents for a well child examination. His family recently moved to the area. His fat...
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ABFM health Assessment Guidance and
counseling Essential Test Toolkit Exam Case
Scenario Questions and Approved with
Distinction Marking Scheme Latest
2024/2025
A 3-year-old male is brought to your office by his parents for a
well child examination. His family recently moved to the area.
His father says that both he and his wife have always had
problems controlling their weight, and he asks if their son is
likely to have the same problem as he gets older. Factors
associated with obesity in adulthood include which one of the
following?
A birth weight categorized as low for gestational age
A high socioeconomic level
Being a member of an ethnic minority
An increase in bmi of 2 kg/m2 in 1 year - correct answer a
Risk factors for overweight and obesity include low or high birth
weights, low socioeconomic levels, poor eating habits, a change
in bmi >3-4 kg/m2 per year, depression, >2 hours per day of
sedentary activity such as watching television or playing
computer games, and minority status (sor c).numerous sources
have suggested that prevention of obesity is the best way to
combat this epidemic. The u.s. Preventive services task force
recommends screening for obesity starting at age 6, with referral
to intensive therapy (more than 26 contact hours) for children
with a bmi greater than the 95th percentile. The bmi value by
itself is not as meaningful when assessing children because
normal values are based on age. For example, a 10-year-old male
,with a bmi of 23 kg/m2 would be considered obese, whereas a
15-year-old male with the same bmi would not. A bmi above the
85th percentile is considered overweight.the american academy
of pediatrics recommends screening for obesity starting at age 2,
with interventions for any child with a bmi between the 85th and
94th percentile. Being obese in childhood increases the risk for
obesity in adulthood. Thus, it is currently recommended that
physicians screen children annually for risk factors for being
overweight.
One of your patients asks if her children should receive hpv
vaccine. She has 12-year-old and 22-year-old daughters and a 16-
year-old son. None of them have received hpv vaccine.which one
of the following would be appropriate advice about hpv vaccine?
Only her daughters should receive the vaccine
All of the siblings should receive the vaccine
Her 13-year-old daughter should receive a three-dose series
The vaccine is not recommended for patients who are already
sexually active
The vaccine is about 75% effective in reducing the hpv subtypes
that cause hpv cancers - correct answer b
Hpv is the most common sexually transmitted infection in the
world and there is good evidence that most individuals who are
sexually active will be exposed to hpv at some time. It is
estimated that 20 million people in the united states are infected
with this virus.hpv vaccine is highly immunogenic and
efficacious, and is very well tolerated. The cdc's advisory
committee on immunization practices (acip) recommends routine
administration of the hpv vaccine for both males and females at
11-12 years of age, so that they are vaccinated before becoming
,sexually active. The minimum age approved for the vaccine is 9
years. In addition, catch-up vaccination has been recommended
for females ages 12-26 if they have not been previously
vaccinated or if they have not completed the vaccine series (sor
a). The vaccine may also be given to those age 26-45 after a
discussion of the benefits and shared decision-making, although
the benefit is much lower in this age group. According to the
acip, people in this age group who are not in a monogamous
relationship and are sexually active should still be offered the
vaccine, as well as those who are sexually active with a new
partner.the recommended hpv series is two doses for those who
start the vaccine series before the age of 15. The second dose
should be given 6-12 months after the first dose. For patients
who begin the vaccine series at age 15 or after, a three-dose
schedule is recommended by the cdc, with the second dose given
1-2 months after the first dose and the third dose 6 months after
the first dose.hpv types that cause most hpv cancers and genital
warts have dropped 86% among teen girls. Among vaccinated
women the percentage of cervical precancers caused by the hpv
types most often linked to cervical cancer has dropped by 40%.
A 50-year-old female sees you for a routine health maintenance
visit. She is asymptomatic and has no known family history of
cancer. She underwent breast augmentation surgery 20 years
ago. On examination she has a bmi of 22 kg/m2.according to the
u.s. Preventive services task force, which one of the following
has the best evidence for breast cancer screening for this patient
at this time?
Monthly breast self-examinations
Mammography only
A clinical breast examination and mammography
Breast mri only
, Mammography, followed by breast mri if dense breast tissue is
noted on mammography - correct answer b
The u.s. Preventive services task force (uspstf) recommends
screening mammography every 1-2 years beginning at age 50 for
all women (b recommendation). The uspstf recommends against
teaching breast self-examination (d recommendation) and has
found insufficient evidence to recommend for or against clinical
breast examinations to screen asymptomatic women (i
recommendation). Clinical trials have not found that mortality is
improved in women screened with a clinical breast examination
when done in concert with mammography. The patient should be
provided with this information and the physician should ask
about her preferences with regard to the clinical breast
examination.the american cancer society has somewhat different
recommendations for breast cancer screening as noted below:
Women age 40-44 may choose to start annual screening
mammography
Women age 45-54 should have annual mammography
Women age 55 and older should switch to mammography every 2
years, or may choose to continue annual screening
Screening should continue as long as a woman is in good health
and is expected to live 10 more years or longer
All women should be familiar with the known benefits,
limitations, and potential harms linked to breast cancer
screening
Which recommendations to follow are a source of controversy in
clinical practice and for patient education.the uspstf has
concluded that the evidence is insufficient to assess the benefits
and harms of mri screening for breast cancer (i
recommendation). The american cancer society recommends
annual mri screening in addition to mammography for women
with a ≥20% lifetime risk for breast cancer, and recommends
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