2010 American Occupational Health Conference (AOHC)
Orlando, Florida ~ May 2-5, 2010
ABPM MOC ATTENDANCE CALCULATION FORMA...
SUNDAY, MAY 2, 2010
Session 7000 7:00am-8:15am 0 ABPM MOC Credits
New Member Orientation – ABPM MOC Credit is not availabl...
b. Skip, trip, or fall
c. Violent event
d. Repetitive motion
2. Currently available components of the National Healthcare ...
Meal Session 7103 12Noon-1:15pm 0 ABPM MOC Credits
Becoming and Maintaining Board Certification in Occupational Medicine –...
1. Which of the following types of personal respiratory protection would be considered most appropriate for a 38-
year-old...
c. Value-based benefit design does not consider economic impact
d. Value-based benefit design cannot be used in the public...
9. True statements about the demographics of the United States Military include
a. There are more men and women in the mil...
c. MMR
d. Cervarix
MONDAY, MAY 3, 2010
Meal Session 7200 7:00am-8:15am 1 ABPM MOC Credits
Metrics to Manage By
1. What is ...
Session 2200 8:30am-10:00am 1.5 ABPM MOC Credits
Legal Implications Associated with Corporate Medical Department Responses...
c. Are 3 years out from closed head trauma associated with a 20 hour loss of consciousness
d. Are 30 days out from a mild ...
b. 10-15%
c. 40-60%
d. >90%
3. According to this study, what is the most common occupational skin disease?
a. Infection
b....
a. Billing, scheduling, and electronic documentation of the medical record
b. Use of clinical protocols, and medical surve...
c. Diabetes mellitus
d. Asthma
2. What medical category covers the top three diagnoses for which time off under FMLA is re...
c. House of Moves
d. Clinical Motion Analysis Laboratory and Training Facilities
e. All of the above
7. Golden Volume refe...
a. It is not necessary to support your decisions with EBM if you are an experienced clinician with years of
patient practi...
a. Dysnoe
b. Vertigo
c. Headache
d. Sleepiness
Session 2210 1:30pm-5:00pm 3 ABPM MOC Credits
MRO Controversies
1. The MRO ...
1. Would you qualify a 33 year old woman with moderate, persistent asthma for respirator use
a. No way
b. Yes, for any res...
a. The prominence of bone cysts in berylliosis
b. The prominent finding of alveolitis in berylliosis
c. The common finding...
TUESDAY, MAY 4, 2010
Meal Session 7300 7:00am-8:15am 1 ABPM MOC Credits
Travel Health Consultation Services in the Occupat...
days to second hand smoke while on the construction site?
a. 20%
b. 40%
c. 60%
d. 80%
e. 100%
Meal Session 7303 7:00am-8:1...
c. 2007
5. Rosen Shingle Creek has how many total sleeping rooms
a. 1,000
b. 1,500
c. 2,000
d. 2,225
6. The maximum number...
compensation cases. True/False
4. Corporate medical directors, when involved in a case in which an employee and the employ...
a. Billed charges
b. Clinical behavior
c. Policy
d. Hearts and minds
4. One goal of Guidelines-based Utilization Managemen...
b. Conditional medical waivers are never approved for cardiac conditions
c. Once issued, a conditional medical waiver may ...
e. Contamination from household (gasoline, oil, cleaning chemicals, etc) chemical spills that have been
inadequately conta...
c. Somatic dysfunction is named for freedom of motion
d. Somatic dysfunction is named by local convention; there is not na...
Session 2310 2:15pm-5:45pm 3 ABPM MOC Credits
Questions of Causation/Questions of Practice: Investigations by OSHA and NIO...
e. They are not related to any biological effect
5. Which of the following have been associated with immunologic interstit...
Legislative Advocacy for Physicians: An Interactive Workshop
1. Which of the following arguments supporting the need for a...
1. Which of the following is (are) recurrent challenges in emergency responses?
a. Communications
b. Relief of ICS
c. Comp...
4. Use of psychiatric medications for treatment of chronic pain can be problematic in workers’ compensation
because the ma...
7. If a worker’s FEV1 changes from 120% of predicted in 1980 to 90% of predicted in 2002, this is not significant
because ...
ABPM MOC ATTENDANCE CALCULATION FORM.doc
ABPM MOC ATTENDANCE CALCULATION FORM.doc
ABPM MOC ATTENDANCE CALCULATION FORM.doc
ABPM MOC ATTENDANCE CALCULATION FORM.doc
ABPM MOC ATTENDANCE CALCULATION FORM.doc
ABPM MOC ATTENDANCE CALCULATION FORM.doc
ABPM MOC ATTENDANCE CALCULATION FORM.doc
ABPM MOC ATTENDANCE CALCULATION FORM.doc
ABPM MOC ATTENDANCE CALCULATION FORM.doc
ABPM MOC ATTENDANCE CALCULATION FORM.doc
ABPM MOC ATTENDANCE CALCULATION FORM.doc
ABPM MOC ATTENDANCE CALCULATION FORM.doc
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ABPM MOC ATTENDANCE CALCULATION FORM.doc

  1. 1. 2010 American Occupational Health Conference (AOHC) Orlando, Florida ~ May 2-5, 2010 ABPM MOC ATTENDANCE CALCULATION FORMABPM MOC ATTENDANCE CALCULATION FORM For Distance Learning Following AOHC 2010 ABPM MOC Code: 608 ABPM MOC CREDIT ABPM Maintenance of Certification (MOC) Credit is only for physicians board-certified in occupational medicine and who are subject to the ABPM requirements. DIRECTIONS: 1. Enter actual number of ABPM MOC hours attended. Breaks and non-session lunches do not count for credit. 2. Transfer the total credits below to the “CME & ABPM MOC Verification Form for Distance Learning Credit 2010 AOHC.” Be sure to read the requirements and instructions on that form carefully and return it with appropriate payment as noted on that form. 3. You do not need to return this form if you transfer the number of MOC credits to the “CME & ABPM MOC…” form. Keep this form for your records. Please do not return the full Q&A Booklet. 4. No certificates will be issued - credit will appear in your ABPM profile approximately 60 days after ACOEM receives your request. 2010 American Occupational Health Conference ABPM MOC Credit Maximum ABPM MOC Hours Available* ABPM MOC Hours Actually Attended Sunday, May 2, 2010 5.5 Monday, May 3, 2010 6 Tuesday, May 4, 2010 6 Wednesday, May 5, 2010 3 Total ABPM MOC Hours (excluding meal sessions): Additional ABPM MOC Hours Available: Meal Sessions *Hours above do NOT include meal sessions. If you attended a meal session and wish to obtain ABPM MOC credit for it, please check the appropriate box below. Please Note: Credit is not given for pharmaceutical sponsored meal sessions/events, or for meal sessions 7000, 7103, or 7201. You must have registered and paid for each meal session you are requesting credit for. Maximum credit per meal session is one hour. Sunday 12PM  7104  7105 Monday 7AM  7200  7202  7207 Monday 12PM  7203  7204  7205  7206 Tuesday 7AM  7300  7301  7302  7303 Wednesday 7AM  7400  7401  7402 Total ABPM MOC Hours for Meal Sessions Only (if applicable): Total ABPM MOC Hours Submitted: Transfer this total to the “CME & ABPM MOC Verification Form for Distance Learning Credit 2010 AOHC.” Keep this form and the Q&A booklet that follows for your records. I attest that I have participated in the ABPM MOC portion of these sessions by answering and self scoring the ABPM MOC questions for each related session. _________________________________________________ _________ ______ Signature Date Last Name: First Name: ACOEM Education Department, 25 Northwest Point Blvd, Ste 700, Elk Grove Village, IL 60007
  2. 2. SUNDAY, MAY 2, 2010 Session 7000 7:00am-8:15am 0 ABPM MOC Credits New Member Orientation – ABPM MOC Credit is not available for this session. Session 7102 7:00am-8:15am 0 ABPM MOC Credits International Environmental Health – CANCELED Session 2000 8:30am-10:00am 1 ABPM MOC Credits AOHC Opening Session: C.O. Sappington Memorial Lecture 1. Michael Grunwald is a senior national correspondent for Time magazine. True/False 2. The Swamp is the winner of the George Polk Award. True/False 3. The Clarence Olds Sappington Memorial Lecture was first presented in 1954. True/False Session 2100 10:30am-12Noon 1.5 ABPM MOC Credits Electrodiagnosis (EMG/NCS) in Low Back Pain and CTS 1. Median mononeuropathy (CTS) is the most common entrapment neuropathy in the body. True/False 2. The only L4 innervated muscle below the knee is the tibialis anterior. True/False 3. The only L5 innervated muscle below the ankle is the extensor digitorum brevis. True/False 4. An electrodiagnostic report should always end with “needs to be clinically correlated.” True/False 5. One of the main goals of electodiagnosis is a suspected radiculopathy is to try and localize the compression to a single or multiple nerve roots. True/False Session 2101 10:30am-12Noon 1.5 ABPM MOC Credits Changing Behaviors: Achieving Results with an Effective Integrated Health and Productivity Strategy 1. How is a health and productivity management strategy potentially valuable to employees and employers? a. Improve employee health status b. Reduce employer productivity costs c. Reduce medical care utilization and costs d. A and B only e. B and C only f. None of the above 2. What role can a health plan have in health and productivity improvement for members and plan sponsors? a. Providing health services that reduce absenteeism and presenteeism b. Providing health services that reduce disability c. Implementing medical care quality improvement programs d. Measuring program impact in terms of health and productivity improvement e. All of the above f. None of the above 3. Which of the following is not an example of “irrational” behavioral economic principle: a. The power of free b. The recency effect c. Loss aversion d. Status quo bias 4. Which choice best describe a factor or factors in the motivational matrix? a. Importance of change b. Confidence to make the change c. Both A and B d. Neither A nor B 5. An Integrated Health and Disability program results in: a. No statistical significant results b. Statistically significant reduction in both healthcare and disability costs c. Statistically significant reduction in disability durations d. Statistically significant reduction in healthcare costs Session 2102 10:30am-12Noon 1.5 ABPM MOC Credits Occupational Health Surveillance with the Healthcare Personnel Safety Component of the NHSN 1. According to data from the Bureau of Labor Statistics, which type of event led to the most lost workday injuries and illnesses per 100,000 full-time hospital employees in 2008 a. Overexertion
  3. 3. b. Skip, trip, or fall c. Violent event d. Repetitive motion 2. Currently available components of the National Healthcare Safety Network include a. Patient safety & healthcare personnel safety b. Patient safety, healthcare personnel safety, biovigilance c. Patient safety only d. No components are available for use yet 3. Currently available modules within the Healthcare Personnel Safety Component of the NHSN a. None are currently available b. Blood and body fluid exposure, influenza vaccination c. Blood and body fluid exposure only, blood and bold fluid exposure with exposure management, influenza vaccination with (or without) exposure management, influenza exposure management only d. Blood and body fluid exposure only; blood and body fluid exposure with exposure management; influenza vaccination with (or without) exposure management; influenza exposure management only; tuberculosis exposure; overexertion/lifting (patient handling injuries); slips, trips, and falls; physical assaults; work-related asthma; dermatitis 4. Which of the following statements is true regarding influenza vaccination of healthcare personnel a. Vaccine uptake among healthcare personnel was over 75% from 2004-2008 b. It is mandated by OSHA c. Joint Commission now requires annual evaluation of vaccination rates and reasons for non-participation d. Data from the National Health Interview Survey can be used to measure vaccine uptake rates for specific facilities 5. Which of the following benefits of using the NHSN for additional occupational health surveillance is most likely a. Will promote interaction between healthcare facilities and CDC/NIOSH b. Will replace the Bureau of Labor Statistics annual survey c. Will facilitate employee health appointment scheduling Session 2103 10:30am-12Noon 1.5 ABPM MOC Credits Critical Appraisal of Occupational and Environmental Health Literature 1. Which of the following is a systematic error in the design, conduct or analysis of a study a. Chance b. Bias c. Confounding d. Factoring 2. Name three of Sir Bradford Hill’s criteria for causation. 3. Cross-sectional studies can generate incidence data. True/False 4. What are the main routes of occupational exposure to beryllium in the industrial setting? 5. Chronic beryllium disease is a granulomatous disease. True/False Session 2104 10:30am-12Noon 1.5 ABPM MOC Credits What Constitutes Excellence: Corporate Health Achievement Award Winner Presentations 1. The purpose of the CHAA award is to a. Champion improving worker health, safety and environmental management b. Communicate highest standards of excellence to the business community c. Provide model organizations with visibility and validation for their efforts d. Emphasize performance measures and outcomes e. All of the above 2. The CHAA Exemplary Practice Citation puts the focus on encouraging step by step improvements in companies. True/False 3. The success of Baptist Health South Florida’s program is due to a. Leadership support b. Integration of health and safety initiatives c. Culture of wellness d. Environmental stewardship e. All of the above 4. TOCDF Medical Clinic Absence/Disability Management Program has resulted in efficient employee case management and the “Return to Work” process has contributed to effective cost management, enhanced productivity and employee safety/well-being. True/False 5. The CHAA award focuses on metrics and trends that assist in driving improvement in delivery of health services. True/False
