ABFM HEALTH COUNSELING AND
PREVENTIVE CARE EXAM WITH
CORRECT ANSWERS 2025
You are counseling a 45-year-old male with elevated LDL-
cholesterol.dietary
discussing When 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 will help lower his LDL-cholesterol
hypertension
level
Saturated fats should comprise 15% or less of his
caloric
He shouldintake
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 ( Correct
answers )
B
In 2013, the American Heart Association (AHA) issued lifestyle
management
designed guidelines
to reduce cardiovascular risk. For adult patients with
elevated LDL-
cholesterol levels the AHA advises following diet plans such as
the Dietary to Stop Hypertension (DASH) diet, the AHA diet, or the USDA
Approaches
FoodAHA
The Pattern.
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
oils, and nuts. vegetable
Consumption of red meat, sweets, and sugar-sweetened
should be discouraged.Although dietary fiber has been shown to
beverages
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
intake for males daily
agefiber
14-50 is 38 g daily. For other populations the
amount is lower, and varies according to age and sex. Several randomized,
recommended
trials have shown a reduction of LDL-cholesterol with higher fiber
controlled
consumption.
food diary is an A important aspect of dietary behavior change but it is
most accurate
entries are made if 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
disorde
attention-deficit/hyperactivity
rSmoking during pregnancy increases the risk of
Smoking during pregnancy increases the risk of congenital atrial
clubfoot
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 ( Correct
answers ) D
There are many reproductive problems related to smoking, including
conception
and delay and secondary infertility; an increased risk of ectopic
both primary
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
Surgeon General's
2001 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
of maternaloutcome
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 risk
The increased.
of having an SGA infant is avoided if smoking is reduced, but
the risks for and increased fetal death are not.In 2014 the U.S. Surgeon
prematurity
General
a issued
new report on the health consequences of smoking that noted that the
evidence
strong enough
was to infer a causal link between maternal smoking and
orofacial
This was clefts.
still true when the Surgeon General issued a report on smoking
cessation
2020. in could be inferred, however, between smoking and other
No link
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.
A 55-year-old male expresses concern about his inability to maintain an
erection
allows forthat
satisfactory sexual intercourse with his wife. He takes over-
diphenhydramine (Benadryl) at night for sleep and takes a daily
the-counter
multivitamin.
he drinks one He 12-ounce
says beer 2-3 times per week. A physical
examination
including his is
blood
normal,
pressure.Which one of the following would you
tell him?
Most cases of erectile
Diphenhydramine has dysfunction
little impact (ED)
on have a psychogenic
etiology
his ED
Abstaining from alcohol use will improve his
Erectile dysfunction may be an early indication of
symptoms
vascular
About 5%disease
of men his age experience ED ( Correct answers ) D
Erectile dysfunction (ED) is common, affecting an estimated 30 million
men in States,
United the and becomes more common with advancing age.
The Health Follow-up Study reported moderate to severe ED in 12% of
Professionals
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
ED is due to organic
80% ofdisease, which can be divided into hormonal,
vasculogenic,
neurogenic causes.
and 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
and that furtherdisease
evaluation may be appropriate. It is important to
remember,
that even though
however,
the primary etiology of ED is most often organic,
factors frequently coexist and play a role in the dysfunction.Many
psychological
medications
cause or contribute
can to ED. It is estimated that as many as 25% of ED
cases are due
medication sidetoeffects. This highlights the crucial role of the primary care
physician in
reviewing medication lists and modifying treatment regimens as part of
addressing
Common offenders
ED. include antihistamines, antihypertensives and
diuretics such as hydrochlorothiazide and spironolactone, psychoactive
medications
and anti-epilepsy
including
medications.
SSRIs, It is not clear whether low amounts of
alcohol cause
erectile dysfunction.
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,Which
screening. and one of the following would be appropriate
advice?
A past history
Hormone of oral contraceptive
replacement therapy after use increasesdecreases
menopause the risk for
the risk for
ovarian cancer
subsequent
cancer
CA-125 has a false-positive rate of 98% when used to screen for
ovarian
Bimanualcancer
examinations are recommended to screen for
ovarian cancer
Transvaginal ultrasonography is recommended to screen for ovarian cancer
( Correct ) C
answers
Ovarian cancer is the fifth leading cause of cancer death among women
in the United
States. Risk factors associated with ovarian cancer include a positive
family
and having
history
the BRCA1 or BRCA2 gene mutation. A first or second degree
relative cancer
ovarian with increases the risk by about threefold. The use of oral
during the reproductive years, and pregnancy, especially after age 35,
contraceptives
reduce
of ovarian
thecancer,
risk but postmenopausal estrogen use may increase the
risk.The U.S.
Preventive Services Task Force does not currently recommend screening
for ovarian
cancer, as it is likely to have a relatively low yield (D
recommendation).
women with a positive
Almost
screening
all test for CA-125 will not have
ovarian at
women cancer.
averageIn risk, the positive predictive value of an
abnormal CA-125
approximately 2%,isso 98% of women with positive test results will not
have ovarian
cancer. There are no current recommendations for ovarian cancer
screening by either transvaginal ultrasonography or pelvic examination.
