Can medical knowledge make you a better patient? Take this quiz.

Parents and educators in my state have been debating the merits of standardized testing for school children and maybe where you live also. And it’s not just a question for children, adults can be subjected to professional testing also.

After I finished my family medicine residency, I took an 8 hour paper multiple choice written exam to become certified by the American Board of Family Medicine (ABFM). And every 10 years since I have taken the test to re-certify. (Originally it was every 7 years).

The purpose of board certification is to make sure you, the patient, are getting the best care possible from a physician. According to the ABFM,

We promise that board certification means that the family physician you choose for your care meets high standards. 

My certification expires at the end of 2019.

Eventually the Board transitioned to a computer based exam taken at a local testing center, still 8 hours long. This year they are trying something new- doctors can take the test on their own computer or tablet whenever and wherever they choose.

The new system is a trial and voluntary. Those of us who have chosen to do it give feedback on the process, what we like and don’t like about it. They hope this will prove to be a workable system that eventually everyone will do.

Here is another experience and opinion about the exam from Clif Knight, M.D. , who is the AAFP’s senior vice president for education.

Certification Pilot Proves Worthy Alternative

a male doctor using a tablet while working
Doctors can answer questions on a computer or tablet any time of day or night.

This exam consists of 25 questions posted quarterly over 3 years, with a 5 minute time limit for each question . Besides being able to take the exam in my pajamas, I can research the answers online if I need to-as long as I can do it in 5 minutes. The rules prohibit me from discussing the questions with another person, based on an honor system that I attest to before beginning each session. Being able to look up information is more like actual medical practice.

More aligned with adult learning principles, this approach allows for use of references and promotes greater retention of new knowledge to be applied in daily practice.

ABFM web site

You can learn more about the value of board certification at this link

American Board of Family Medicine Patient Page

While board certification is a voluntary process, many organizations prefer or require the physicians they hire or work with to be board certified.

Take an “exam” designed for patients

I thought I would give you a taste of what I am doing by creating a patient certification exam for you. The rules prohibit me from sharing actual test questions so I have written my own, in simple medical terms, but using a format similar to the questions I answer.

When I answer questions, I get immediate feedback if my answer was right or wrong, with an explanation and a reference. So I have done the same for you. In this case, the reference is from a blog post I have written.

There’s no time limit for each question and for this exam, feel free to discuss your answers with someone else, I encourage you to. Choose the single best answer. Check at the end for the correct answers.

I had fun writing these questions so I hope you have fun answering them. Good luck! I hope you pass.

Question 1

A woman came to her doctor with a skin rash soon after starting to take a new medication. The medication is most likely

  1. An Antidepressant
  2. A blood pressure lowering drug
  3. An anti-inflammatory drug
  4. An antibiotic

Question 2

A 25 year old woman notices that the skin on her face has darkened over the past several months. This condition is called

  1. Melasma
  2. Eczema
  3. Psoriasis
  4. Tinea

How common meds hurt skin

Skin: Epidermis and Dermis illustration
Line drawing showing cross-section of dermal and epidermal skin layers. National Cancer Institute Creator: Unknown Illustrator This image is in the public domain and can be freely reused. Please credit the source and, where possible, the creator listed above.

Question 3

A mother brings her 8 year old daughter to her family doctor. The child has a cough, runny nose, and mild sore throat. Her temperature is 100.2 degrees. The doctor diagnosed the illness as a cold, or upper respiratory infection and explains this is caused by a virus. She does not prescribe an antibiotic because

  1. The child is allergic to penicillin
  2. The family does not have health insurance
  3. The mother has left over antibiotic from another child at home.
  4. An antibiotic will not help an infection caused by a virus.

How to cope with winter illness

Question 4

A 30 year old woman comes to her doctor because she is losing an excessive amount of hair. She is afraid she will become bald. Most likely she

  1. Started using a cheap shampoo
  2. Delivered a baby
  3. Needs vitamins
  4. Should investigate hair implants

Effective solutions if you experience hair loss

Question 5

Dr. Oglesby believes that certain medications should be used more often because of their benefit to patients. These drugs include all except

  1. Antibiotics
  2. Vitamins
  3. Sleeping pills
  4. Stop smoking drugs

7 underused drugs

Question 6

A young man who is a computer programmer has difficulty falling asleep. His doctor may recommend

  1. Buy a new mattress
  2. Taking a sleeping pill an hour before bedtime
  3. Regular exercise and relaxation techniques
  4. Watching television until he falls asleep

Expert advice to sleep

a simple bed, window shade down, small lamp on a side table

Question 7

Author and motivational speaker Nick Vijucic was born with amelia. This term means he lacks certain parts of his body which are his

  1. Limbs
  2. Eyes
  3. Ears
  4. Teeth

Light and life without limbs

Question 8

A woman sees her doctor because she researched her symptoms online and believes she has endometriosis. She thinks this because

  1. She does not have regular periods.
  2. She had a miscarriage.
  3. She has not been able to get pregnant.
  4. Her sister has it.