  4. 4. Meal Session 7103 12Noon-1:15pm 0 ABPM MOC Credits Becoming and Maintaining Board Certification in Occupational Medicine – ABPM MOC Credit is not available for this session. Meal Session 7104 12Noon-1:15pm 1 ABPM MOC Credits Legal Update: ADA, HIPAA, and GINA 1. What major change was sought by the ADAAA of 2008? a. To reject the Supreme Court’s reasoning in Sutton v United Air Lines, Inc., 527 US 471 (1999) with regard to coverage under the third prong of the definition of disability and to reinstate the reasoning of the Supreme Court in School Board of Nassau County v Arline, 480 US 273 (1987) which set forth a board view of the third prong of the definition of handicap under the Rehabilitation Act of 1973 b. To reject the standards enunciated by the Supreme Court in Toyota Motor Manufacturing, Kentucky, Inc., v Williams, 534 US 184 (2002), that the terms “substantially” and “major” in the definition of disability under the ADA “need to be interpreted strictly to create a demanding standard for qualifying as disabled,” and that to be substantially limited in performing a major life activity under the ADA “an individual must have an impairment that prevents or severely restricts the individual from doing activities that are of central importance to most people’s daily lives.” c. To convey congressional intent that the standard created by the Supreme Court in the case of Toyota Motor Manufacturing, Kentucky, Inc., v Williams, 534 US 184 (2002) for “substantially limits,” and applied by lower courts in numerous decisions, has created an inappropriately high level of limitation necessary to obtain coverage under the ADA, to convey that it is the intent of Congress that the primary object of attention in cases brought under the ADA should be whether entities covered under the ADA have complied with their obligations, and to convey that the question of whether an individual’s impairment is a disability under the ADA should not demand extensive analysis. d. All of the above 2. Which of these is addressed by the HIPPA non-discrimination requirement? a. Group health plans may not charge similarly situated individuals different premiums or contributions or impose different deductible, copayment or other cost sharing requirements based on a health factor b. Plans may provide a premium differential for smokers that may not exceed 20% of the total cost c. Plans may offer rewards based on the results of testing d. Programs that reward employees for attending health education seminars are not addressed 3. Under the Genetic Nondiscrimination Act of 2008 (GINA) a. Genetic information includes information about the sex or age of an individual or information that an individual currently has a disease or disorder b. Genetic information includes tests for alcohol or drug use c. Genetic information may not be collected by a plan for underwriting purposes d. Genetic information can be collected by health plans as long as they provide a reward for the information Meal Session 7105 12Noon-1:15pm 1 ABPM MOC Credits OSHA Record Keeping 1. The OSHA Recordkeeping Process consists of the following basic steps: determine if a case exists; determine if the case is work-related; determine if the case is new; and determine if the case meets one of the Specific Severity Criteria. True/False 2. The Recordkeeping National Emphasis Program (NEP) will expire a. September 30, 2010 b. December 31, 2010 c. October 31, 2010 d. The NEP does not expire e. None of the above 3. The OSHA Recordkeeping System is a a. Medical system b. Surveillance system c. Safety system Meal Session 7106 12Noon-1:15pm 0 ABPM MOC Credits Optimizing the Use of Functional Capacity Evaluations - CANCELED Session 2105 1:30pm-5:00pm 3 ABPM MOC Credits A Practical Approach to Occupational Asthma
  5. 5. 1. Which of the following types of personal respiratory protection would be considered most appropriate for a 38- year-old sandblaster who works in a stationary booth within a foundry? a. Particulate dust mask b. Half-face negative pressure respirator c. Powered-air purifying respirator d. Airline Respirator (pressure demand or continuous flow) e. Self containing breathing apparatus (SCBA) 2. Which of the following items are not key components of an independent medical evaluation? a. Establishing an illness or injury b. Determining if the illness or injury occurred in the course of employment c. Identifying if the claimant has valid medical insurance d. Estimating if the individual has reached maximal medical improvement e. Recommending if the employee can return to the workplace safely 3. Which of the following statements most accurately describes the Worker’s compensation system? a. All cases fall under common civil law b. Is a “no-fault” insurance system c. Across the US, it involves a universal system for compensation of injury or ill employees d. Medical costs (including rehabilitation) and lost wages are fully compensated when a claim has been approved 4. Which of the following chemical is a known cause of occupational asthma? a. Mercaptobenzothiazole b. Glutaraldehyde c. Isothiazolinone d. Thiuram 5. Which worker shown below is at greatest risk for developing occupational asthma? a. A painter using epoxy-based spray paints b. A nurse with pre-existing asthma working in a hospital using powder-free latex gloves c. A carpenter exposed to plicatic acid, an organic acid contained in wood dust d. A precious metal refining worker processing scrap gold metal 6. Work-exacerbated asthma is defined when a. Asthma onset is attributed to workplace exposures/conditions b. A health care provider had diagnosed asthma and there is an association between asthma symptoms and work c. Working conditions or exposures worsen asthma symptoms d. Asthma develops during work tenure, but not related to work exposures or conditions 7. Identify a true statement pertaining to occupational asthma a. The late respiratory systemic syndrome is associated with exposure to fumes of phthallic acid anhydride (PA) b. Serum specific IgE is a sensitive marker of diisocyanate sensitization in urethane workers with OA c. Isolated late asthmatic responses are associated with OA induced by protein allergens d. Sensitization to pimaric acid may cause OA in electronic soldering workers 8. In a patient with occupational asthma, complete avoidance of the inhaled antigen is the usual best approach to treatment. Under which of the following circumstances would use of a respiratory protective device be acceptable a. Isocyanate asthma b. Steroid dependant asthma c. Very intermittent and brief exposures for which a respirator would be well tolerated d. Patients on omalizumab therapy for occupational asthma e. Patients with high molecular weight-antigen asthma 9. In patients with occupational asthma requiring long term medical therapy, which of the following is most true a. Leukotriene inhibitors have no role in occupational asthma b. A possible adverse effect of daily use of long acting beta agonists is death c. Hyposensitization therapy (allergy shots) are frequently helpful in reducing medication requirements d. Muscarinic antagonists (ipratropium bromide, tiotropium) are first-line pharmacotherapy in occupational asthma e. Daily inhaled corticosteroids have no role in occupational asthma Session 2106 1:30pm-5:00pm 3 ABPM MOC Credits Relating HPM and Value-Based Design to Both the Private Practice and Corporate Medicine Physician 1. What is the difference between a cost-based benefit design and a value-based benefit design? a. Value-based benefit design applies to the pharmaceutical incentives only b. Value-based benefit design is an investment strategy focused on outcomes
  6. 6. c. Value-based benefit design does not consider economic impact d. Value-based benefit design cannot be used in the public sector 2. A value-based benefit design can be built on medical claims alone. True/False 3. A value-based benefit design can be only used in a big, self-insured company. True/False 4. Alignment of incentives is a hallmark of value-based design. What stakeholders can be aligned to produce value? a. Medical plans (health plans) and pharmacy benefit companies b. Medical plans, pharmacy benefit companies, and consumers c. Medical plans, pharmacy benefit companies, consumers and doctors d. Medical plans, pharmacy benefit companies, consumers, doctors, health systems, service providers, and more 5. A value-based benefit design can improve health, quality and productivity while reducing financial trends if the plan design aligns with the business strategy. True/False 6. Name at least two large trends in occupational medicine that are likely to impact the private practice of occupational medicine in the next five years. 7. Name at least two medical conditions, whose control among workers has been shown to improve worker productivity. 8. Rates of work injuries in the European Union tend to be lower than in the United States, but disability management after work injuries tends to be better in the United States. True/False 9. EMPAQ benchmarking is employer driven and is a set of standardized definitions and outcomes. True/False Session 2107 1:30pm-5:00pm 3 ABPM MOC Credits Exposure Concerns of Veterans Returning from Afghanistan and Iraq 1. A veteran’s perception of the risk of adverse outcome from a deployment related exposure is likely to be perceived as lower based on which of the following risk perception characteristics a. High toxicity of the chemical/substance of concern b. If there is a sensory cue of exposure c. If the risk is perceived as involuntary or outside their control d. If the source of information is highly trusted 2. If the veteran’s perception is based on faulty information it will be a misperception. True/False 3. Good clinical risk communications practice with veterans includes which of the following a. Listening to the veteran to obtain their account of their experience and how they might impact their health b. Keeping the visit short and to the point and not allowing the veteran to go off on a “tangent” c. Stressing to the veteran that you are the expert and they should dismiss what they have read or heard from family and the media d. Using scientific data to convince the veteran that their concerns are silly 4. Veterans with concerns about exposures sustained during their deployment began with the Gulf War of 1990- 1991. True/False 5. Depleted uranium has been widely used as a. Automotive reflective bumper protectors b. Small caliber bullet casings c. Armor piercing artillery rounds by several nations d. Dietary supplement for world class athletes 6. Sandstorms in Iraq a. Occur only during droughts, every seven years b. Cause very fine particulate matter to become airborne c. Have been linked with prostate cancer in US service members d. Are generally mild and don’t obstruct vision 7. Multiple vaccinations given either together or in close proximity of each other a. Have been given to civilians, travelers and the military of many countries for many years b. Have always only been given to military service members prior to their deployment to a combat zone c. Have been definitely shown to cause osteosarcomas in middle aged service members d. Are easy to conduct large scale post administration testing on in military personnel that received them pre-deployment to a combat zone 8. Common exposure concerns expressed by returning veterans include a. Depleted uranium, burn pits, food preservatives, sandstorms, and multiple vaccinations b. Sandstorms, multiple vaccinations, depleted uranium, food coloring and poor sanitary conditions c. Multiple vaccinations, non-traditional warfare (WMD), second hand cigarette smoke, food coloring and depleted uranium d. Multiple vaccinations, depleted uranium, burn pits and sandstorms
