ABPM MOC ATTENDANCE CALCULATION FORM.doc

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2010 American Occupational Health Conference (AOHC) Orlando, Florida ~ May 2-5, 2010 ABPM MOC ATTENDANCE CALCULATION FORM ABPM 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

Transcript of ABPM MOC ATTENDANCE CALCULATION FORM.doc

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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 2010ABPM MOC Code: 608

ABPM MOC CREDITABPM 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.

2010American Occupational Health Conference

ABPM MOC Credit

Maximum ABPM MOCHours 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 7207Monday 12PM 7203 7204 7205 7206

Tuesday 7AM 7300 7301 7302 7303Wednesday 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

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SUNDAY, MAY 2, 2010

Session 7000 7:00am-8:15am 0 ABPM MOC CreditsNew Member Orientation – ABPM MOC Credit is not available for this session.

Session 7102 7:00am-8:15am 0 ABPM MOC CreditsInternational Environmental Health – CANCELED

Session 2000 8:30am-10:00am 1 ABPM MOC CreditsAOHC Opening Session: C.O. Sappington Memorial Lecture1. Michael Grunwald is a senior national correspondent for Time magazine. True/False2. The Swamp is the winner of the George Polk Award. True/False3. The Clarence Olds Sappington Memorial Lecture was first presented in 1954. True/False

Session 2100 10:30am-12Noon 1.5 ABPM MOC CreditsElectrodiagnosis (EMG/NCS) in Low Back Pain and CTS1. Median mononeuropathy (CTS) is the most common entrapment neuropathy in the body. True/False2. The only L4 innervated muscle below the knee is the tibialis anterior. True/False3. The only L5 innervated muscle below the ankle is the extensor digitorum brevis. True/False4. An electrodiagnostic report should always end with “needs to be clinically correlated.” True/False5. 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 CreditsChanging Behaviors: Achieving Results with an Effective Integrated Health and Productivity Strategy1. How is a health and productivity management strategy potentially valuable to employees and employers?

a. Improve employee health statusb. Reduce employer productivity costsc. Reduce medical care utilization and costsd. A and B onlye. B and C onlyf. 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 presenteeismb. Providing health services that reduce disabilityc. Implementing medical care quality improvement programsd. Measuring program impact in terms of health and productivity improvemente. All of the abovef. None of the above

3. Which of the following is not an example of “irrational” behavioral economic principle:a. The power of freeb. The recency effectc. Loss aversiond. Status quo bias

4. Which choice best describe a factor or factors in the motivational matrix?a. Importance of changeb. Confidence to make the changec. Both A and Bd. Neither A nor B

5. An Integrated Health and Disability program results in:a. No statistical significant resultsb. Statistically significant reduction in both healthcare and disability costsc. Statistically significant reduction in disability durationsd. Statistically significant reduction in healthcare costs

Session 2102 10:30am-12Noon 1.5 ABPM MOC CreditsOccupational Health Surveillance with the Healthcare Personnel Safety Component of the NHSN1. 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 2008a. Overexertion

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b. Skip, trip, or fallc. Violent eventd. Repetitive motion

2. Currently available components of the National Healthcare Safety Network includea. Patient safety & healthcare personnel safetyb. Patient safety, healthcare personnel safety, biovigilancec. Patient safety onlyd. No components are available for use yet

3. Currently available modules within the Healthcare Personnel Safety Component of the NHSNa. None are currently availableb. Blood and body fluid exposure, influenza vaccinationc. Blood and body fluid exposure only, blood and bold fluid exposure with exposure management,

influenza vaccination with (or without) exposure management, influenza exposure management onlyd. 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 personnela. Vaccine uptake among healthcare personnel was over 75% from 2004-2008b. It is mandated by OSHAc. Joint Commission now requires annual evaluation of vaccination rates and reasons for non-participationd. Data from the National Health Interview Survey can be used to measure vaccine uptake rates for

specific facilities5. 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/NIOSHb. Will replace the Bureau of Labor Statistics annual surveyc. Will facilitate employee health appointment scheduling

Session 2103 10:30am-12Noon 1.5 ABPM MOC CreditsCritical Appraisal of Occupational and Environmental Health Literature1. Which of the following is a systematic error in the design, conduct or analysis of a study

a. Chanceb. Biasc. Confoundingd. Factoring

2. Name three of Sir Bradford Hill’s criteria for causation.3. Cross-sectional studies can generate incidence data. True/False4. 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 CreditsWhat Constitutes Excellence: Corporate Health Achievement Award Winner Presentations1. The purpose of the CHAA award is to

a. Champion improving worker health, safety and environmental managementb. Communicate highest standards of excellence to the business communityc. Provide model organizations with visibility and validation for their effortsd. Emphasize performance measures and outcomese. 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 toa. Leadership supportb. Integration of health and safety initiativesc. Culture of wellnessd. Environmental stewardshipe. 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

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Meal Session 7103 12Noon-1:15pm 0 ABPM MOC CreditsBecoming 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 CreditsLegal Update: ADA, HIPAA, and GINA1. 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 above2. 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 costc. Plans may offer rewards based on the results of testingd. 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 disorderb. Genetic information includes tests for alcohol or drug usec. Genetic information may not be collected by a plan for underwriting purposesd. 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 CreditsOSHA Record Keeping1. 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 expirea. September 30, 2010b. December 31, 2010c. October 31, 2010d. The NEP does not expiree. None of the above

3. The OSHA Recordkeeping System is aa. Medical systemb. Surveillance systemc. Safety system

Meal Session 7106 12Noon-1:15pm 0 ABPM MOC CreditsOptimizing the Use of Functional Capacity Evaluations - CANCELED

Session 2105 1:30pm-5:00pm 3 ABPM MOC CreditsA Practical Approach to Occupational Asthma

