Page 1 of 89
ABFM HEALTH COUNSELING AND PREVENTIVE CARE
Exam ACTUAL EXAM ALL 100 QUESTIONS and CORRECT
ANSWERS LATEST UPDATE THIS YEAR
QUESTION: 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
1
, Page 2 of 89
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 of
childhood attention-deficit/hyperactivity disorder.
QUESTION: 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?
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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
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 the most common,
with arterial or "inflow" disorders accounting for more problems than venous disorders. The
patient should be advised that their ED is a risk factor for underlying cardiovascular disease and
that further evaluation may be appropriate. It is important to remember, however, that even
though the primary etiology of ED is most often organic, psychological factors frequently
coexist and play a role in the dysfunction.Many medications can cause or contribute to ED. It is
estimated that as many as 25% of ED cases are due to medication side effects. This highlights
the crucial role of the primary care physician in reviewing medication lists and modifying
3
, Page 4 of 89
treatment regimens as part of addressing ED. Common offenders include antihistamines,
antihypertensives and diuretics such as hydrochlorothiazide and spironolactone, psychoactive
medications including SSRIs, and anti-epilepsy medications. It is not clear whether low amounts
of alcohol cause erectile dysfunction.
QUESTION: A 42-year-old female sees you for a routine health maintenance visit. Her neighbor
was just diagnosed with ovarian cancer and has encouraged her to have her CA-125 level
checked. The patient asks about ovarian cancer risk factors, prevention, and screening. Which
one of the following would be appropriate advice?
A past history of oral contraceptive use increases the risk for ovarian cancer
Hormone replacement therapy after menopause decreases the risk for subsequent ovarian
cancer
CA-125 has a false-positive rate of 98% when used to screen for ovarian cancer
Bimanual examinations are recommended to screen for ovarian cancer
Transvaginal ultrasonography is recommended to screen for ovarian cancer - ANSWER-C
4
ABFM HEALTH COUNSELING AND PREVENTIVE CARE
Exam ACTUAL EXAM ALL 100 QUESTIONS and CORRECT
ANSWERS LATEST UPDATE THIS YEAR
QUESTION: 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
1
, Page 2 of 89
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 of
childhood attention-deficit/hyperactivity disorder.
QUESTION: 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?
2
, Page 3 of 89
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
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 the most common,
with arterial or "inflow" disorders accounting for more problems than venous disorders. The
patient should be advised that their ED is a risk factor for underlying cardiovascular disease and
that further evaluation may be appropriate. It is important to remember, however, that even
though the primary etiology of ED is most often organic, psychological factors frequently
coexist and play a role in the dysfunction.Many medications can cause or contribute to ED. It is
estimated that as many as 25% of ED cases are due to medication side effects. This highlights
the crucial role of the primary care physician in reviewing medication lists and modifying
3
, Page 4 of 89
treatment regimens as part of addressing ED. Common offenders include antihistamines,
antihypertensives and diuretics such as hydrochlorothiazide and spironolactone, psychoactive
medications including SSRIs, and anti-epilepsy medications. It is not clear whether low amounts
of alcohol cause erectile dysfunction.
QUESTION: A 42-year-old female sees you for a routine health maintenance visit. Her neighbor
was just diagnosed with ovarian cancer and has encouraged her to have her CA-125 level
checked. The patient asks about ovarian cancer risk factors, prevention, and screening. Which
one of the following would be appropriate advice?
A past history of oral contraceptive use increases the risk for ovarian cancer
Hormone replacement therapy after menopause decreases the risk for subsequent ovarian
cancer
CA-125 has a false-positive rate of 98% when used to screen for ovarian cancer
Bimanual examinations are recommended to screen for ovarian cancer
Transvaginal ultrasonography is recommended to screen for ovarian cancer - ANSWER-C
4