  7. 7. 9. True statements about the demographics of the United States Military include a. There are more men and women in the military uniform today than at any time in the past 100 years b. Currently just over 20% of the US Military is women c. The marital status is higher than in the civilian population, but the divorce rate is higher as well d. The military followed civilian society in desegregation Session 2108 1:30pm-5:00pm 3 ABPM MOC Credits Hands on Orthopedics 1. The shoulder has certain ranges of motion. What range of motion particularly is the most sensitive indicator on physical examination of intrinsic shoulder pathology? 2. Finkelstein’s test is associated with a physical examination of Dequervain’s disease. True/False 3. A radial head fracture can be confused with the clinical presentation of lateral epicondylitis. True/False 4. Tinel’s test is specific for carpal tunnel syndrome. True/False 5. What diagnoses in the shoulder is consistent with a positive Hawkins maneuver and a crossed arm adduction test? 6. What range of motion with regards to the hip is the most sensitive indicator of true/intrinsic hip pathology? 7. A Lachman’s test is used to diagnose an injury to what structure in the knee? 8. Name three of six possible range of motion of the hip joint. 9. When diagnosing a severe ankle sprain the lateral, medial and anterior capsule or structures are usually injured. True/False Session 2109 1:30pm-5:00pm 3 ABPM MOC Credits Emerging Infectious Diseases 1. Which infectious disease presently infects a third of the world’s population? a. Malaria b. Dengue fever c. TB d. Norovirus 2. What factors make dengue an occupational risk of construction work in endemic areas? (More than one answer may be correct). a. Transmission by mosquito vector b. Disturbed ground, water containers, and rubbish create breeding grounds c. Construction workers usually housed in temporary camps d. Construction work is outdoors e. Virus is introduced by immigration of infected workers 3. What age group has had the most deaths from A(H1N1) 2009 in the United States? a. Age 0-4 years b. Age 18-64 years c. Age 65-85 years d. Older than age 85 4. The duration of treatment for latent TB is at least a. One month b. Six months c. Twelve months d. Over one year 5. Treatment for Active TB includes a. Isoniazid b. Rifampicin c. Ethambutol d. All of the above 6. TB is curable. True/False 7. TB test tools include the following except a. Quantiferon b. Heaf test c. Mantoux d. Fern test 8 The primary and first-stated purpose of the 2007 International Health Regulations is to ensure public health through prevention of disease spread. True/False 9. Available vaccine for TB prevention is a. Gardasil b. BCG
  8. 8. c. MMR d. Cervarix MONDAY, MAY 3, 2010 Meal Session 7200 7:00am-8:15am 1 ABPM MOC Credits Metrics to Manage By 1. What is a Dashboard? a. A tool that allows business leadership to monitor an organization’s progress toward meeting the company’s strategic objectives b. A surface that allows athletes to run faster than on dirt c. A display that indicates the why employees of a company are doing poorly at work d. A display monitoring the organization’s performance in great detail, focusing on specific low level processes 2. What does a Dashboard display? a. The speed at which an organization completes its projects b. Clear, concise, visual indicators of metrics that reflect the key performance indicators of a company c. The dollars that any given department of a healthcare organization generates d. All the different outcomes that indicate how a company is performing, in a multiple listing 3. What are the most important characteristics of Key Performance Indicators? a. They are the same for all types of companies b. They are numbers that document the net revenue of a company c. They are reliable, repeatable, consistent, measures of processes that a company deems critical to achieving its strategic goals d. They should always have a benchmark or target, to help companies identify areas of concern and guide attention to those critical processes e. They should provide actionable data; information that helps management determine what responses should be taken to make improvements in its performance Meal Session 7201 7:00am-8:15am 0 ABPM MOC Credits ACOEM’s MOC Part IV Program: What Re-certifying ABPM Diplomates Need to Know– ABPM MOC Credit is not available for this session. Meal Session 7202 7:00am-8:15am 1 ABPM MOC Credits Practical Steps to Establish On-site Employee Clinics and Managing Data to Demonstrate a Positive ROI 1. Characteristics of “best practice” wellness programs include all of the following except a. Top management supports the program b. Evaluation is an integral part of the program c. Program is not linked to the business objectives d. Adequate budget 2. S-M-A-R-T goals for provider performance include all of the following except a. Specific b. Measureable c. Not dependent on time d. Achievable 3. Published studies on ROI indicate that onsite health and wellness programs yield a. Fifty cents for every dollar invested b. Twenty dollars for every dollar invested c. One dollar for every dollar invested d. Three and a half dollars for every dollar invested Meal Session 7207 7:00am-8:15am 1 ABPM MOC Credits Computer Users: Update on Preventing Vision and Musculoskeletal Symptoms 1. Forearm support boards can reduce neck should pain in computer users who use a computer for more than 20 hours per week. True/False 2. For optimal visual performance and comfort, the task should be located so that the gaze angle of the eye is depressed about 10 degrees from straight-head. True/False 3. For optimal reading performance and comfort, the size of the text characters should be at least 3 times larger than the acuity threshold size for that distance. True/False
  9. 9. Session 2200 8:30am-10:00am 1.5 ABPM MOC Credits Legal Implications Associated with Corporate Medical Department Responses to Pandemics, Including H1N1 1. When OSHA conducts H1N1-related inspections, the criteria used will be based upon a. The inspector’s discretion b. The on-site physician’s reasonable judgment c. The CDC Healthcare Personnel Guidelines d. A local hospital’s policies and procedures 2. A declaration under the Public Readiness and Emergency Preparedness Act can provide immunity from certain tort liability for public health emergency countermeasures. True/False 3. In a public health emergency, what benefits can a private individual performing duties in compliance with orders or instructions of a state or local health authority issued with respect to communicable diseases expect a. Immunity from liability for a death of or injury resulting from complying with the orders or instructions of a state or local health authority b. A gubernatorial citation c. Martial law powers to confiscate private property d. Suitable free office space to see patients 4. Can a private employer’s health care department institute a mandatory vaccination program in a public health emergency? a. Yes, pursuant to state police powers b. Yes, if there is a legitimate business need c. No, the Constitution prohibits mandatory vaccination d. Only if the ACOEM issues mandatory vaccination guidelines 5. Can physicians and other practitioners dispense medications to their patients in a pandemic such as the H1N1 situation? a. Yes, in all states b. Yes, if permitted in the applicable state c. No, state law prohibits physician dispensing d. Only if the physician or practitioner has a retail pharmacy license Session 2201 8:30am-10:00am 1.5 ABPM MOC Credits Emerging and Contemporary Issues in Military OEM 1. The most likely acute health effect associated with burn pit exposure is headache. True/False 2. Given the large number of water bottles burned per day, the expected levels of dioxins from burn pits is very high. True/False 3. Epidemiological studies in deployed settings are most likely to suffer from a. Ascertainment bias b. Recall bias c. Misclassification of exposure d. Low power 4. The permissible exposure limit for hexavalent chromium is considered very conservative. True/False 5. Chrome holes in nasal mucosa generally don’t appear until after a year or more chronic. True/False Session 2202 8:30am-12Noon 3 ABPM MOC Credits Update and Case Studies in Commercial Driver Medical Fitness 1. Examiners must follow FMCSA Guidance. True/Fals 2. The Psych MEP reported that which of the following has the highest likelihood of being associated with an increased crash risk a. Antidepressants b. Antipsychotics c. Benzodiazpines 3. The Medical Review Board made which of the following recommendations with regards to drivers with moderate psychiatric disease a. They should not be certified b. They could be certified if they are cleared by a treating healthcare provider c. They should be qualified for no longer than six months d. They should be qualified for no longer than one year 4. Recommendations from the Expert Panel on Traumatic Brain Injury suggested that drivers who sustained a traumatic brain injury can be medically certified if they are currently on no antiseizure medication and have no residual deficits a. Are 5 years out from a penetrating injury b. Had a skull fracture 1 year earlier with a 15 minute loss of consciousness
  10. 10. c. Are 3 years out from closed head trauma associated with a 20 hour loss of consciousness d. Are 30 days out from a mild TBI with a 10 minute loss of consciousness 5. The FMCSA Medical Examiner handbook offers which of the following guidance on drivers who have had central nervous system infections a. Drivers who have had bacterial meningitis without early seizures can be certified if they are 6 months seizure free and off anticonvulsant medication b. Drivers who have had viral encephalitis without early seizures should not be certified until they are at least 5 years seizure free and off anticonvulsant medication c. Drivers who have had bacterial meningitis with early seizures should be 5 years seizure free and off anticonvulsant medication prior to certification d. Drivers who have had viral encephalitis with early seizures should be 5 years seizure free and off anticonvulsant medication prior to certification 6. A driver who has limb impairment due to multiple sclerosis may be eligible for a Skill Performance Evaluation Certificate. True/False 7. Drivers with autonomic neuropathy can be medically certified if a. It is at least 1 year since the diagnosis has been established b. They have cardiac autonomic neuropathy which causes orthostatic hypotension c. Treatment has been shown to be effective and not interfere with safe driving 8. Which of the following should be disqualifying according to the FMCSA Medical Examiners Handbook unless specific criteria are met a. Congenital Myopathies b. Inflammatory Myopathies c. Metabolic Muscle d. Myasthenia Gravis e. All of the above 9. Which statement on drivers with ADHD is correct based on guidance from the FMCSA Medical Examiners Handbook a. A driver with ADHD can be certified for 2 years if stable b. Does not need to be evaluated by a mental health professional c. Can be certified if they have attentional difficulties but are under treatment d. Must use medications as directed Session 2203 8:30am-12Noon 3 ABPM MOC Credits Protection of Healthcare Workers from Novel H1N1 Influenza: Public Health Guidance and the Debate Over Airborne Viral Transmission 1. H1N1 resulted in a substantial public health impact due to its disproportionate mortality among younger individuals. True/False 2. Obesity was among the co-morbidities which predisposed to worsened outcomes among H1N1 patients. True/False 3. State health departments consistently re-enforced interim guidelines from the CDC for personal protective equipment during both phases of the H1N1 epidemic. True/False 4. Prior to OSHA’s backing the CDC guidance for airborne protection, an adequate national supply of respirators was assured for hospitals. True/False 5. Studies among healthcare workers showed that the N95 respirators were more effective in preventing H1N1 transmission that were surgical masks. True/False 6. Lack of transmission across distances exceeding 6 feet is adequate evidence that airborne transmission does not take place. True/False 7. The Healthcare Infection Control Practices Advisory Committee did not support a recommendation for the use of N95 respirators during routine care of H1N1 patients. True/False 8. The period of maximal risk of H1N1 transmission to healthcare workers likely occurs when healthcare workers are unaware of a patient’s being infected with H1N1 and hence are using no personal protective equipment at all. True/False 9. Intubations and bronchoscopies likely represent procedures which place unprotected healthcare workers at higher risk for aerosol transmission than does routine patient care. True/False Session 2204 8:30am-12Noon 3 ABPM MOC Credits Current Research in OEM and Resident Research 1. There is sufficient epidemiological evidence to suggest an association between arsenic exposure and obstructive pulmonary lung disease in the US population. True/False 2. According to NIOSH, dermatoses represent what percentage of total workplace injuries? a. <10%