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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 maskb. Half-face negative pressure respiratorc. Powered-air purifying respiratord. 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 injuryb. Determining if the illness or injury occurred in the course of employmentc. Identifying if the claimant has valid medical insuranced. Estimating if the individual has reached maximal medical improvemente. 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 lawb. Is a “no-fault” insurance systemc. Across the US, it involves a universal system for compensation of injury or ill employeesd. Medical costs (including rehabilitation) and lost wages are fully compensated when a claim has been

approved4. Which of the following chemical is a known cause of occupational asthma?

a. Mercaptobenzothiazoleb. Glutaraldehydec. Isothiazolinoned. Thiuram

5. Which worker shown below is at greatest risk for developing occupational asthma?a. A painter using epoxy-based spray paintsb. A nurse with pre-existing asthma working in a hospital using powder-free latex glovesc. A carpenter exposed to plicatic acid, an organic acid contained in wood dustd. A precious metal refining worker processing scrap gold metal

6. Work-exacerbated asthma is defined whena. Asthma onset is attributed to workplace exposures/conditionsb. A health care provider had diagnosed asthma and there is an association between asthma symptoms

and workc. Working conditions or exposures worsen asthma symptomsd. Asthma develops during work tenure, but not related to work exposures or conditions

7. Identify a true statement pertaining to occupational asthmaa. 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 OAc. Isolated late asthmatic responses are associated with OA induced by protein allergensd. 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 asthmab. Steroid dependant asthmac. Very intermittent and brief exposures for which a respirator would be well toleratedd. Patients on omalizumab therapy for occupational asthmae. Patients with high molecular weight-antigen asthma

9. In patients with occupational asthma requiring long term medical therapy, which of the following is most truea. Leukotriene inhibitors have no role in occupational asthmab. A possible adverse effect of daily use of long acting beta agonists is deathc. Hyposensitization therapy (allergy shots) are frequently helpful in reducing medication requirementsd. Muscarinic antagonists (ipratropium bromide, tiotropium) are first-line pharmacotherapy in occupational

asthmae. Daily inhaled corticosteroids have no role in occupational asthma

Session 2106 1:30pm-5:00pm 3 ABPM MOC CreditsRelating HPM and Value-Based Design to Both the Private Practice and Corporate Medicine Physician1. 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 onlyb. Value-based benefit design is an investment strategy focused on outcomes

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c. Value-based benefit design does not consider economic impactd. 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/False3. A value-based benefit design can be only used in a big, self-insured company. True/False4. 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 companiesb. Medical plans, pharmacy benefit companies, and consumersc. Medical plans, pharmacy benefit companies, consumers and doctorsd. Medical plans, pharmacy benefit companies, consumers, doctors, health systems, service providers,

and more5. 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/False6. 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/False9. 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 CreditsExposure Concerns of Veterans Returning from Afghanistan and Iraq1. 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 characteristicsa. High toxicity of the chemical/substance of concernb. If there is a sensory cue of exposurec. If the risk is perceived as involuntary or outside their controld. 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/False3. 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 mediad. 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 asa. Automotive reflective bumper protectorsb. Small caliber bullet casingsc. Armor piercing artillery rounds by several nationsd. Dietary supplement for world class athletes

6. Sandstorms in Iraqa. Occur only during droughts, every seven yearsb. Cause very fine particulate matter to become airbornec. Have been linked with prostate cancer in US service membersd. Are generally mild and don’t obstruct vision

7. Multiple vaccinations given either together or in close proximity of each othera. Have been given to civilians, travelers and the military of many countries for many yearsb. Have always only been given to military service members prior to their deployment to a combat zonec. Have been definitely shown to cause osteosarcomas in middle aged service membersd. Are easy to conduct large scale post administration testing on in military personnel that received them

pre-deployment to a combat zone8. Common exposure concerns expressed by returning veterans include

a. Depleted uranium, burn pits, food preservatives, sandstorms, and multiple vaccinationsb. Sandstorms, multiple vaccinations, depleted uranium, food coloring and poor sanitary conditionsc. Multiple vaccinations, non-traditional warfare (WMD), second hand cigarette smoke, food coloring and

depleted uraniumd. Multiple vaccinations, depleted uranium, burn pits and sandstorms

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9. True statements about the demographics of the United States Military includea. There are more men and women in the military uniform today than at any time in the past 100 yearsb. Currently just over 20% of the US Military is womenc. The marital status is higher than in the civilian population, but the divorce rate is higher as welld. The military followed civilian society in desegregation

Session 2108 1:30pm-5:00pm 3 ABPM MOC CreditsHands on Orthopedics1. 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/False3. A radial head fracture can be confused with the clinical presentation of lateral epicondylitis. True/False4. Tinel’s test is specific for carpal tunnel syndrome. True/False5. 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 CreditsEmerging Infectious Diseases1. Which infectious disease presently infects a third of the world’s population?

a. Malariab. Dengue feverc. TBd. 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 vectorb. Disturbed ground, water containers, and rubbish create breeding groundsc. Construction workers usually housed in temporary campsd. Construction work is outdoorse. 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 yearsb. Age 18-64 yearsc. Age 65-85 yearsd. Older than age 85

4. The duration of treatment for latent TB is at leasta. One monthb. Six monthsc. Twelve monthsd. Over one year

5. Treatment for Active TB includesa. Isoniazidb. Rifampicinc. Ethambutold. All of the above

6. TB is curable. True/False7. TB test tools include the following except

a. Quantiferonb. Heaf testc. Mantouxd. 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 isa. Gardasilb. BCG

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c. MMRd. Cervarix

MONDAY, MAY 3, 2010

Meal Session 7200 7:00am-8:15am 1 ABPM MOC CreditsMetrics to Manage By1. 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 dirtc. A display that indicates the why employees of a company are doing poorly at workd. A display monitoring the organization’s performance in great detail, focusing on specific low level

processes2. What does a Dashboard display?

