ABFM HEALTH COUNSELING AND PREVENTIVE CARE

ABFM HEALTH COUNSELING AND PREVENTIVE CARE EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS & RATIONALES | 100% PASS (A+ CERTIFIED) 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? He should minimize his consumption of nuts The Dietary Approaches to Stop Hypertension (DASH) diet recommended for reducing hypertension will help lower his LDL-cholesterol level Saturated fats should comprise 15% or less of his caloric intake He should aim for a fiber intake of 25 g daily He should record what he has eaten in a food diary at the end of each day - Answer 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 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 populations the recommended amount is lower, and varies according to age and sex. 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 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 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? Smoking during pregnancy increases the risk of attention deficit/hyperactivity disorder Smoking during pregnancy increases the risk of clubfoot Smoking during pregnancy increases the risk of congenital atrial septal defects Stopping smoking now will reduce the increased risk of orofacial defects in her infant Reducing smoking now will reduce the risk of preterm delivery - Answer 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, placenta previa, and premature delivery; and increased perinatal morbidity and mortality, 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 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) 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 deficit/hyperactivity disorder. of childhood attention 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? Most cases of erectile dysfunction (ED) have a psychogenic etiology Diphenhydramine has little impact on his ED Abstaining from alcohol use will improve his symptoms Erectile dysfunction may be an early indication of vascular disease About 5% of men his age experience ED - Answer D