  11. 11. b. 10-15% c. 40-60% d. >90% 3. According to this study, what is the most common occupational skin disease? a. Infection b. Burn c. Dermatitis d. Bite 4. What are the three physical activity components assessed in this study? a. Frequency, location and intensity b. Location, duration, and type c. Frequency, duration, and intensity d. Frequency, intensity, and type 5. Which physical activity components are significantly associated with the objective cardio-respiratory fitness measures? a. Frequency, duration, and intensity b. Only frequency c. Frequency and location d. None of the components presented association 6. Which physical activity component is significantly correlated to TC/HDL ration? a. Duration b. Intensity c. Location d. Frequency 7. Preterm delivery occurs prior to what gestational age in a human mother? a. 34 completed gestational weeks b. 35 completed gestational weeks c. 36 completed gestational weeks d. 37 completed gestational weeks 8. What work related or maternal factors have been associated with preterm labor in pregnant women? a. Elevated ambient noise levels b. Low levels of emotional stress c. Prior history of gestational hypertension or preeclampsia d. Multiparity 9. This session provides investigators in occupational and environmental health with a forum for presentation of current and cutting edge research in OEM. True/False Session 2205 10:30am-12Noon 1.5 ABPM MOC Credits Electronic Medical Records in Occupational Medicine Practice: A State-of-the-Art Review 1. Electronic medical records can be reasonably expected to include which of the following (select all that apply) a. Patient scheduling features b. Medical records c. Physician service data d. Decision support tools 2. What is your estimate of the percentage of US physicians that used EMR in their daily practice as of 2008? a. 50% b. 20% c. 30% d. 80% 3. Based on their report, what is the most frequently reported barrier to adoption of EMR by occupational physicians? a. Expensive b. Inefficiency of use c. Interference with patient interaction d. Worsening of patient safety 4. The percentage of occupational physicians that are very satisfied with their EMR is a. 10% b. 25% c. 50% d. 75% 5. As of 2010, occupational physicians consider which of the following to be the most valuable feature of EMR
  12. 12. a. Billing, scheduling, and electronic documentation of the medical record b. Use of clinical protocols, and medical surveillance capabilities c. Time management and accessibility through EMR d. EMR contribution to patient safety and service quality Session 2206 10:30am-12Noon 1.5 ABPM MOC Credits Strategic Use of Occupational Medicine Reviews in Federal Workers’ Compensation Cases 1. The ideal time for an agency physician review of a Ca-2 (occupational illness) claim is a. Before it is filled b. As soon as it is filled c. While it is under development d. After it has been accepted 2. The following option usually carries the most weight in claims with a conflict in medical opinion a. The treating provider b. The agency physician c. The second opinion examiner d. The referee (IME) examiner 3. Agency physician reviews are effective in obtaining the following results a. Getting DOL to set up a second opinion exam b. Reversing a DOL claim acceptance decision c. Requiring a claimant to see a specific treating provider d. Obtaining authorization for creating a new limited duty position 4. Reviews in cases of disability attributed to chronic pain should focus on the following issues a. Determining the underlying psychiatric condition b. Obtaining accurate measurements of pain levels c. Determining physical abilities using objective tools when possible d. Obtaining authorization for more testing in order to identify the cause of the pain 5. The following is a true statement about the federal workers’ compensation system a. Claim acceptance may be appealed by the employing agency through several levels b. Wage compensation can be terminated if claimant declines RTW offer based on medical release c. FECA claims are routinely closed after 6 months of inactivity d. FECA claimants unable to return to work are shifted to the federal medical disability retirement system at age 65 Meal Session 7203 12Noon-1:15pm 1 ABPM MOC Credits Operationalizing HPM: The Value of Integrated Data Management 1. For an effective employer health and productivity management program, integration should happen at the following levels a. Strategic b. Operational c. Information systems/data d. All of the above 2. Representative examples of effectively integrated data systems include all of the following combinations excepts a. Functional fitness for duty assessment and physical job requirements b. OSHA log and safety investigations c. Biometric data and worksite clinic software d. Personal health records and absence management software 3. The benefits of integrated health and productivity data management include all of the following except a. Less redundant data capture/entry b. Improved management capability and operational efficiency c. Reduced interaction between health and productivity management program managers d. Enhanced ability to perform root cause analysis of health and safety issues e. More effective return to work program management Meal Session 7204 12Noon-1:15pm 1 ABPM MOC Credits Leave and Reasonable Accommodation Claims in Federal Civil Service Workers 1. In fiscal year 2009, what is the most prevalent medical diagnosis requiring accommodation in the female subgroup of federal workers a. Anxiety b. Migraines
  13. 13. c. Diabetes mellitus d. Asthma 2. What medical category covers the top three diagnoses for which time off under FMLA is requested in the federal civilian workers a. Endocrine b. Psychiatric c. Respiratory d. Cardiac 3. Within what federal agency is federal occupational health located a. Department of Health & Human Services (HHS) b. Department of Homeland Security (DHS) c. Department of Interior (DOI) d. Department of Labor (DOL) Meal Session 7205 12Noon-1:15pm 1 ABPM MOC Credits The Independent Medical Examination 1. The independent medical examination a. Is not a doctor patient relationship b. Is only requested in workers compensation cases c. Requires the physician to be certified d. Requires the physician to use ACOEM forms and templates 2. The most important product of an IME is the a. Relationship made with the requesting party b. Relationship made with the examinee c. Report d. Deposition that will come out of the examination 3. Which of the following is not true concerning IME reports a. The report is generally only sent to the requesting party b. Attorneys collect examples of physicians’ reports for later legal use c. It is a script for later testimony d. They are not considered an attorney work product Meal Session 7206 12Noon-1:15pm 1 ABPM MOC Credits Update on Vision Issues in the Workplace 1. For current 3D movies the viewer must wear special glasses that alternately block each eye in synchrony with alternating frames in the movie projections. True/False 2. e-Ink displays, an example of which is Kindle, rely entirely on reflected light and do not emit light. True/False 3. Hand held computer devices are habitually held closer to the eyes because they are dimmer than most other reading materials. True/False Work-site Visit 8100 1:00pm-5:00pm 3 ABPM MOC Credits Lights, Camera, Action – Explore Digital Media 1. House of Moves is the world’s second most experienced motion capture service studio. True/False 2. Attendees had the opportunity to interact with a. Mickey Mouse b. Technical staff to address specific areas of interest c. Mr. Walt Disney d. Cashiers in the gift shop 3. House of Moves has been in business for 10 years. True/False 4. House of Moves was acquired by VICON Motion Systems in a. 2006 b. 2005 c. 2004 5. Which city is a global digital media leader? a. Orlando, FL b. Shamokin, PA c. Orland Park, IL d. Cincinnati, OH 6. On this worksite visit, participants visited a. Orlando Technical Center b. VICON
  14. 14. c. House of Moves d. Clinical Motion Analysis Laboratory and Training Facilities e. All of the above 7. Golden Volume refers to the capturing of the face, full-body and hands simultaneously. True/False 8. Two products of the House of Moves are a. Stock Motion Data b. Diva Motion Editing Software c. Clinical Motion Analysis Data d. Medical Stimulation Software 9. This worksite visit explored the evolution of digital media with its current use in the human performance and medical simulation areas. True/False Work-site Visit 8101 1:00pm-5:00pm 3 ABPM MOC Credits SeaWorld – Where Worlds Connect 1. Attendees were able to (select all that apply) a. Get in the water with the animals b. Learn how Health Services works together with local emergency service agencies to provide the quality care to guests and employees c. Receive free items from the gift shop d. Go to behind-the-scenes areas where care and treatment are provided to both guests and employees 2. Polar Bears are an attraction at SeaWorld. True/False 3. Smoking is not permitted anywhere on the SeaWorld property in order to protect the health of the animals. 4. This worksite included a visit to the first aid units throughout the park with a Health Services team member. True/False 5. Because the animals need constant care and attention, SeaWorld is open 24 hours a day. True/False 6. SeaWorld’s headquarters is located in Johnsburg, IL True/False 7. SeaWorld employees are responsible for their own first aid. True/False 8. This worksite covered the common medial illnesses and injuries health services encounters and anticipates in a theme park setting. True/False 9. Orlando, FL is SeaWorld’s only location. True/False Session 2207 1:30pm-3:00pm 1.5 ABPM MOC Credits Occupational Health Services: Organization and Competencies 1. Vertical Integration is about a. Marketing, selling and penetration into new segments b. Climbing a mountain c. A single owner controlling the chain of production of a product or service d. Creating alliances with competitors 2. Horizontal Integration is about a. Marketing, selling and penetration into new segments b. Lying on a hammock c. A single owner controlling the chain of production of a product or service d. Buying one of your key suppliers of an essential product or service 3. Sharing the same client with a competitor allows a. Easier growth and expansion b. Greater revenues c. More accurate and comparable benchmark data on performance d. More time for vacations for the providers 4. International occupational health clinics in developing countries provide general medical services as well as occupational health services. True/False 5. International occupational health clinics provide general medical services to employees as well as their families. True/False Session 2208 1:30pm-3:00pm 1.5 ABPM MOC Credits Inside the Mysterious Realm of Utilization Review 1. Which of the following statements is true about the utilization review process? a. Utilization review is subject to federally created regulatory processes b. A non-certification decision is binding c. Effective utilization review is supported by nationally recognized evidence based medical guidelines d. A non-certification decision can be made by any healthcare provider reviewing a request 2. Which of the following statements is true about UR?