a. The speed at which an organization completes its projectsb. Clear, concise, visual indicators of metrics that reflect the key performance indicators of a companyc. The dollars that any given department of a healthcare organization generatesd. 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 companiesb. They are numbers that document the net revenue of a companyc. They are reliable, repeatable, consistent, measures of processes that a company deems critical to

achieving its strategic goalsd. They should always have a benchmark or target, to help companies identify areas of concern and guide

attention to those critical processese. 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 CreditsACOEM’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 CreditsPractical Steps to Establish On-site Employee Clinics and Managing Data to Demonstrate a Positive ROI1. Characteristics of “best practice” wellness programs include all of the following except

a. Top management supports the programb. Evaluation is an integral part of the programc. Program is not linked to the business objectivesd. Adequate budget

2. S-M-A-R-T goals for provider performance include all of the following excepta. Specificb. Measureablec. Not dependent on timed. Achievable

3. Published studies on ROI indicate that onsite health and wellness programs yielda. Fifty cents for every dollar investedb. Twenty dollars for every dollar investedc. One dollar for every dollar investedd. Three and a half dollars for every dollar invested

Meal Session 7207 7:00am-8:15am 1 ABPM MOC CreditsComputer Users: Update on Preventing Vision and Musculoskeletal Symptoms1. Forearm support boards can reduce neck should pain in computer users who use a computer for more than 20

hours per week. True/False2. 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/False3. 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

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Session 2200 8:30am-10:00am 1.5 ABPM MOC CreditsLegal Implications Associated with Corporate Medical Department Responses to Pandemics, Including H1N11. When OSHA conducts H1N1-related inspections, the criteria used will be based upon

a. The inspector’s discretionb. The on-site physician’s reasonable judgmentc. The CDC Healthcare Personnel Guidelinesd. 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 citationc. Martial law powers to confiscate private propertyd. 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 powersb. Yes, if there is a legitimate business needc. No, the Constitution prohibits mandatory vaccinationd. 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 statesb. Yes, if permitted in the applicable statec. No, state law prohibits physician dispensingd. Only if the physician or practitioner has a retail pharmacy license

Session 2201 8:30am-10:00am 1.5 ABPM MOC CreditsEmerging and Contemporary Issues in Military OEM1. The most likely acute health effect associated with burn pit exposure is headache. True/False2. Given the large number of water bottles burned per day, the expected levels of dioxins from burn pits is very

high. True/False3. Epidemiological studies in deployed settings are most likely to suffer from

a. Ascertainment biasb. Recall biasc. Misclassification of exposured. Low power

4. The permissible exposure limit for hexavalent chromium is considered very conservative. True/False5. 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 CreditsUpdate and Case Studies in Commercial Driver Medical Fitness1. Examiners must follow FMCSA Guidance. True/Fals2. The Psych MEP reported that which of the following has the highest likelihood of being associated with an

increased crash riska. Antidepressantsb. Antipsychoticsc. 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 certifiedb. They could be certified if they are cleared by a treating healthcare providerc. They should be qualified for no longer than six monthsd. 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 injuryb. Had a skull fracture 1 year earlier with a 15 minute loss of consciousness

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c. Are 3 years out from closed head trauma associated with a 20 hour loss of consciousnessd. 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 ifa. It is at least 1 year since the diagnosis has been establishedb. They have cardiac autonomic neuropathy which causes orthostatic hypotensionc. 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 Myopathiesb. Inflammatory Myopathiesc. Metabolic Muscled. Myasthenia Gravise. 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 stableb. Does not need to be evaluated by a mental health professionalc. Can be certified if they have attentional difficulties but are under treatmentd. Must use medications as directed

Session 2203 8:30am-12Noon 3 ABPM MOC CreditsProtection of Healthcare Workers from Novel H1N1 Influenza: Public Health Guidance and the Debate Over Airborne Viral Transmission1. H1N1 resulted in a substantial public health impact due to its disproportionate mortality among younger

individuals. True/False2. Obesity was among the co-morbidities which predisposed to worsened outcomes among H1N1 patients.

True/False3. State health departments consistently re-enforced interim guidelines from the CDC for personal protective

equipment during both phases of the H1N1 epidemic. True/False4. Prior to OSHA’s backing the CDC guidance for airborne protection, an adequate national supply of respirators

was assured for hospitals. True/False5. Studies among healthcare workers showed that the N95 respirators were more effective in preventing H1N1

transmission that were surgical masks. True/False6. Lack of transmission across distances exceeding 6 feet is adequate evidence that airborne transmission does

not take place. True/False7. 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/False8. 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 CreditsCurrent Research in OEM and Resident Research1. There is sufficient epidemiological evidence to suggest an association between arsenic exposure and

obstructive pulmonary lung disease in the US population. True/False2. According to NIOSH, dermatoses represent what percentage of total workplace injuries?

a. <10%

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b. 10-15%c. 40-60%d. >90%

3. According to this study, what is the most common occupational skin disease?a. Infectionb. Burnc. Dermatitisd. Bite

4. What are the three physical activity components assessed in this study?a. Frequency, location and intensityb. Location, duration, and typec. Frequency, duration, and intensityd. Frequency, intensity, and type

5. Which physical activity components are significantly associated with the objective cardio-respiratory fitness measures?

a. Frequency, duration, and intensityb. Only frequencyc. Frequency and locationd. None of the components presented association

6. Which physical activity component is significantly correlated to TC/HDL ration?a. Durationb. Intensityc. Locationd. Frequency

7. Preterm delivery occurs prior to what gestational age in a human mother?a. 34 completed gestational weeksb. 35 completed gestational weeksc. 36 completed gestational weeksd. 37 completed gestational weeks

