BESTLEC
ABFM HEALTH COUNSELING AND PREVENTIVE CARE
Questions and Correct Answers/ Latest Update / Already Graded
You are counseling a 45-year-old male with elevated LDL- cholesterol. When
discussing dietary changes to promote healthy lipid levels, which one of the
following would be accurate advice?
C
LE
A. He should minimize his consumption of nuts
ST
B. The Dietary Approaches to Stop Hypertension (DASH) diet recommended for
reducing hypertension will help lower his LDL- cholesterol level
BE
C. Saturated fats should comprise 15% or less of his caloric intake He should
aim for a fiber intake of 25 g daily
D. He should record what he has eaten in a food diary at the end of each day
Ans: B
In 2013, the American Heart Association (AHA) issued lifestyle management guidelines
designed to reduce cardiovascular risk. For adult patients with elevated LDL-cholesterol
levels the AHA advises following diet plans such as the Dietary Approaches to Stop
Hypertension (DASH) diet, the AHA diet, or the USDA Food Pattern. The AHA specifically
, BESTLEC
recommends reducing the percentage of calories from saturated fat, aiming for a goal of
6%-7% of calories from this source. The AHA also recommends a diet that emphasizes the
consumption of fruits, vegetables, and whole grains, and which includes fish, poultry, low-
fat dairy products, legumes, nontropical vegetable oils, and nuts.
Consumption of red meat, sweets, and sugar-sweetened beverages should be discouraged.
Although dietary fiber has been shown to have several beneficial health effects, the average
daily intake for most Americans is 15 g daily, which is much lower than the recommended
amount. The recommended daily fiber intake for males age 14-50 is 38 g daily. For other
C
populations the recommended amount is lower, and varies according to age and sex.
LE
Several randomized, controlled trials have shown a reduction of LDL-cholesterol with higher
fiber consumption. A food diary is an important aspect of dietary behavior change but it is
ST
most accurate if entries are made immediately after food is consumed.
A 24-year-old female sees you for a preconception visit and removal of her IUD. This
BE
will be her first pregnancy and she tells you that she has smoked ¼-½ pack of cigarettes a
day for the past 5 years. Which one of the following would be appropriate advice
regarding the risks from smoking?
A. Smoking during pregnancy increases the risk of attention- deficit/hyperactivity
disorder
B. Smoking during pregnancy increases the risk of clubfoot
C. Smoking during pregnancy increases the risk of congenital atrial septal defects
, BESTLEC
D. Stopping smoking now will reduce the increased risk of orofacial defects in her
infant
E. Reducing smoking now will reduce the risk of preterm delivery
Ans: D
There are many reproductive problems related to smoking, including conception delay and
both primary and secondary infertility; an increased risk of ectopic pregnancy and
spontaneous abortion; an increased risk of abruption, preterm rupture of membranes,
C
placenta previa, and premature delivery; and increased perinatal morbidity and mortality,
LE
including stillbirth, low birth weight, and SIDS-related deaths. The 2001 Surgeon General's
Report on women and smoking makes it clear that stopping smoking during pregnancy
ST
reduces and sometimes eliminates many of these consequences.Small for gestational age
(SGA) infants are a dose-dependent outcome of maternal smoking, with an odds ratio (OR)
BE
of 2.11 when women smoke throughout pregnancy. Risks for prematurity (OR 1.15) and fetal
death (OR 1.15) are also increased. The risk of having an SGA infant is avoided if smoking is
reduced, but the risks for prematurity and increased fetal death are not.In 2014 the U.S. Surgeon
General issued a new report on the health consequences of smoking that noted that the
evidence was strong enough to infer a causal link between maternal smoking and orofacial
clefts. This was still true when the Surgeon General issued a report on smoking cessation in
2020. No link could be inferred, however, between smoking and other congenital defects,
including clubfoot, gastroschisis, and atrial septal defects. There is
no evidence that maternal smoking leads to increased rates of childhood attention-
deficit/hyperactivity disorder.
, BESTLEC
A 55-year-old male expresses concern about his inability to maintain an erection that
allows for satisfactory sexual intercourse with his wife. He takes over-the-counter
diphenhydramine (Benadryl) at night for sleep and takes a daily multivitamin. He says he
drinks one 12- ounce beer 2-3 times per week. A physical examination is normal,
including his blood pressure.Which one of the following would you tell him?
C
A. Most cases of erectile dysfunction (ED) have a psychogenic etiology
LE
B. Diphenhydramine has little impact on his ED
ST
C. Abstaining from alcohol use will improve his symptoms
D. Erectile dysfunction may be an early indication of vascular disease About 5% of
BE
men his age experience ED
Ans: D
Erectile dysfunction (ED) is common, affecting an estimated 30 million men in the United
States, and becomes more common with advancing age. The Health Professionals Follow-
up Study reported moderate to severe ED in 12% of men younger than 59, 22% of men ages 60-
69, and 30% of men older than 69.It was previously thought that the majority of cases of ED
were caused by psychogenic factors such as family or occupational stress. However,
evidence suggests that approximately 80% of ED is due to organic disease, which can be
divided into hormonal, vasculogenic, and neurogenic causes. Vasculogenic etiologies are
ABFM HEALTH COUNSELING AND PREVENTIVE CARE
Questions and Correct Answers/ Latest Update / Already Graded
You are counseling a 45-year-old male with elevated LDL- cholesterol. When
discussing dietary changes to promote healthy lipid levels, which one of the
following would be accurate advice?