  15. 15. a. It is not necessary to support your decisions with EBM if you are an experienced clinician with years of patient practice experience b. Peer to peer discussion is always necessary in making a clinical decision c. Depending on jurisdictions, the peer to peer discussion can be made with an MD, DO, PA, NP, PT, OT DC, PhD, etc d. All states follow URAC standards e. All reviewing physicians must have an active medical license in the state where the care under discussion will take place 3. Which of the following statements are true? a. A patient relationship needs to be established in order to be held for an outcome b. It is necessary for there to be intention to treat in order for a liability claim to be established c. UM reviewers can be held liable if a reasonable standard of care is not followed d. Although independent medical evaluators have potential liability, UM reviewers are protected because they only reference established guidelines 4. Utilization review a. Is a process in which medical services are reviewed by third parties to determine if they are medically appropriate and necessary b. Always involves an outcome involving authorization of payment for only those services deemed causally related to the work injury or work illness by the reviewer (if the condition being assessed or treated has been accepted as causally related to the covered injury) c. Involves outcomes which, if the determination is adverse, indicates that the treating physician who is requesting the diagnostic study or procedure has engaged, or attempting to engage, in some form of overutilization d. Requires “same specialty” status with respect to the peer reviewer and the requesting/treating physician 5. With regard to the process of a peer reviewer conducting a telephone conference with the treating physician, as part of the utilization review a. Attempts to hold a conference, if not successful, are not cited in the peer review report. b. In general, questions remain concerning the medical necessity of the test or treatment being requested, following the peer reviewer’s assessment of the provided medical documentation; and the reviewer is unable to certify the request based upon apparent deviation from evidence-based medicine or insufficient information to justify the request. c. Telephone conference generally represent an opportunity for the peer reviewer to extend a professional courtesy of informing the treating physician that the request is not being certified, and explaining the rationale. There is no opportunity for the treating physician to attempt the reverse a proposed non- certification. d. The peer reviewer must always allow at least 72 hours to reasonably improve the chances that contact with the treating physician can be made. Session 2209 1:30pm-3:00pm 1.5 ABPM MOC Credits Individual Scientific Abstract Oral Presentations 1. Preliminary test results show that the amount of exposure is not dependent on the protection factor. True/False 2. In an initial medical consultation for work-related low back pain in a community-based, occupational medicine clinic, what is the average ratio of provider utterances to patient utterances? a. 5 provider utterances to every 1 patient utterances b. 3 provider utterances to every 2 patient utterances c. 1 provider utterances to every 5 patient utterances d. 1 provider utterances to every 10 patient utterances 3. What additional health and absence costs are incurred by employees over the 3 months immediately preceding voluntarily termination of their employment (compared with earlier months)? a. $0 b. $100 c. $1,000 d. $2,000 4. The estimated amount of lost earning due to influenza in the US is a. 2 billion b. 6 billion c. 10 billion d. 16 billion e. 121 billion 5. Hypoxia, either as hypobaric hypoxia at altitude or normobaric hypoxia in fire protected rooms may cause symptoms of a syndrome termed “acute mountain sickness.” The most typical, frequent symptom of acute mountain sickness is
  16. 16. a. Dysnoe b. Vertigo c. Headache d. Sleepiness Session 2210 1:30pm-5:00pm 3 ABPM MOC Credits MRO Controversies 1. The MRO in the DOT program is responsible for fitness for duty evaluations. True/False 2. Which of the following (one or more) are true a. A MRO in a DOT program who learns about a person taking a controlled medication must report this to the person responsible for determining fitness for duty b. A MRO in a DOT program needs a HIPPA compliant release to give information to the employer about a controlled medication the person is taking c. A MRO in a non regulated program needs a HIPPA compliant release to give information to the employer about a controlled medication the person is taking d. A person taking a controlled medication is automatically disqualified to work in a safety sensitive DOT setting e. A person taking a non controlled medication may be disqualified to work in a safety sensitive DOT setting 3. The MRO in an NRC program is responsible for determining fitness for duty as well as reviewing the drug testing results. True/False 4. In Bates vs Dura Automotive the problems were (which were true) a. The company chose to ignore recommendations from the MRO b. The company had information about medications the person was taking c. The company did drug testing d. According to the court, the procedure used violated ADA e. The MRO made reports to the company about safety sensitive medications 5. In verifying a confirmed positive test as negative based on prescription medications that explain the laboratory results, MRO best practice is a. Have donor fill out a form listing all medications the donor is currently using b. Document in the MRO interview notes all relevant prescribed medications the donor states he/she is using c. Contact the prescribing medical/dental practitioner to validate the prescription information provided by the donor d. Request and review “hard copy” documentation (copy of prescription, pharmacy printout, bottle label) of prescription medications identified by donor e. Require copies of patient or medical records documenting prescribed medications 6. In reviewing and verifying invalid specimen laboratory results, the MRO must a. Discuss the laboratory result with the laboratory certifying scientist b. Order a reanalysis of Bottle A at a second drug testing laboratory c. Verify the test as negative if there is an acceptable medical explanation for the specimen’s invalidity d. Order additional specimen validity tests e. Offer the donor the opportunity for a split specimen analysis at a second drug testing laboratory 7. The recent NPRM published by the DOT asks for comments concerning the proposal to a. Eliminate PCP testing b. Lower the cutoff levels for cocaine and amphetamine c. Require MRO certification every other year d. Require MROs to keep records for 3 months only 8. An increasing concern for many MROs is that the federal drug testing panel does not a. Test for opioids b. Test for synthetic opioids c. Distinguish amphetamine from methamphetamine d. Allow the MRO to raise a safety sensitive concern 9. MROs generally approach ethical dilemmas in all of the following manners except a. Relying upon ACOEM education and training b. Discussing with other MROs how they handle certain situations c. Reading MRO periodical publications and referring to MRO texts d. Deferring judgment to the designated employer representative Session 2211 1:30pm-5:00pm 3 ABPM MOC Credits Respirators and FIT Testing: Current and Future Approaches
  17. 17. 1. Would you qualify a 33 year old woman with moderate, persistent asthma for respirator use a. No way b. Yes, for any respirator c. Yes, for some types of respirators d. Not sure 2. Which of the following is the least important cause of respirator intolerance for most workers a. Psychophysical stresses b. Pulmonary demands c. Sensory limitations d. Failure to fit test 3. Which of the following is most predictive of an individual’s ability to tolerate and safely use a respirator a. Office spirometry b. Exercise stress test c. Documented ability to perform similar job tasks d. Physical exam 4. Which is likely to be the most frequent cause of inadequate respirator-based protection a. Inability to overcome the respirator resistance b. Incomplete facial seal c. Incomplete compliance with proper use d. Inadequate protection factor of the respirator 5. Which of the following exposure control methods is generally less preferable than respirator use in the hierarchy of controls a. Product substitution b. Local exhaust ventilation c. Discontinuing work d. Administration controls 6. Which of the following as shown the least impact upon respirator subjective responses a. Age b. Gender c. Asthma d. Respirator type 7. Which of the following decontamination agents caused no significant change in the performance and structural integrity of N95 filtering facepiece respirators a. Ethylene oxide b. Ultraviolet light c. Soap and water d. Autoclave 8. Filtering facepiece respirators treated with which one of the following agents were somewhat effective against Ms-2 virus a. Iodine b. Silver c. Quarternary Ammonium Compound d. Ozone-like agent 9. Which of the following physiological effects was not noted in healthcare workers wearing a half facepiece elastomeric air-purifying respirator (with twin P-100 filters) at low work loads for one hour, except a. Transcutaneous carbon dioxide levels were elevated in ~50% of users b. Increased respiratory rate c. Normal oxygen saturation d. Increases in tidal volume Session 2212 3:30pm-5:00pm 1.5 ABPM MOC Credits Heavy Metals…Not Your Typical Metallica! 1. The finding of elevated levels of mercury in the blood, with little or none in the urine, of the same patient may suggest a. Expected laboratory error b. Toxic effect of mercury on the kidneys to the extent that the kidneys cannot adequately excrete mercury c. The presence of only organomercury compounds, with little or no inorganic mercury d. A and B e. A and C f. B and C 2. Berylliosis (“Salem sarcoidosis”) may be distinguished from standard/idiopathic sarcoidosis via
  18. 18. a. The prominence of bone cysts in berylliosis b. The prominent finding of alveolitis in berylliosis c. The common finding of pulmonary fibrosis in berylliosis d. The positivity of the lymphocyte transformation test (LTT) in berylliosis vs. a negative test in idiopathic sarcoidosis e. Pulmonary parenchymal involvement always in berylliosis and only sometimes in idiopathic sarcoidosis f. Only answer A g. All of the above except answer A 3. When one is trying to ascertain true arsenic toxicity, it is imperative to a. Request a blood level of arsenic b. First assess for renal function c. Fractionate the total arsenic into inorganic vs. organic/chelated arsenic d. Do a blood-lead to blood-arsenic ratio 4. In assessing silver toxicity, the most reliable test for assessing the body burden of silver is a. Blood b. Hair c. Feces d. Urine 5. The presence of basophilic stippling in immature erythrocytes may suggest a. Normal fetal and neonatal RBCs b. Chronic anemias, including Mediterranean anemias c. Leukemia d. Lead and/or arsenic toxicities e. Pyrimidine-5’-nucleotidase deficiency f. Only D g. All of the above Session 2213 3:30pm-5:00pm 1.5 ABPM MOC Credits Integrating Environment, Social and Health Impact Assessments 1. The integrated ESHIA provides a systematic assessment of potential environmental, social and health impacts. True/False 2. The integrated ESHIA provides benefits to the local community but does not benefit the company’s business operations. True/False 3. The basic ESHIA process has multiple steps. The first step in the process is a. Baseline studies b. Impact identification c. Screening and scoping d. Community engagement 4. The integrated ESHIA process focuses its efforts on promoting the health of the a. Employees and contractors b. Community 5. Health Impact Assessments (HIA) assist in mapping the relationships between physical, biological, health and socioeconomic impacts of project. True/False Session 2214 3:30pm-5:00pm 1.5 ABPM MOC Credits Individual Scientific Abstract Oral Presentations 1. Only professional aircraft maintainers work on aircraft so they are the only population at risk. True/False 2. Skin absorption is a major route of exposure for solvents. True/False 3. Cost intensive physicians treated more complicated injuries than non-cost intensive physicians. True/False 4. Based on the information given, and the statement that a higher job satisfaction showed significantly less work days missed than a low job satisfaction, could we expect to see a significant production loss difference between higher, and lower rated jobs within a cohort of ISS 1-8? Yes/No 5. Could pending litigation’s in No Fault Law states be a predictor for LWP with an ISS 1-8? Yes/No 6. Epidemiological evidence for the positive association between sedentary work and obesity has been generally stronger in female workers than in male workers. True/False 7. This study recommends that a decrease in health risk behaviors by what percent would yield a reduction in medical care costs by over $2 billion a. 0.1% b. 1.0% c. 5.0% d. 10.0%