8. What work related or maternal factors have been associated with preterm labor in pregnant women?a. Elevated ambient noise levelsb. Low levels of emotional stressc. Prior history of gestational hypertension or preeclampsiad. 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 CreditsElectronic Medical Records in Occupational Medicine Practice: A State-of-the-Art Review1. Electronic medical records can be reasonably expected to include which of the following (select all that apply)

a. Patient scheduling featuresb. Medical recordsc. Physician service datad. 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. Expensiveb. Inefficiency of usec. Interference with patient interactiond. Worsening of patient safety

4. The percentage of occupational physicians that are very satisfied with their EMR isa. 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

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a. Billing, scheduling, and electronic documentation of the medical recordb. Use of clinical protocols, and medical surveillance capabilitiesc. Time management and accessibility through EMRd. EMR contribution to patient safety and service quality

Session 2206 10:30am-12Noon 1.5 ABPM MOC CreditsStrategic Use of Occupational Medicine Reviews in Federal Workers’ Compensation Cases1. The ideal time for an agency physician review of a Ca-2 (occupational illness) claim is

a. Before it is filledb. As soon as it is filledc. While it is under developmentd. After it has been accepted

2. The following option usually carries the most weight in claims with a conflict in medical opiniona. The treating providerb. The agency physicianc. The second opinion examinerd. The referee (IME) examiner

3. Agency physician reviews are effective in obtaining the following resultsa. Getting DOL to set up a second opinion examb. Reversing a DOL claim acceptance decisionc. Requiring a claimant to see a specific treating providerd. Obtaining authorization for creating a new limited duty position

4. Reviews in cases of disability attributed to chronic pain should focus on the following issuesa. Determining the underlying psychiatric conditionb. Obtaining accurate measurements of pain levelsc. Determining physical abilities using objective tools when possibled. 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 systema. Claim acceptance may be appealed by the employing agency through several levelsb. Wage compensation can be terminated if claimant declines RTW offer based on medical releasec. FECA claims are routinely closed after 6 months of inactivityd. 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 CreditsOperationalizing HPM: The Value of Integrated Data Management1. For an effective employer health and productivity management program, integration should happen at the

following levelsa. Strategicb. Operationalc. Information systems/datad. 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 requirementsb. OSHA log and safety investigationsc. Biometric data and worksite clinic softwared. Personal health records and absence management software

3. The benefits of integrated health and productivity data management include all of the following excepta. Less redundant data capture/entryb. Improved management capability and operational efficiencyc. Reduced interaction between health and productivity management program managersd. Enhanced ability to perform root cause analysis of health and safety issuese. More effective return to work program management

Meal Session 7204 12Noon-1:15pm 1 ABPM MOC CreditsLeave and Reasonable Accommodation Claims in Federal Civil Service Workers1. In fiscal year 2009, what is the most prevalent medical diagnosis requiring accommodation in the female

subgroup of federal workersa. Anxietyb. Migraines

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c. Diabetes mellitusd. Asthma

2. What medical category covers the top three diagnoses for which time off under FMLA is requested in the federal civilian workers

a. Endocrineb. Psychiatricc. Respiratoryd. Cardiac

3. Within what federal agency is federal occupational health locateda. 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 CreditsThe Independent Medical Examination1. The independent medical examination

a. Is not a doctor patient relationshipb. Is only requested in workers compensation casesc. Requires the physician to be certifiedd. Requires the physician to use ACOEM forms and templates

2. The most important product of an IME is thea. Relationship made with the requesting partyb. Relationship made with the examineec. Reportd. Deposition that will come out of the examination

3. Which of the following is not true concerning IME reportsa. The report is generally only sent to the requesting partyb. Attorneys collect examples of physicians’ reports for later legal usec. It is a script for later testimonyd. They are not considered an attorney work product

Meal Session 7206 12Noon-1:15pm 1 ABPM MOC CreditsUpdate on Vision Issues in the Workplace1. 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/False2. e-Ink displays, an example of which is Kindle, rely entirely on reflected light and do not emit light. True/False3. 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 CreditsLights, Camera, Action – Explore Digital Media1. House of Moves is the world’s second most experienced motion capture service studio. True/False2. Attendees had the opportunity to interact with

a. Mickey Mouseb. Technical staff to address specific areas of interestc. Mr. Walt Disneyd. Cashiers in the gift shop

3. House of Moves has been in business for 10 years. True/False4. House of Moves was acquired by VICON Motion Systems in

a. 2006b. 2005c. 2004

5. Which city is a global digital media leader?a. Orlando, FLb. Shamokin, PAc. Orland Park, ILd. Cincinnati, OH

6. On this worksite visit, participants visiteda. Orlando Technical Centerb. VICON

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c. House of Movesd. Clinical Motion Analysis Laboratory and Training Facilitiese. All of the above

7. Golden Volume refers to the capturing of the face, full-body and hands simultaneously. True/False8. Two products of the House of Moves are

a. Stock Motion Datab. Diva Motion Editing Softwarec. Clinical Motion Analysis Datad. 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 CreditsSeaWorld – Where Worlds Connect1. Attendees were able to (select all that apply)

a. Get in the water with the animalsb. Learn how Health Services works together with local emergency service agencies to provide the quality

care to guests and employeesc. Receive free items from the gift shopd. 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/False3. 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/False5. Because the animals need constant care and attention, SeaWorld is open 24 hours a day. True/False6. SeaWorld’s headquarters is located in Johnsburg, IL True/False7. SeaWorld employees are responsible for their own first aid. True/False8. This worksite covered the common medial illnesses and injuries health services encounters and anticipates in a

theme park setting. True/False9. Orlando, FL is SeaWorld’s only location. True/False

Session 2207 1:30pm-3:00pm 1.5 ABPM MOC CreditsOccupational Health Services: Organization and Competencies1. Vertical Integration is about

a. Marketing, selling and penetration into new segmentsb. Climbing a mountainc. A single owner controlling the chain of production of a product or serviced. Creating alliances with competitors