, A male who was born in 1970 comes to your office for a preoperative
examination for an orthopedic procedure on his knee. He is otherwise
healthy and does not take any medications, but he has not seen a
physician for 6 years. He used illicit drugs for a brief period at age 23
but has not done so since that time and has had three sexual partners,
all of them female. You use this opportunity to counsel him on preventive
health screenings, including hepatitis C.Which one of the following is true
regarding screening for hepatitis C?
high recommends
The CDC cost of treatment outweighs
testing the potential
for hepatitis benefit
C virus every 3-5ofyears
screening
in
patients
have a history
who of drug
The U.S. Preventive Services Task Force recommends routine screening for
injection
hepatitis
only for those
C born between 1945
and 1965
This patient should be screened with hepatitis C RNA polymerase chain
reactionanswers
Correct (PC ( ) E
In 2019 the U.S. Preventive Services Task Force (USPSTF) recommended
screening18-79
patients all years of age at least once for hepatitis C with the anti-
HCV antibody
test. Detection of hepatitis C virus (HCV) RNA by polymerase chain
reactionprovides
testing (PCR) evidence of active HCV infection, confirms the diagnosis,
and
in monitoring
is used the antiviral response to therapy. Quantitative PCR is used
to determine
viral load. The CDC previously recommended screening for people born
between
and 1965,1945but that has been expanded.HCV is the most common
chronic bloodborne
pathogen in the United States and a leading cause of complications from
chronic liver
disease. Before the COVID pandemic, HCV infection was associated with
more deaths
than the top 60 other reportable infectious diseases combined, including
HIV. The most
important risk factor for HCV infection is past or current injection drug
use. In States
United the an estimated 4.1 million people have past or current HCV
infection,
on a positive
basedtest for the anti-HCV antibody. Approximately 2.4 million
persons antibody
positive with a test have a current infection based on results of
molecular
for HCV RNA assays
and would be potential candidates for treatment.
Treatment
very high levels
resultsofinvirus remission.Cases of acute HCV infection
approximately 3.5-fold between 2010 and 2017. The increased
increased
incidenceyoung
affected has mostly
white people who inject drugs, especially those living in
rural areas.
There has also been an increase in the number of women age 15-44
years withThere
infection. HCV is no recommended testing frequency for high-risk
individuals at this
time.
You see a 45-year-old male who has smoked cigarettes for 25 years.
He is very in quitting but has not been able to do so despite many
interested
attempts. He
interested is
in using medications to help.Which one of the following would
likely be most
effective
?
Calling the QUIT LINE and using over-the-counter nicotine
patches
PREVENTIVE CARE EXAM WITH
CORRECT ANSWERS 2025
You are counseling a 45-year-old male with elevated LDL-
cholesterol.dietary
discussing When 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 will help lower his LDL-cholesterol
hypertension
level
Saturated fats should comprise 15% or less of his
caloric
He shouldintake
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 ( Correct
answers )
B
In 2013, the American Heart Association (AHA) issued lifestyle
management
designed guidelines
to reduce cardiovascular risk. For adult patients with
elevated LDL-
cholesterol levels the AHA advises following diet plans such as
the Dietary to Stop Hypertension (DASH) diet, the AHA diet, or the USDA
Approaches
FoodAHA
The Pattern.
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
oils, and nuts. vegetable
Consumption of red meat, sweets, and sugar-sweetened
should be discouraged.Although dietary fiber has been shown to
beverages
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
intake for males daily
agefiber
14-50 is 38 g daily. For other populations the
amount is lower, and varies according to age and sex. Several randomized,
recommended
trials have shown a reduction of LDL-cholesterol with higher fiber
controlled
consumption.
food diary is an A important aspect of dietary behavior change but it is
most accurate
entries are made if 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
disorde
attention-deficit/hyperactivity
rSmoking during pregnancy increases the risk of
Smoking during pregnancy increases the risk of congenital atrial
clubfoot
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 ( Correct
answers ) D
There are many reproductive problems related to smoking, including
conception
and delay and secondary infertility; an increased risk of ectopic
both primary
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
Surgeon General's
2001 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
of maternaloutcome
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 risk
The increased.
of having an SGA infant is avoided if smoking is reduced, but
the risks for and increased fetal death are not.In 2014 the U.S. Surgeon
prematurity
General
a issued
new report on the health consequences of smoking that noted that the
evidence
strong enough
was to infer a causal link between maternal smoking and
orofacial
This was clefts.
still true when the Surgeon General issued a report on smoking
cessation
2020. in could be inferred, however, between smoking and other
No link
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.
A 55-year-old male expresses concern about his inability to maintain an
erection
allows forthat
satisfactory sexual intercourse with his wife. He takes over-
diphenhydramine (Benadryl) at night for sleep and takes a daily
the-counter
multivitamin.
he drinks one He 12-ounce
says beer 2-3 times per week. A physical
examination
including his is
blood
normal,
pressure.Which one of the following would you
tell him?