  19. 19. TUESDAY, MAY 4, 2010 Meal Session 7300 7:00am-8:15am 1 ABPM MOC Credits Travel Health Consultation Services in the Occupational Health Clinic 1. The components of a travel medicine consultation are a. Review of the itinerary and lodging choices b. Provision of itinerary-specific vaccinations only c. Review of itinerary, preventive education, vaccinations, provision of anti-malarial medications, provision of self-care medications for use in case of traveler’s diarrhea d. Provision of required vaccinations and anti-malarial medications only 2. The most common reasons that travelers need to interrupt their trip to seek medical care are a. Lack of language proficiency b. Food and water-borne diseases and preventable injuries c. Unsuitable lodging d. Adjustment disorders 3. Some countries require proof or waiver of the following vaccination(s) in order for entry a. Typhoid and Hepatitis A b. Hepatitis B c. Yellow Fever d. Typhoid and Yellow Fever Meal Session 7301 7:00am-8:15am 1 ABPM MOC Credits The Company Doctor Game 1. Return on Investment “ROI” means a. If you are making money in your business you can spend more on advertising b. Calculates how successful you are c. How many patients come back to your office after “investing” in you as their doctor d. Sales people use this to calculate how much you can spend on their product e. (Gain from Investment-Cost of investment)/Cost of investment 2. “Top of Mind Awareness” means a. Remembering to wear a hat so as not to get sunburned on your bald spot b. Remembering to put sunscreen on your bald spot to prevent sunburn c. Remembering to put aloe on your sunburned scalp to prevent skin peeling d. Remembering to go to an urgent care clinic instead of an ER to get treated for sunburn e. All of the above 3. When marketing your practice the most important person to be able to articulate your message is a. Your patients b. An unbiased actor as a spokesperson c. You d. Your office manager e. All of the above Meal Session 7302 7:00am-8:15am 1 ABPM MOC Credits Medical Issues in Diverse and Underserved Populations: Benchmark Activities in South Florida 1. Which of the following is the most direct barrier to access to work-related medical care among underserved worker populations? a. Denial of workers’ claim b. Lack of an approved community occupational medicine physician c. Allowable fee schedules by the occupational medicine provider d. Waiting times for an occupational medicine physician e. Lack of medical determination by the occupational medicine physician 2. Which country yields the greatest number of migrant workers into the US? a. Mexico b. China c. Dominican Republic d. Cuba e. Russia 3. Among Hispanic construction workers in South Florida, what percentage reported being exposed in the past 7
  20. 20. days to second hand smoke while on the construction site? a. 20% b. 40% c. 60% d. 80% e. 100% Meal Session 7303 7:00am-8:15am 1 ABPM MOC Credits Being Smart About Your Financial Security 1. A very important question to ask a potential financial advisor is a. What type of music do you like b. How are you paid c. What is your favorite color 2. A reasonable amount of your income to save for retirement is a. 15-20% b. 35% c. Don’t save, the government will take care of you 3. Revocable Living Trusts offer decent asset protection. True/False Work-site Visit 8200 8:00am-12Noon 3 ABPM MOC Credits The Nature Conservancy’s Disney Wilderness Preserve 1. Remote areas of the Everglades were covered on this visit. True/False 2. A topic covered by DWP staff on this visit was the environmental and health issues created by previous endeavors in the Everglades. True/False 3. The preserve is bordered by a. Lake Maria b. Lake Russell c. Highway 88 4. Sunscreen is a. Recommended for use in the Everglades b. Prohibited from use in the Everglades due to environmental issues c. Not needed if one is wearing a poncho 5. The preserve is home to such rare creatures at the a. Bald eagle b. Florida scrub-jay c. Sandhill crane d. Gopher tortoise e. All of the above 6. Hiking is prohibited in the preserve in order to protect the environment and to ensure the safety of all. True/False 7. This worksite visit took place on the more than 11,000 acres of protected land that is the headwaters of the Everglades. True/False 8. The red-cockaded woodpecker was removed from the preserve to prevent the spread of ticks to humans. True/False 9. The DWP enabled attendees on this worksite visit to see a. The beauty of a man-made preservation b. Land restoration in progress c. Over 35 lakes d. All of the above Work-site Visit 8201 8:00am-12Noon 3 ABPM MOC Credits Rosen Shingle Creek – Under the Mattress 1. It is important for physicians to understand the key challenges for maintaining the health of specialized work forces within a hotel. True/False 2. Harris Rosen was recently honored with a Legacy Award during the organization’s 11th Annual Best Practices Awards in June 2009. True/False 3. Rosen Green Meetings® are events which are conducted in specific ways which help reduce the environmental burdens imposed by such activities. True/False 4. Rosen Shingle Creek opened in a. 2005 b. 2006
  21. 21. c. 2007 5. Rosen Shingle Creek has how many total sleeping rooms a. 1,000 b. 1,500 c. 2,000 d. 2,225 6. The maximum number of meeting rooms is 99. True/False 7. The largest theater-style seating at Rosen Shingle Creek can accommodate a. 9,500 people b. 8,500 people c. 25,000 people 8. Rosen Hotel’s focus on prevention and outcomes enables insurance and health-care costs that are half the national average. True/False 9. On this worksite visit, participants experienced first hand the job requirements of a. Food service workers b. Housekeepers c. Maintenance crews d. All of the above Session 2300 8:30am-10:00am 1.5 ABPM MOC Credits Quantifying the Return on Investment for Worksite Clinics 1. Measurement of return on investment for worksite clinics and particularly for non-occupational services a. Has a standardized and widely accepted methodology b. Is readily quantifiable c. Routinely incorporated all considered variables d. Typically includes time spent away from work for use of community healthcare services e. Typically includes time spent away from work for use of worksite clinics 2. Say’s Law refers to the economic principle that supply creates demand. True/False 3. Most employers responding to the worksite clinic ROI survey a. Offer full-service primary care to their employees b. Use HEDIS measures to evaluate worksite clinics performance c. Use CPT (procedure) codes in quantifying ROI d. Use a software system for recording worksite clinic utilization 4. Cost factors that should reasonably be considered for inclusion in the ROI calculation for worksite clinic services are a. Staff wages and benefits b. Facility maintenance c. Opportunity cost of physical space if used for primary business purposes d. Medical equipment and supplies e. All of the above 5. Of the following, the most impactful business measure for meaningful evaluation of non-occupational healthcare services by worksite clinics is a. Utilization b. Market value of provided services in comparison to operating costs c. Healthcare cost trend d. Clinical outcomes Session 2301 8:30am-10:00am 1.5 ABPM MOC Credits ACOEM Code of Ethics 1. Prior to ACOEM’s 2010 revision of its code of ethics, the last revision occurred how many years ago? a. 6 years b. 17 years c. 55 years d. 82 years 2. Traditionally, which of the following terms is/are closely aligned with ethics a. Moral philosophy b. Utilitarianism c. Virtue d. All of the above e. A and C only 3. The fifth article of ACOEM’s code of ethics, Protect Patient Confidentiality, does not apply to worker
  22. 22. compensation cases. True/False 4. Corporate medical directors, when involved in a case in which an employee and the employer are at odds over an occupational issue but the evidence is equally compelling in both sides, should usually side with the employer. True/False 5. When performing a post-offer, pre-placement medical evaluation for an employer who pays for the evaluation, an occupational physician familiar with the intended job believes that a prospective employee has credible evidence of a medical condition that could put that person at risk of harm from exposure to that job. However, the employee does not consent that the physician release that opinion to the employer. The physician should a. Appease the new employee and render a “no restrictions” opinion b. Report restrictions to the employer despite the lack of consent c. Avoid writing restrictions but imply them by recommending accommodations to the employer d. Inform the employer that the employee did not complete the medical evaluation Session 2302 8:30am-10:00am 1.5 ABPM MOC Credits The ACOEM Hand, Wrist, and Forearm Disorder Practice Guidelines 1. Which of the following describes the relationship between carpal tunnel release operative approach (open vs. endoscopic) and average lost time a. Greater lost time with open approach b. No difference in lost time c. Greater lost time with endoscopic approach 2. A 45 year old male construction worker has numbness and tingling nocturnally in the thumb, index and middle finger with awakening 2 to 3 times a night going on for the past 2 months. After completing a history and physical which does not alter the clinical assessment, the next best step is a. NSAID b. Wrist splinting c. Ionotophoresis with dexamethasone d. Glucocorticosteroid injection e. Electrodiagnostic study 3. A 35 year old female assembly line worker has volar tingling and numbness in a median nerve distribution. She is obese, but does not have diabetes mellitus. She is presumptively diagnosed with CTS and initially treated with a wrist brace. Two months later symptoms have returned. Which of the following is the best treatment option at this point a. Ultrasound b. Iontophoresis with dexamethasone c. Glucocorticoteroid injection d. Surgical release 4. A patient has surgical fixation of a scaphoid fracture. Which of the following describes the risk of a subsequent osteoarthrosis compared to non-operative treatment a. Reduced risk b. Comparable risk c. Increased risk 5. A 56 year old male mechanic who is otherwise healthy has triggering of the right middle finger. Which of the following is the best intervention a. Workplace limitations b. NSAID c. Steroid injection d. Percutaneous surgical release Session 2303 8:30am-10:00am 1.5 ABPM MOC Credits Individual Scientific Abstract Oral Presentations 1. Biopsychosocial model in occupational medicine assess a. Interplay between psychological condition of one worker and his medical illness b. Interplay between psychological condition of one worker, his medical illness and his work life c. Interplay between psychological condition of one worker, his medical illness and his social life outside work 2. Ergonomic stressors associated musculoskeletal (MSDs) disorders could be a. A risk factor for biopsychsocial model b. Preventive factor for biopsychosocial model c. Irrilivant to biopsychosocial model 3. Retrospective Utilization Management reduces costs through a payment denial process. In contrast, the goal of Prospective and Concurrent Utilization Management practices is to change
  23. 23. a. Billed charges b. Clinical behavior c. Policy d. Hearts and minds 4. One goal of Guidelines-based Utilization Management is to reduce overall practice pattern variation (ie further the use of “best practice”). In order to accomplish that the Utilization Management Guidelines should evidence- based and patient-centered. A patient-centered guideline would include a. Patient satisfaction b. References to relevant literature c. Case-mix adjustors d. Expected cost 5. Which of the Presidential Safety, Health and Return to Employment (SHARE) statistics would be expected to show the most impact from an initiative that focuses on early intervention to facilitate care, return to work, and provision of limited duty jobs? a. Timelines of claim filing b. Total case rate (new case rate) c. Lost time case rate d. Lost production day rate Session 2304 8:30am-12Noon 3 ABPM MOC Credits Everything You Always Wanted to Know About Seaman Medical Examinations but Were Afraid to Ask 1. CG-719K Merchant Mariner Credential Medical Evaluation Report a. Is used for entry level mariners and does not require a medical history b. Records medical history and physical examination components including vision and hearing so that the coast guard may review to issue mariner credential c. Requires chest x-rays and EKGs on every examination d. May only be completed by physicians 2. Audiograms must be performed to document adequate hearing. True/False 3. In there is no response in the medication section it is assumed that the mariner is not taking any medications. True/False 4. Color Sensing Lenses may be worn during color vision testing. True/False 5. If a mariner has diabetes, his HA1C record must demonstrate a. HA1C of 5.8% three years prior to the exam b. HA1C < 8.0% on two recent tests at least 90 days apart c. HA1C > 14% for the past 5 years d. That he takes his medication sometimes 6. If a mariner with a past medical history of seizures, what history/medical record is least likely to be waived? a. A single febrile seizure at age two b. A history of withdrawal seizure as patient was deciding to go to alcohol rehab three years ago c. A seizure two years ago while on anti-epileptic medications d. A seizure after a football head injury in high school 35 years ago 7. Which of the following best describes the medical evaluation process conducted by the NMC when determining mariner fitness for duty? a. The NMC performs all physical examinations for mariners applying for various credentials b. The MNC reviews completed physical exams and supporting objective medical documentation to include consultative reports and results of relevant lab/imaging studies c. The NMC reviews completed physical exams and accepts the examiner’s competency statement that the applicant is medically competent d. All mariners are required by law to report changes in their health status so periodic physical exams are unnecessary 8. Which of the following best describes NVIC 04-08? a. It is an all inclusive document defining all disqualifying medical conditions for which no waiver can be considered b. Only those medical conditions listed in NVIC 04-08 may be considered when evaluating mariner medical fitness for duty c. It is a non-exhaustive guidance document which identifies over 200 medical conditions subject to further review and provides recommended evaluation data d. The document can only be obtained from a Regional Exam Center, and cannot be accessed from the NMC website at this time 9. Which of the following is true concerning NMC approval of conditional medical waivers? a. Conditional medical waivers are rarely approved by the NMC