2. Horizontal Integration is abouta. Marketing, selling and penetration into new segmentsb. Lying on a hammockc. A single owner controlling the chain of production of a product or serviced. Buying one of your key suppliers of an essential product or service

3. Sharing the same client with a competitor allowsa. Easier growth and expansionb. Greater revenuesc. More accurate and comparable benchmark data on performanced. 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 CreditsInside the Mysterious Realm of Utilization Review1. Which of the following statements is true about the utilization review process?

a. Utilization review is subject to federally created regulatory processesb. A non-certification decision is bindingc. Effective utilization review is supported by nationally recognized evidence based medical guidelinesd. A non-certification decision can be made by any healthcare provider reviewing a request

2. Which of the following statements is true about UR?

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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 decisionc. Depending on jurisdictions, the peer to peer discussion can be made with an MD, DO, PA, NP, PT, OT

DC, PhD, etcd. All states follow URAC standardse. All reviewing physicians must have an active medical license in the state where the care under

discussion will take place3. Which of the following statements are true?

a. A patient relationship needs to be established in order to be held for an outcomeb. It is necessary for there to be intention to treat in order for a liability claim to be establishedc. UM reviewers can be held liable if a reasonable standard of care is not followedd. Although independent medical evaluators have potential liability, UM reviewers are protected because

they only reference established guidelines4. 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 CreditsIndividual Scientific Abstract Oral Presentations1. Preliminary test results show that the amount of exposure is not dependent on the protection factor. True/False2. 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 utterancesb. 3 provider utterances to every 2 patient utterancesc. 1 provider utterances to every 5 patient utterancesd. 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. $0b. $100c. $1,000d. $2,000

4. The estimated amount of lost earning due to influenza in the US isa. 2 billionb. 6 billionc. 10 billiond. 16 billione. 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

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mountain sickness isa. Dysnoeb. Vertigoc. Headached. Sleepiness

Session 2210 1:30pm-5:00pm 3 ABPM MOC CreditsMRO Controversies1. The MRO in the DOT program is responsible for fitness for duty evaluations. True/False2. 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 MROb. The company had information about medications the person was takingc. The company did drug testingd. According to the court, the procedure used violated ADAe. 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 usingb. Document in the MRO interview notes all relevant prescribed medications the donor states he/she is

usingc. Contact the prescribing medical/dental practitioner to validate the prescription information provided by

the donord. Request and review “hard copy” documentation (copy of prescription, pharmacy printout, bottle label)

of prescription medications identified by donore. Require copies of patient or medical records documenting prescribed medications

6. In reviewing and verifying invalid specimen laboratory results, the MRO musta. Discuss the laboratory result with the laboratory certifying scientistb. Order a reanalysis of Bottle A at a second drug testing laboratoryc. Verify the test as negative if there is an acceptable medical explanation for the specimen’s invalidityd. Order additional specimen validity testse. 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 toa. Eliminate PCP testingb. Lower the cutoff levels for cocaine and amphetaminec. Require MRO certification every other yeard. Require MROs to keep records for 3 months only

8. An increasing concern for many MROs is that the federal drug testing panel does nota. Test for opioidsb. Test for synthetic opioidsc. Distinguish amphetamine from methamphetamined. Allow the MRO to raise a safety sensitive concern

9. MROs generally approach ethical dilemmas in all of the following manners excepta. Relying upon ACOEM education and trainingb. Discussing with other MROs how they handle certain situationsc. Reading MRO periodical publications and referring to MRO textsd. Deferring judgment to the designated employer representative

Session 2211 1:30pm-5:00pm 3 ABPM MOC Credits

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Respirators and FIT Testing: Current and Future Approaches1. Would you qualify a 33 year old woman with moderate, persistent asthma for respirator use

a. No wayb. Yes, for any respiratorc. Yes, for some types of respiratorsd. Not sure

2. Which of the following is the least important cause of respirator intolerance for most workersa. Psychophysical stressesb. Pulmonary demandsc. Sensory limitationsd. Failure to fit test

3. Which of the following is most predictive of an individual’s ability to tolerate and safely use a respiratora. Office spirometryb. Exercise stress testc. Documented ability to perform similar job tasksd. Physical exam

4. Which is likely to be the most frequent cause of inadequate respirator-based protectiona. Inability to overcome the respirator resistanceb. Incomplete facial sealc. Incomplete compliance with proper used. 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 substitutionb. Local exhaust ventilationc. Discontinuing workd. Administration controls

6. Which of the following as shown the least impact upon respirator subjective responsesa. Ageb. Genderc. Asthmad. 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 oxideb. Ultraviolet lightc. Soap and waterd. Autoclave

8. Filtering facepiece respirators treated with which one of the following agents were somewhat effective against Ms-2 virus

a. Iodineb. Silverc. Quarternary Ammonium Compoundd. 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 usersb. Increased respiratory ratec. Normal oxygen saturationd. Increases in tidal volume

Session 2212 3:30pm-5:00pm 1.5 ABPM MOC CreditsHeavy 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

suggesta. Expected laboratory errorb. Toxic effect of mercury on the kidneys to the extent that the kidneys cannot adequately excrete mercuryc. The presence of only organomercury compounds, with little or no inorganic mercuryd. A and Be. A and Cf. B and C

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2. Berylliosis (“Salem sarcoidosis”) may be distinguished from standard/idiopathic sarcoidosis viaa. The prominence of bone cysts in berylliosisb. The prominent finding of alveolitis in berylliosisc. The common finding of pulmonary fibrosis in berylliosisd. The positivity of the lymphocyte transformation test (LTT) in berylliosis vs. a negative test in idiopathic

sarcoidosise. Pulmonary parenchymal involvement always in berylliosis and only sometimes in idiopathic sarcoidosisf. Only answer Ag. All of the above except answer A