Women’s health update

Question 9

The HPV (human papilloma virus) causes cancer. Vaccination against this virus decreases the risk of cancer of the

  1. Cervix
  2. Uterus
  3. Breast
  4. Ovary

Women’s health update

Question 10

Kristin Chenoweth, Tony Award winning actress and singer, suffers from Meniere’s syndrome. She was born in a small town in Oklahoma named

  1. Muskogee
  2. Broken Arrow
  3. Ada
  4. McAlester

Kristin Chenoweth– a review of her memoir

a letter jacket, bag, and shoes, belonging to Kristen Chenoweth
Kristin’s jacket from high school on display at the Performing Arts Center

ANSWERS TO QUESTIONS

  1. The most common drug that causes a skin rash is an antibiotic.
  2. Melasma
  3. Antibiotics do not help a cold or any other viral infection
  4. delivered a baby; hair loss is common after pregnancy
  5. Stop smoking drugs can be useful to help smokers quit. The other drugs listed are often overused.
  6. Exercise and relaxation can improve one’s sleep.
  7. Nick was born without limbs.
  8. Infertility is a common symptom of endometriosis.
  9. Cancer of the cervix is caused by the HPV virus.
  10. Broken Arrow. The other Oklahoma towns produced Carrie Underwood, Blake Shelton, and Reba McIntyre.

testing the HEART of health

Thanks for testing your knowledge with this first ever Watercress Words Certification Exam. If you liked it, let me know, maybe we’ll do it again.

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

                              Dr. Aletha 

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2019 Women’s health update- hormones, the heart, and HPV

Multiple health issues impact women exclusively or differently than men, so new and updated information is important to share. The issues we women face vary with our age, stage of life and health status.

Let’s look at some medical news about women’s health issues, information I picked up recently from several medical journals I follow.

This is current, general medical information that helps a doctor and patient make decisions about what is right for her. Medical recommendations and practice changes as we learn new things.
If you deal with any of these issues , please discuss with your doctor before  taking any action.

I’m illustrating this post with photos of art featuring women. I’ll tell you more about the source at the end.

statue of a woman holding an infant

Human papillomavirus and cancer 

Infection with the human papillomavirus, HPV, can cause  genital warts and cervical cancer.

The percentage of young women with confirmed HPV (human papillomavirus) infection  in the United States fell significantly from 2006 to 2012. Women who had received the HPV vaccine showed the greatest decline in infection rates, compared to those who had not. Even one dose was effective, even though 2 or 3 are recommended.

A new study reported by the New England Journal of Medicine shows that women who become infected with the HPV strains 16 and 18 have a much higher risk of changes in their cervix called CIN-cervical intraepithelial neoplasia-which can be a precursor to cancer. These changes may not be picked up by a Papanicolaou (Pap) test.

Thus, protection against infection with HPV should also provide protection against cancers caused by HPV.

Human papillomavirus vaccine

Gardasil, a vaccine which targets the HPV has been available to females and males from 9 years old to 26 years old. Now the age has been extended through age 45 years for both genders.

Here is a link to detailed information about HPV vaccination from the National Cancer Institute.


Human Papillomavirus (HPV) Vaccines

statue of a pioneer woman with rifle and infant

Long-acting reversible contraception-LARC  

Two forms of long-acting reversible contraception are available to women in the United States.

Nexplanon, a contraceptive implant, slowly releases the hormone progestin and does not have estrogen. It can be used in women who cannot take estrogen, such as those with uterine fibroids or endometrial cancer.

Intrauterine devices, IUDs, containing copper only are appropriate for women with past or present breast cancer, ischemic heart disease, and women at risk for blood clots.

Use of LARCs accounts for 12% of all contraceptive use. Additional benefits include controlling excessive menstrual bleeding, potentially saving women from surgery.

Here is a link to Quick Fact about intrauterine devices and other forms of contraception from the Department of Health and Human Services

Intrauterine Device

statue of woman, holding infant, standing next to a child

Hormone therapy and prevention of heart disease

A 2015 Cochrane review of 40,410 postmenopausal women examined the use of oral hormone therapy (estrogen with or without progesterone) taken for at least six months, compared with placebo (no real drug), to determine the effect on death from any cause, and deaths caused by heart disease, stroke, and blood clot in a leg or lung.

The review found no benefits for preventing heart attack (fatal or nonfatal), or death due to any cause.

In women who took hormones they found

 
1 in 165 women had a stroke
1 in 118 women had a blood clot in the leg or lung
1 in 242 women had a blood clot in the lung

The women in this study were all older than 60 years old, so it is possible there might be benefit in younger women.

statue of woman with arm raised and holding an infant

Vaginal estrogen and heart health

While estrogen replacement after menopause is effective at controlling the undesirable effects of night sweats, hot flashes, and vaginal dryness, it potentially increases the risk of developing cardiovascular disease-heart attacks and stroke, and some cancers-breast and uterine.

However, results of the Nurses Health Study over 18 years shows no increase in incidence of these complications in women who used vaginal estrogen, suggesting this is a safe option for women who elect to use estrogen. (from the journal Menopause)

The photos- a tribute to women

I took these photos during a recent visit to Woolaroc ,a museum and wildlife preserve located in the Osage Hills of Northeastern Oklahoma. Woolaroc was established in 1925 as the ranch retreat of oilman Frank Phillips. 

These statues displayed there were all models considered for a larger project now known as the Pioneer Woman Statue in Ponca City, Oklahoma.

What do you think? Would you have chosen one of the other statues for the final version?

More women’s health info

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

a statue of a woman holding a child, "CROSSING THE PRAIRIE"
“CROSSING THE PRAIRIE” by Glenna Goodacre, Broken Arrow, Oklahoma
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