  24. 24. b. Conditional medical waivers are never approved for cardiac conditions c. Once issued, a conditional medical waiver may never be invalidated d. Conditional medical waivers are only approved by the NMC when objective evidence demonstrates the condition is sufficiently controlled to mitigate risk maritime and public safety Session 2305 10:30am-12Noon 1.5 ABPM MOC Credits The Patient-centered Medical Home, Worksite Clinics, and the OEM Clinician 1. From the employer perspective, patient-centered medical home has appeal because of all of the following except a. The potential for lowered healthcare costs b. Improved compliance with treatment guidelines c. Increased near-term implementation costs d. Enhanced workforce productivity 2. Care provided by a patient-centered medical home is likely to improve clinical outcomes for chronic conditions because of all of the following except a. Improved patient-clinician relationships b. Patient incentives c. More effective communication between healthcare clinicians and patients d. Improved tracking of disease-specific preventive care services 3. Data from patient-centered medical home pilots thus far has been shown to result in all of the following except a. Improved patient adherence to recommended treatment b. Enhance both patient and provider satisfaction with care delivery c. Long-term increases in healthcare costs d. Decrease ambulatory care-sensitive hospitalization rates e. Decrease emergency department utilization rates 4. Worksite clinics can reasonably support medical home practices by all of the following except a. Enforcing the importance of medication adherence b. Enhancing access to clinicians for chronic condition monitoring c. Ordering changes to treatment regimens d. Providing lifestyle behavior change coaching 5. The development of a trusting relationship between patients and medical home clinicians is associated with all of the following except a. Better compliance with preventive care services b. Better compliance with chronic medications c. More effective treatment to target goals d. Improved patient satisfaction with care e. All of the above Session 2306 10:30am-12Noon 1.5 ABPM MOC Credits Hazards in Drinking Water from Private and Municipal Wells 1. Bottled water is generally “safer” than municipal water sources. True/False 2. The US Environmental Protection Agency, through the Safe Drinking Water Act has established drinking water standards for how many potential contaminants a. 13 b. 18 c. 20 d. 56 e. 118 3. The EPA requires that all private well water meets federal drinking water standards. True/False 4. Contamination of a water source with which of the following can result in a condition know as “baby blue” syndrome a. Cobalt b. Nitrates c. Radionuclides d. Fluoride e. Lead 5. The most common problems in rural well-water contamination is related to which of the following a. Methane gas in the well b. Barnyard runoff c. Leaching of metals from surrounding rocks d. Bacteria
  25. 25. e. Contamination from household (gasoline, oil, cleaning chemicals, etc) chemical spills that have been inadequately contained and/or remediated Session 2307 10:30am-12Noon 1.5 ABPM MOC Credits Late Breaker: Health Care Reforms 1. Provisions in the Patient Protection and Affordable Care Act became law on March 23, 2010. True/False 2. National Prevention, Health Promotion & Public Health Council (Sec. 4001) – Creates a Council within HHS to provide coordination and leadership at the Federal level, and among Federal departments and agencies, with respect to prevention, wellness and health promotion practices, the public health system and integrative health care in the U.S. & to develop the National Prevention Strategy. The Council shall be composed of departmental Secretaries from across the federal government, with the Surgeon General serving as Chair. True/False 3. Preventive Medicine and Public Health Training Grant Program -- Directs the universities to award grants to or enter into contracts with eligible entities to provide training to graduate medical residents in preventive medicine specialties. True/False 4. Prevention and Public Health Fund (Sec. 4002) – Establishes a fund, to be administered through the Office of the Secretary at HHS, to provide for an expanded and sustained national investment in prevention and public health programs. The Fund will support programs authorized by the Public Health Service Act, for prevention, wellness and public health activities, including prevention research and health screenings and initiatives. True/False 5. Effectiveness of Federal Health and Wellness Initiatives (Sec. 4402) - Requires the Secretary of HHS to evaluate all existing Federal health and wellness initiatives and report to Congress concerning the evaluation, including conclusions concerning the reasons that such existing programs have proven successful or not successful and what factors contributed to such conclusions. True/False Session 2308 10:30am-12Noon 1.5 ABPM MOC Credits The Collaborative MSD Program 1. Which of the following statements about the Iowa Consortium Study is false? a. Hand-arm symptoms occurred more frequently among study participants than neck-shoulder symptoms b. Participants who reported changing jobs within the study facility had an increased risk of musculoskeletal symptoms c. Self-reported job strain (high demand, low control) was not associated with hand/arm symptoms d. Negative affectivity (a tendency towards pessimism) was not associated with neck/shoulder symptoms 2. Which of the following best describes the epidemiology of lateral epicondylitis? a. Primarily occupational condition b. Primarily non-occupational condition c. Multifactorial condition 3. Which factor had the strongest association with prevalent symptoms of carpal tunnel syndrome in cross- sectional analysis of the Saint Louis study? a. High social support b. Physical exposure to forceful grip c. Female gender 4. Which of the following workplace factors was found to be strongly associated with the new cases of right wrist tendonitis in hand-intensive work in the UCSF Consortium study? a. High grip force b. High pinch force c. Awkward posture d. Sustained posture 5. The following factor was associated with incident right wrist tendonitis in the UCSF Consortium study a. Educational level b. Smoking status c. Job satisfaction d. Job shift Session 2500 12Noon-2:00pm 0 ABPM MOC Credits ACOEM Annual Membership Meeting and Luncheon - ABPM MOC Credit is not available for this session. Session 2309 2:15pm-5:45pm 3 ABPM MOC Credits A Primer on Osteopathy and Osteopathic Manual Manipulation 1. What is the convention that is used for naming somatic dysfunction? a. Somatic dysfunction is named for restriction of motion b. Somatic dysfunction is named based on radiological findings
  26. 26. c. Somatic dysfunction is named for freedom of motion d. Somatic dysfunction is named by local convention; there is not nationally recognized convention e. There is no agreed upon terminology for naming somatic dysfunction 2. A 47 year old male presents to the office with upper neck tension and right occipital headache. Evaluation reveals tissue texture changes, asymmetry and restricted rotation to the right at C2. Which of the following is the most likely type of contraction used to treat this dysfunction with direct muscle energy technique? a. Concentric b. Isotonic c. Isolytic d. Eccentric e. Isometric 3. Which of the following is a characteristic of an indirect technique? a. The somatic dysfunction is exaggerated b. The dysfunction is taken the way it does not like to go c. The barrier is engaged d. The dysfunction is positioned opposite of the injury e. It uses external forces to correct the somatic dysfunction 4. A 42 year old male complains of right upper back pain. An extended, rotated right and sidebent right somatic dysfunction is noted at T3. Which sensory receptor lies in series with muscle fibers and reports information to the central nervous system about the degree of muscle tension? a. Muscle spindle b. Nociceptors c. Golgi tendon organs d. Pacinian corpuscles e. Mechanoreceptors 5. Which of the following is true regarding somatic dysfunctions? a. The golgi tendon organ is involved in reporting somatic afferent information about muscle length and rate of change of length b. Somatic dysfunctions in the thoracolumbar spine tend to decrease local and segmentally related organ sympathetic activation c. Somatic dysfunctions alter the subconscious mechanism in the self-regulation of posture and movement therefore increasing risk of further injury d. Osteopathic techniques to restore the normal length to a muscle involve purposeful stimulation of nonioceptors e. Somatic dysfunctions are least likely to occur at sagittal transitional areas to the spine 6. A 24 year old construction worker complains of a dull, achy pain in his lower back for the past six months. Which other findings would most likely be present? a. Sluggish mobility b. Boggy, edematous tissue c. Moist skin with no trophic changes d. Folliculitis e. Minimal somatovisceral effects 7. In extremities in which the muscle being treated is so severely injured that it cannot be directly touched or manipulated, which of the following techniques may be used to treat this muscle? a. High velocity, low amplitude b. Still technique c. Muscle energy d. Low velocity, moderate amplitude e. Soft tissue 8. Which of the following is a relative contraindication for HVLA? a. Fractures b. Odontoid instability c. Bone malignancies d. Hemoplilia e. Ligamentous instability 9. Golfer’s elbow is also known as which of the following? a. Medial epicondylitis b. Adducted ulna c. Posterior radial head d. Lateral epicondylitis e. Abducted ulna
  27. 27. Session 2310 2:15pm-5:45pm 3 ABPM MOC Credits Questions of Causation/Questions of Practice: Investigations by OSHA and NIOSH 1. The diagnosis of Legionnaire’s Disease is made with the following test a. Sputum gram stain positive for gram negative cocci b. Urine positive for Legionella pneumophila antigen c. PCR positive for Legionella pneumophila in water testing d. Two-fold increase in serology for Legionella pneumophila 2. Because legionella bacteria are destroyed when engulfed by amoeba and parasites in biofilm that lines water- filled vessels, such as cooling towers, the legionella concentration in the water is greater than the concentration in the biofilm. True/False 3. Exposure to n-propyl bromide has been associated with the development of peripheral neuropathy in non- drycleaning industries such as electronics degreasing and foam cushion manufacturing. True/False 4. The appropriate laboratory test to document hydrogen sulfide exposure in a survivor seen 10 hours post- exposure is a. Blood sulfhemoglobin b. Urine sulfide c. Blood thiosulfate d. Urine thiosulfate 5. The appropriate post-mortem laboratory test to document a hydrogen sulfide fatality is a. Blood sulfemoglobin b. Urine sulfide c. Blood thiosulfate d. Urine thiosulfate 6. Which laboratory test is both appropriate and practical to use in a medical surveillance program for workers with chronic exposure to elemental mercury? a. Blood mercury level b. Spot urine mercury level c. 24-hour urine mercury level d. Hair mercury level 7. Levels of mercury found in whole blood represent a total level of all three forms of mercury. True/False 8. The diagnosis of Legionnaires’ Disease is made with the following test a. Sputum gram stain positive for gram negative cocci b. Urine positive for Legionella pneumophila antigen c. PCR positive for Legionella pneumophila in water testing d. Two-fold increase in serology for Legionella pneumophila 9. Because Legionella bacteria are destroyed when engulfed by amoeba and parasites in biofilm that lines water- filled vessels, such as cooling towers, the Legionella concentration in the water is greater than the concentration in the biofilm. True/False Session 2311 2:15pm-5:45pm 3 ABPM MOC Credits Bioaerosols, Disease, and Toxicity: What Does Science Tell Us 1. Current asthma attributes to dampness and mold is what percentage of all asthma cases? a. 50% b. 21% c. 5% d. 30% e. 29% 2. New onset occupational asthma related to dampness and mold includes non-atopic asthma. True/False 3. Which of the following diseases have been linked to moisture and bioaerosols in indoor environmental exposures? a. Sarcoidosis b. Usual interstitial pneumonitis c. Hypersensitivity pneumonitis d. Lung cancer 4. What attribute of small particles from molds and bacteria is not correct? a. They have a much larger aggregate surface area per unit mass than intact mold spores or whole bacteria b. They penetrate more deeply into the lung than whole mold spores or bacteria c. They are more buoyant and have a longer residence time in are than intact spores and bacteria d. They expose and can absorb allergens, proteins, and toxic molecules and carry these into the respiratory system