3. When one is trying to ascertain true arsenic toxicity, it is imperative toa. Request a blood level of arsenicb. First assess for renal functionc. Fractionate the total arsenic into inorganic vs. organic/chelated arsenicd. Do a blood-lead to blood-arsenic ratio

4. In assessing silver toxicity, the most reliable test for assessing the body burden of silver isa. Bloodb. Hairc. Fecesd. Urine

5. The presence of basophilic stippling in immature erythrocytes may suggesta. Normal fetal and neonatal RBCsb. Chronic anemias, including Mediterranean anemiasc. Leukemiad. Lead and/or arsenic toxicitiese. Pyrimidine-5’-nucleotidase deficiencyf. Only Dg. All of the above

Session 2213 3:30pm-5:00pm 1.5 ABPM MOC CreditsIntegrating Environment, Social and Health Impact Assessments1. The integrated ESHIA provides a systematic assessment of potential environmental, social and health impacts.

True/False2. The integrated ESHIA provides benefits to the local community but does not benefit the company’s business

operations. True/False3. The basic ESHIA process has multiple steps. The first step in the process is

a. Baseline studiesb. Impact identificationc. Screening and scopingd. Community engagement

4. The integrated ESHIA process focuses its efforts on promoting the health of thea. Employees and contractorsb. 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 CreditsIndividual Scientific Abstract Oral Presentations1. Only professional aircraft maintainers work on aircraft so they are the only population at risk. True/False2. Skin absorption is a major route of exposure for solvents. True/False3. Cost intensive physicians treated more complicated injuries than non-cost intensive physicians. True/False4. 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/No6. Epidemiological evidence for the positive association between sedentary work and obesity has been generally

stronger in female workers than in male workers. True/False7. This study recommends that a decrease in health risk behaviors by what percent would yield a reduction in

medical care costs by over $2 billiona. 0.1%b. 1.0%c. 5.0%

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d. 10.0%

TUESDAY, MAY 4, 2010

Meal Session 7300 7:00am-8:15am 1 ABPM MOC CreditsTravel Health Consultation Services in the Occupational Health Clinic1. The components of a travel medicine consultation are

a. Review of the itinerary and lodging choicesb. Provision of itinerary-specific vaccinations onlyc. Review of itinerary, preventive education, vaccinations, provision of anti-malarial medications, provision

of self-care medications for use in case of traveler’s diarrhead. 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 area. Lack of language proficiencyb. Food and water-borne diseases and preventable injuriesc. Unsuitable lodgingd. Adjustment disorders

3. Some countries require proof or waiver of the following vaccination(s) in order for entrya. Typhoid and Hepatitis Ab. Hepatitis Bc. Yellow Feverd. Typhoid and Yellow Fever

Meal Session 7301 7:00am-8:15am 1 ABPM MOC CreditsThe Company Doctor Game1. Return on Investment “ROI” means

a. If you are making money in your business you can spend more on advertisingb. Calculates how successful you arec. How many patients come back to your office after “investing” in you as their doctord. Sales people use this to calculate how much you can spend on their producte. (Gain from Investment-Cost of investment)/Cost of investment

2. “Top of Mind Awareness” meansa. Remembering to wear a hat so as not to get sunburned on your bald spotb. Remembering to put sunscreen on your bald spot to prevent sunburnc. Remembering to put aloe on your sunburned scalp to prevent skin peelingd. Remembering to go to an urgent care clinic instead of an ER to get treated for sunburne. All of the above

3. When marketing your practice the most important person to be able to articulate your message isa. Your patientsb. An unbiased actor as a spokespersonc. Youd. Your office managere. All of the above

Meal Session 7302 7:00am-8:15am 1 ABPM MOC CreditsMedical Issues in Diverse and Underserved Populations: Benchmark Activities in South Florida1. Which of the following is the most direct barrier to access to work-related medical care among underserved

worker populations?a. Denial of workers’ claimb. Lack of an approved community occupational medicine physicianc. Allowable fee schedules by the occupational medicine providerd. Waiting times for an occupational medicine physiciane. Lack of medical determination by the occupational medicine physician

2. Which country yields the greatest number of migrant workers into the US?a. Mexicob. Chinac. Dominican Republicd. Cubae. Russia

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3. Among Hispanic construction workers in South Florida, what percentage reported being exposed in the past 7 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 CreditsBeing Smart About Your Financial Security1. A very important question to ask a potential financial advisor is

a. What type of music do you likeb. How are you paidc. What is your favorite color

2. A reasonable amount of your income to save for retirement isa. 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 CreditsThe Nature Conservancy’s Disney Wilderness Preserve1. Remote areas of the Everglades were covered on this visit. True/False2. A topic covered by DWP staff on this visit was the environmental and health issues created by previous

endeavors in the Everglades. True/False3. The preserve is bordered by

a. Lake Mariab. Lake Russellc. Highway 88

4. Sunscreen isa. Recommended for use in the Evergladesb. Prohibited from use in the Everglades due to environmental issuesc. Not needed if one is wearing a poncho

5. The preserve is home to such rare creatures at the a. Bald eagleb. Florida scrub-jayc. Sandhill craned. Gopher tortoisee. 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 seea. The beauty of a man-made preservationb. Land restoration in progressc. Over 35 lakes d. All of the above

Work-site Visit 8201 8:00am-12Noon 3 ABPM MOC CreditsRosen Shingle Creek – Under the Mattress1. It is important for physicians to understand the key challenges for maintaining the health of specialized work

forces within a hotel. True/False2. Harris Rosen was recently honored with a Legacy Award during the organization’s 11th Annual Best Practices