Most cases of erectile
Diphenhydramine has dysfunction
little impact (ED)
on have a psychogenic
etiology
his ED
Abstaining from alcohol use will improve his
Erectile dysfunction may be an early indication of
symptoms
vascular
About 5%disease
of men his age experience ED ( Correct answers ) D
Erectile dysfunction (ED) is common, affecting an estimated 30 million
men in States,
United the and becomes more common with advancing age.
The Health Follow-up Study reported moderate to severe ED in 12% of
Professionals
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
ED is due to organic
80% ofdisease, which can be divided into hormonal,
vasculogenic,
neurogenic causes.
and 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
and that furtherdisease
evaluation may be appropriate. It is important to
remember,
that even though
however,
the primary etiology of ED is most often organic,
factors frequently coexist and play a role in the dysfunction.Many
psychological
medications
cause or contribute
can to ED. It is estimated that as many as 25% of ED
cases are due
medication sidetoeffects. This highlights the crucial role of the primary care
physician in
reviewing medication lists and modifying treatment regimens as part of
addressing
Common offenders
ED. include antihistamines, antihypertensives and
diuretics such as hydrochlorothiazide and spironolactone, psychoactive
medications
and anti-epilepsy
including
medications.
SSRIs, It is not clear whether low amounts of
alcohol cause
erectile dysfunction.
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,Which
screening. and one of the following would be appropriate
advice?
A past history
Hormone of oral contraceptive
replacement therapy after use increasesdecreases
menopause the risk for
the risk for
ovarian cancer
subsequent
cancer
CA-125 has a false-positive rate of 98% when used to screen for
ovarian
Bimanualcancer
examinations are recommended to screen for
ovarian cancer
Transvaginal ultrasonography is recommended to screen for ovarian cancer
( Correct ) C
answers
Ovarian cancer is the fifth leading cause of cancer death among women
in the United
States. Risk factors associated with ovarian cancer include a positive
family
and having
history
the BRCA1 or BRCA2 gene mutation. A first or second degree
relative cancer
ovarian with increases the risk by about threefold. The use of oral
during the reproductive years, and pregnancy, especially after age 35,
contraceptives
reduce
of ovarian
thecancer,
risk but postmenopausal estrogen use may increase the
risk.The U.S.
Preventive Services Task Force does not currently recommend screening
for ovarian
cancer, as it is likely to have a relatively low yield (D
recommendation).
women with a positive
Almost
screening
all test for CA-125 will not have
ovarian at
women cancer.
averageIn risk, the positive predictive value of an
abnormal CA-125
approximately 2%,isso 98% of women with positive test results will not
have ovarian
cancer. There are no current recommendations for ovarian cancer
screening by either transvaginal ultrasonography or pelvic examination.
, A male who was born in 1970 comes to your office for a preoperative
examination for an orthopedic procedure on his knee. He is otherwise
healthy and does not take any medications, but he has not seen a
physician for 6 years. He used illicit drugs for a brief period at age 23
but has not done so since that time and has had three sexual partners,
all of them female. You use this opportunity to counsel him on preventive
health screenings, including hepatitis C.Which one of the following is true
regarding screening for hepatitis C?
high recommends
The CDC cost of treatment outweighs
testing the potential
for hepatitis benefit
C virus every 3-5ofyears
screening
in
patients
have a history
who of drug
The U.S. Preventive Services Task Force recommends routine screening for
injection
hepatitis
only for those
C born between 1945
and 1965
This patient should be screened with hepatitis C RNA polymerase chain
reactionanswers
Correct (PC ( ) E
In 2019 the U.S. Preventive Services Task Force (USPSTF) recommended
screening18-79
patients all years of age at least once for hepatitis C with the anti-
HCV antibody
test. Detection of hepatitis C virus (HCV) RNA by polymerase chain
reactionprovides
testing (PCR) evidence of active HCV infection, confirms the diagnosis,
and
in monitoring
is used the antiviral response to therapy. Quantitative PCR is used
to determine
viral load. The CDC previously recommended screening for people born
between
and 1965,1945but that has been expanded.HCV is the most common
chronic bloodborne
pathogen in the United States and a leading cause of complications from
chronic liver
disease. Before the COVID pandemic, HCV infection was associated with
more deaths
than the top 60 other reportable infectious diseases combined, including
HIV. The most
important risk factor for HCV infection is past or current injection drug
use. In States
United the an estimated 4.1 million people have past or current HCV
infection,
on a positive
basedtest for the anti-HCV antibody. Approximately 2.4 million
persons antibody
positive with a test have a current infection based on results of
molecular
for HCV RNA assays
and would be potential candidates for treatment.
Treatment
very high levels
resultsofinvirus remission.Cases of acute HCV infection
approximately 3.5-fold between 2010 and 2017. The increased
increased
incidenceyoung
affected has mostly
white people who inject drugs, especially those living in
rural areas.
There has also been an increase in the number of women age 15-44
years withThere
infection. HCV is no recommended testing frequency for high-risk
individuals at this
time.
You see a 45-year-old male who has smoked cigarettes for 25 years.
He is very in quitting but has not been able to do so despite many
interested
attempts. He
interested is
in using medications to help.Which one of the following would
likely be most
effective
?
Calling the QUIT LINE and using over-the-counter nicotine
patches