  28. 28. e. They are not related to any biological effect 5. Which of the following have been associated with immunologic interstitial lung disease? a. Fungi b. Bacteria c. Dust mites d. Cockroaches 6. What agents have been associated with asthma in the indoor environment? a. Fungi b. Bacteria c. Dust mites d. Cockroaches 7. Fungi are unable to cause interstitial lung disease because spores are too large to penetrate to the deep pulmonary tissue. True/False 8. When disease results from exposure to bioaerosols, and specifically to fungi, a single gene is likely to cause based on development of sensitization to a specific protein. True/False 9. The many reviews in the peer-reviewed literature on bioaerosols, human disease, and [myco]toxins generally failed to cite the pertinent scientific literature and mostly quote each of their predecessors reviewing a limited set of pertinent publications. True/Fasle Session 2312 2:15pm-5:45pm 3 ABPM MOC Credits State-of-the Art Update in Public Safety Medicine 1. What is a major risk for police officers entering an active methamphetamine laboratory? a. Radiation b. Fall c. Burns d. Lead exposure 2. What is a major job-related hazard for pregnant officers? a. Firearms training b. Physical workload c. Radiation exposure d. Pesticide exposure 3. What level of respiratory protection is indicated for the entry team in a currently active methamphetamine laboratory? a. Air-purifying respirator APR b. Self contained breathing apparatus (SCBA) c. N 95 mask d. No protection needed 4. According to NFPA 1582, what is the MET requirement for fire fighters with no coronary artery disease (CAD)? a. 12 METs b. 10 METs c. 8 METs d. There is not MET requirements for FF with no known CAD 5. According to Dr. Kales study published in the New England Journal of Medicine 2007, does a FF responding to an alarm have an increase risk of suffering from sudden cardiac death? Yes/No 6. Does the American Heart Association recommend coronary artery calcium scans for FF at high risk of coronary heart disease? Yes/No 7. Does NFPA 1582 recommend diagnostic (symptom-limiting) exercise stress test for a 40 year old FF with 2 risk factors for CAD? Yes/ No 8. According to NFPA 1582 for members of fire department, which of the following blood pressures would require restrictions (more than one answer is possible)? a. 130/85 b. 150/95 c. 170/95 d. 180/95 9. What is the best test to detect LVH? a. Echocardiogram b. EKG c. Chest X-ray d. Coronary artery calcium score Session 2313 2:15pm-5:45pm 3 ABPM MOC Credits
  29. 29. Legislative Advocacy for Physicians: An Interactive Workshop 1. Which of the following arguments supporting the need for an increase in workers compensation medical fees set by your state is most likely to be successful? a. The fees should be increased due to a demonstrable increase in business costs, e.g. rent and utilities for clinic space, and employee wages and benefits b. Doctors are not being fairly compensated for the time they spend on these more complex cases c. Doctors will leave they system if fees aren’t increased d. Specialists each have their own needs bases on difficulty of procedure and other economic issues and should each present their specific arguments for increased fees 2. State legislators are very likely to vote with their party, therefore developing most of your bills with the party leaders in the best strategy. True/False 3. Which of the following is most likely to be true regarding political issues? a. Money alone controls the political outcome b. Once a statute has passed you should give up. It is unlikely that actively participating at state regulatory hearings will have any impact c. Working with legislators on health issues they view as important can help you gain support for more esoteric, specially interest bills you are strongly supporting d. The state medical society will support positions that are in opposition to their established medical professional principles if a good argument is made by the committees who have reviewed the relevant issues 4. Portions of a bill being proposed in your state are likely to affect occupational medicine specialists adversely. Your state medical society generally is supportive of the bill and there is bipartisan support for the bill as a whole since it is seen as step toward improving general health care in your state. Which of the following actions is least likely to result in a change to assist occupational medicine specialists? a. Testify at the committee hearing, and advocate with the bill sponsors, that a specific change in language would improve the bill and avoid any unanticipated negative consequences for patients being treated in the worker compensation system. b. Work with your state medical society through their lobbyists to make specific language changes in the portions of the bill that concern occupational medicine. c. By testifying at the committee hearing and making your concerns known to the bill sponsors, oppose passage of the bill unless specific changes are made. d. After the bill’s passage, work with the stage regulators on specific language for the state regulators related to the bill to modify its effect on occupational medicine. 5. When drilling down to core values using a consensus group to develop a legislative proposal, the physician can both lead the consensus group process and participate as an advocate. True/False 6. “Bargaining Chips” are a. Used to silence opposition b. Something of value given to another party to offset what they are giving up in a negotiation c. An illegal form of influencing legislators d. Discount junkets to Vegas 7. Which of the following is the most accurate statement about the development of successful legislation a. The approach taken by the author of the bill is the only one that can be considered in addressing the issue b. Amendments to the approach of taken by the author of the bill can be adopted by one legislative body and forced on the other c. The most direct and obvious approach to a problem is always best d. There are often several approaches to resolving the issue a bill presents that will accomplish the objective, and some are likely to be more acceptable than others to stakeholders 8. The governor can only sign a bill after the entire legislature has agreed to final language. True/False 9. A zero sum game a. Almost always generates opposition for proposal legislation b. Is a necessary component of any bill c. Provides the regulator with explicit instructions for implementation d. Refers to the budgetary process WEDNESDAY, MAY 5, 2010 Meal Session 7400 7:00am-8:15am 1 ABPM MOC Credits H1N1 – Impact on Businesses
  30. 30. 1. Which of the following is (are) recurrent challenges in emergency responses? a. Communications b. Relief of ICS c. Compliance with PPE d. All of the above 2. The weekly absenteeism rate among select US companies exceeded 50%. True/False 3. Lesson learned at Cisco from their experience with the H1N1 flu included a. Providers not good at protecting themselves b. People accepted the tiered risk group rules c. Having pandemic plans which provide structure with flexibility helped d. Knowledgeable people in collaboration makes a big difference e. All of the above Meal Session 7401 7:00am-8:15am 1 ABPM MOC Credits Navigating the Workers’ Compensation Payment Maze 1. The rules and funding of workers’ compensation fall under the control of the United States government. True/False 2. This session explained the different structures in workers’ compensation to assist providers in navigating the maze for patients with occupational injuries. True/False 3. Differences in state to state rules for workers’ compensation are particularly pronounced in the areas of organizing and paying for medical service delivery to injured workers. True/False Meal Session 7402 7:00am-8:15am 1 ABM MOC Credits Monitoring On-site Clinic Performance Utilizing a Cost-benefit Tool 1. The average ROI of an on-site clinic increases to “break-even” at a. Six months post clinic opening b. One year post clinic opening c. One and a half years post clinic opening d. Three years post clinic opening 2. Average ROI of an on-site clinic increases to 1.6 at _____ months leveling off thereafter a. Nine months post clinic opening b. One year post clinic opening c. One year and three months post clinic opening d. One year and six months post clinic opening 3. The magnitude of the ROI is a function of a. Number of visits b. Size of the plant population c. Penetration/Utilization rate d. A and B e. A, B, and C Session 2400 8:30am-10:00am 1.5 ABPM MOC Credits Psychosocial Factors in the Management of Chronic Pain in Workers’ Compensation 1. Approximately what percentage of workers’ compensation claims for back injuries involve significant pain (level>5) and disability that persists beyond 3 months? a. 1-2% b. 5-10% c. 15-20% d. 40-50% 2. The types of psychosocial variables that appear to play the most significant role in fostering chronic pain and disability are: a. Personality factors b. Pain beliefs c. Socioeconomic status d. Lifestyle and exercise habits 3. The most effective method for assessing whether a worker is at heightened risk for chronic back pain and disability due to psychosocial factors is: a. By projective tests and other personality measures b. By behavioral observation during physical exam c. By conducting a complete psychiatric history d. By administering a patient self-report questionnaire
  31. 31. 4. Use of psychiatric medications for treatment of chronic pain can be problematic in workers’ compensation because the majority of these medications are not written by psychiatrists, off-label uses are not well documented, and side-effects can impair functional recovery. True/False 5. Pain catastrophizing is best described as: a. An intentional effort to deceive providers about the presence of pain b. Hypochondriasis c. A maladaptive pain coping strategy involving worry, alarm, and lack of control d. A prognostic indication that pain is purely of psychological origins Session 2401 8:30am-12Noon 3 ABPM MOC Credits Fatigue Risk Management 1. Fatigue risk can be effectively managed through the development of good shift schedules and overtime guidelines. True/False 2. In managing fatigue, the time of day that one sleeps is as important as the time of day one is awake. True/False 3. What role do fatigue models serve in fatigue risk management? a. As a biological maker of fatigue to determine if a specific incident was caused by fatigue b. To determine if an employee is telling the truth when they complain of fatigue c. To provide an estimate of the fatigue consequence of alternate work schedules d. To quantify the precise level of effectiveness of each individual 4. The only way to reduce fatigue is to work less. True/False 5. If employees work 14 nights in a row, how much time off should they get before they work for a set of 14 days to allow for restorative sleep? a. 1 day b. 2 days c. 7 days d. 14 days 6. If incident investigations gather appropriate fatigue-related information, the role of fatigue in each incident will become clear. True/Fasle 7. During an office visit a patient reports that he is “tired all of the time.” He may mean that he is a. Sleepy, drowsy and having unrefreshing sleep b. Fatigues, lacking in stamina and needing rest c. Depressed and lacking in motivation d. Any or all of the above 8. Patients that have been prescribed Continuous Positive Airway Pressure (CPAP) treatment can expect to lower their blood pressure a. Only while sleeping b. Regardless of CPAP c. Even if they are not hypertensive d. If they demonstrated a high apnea-hypopnea index (AHI) at baseline 9. Screening for sleepiness a. May be accomplished with a questionnaire and/or a device b. Always identifies severe sleep-disordered breathing c. Is not necessary under the age of 50 d. Always identifies fatigue Session 2402 8:30am-12Noon 3 ABPM MOC Credits Real-World Spirometry in the Workplace 1. If a worker’s BMI increases significantly over time, his pulmonary function may begin to exhibit a restrictive impairment pattern. True/False 2. Serious errors, which elevate test results but are not flagged by the spirometer, may occur during zeroing of the sensor or during performance of the forced expiration when using a flow-type spirometer. True/False 3. Calibration checks of flow-type spirometers should be performed using only one speed of injection of the calibration syringe. True/False 4. The American Thoracic Society (ATS) recommends performing a maximum of 8 forced expirations to measure the Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1). True/False 5. The spirometry measurement that is most sensitive to airways obstruction is the FEV1/FVC, and obstructive impairment is present if a worker’s measured FEV1/FVC falls below his/her Lower Limit of Normal (LLN). True/False 6. If spirometers are calibrated in the factory, there is no need to check their accuracy on a regular basis during use. True/False
  32. 32. 7. If a worker’s FEV1 changes from 120% of predicted in 1980 to 90% of predicted in 2002, this is not significant because both values remain in the normal range, above the Lower Limit of Normal (LLN). True/False 8. The predicted value is the average level of lung function that is expected for a subject based on his age, height, sex, and race. True/False 9. For a valid spirometry test, 3 acceptable curves are required, with the largest FVC and largest FEV1 each repeated to within 0.15 L by the second largest values. True/False Session 2403 10:30am-12Noon 1.5 ABPM MOC Credits Hands on Clinical: Foot and Ankle 1. Foot and ankle problems are frequently evaluated and treated in the Occupational Medicine settings. True/False 2. Drs. Joseph Funk and Wiernik are from the Orlando Orthopedic Center in Orlando, FL. True/False 3. This session addressed proven and new evaluation and treatment options using the ACOEM Guidelines as reference. True/False 4. This session consisted of a lecture on TBI. True/False 5. This session addresses the evaluation and treatment of foot and ankle problems unique to the Midwest area of the country only. True/False

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