Awards in June 2009. True/False3. Rosen Green Meetings® are events which are conducted in specific ways which help reduce the environmental

burdens imposed by such activities. True/False4. Rosen Shingle Creek opened in

a. 2005

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b. 2006c. 2007

5. Rosen Shingle Creek has how many total sleeping roomsa. 1,000b. 1,500c. 2,000d. 2,225

6. The maximum number of meeting rooms is 99. True/False7. The largest theater-style seating at Rosen Shingle Creek can accommodate

a. 9,500 peopleb. 8,500 peoplec. 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 ofa. Food service workersb. Housekeepersc. Maintenance crewsd. All of the above

Session 2300 8:30am-10:00am 1.5 ABPM MOC CreditsQuantifying the Return on Investment for Worksite Clinics1. Measurement of return on investment for worksite clinics and particularly for non-occupational services

a. Has a standardized and widely accepted methodologyb. Is readily quantifiablec. Routinely incorporated all considered variablesd. Typically includes time spent away from work for use of community healthcare servicese. 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/False3. Most employers responding to the worksite clinic ROI survey

a. Offer full-service primary care to their employeesb. Use HEDIS measures to evaluate worksite clinics performancec. Use CPT (procedure) codes in quantifying ROId. 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 benefitsb. Facility maintenancec. Opportunity cost of physical space if used for primary business purposesd. Medical equipment and suppliese. 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. Utilizationb. Market value of provided services in comparison to operating costsc. Healthcare cost trendd. Clinical outcomes

Session 2301 8:30am-10:00am 1.5 ABPM MOC CreditsACOEM Code of Ethics1. Prior to ACOEM’s 2010 revision of its code of ethics, the last revision occurred how many years ago?

a. 6 yearsb. 17 yearsc. 55 yearsd. 82 years

2. Traditionally, which of the following terms is/are closely aligned with ethicsa. Moral philosophyb. Utilitarianismc. Virtued. All of the abovee. A and C only

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3. The fifth article of ACOEM’s code of ethics, Protect Patient Confidentiality, does not apply to worker 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” opinionb. Report restrictions to the employer despite the lack of consentc. Avoid writing restrictions but imply them by recommending accommodations to the employerd. Inform the employer that the employee did not complete the medical evaluation

Session 2302 8:30am-10:00am 1.5 ABPM MOC CreditsThe ACOEM Hand, Wrist, and Forearm Disorder Practice Guidelines1. Which of the following describes the relationship between carpal tunnel release operative approach (open vs.

endoscopic) and average lost timea. Greater lost time with open approachb. No difference in lost timec. 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. NSAIDb. Wrist splintingc. Ionotophoresis with dexamethasoned. Glucocorticosteroid injectione. 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. Ultrasoundb. Iontophoresis with dexamethasonec. Glucocorticoteroid injectiond. 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 riskb. Comparable riskc. 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 limitationsb. NSAIDc. Steroid injectiond. Percutaneous surgical release

Session 2303 8:30am-10:00am 1.5 ABPM MOC CreditsIndividual Scientific Abstract Oral Presentations1. Biopsychosocial model in occupational medicine assess

a. Interplay between psychological condition of one worker and his medical illnessb. Interplay between psychological condition of one worker, his medical illness and his work lifec. Interplay between psychological condition of one worker, his medical illness and his social life outside

work2. Ergonomic stressors associated musculoskeletal (MSDs) disorders could be

a. A risk factor for biopsychsocial modelb. Preventive factor for biopsychosocial modelc. Irrilivant to biopsychosocial model

3. Retrospective Utilization Management reduces costs through a payment denial process. In contrast, the goal of

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Prospective and Concurrent Utilization Management practices is to changea. Billed chargesb. Clinical behaviorc. Policyd. 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 satisfactionb. References to relevant literaturec. Case-mix adjustorsd. 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 filingb. Total case rate (new case rate)c. Lost time case rated. Lost production day rate

Session 2304 8:30am-12Noon 3 ABPM MOC CreditsEverything You Always Wanted to Know About Seaman Medical Examinations but Were Afraid to Ask1. CG-719K Merchant Mariner Credential Medical Evaluation Report

a. Is used for entry level mariners and does not require a medical historyb. Records medical history and physical examination components including vision and hearing so that the

coast guard may review to issue mariner credentialc. Requires chest x-rays and EKGs on every examinationd. May only be completed by physicians

2. Audiograms must be performed to document adequate hearing. True/False3. In there is no response in the medication section it is assumed that the mariner is not taking any medications.

True/False4. Color Sensing Lenses may be worn during color vision testing. True/False5. If a mariner has diabetes, his HA1C record must demonstrate

a. HA1C of 5.8% three years prior to the examb. HA1C < 8.0% on two recent tests at least 90 days apartc. HA1C > 14% for the past 5 yearsd. 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 twob. A history of withdrawal seizure as patient was deciding to go to alcohol rehab three years agoc. A seizure two years ago while on anti-epileptic medicationsd. 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 credentialsb. The MNC reviews completed physical exams and supporting objective medical documentation to

include consultative reports and results of relevant lab/imaging studiesc. The NMC reviews completed physical exams and accepts the examiner’s competency statement that

the applicant is medically competentd. All mariners are required by law to report changes in their health status so periodic physical exams are

unnecessary8. 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?