C
LE
A. He should minimize his consumption of nuts
ST
B. The Dietary Approaches to Stop Hypertension (DASH) diet recommended for
reducing hypertension will help lower his LDL- cholesterol level
BE
C. Saturated fats should comprise 15% or less of his caloric intake He should
aim for a fiber intake of 25 g daily
D. He should record what he has eaten in a food diary at the end of each day
Ans: B
In 2013, the American Heart Association (AHA) issued lifestyle management guidelines
designed to reduce cardiovascular risk. For adult patients with elevated LDL-cholesterol
levels the AHA advises following diet plans such as the Dietary Approaches to Stop
Hypertension (DASH) diet, the AHA diet, or the USDA Food Pattern. The AHA specifically
, BESTLEC
recommends reducing the percentage of calories from saturated fat, aiming for a goal of
6%-7% of calories from this source. The AHA also recommends a diet that emphasizes the
consumption of fruits, vegetables, and whole grains, and which includes fish, poultry, low-
fat dairy products, legumes, nontropical vegetable oils, and nuts.
Consumption of red meat, sweets, and sugar-sweetened beverages should be discouraged.
Although dietary fiber has been shown to have several beneficial health effects, the average
daily intake for most Americans is 15 g daily, which is much lower than the recommended
amount. The recommended daily fiber intake for males age 14-50 is 38 g daily. For other
C
populations the recommended amount is lower, and varies according to age and sex.
LE
Several randomized, controlled trials have shown a reduction of LDL-cholesterol with higher
fiber consumption. A food diary is an important aspect of dietary behavior change but it is
ST
most accurate if entries are made immediately after food is consumed.
A 24-year-old female sees you for a preconception visit and removal of her IUD. This
BE
will be her first pregnancy and she tells you that she has smoked ¼-½ pack of cigarettes a
day for the past 5 years. Which one of the following would be appropriate advice
regarding the risks from smoking?
A. Smoking during pregnancy increases the risk of attention- deficit/hyperactivity
disorder
B. Smoking during pregnancy increases the risk of clubfoot
C. Smoking during pregnancy increases the risk of congenital atrial septal defects
, BESTLEC
D. Stopping smoking now will reduce the increased risk of orofacial defects in her
infant
E. Reducing smoking now will reduce the risk of preterm delivery
Ans: D
There are many reproductive problems related to smoking, including conception delay and
both primary and secondary infertility; an increased risk of ectopic pregnancy and
spontaneous abortion; an increased risk of abruption, preterm rupture of membranes,
C
placenta previa, and premature delivery; and increased perinatal morbidity and mortality,
LE
including stillbirth, low birth weight, and SIDS-related deaths. The 2001 Surgeon General's
Report on women and smoking makes it clear that stopping smoking during pregnancy
ST
reduces and sometimes eliminates many of these consequences.Small for gestational age
(SGA) infants are a dose-dependent outcome of maternal smoking, with an odds ratio (OR)
BE
of 2.11 when women smoke throughout pregnancy. Risks for prematurity (OR 1.15) and fetal
death (OR 1.15) are also increased. The risk of having an SGA infant is avoided if smoking is
reduced, but the risks for prematurity and increased fetal death are not.In 2014 the U.S. Surgeon
General issued a new report on the health consequences of smoking that noted that the
evidence was strong enough to infer a causal link between maternal smoking and orofacial
clefts. This was still true when the Surgeon General issued a report on smoking cessation in
2020. No link could be inferred, however, between smoking and other congenital defects,
including clubfoot, gastroschisis, and atrial septal defects. There is
no evidence that maternal smoking leads to increased rates of childhood attention-
deficit/hyperactivity disorder.
, BESTLEC
A 55-year-old male expresses concern about his inability to maintain an erection that
allows for satisfactory sexual intercourse with his wife. He takes over-the-counter
diphenhydramine (Benadryl) at night for sleep and takes a daily multivitamin. He says he
drinks one 12- ounce beer 2-3 times per week. A physical examination is normal,
including his blood pressure.Which one of the following would you tell him?
C
A. Most cases of erectile dysfunction (ED) have a psychogenic etiology
LE
B. Diphenhydramine has little impact on his ED
ST
C. Abstaining from alcohol use will improve his symptoms
D. Erectile dysfunction may be an early indication of vascular disease About 5% of
BE
men his age experience ED
Ans: D
Erectile dysfunction (ED) is common, affecting an estimated 30 million men in the United
States, and becomes more common with advancing age. The Health Professionals Follow-
up Study reported moderate to severe ED in 12% of men younger than 59, 22% of men ages 60-
69, and 30% of men older than 69.It was previously thought that the majority of cases of ED
were caused by psychogenic factors such as family or occupational stress. However,
evidence suggests that approximately 80% of ED is due to organic disease, which can be
divided into hormonal, vasculogenic, and neurogenic causes. Vasculogenic etiologies are