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a. Conditional medical waivers are rarely approved by the NMCb. Conditional medical waivers are never approved for cardiac conditionsc. Once issued, a conditional medical waiver may never be invalidatedd. 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 CreditsThe Patient-centered Medical Home, Worksite Clinics, and the OEM Clinician1. From the employer perspective, patient-centered medical home has appeal because of all of the following

excepta. The potential for lowered healthcare costsb. Improved compliance with treatment guidelinesc. Increased near-term implementation costsd. 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 relationshipsb. Patient incentivesc. More effective communication between healthcare clinicians and patientsd. 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 excepta. Improved patient adherence to recommended treatmentb. Enhance both patient and provider satisfaction with care deliveryc. Long-term increases in healthcare costsd. Decrease ambulatory care-sensitive hospitalization ratese. Decrease emergency department utilization rates

4. Worksite clinics can reasonably support medical home practices by all of the following excepta. Enforcing the importance of medication adherenceb. Enhancing access to clinicians for chronic condition monitoringc. Ordering changes to treatment regimensd. 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 servicesb. Better compliance with chronic medicationsc. More effective treatment to target goalsd. Improved patient satisfaction with caree. All of the above

Session 2306 10:30am-12Noon 1.5 ABPM MOC CreditsHazards in Drinking Water from Private and Municipal Wells1. Bottled water is generally “safer” than municipal water sources. True/False2. The US Environmental Protection Agency, through the Safe Drinking Water Act has established drinking water

standards for how many potential contaminantsa. 13b. 18c. 20d. 56e. 118

3. The EPA requires that all private well water meets federal drinking water standards. True/False4. Contamination of a water source with which of the following can result in a condition know as “baby blue”

syndromea. Cobaltb. Nitratesc. Radionuclidesd. Fluoridee. Lead

5. The most common problems in rural well-water contamination is related to which of the followinga. Methane gas in the wellb. Barnyard runoffc. Leaching of metals from surrounding rocks

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d. Bacteriae. 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 CreditsLate Breaker: Health Care Reforms1. Provisions in the Patient Protection and Affordable Care Act became law on March 23, 2010. True/False2. 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 CreditsThe Collaborative MSD Program1. 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 symptomsb. Participants who reported changing jobs within the study facility had an increased risk of

musculoskeletal symptomsc. Self-reported job strain (high demand, low control) was not associated with hand/arm symptomsd. 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 conditionb. Primarily non-occupational conditionc. 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 supportb. Physical exposure to forceful gripc. 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 forceb. High pinch forcec. Awkward postured. Sustained posture

5. The following factor was associated with incident right wrist tendonitis in the UCSF Consortium studya. Educational levelb. Smoking statusc. Job satisfactiond. Job shift

Session 2500 12Noon-2:00pm 0 ABPM MOC CreditsACOEM Annual Membership Meeting and Luncheon - ABPM MOC Credit is not available for this session.

Session 2309 2:15pm-5:45pm 3 ABPM MOC CreditsA Primer on Osteopathy and Osteopathic Manual Manipulation1. What is the convention that is used for naming somatic dysfunction?

a. Somatic dysfunction is named for restriction of motion

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b. Somatic dysfunction is named based on radiological findingsc. Somatic dysfunction is named for freedom of motiond. Somatic dysfunction is named by local convention; there is not nationally recognized conventione. 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. Concentricb. Isotonicc. Isolyticd. Eccentrice. Isometric

3. Which of the following is a characteristic of an indirect technique?a. The somatic dysfunction is exaggeratedb. The dysfunction is taken the way it does not like to goc. The barrier is engagedd. The dysfunction is positioned opposite of the injurye. 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 spindleb. Nociceptorsc. Golgi tendon organsd. Pacinian corpusclese. 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 lengthb. Somatic dysfunctions in the thoracolumbar spine tend to decrease local and segmentally related organ

sympathetic activationc. Somatic dysfunctions alter the subconscious mechanism in the self-regulation of posture and

movement therefore increasing risk of further injuryd. Osteopathic techniques to restore the normal length to a muscle involve purposeful stimulation of

nonioceptorse. 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 mobilityb. Boggy, edematous tissuec. Moist skin with no trophic changesd. Folliculitise. 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 amplitudeb. Still techniquec. Muscle energyd. Low velocity, moderate amplitudee. Soft tissue

8. Which of the following is a relative contraindication for HVLA?a. Fracturesb. Odontoid instabilityc. Bone malignanciesd. Hemopliliae. Ligamentous instability

9. Golfer’s elbow is also known as which of the following?a. Medial epicondylitisb. Adducted ulnac. Posterior radial headd. Lateral epicondylitise. Abducted ulna

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Session 2310 2:15pm-5:45pm 3 ABPM MOC CreditsQuestions of Causation/Questions of Practice: Investigations by OSHA and NIOSH1. The diagnosis of Legionnaire’s Disease is made with the following test

a. Sputum gram stain positive for gram negative coccib. Urine positive for Legionella pneumophila antigenc. PCR positive for Legionella pneumophila in water testingd. 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 sulfhemoglobinb. Urine sulfidec. Blood thiosulfated. Urine thiosulfate

5. The appropriate post-mortem laboratory test to document a hydrogen sulfide fatality isa. Blood sulfemoglobinb. Urine sulfidec. Blood thiosulfated. 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 levelb. Spot urine mercury levelc. 24-hour urine mercury leveld. Hair mercury level

7. Levels of mercury found in whole blood represent a total level of all three forms of mercury. True/False8. The diagnosis of Legionnaires’ Disease is made with the following test

a. Sputum gram stain positive for gram negative coccib. Urine positive for Legionella pneumophila antigenc. PCR positive for Legionella pneumophila in water testingd. 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 CreditsBioaerosols, Disease, and Toxicity: What Does Science Tell Us1. 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/False3. Which of the following diseases have been linked to moisture and bioaerosols in indoor environmental

exposures?a. Sarcoidosisb. Usual interstitial pneumonitisc. 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

bacteriab. They penetrate more deeply into the lung than whole mold spores or bacteriac. They are more buoyant and have a longer residence time in are than intact spores and bacteriad. They expose and can absorb allergens, proteins, and toxic molecules and carry these into the

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respiratory systeme. They are not related to any biological effect

5. Which of the following have been associated with immunologic interstitial lung disease?a. Fungi b. Bacteriac. Dust mites d. Cockroaches

6. What agents have been associated with asthma in the indoor environment?a. Fungib. Bacteriac. Dust mitesd. 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 CreditsState-of-the Art Update in Public Safety Medicine1. What is a major risk for police officers entering an active methamphetamine laboratory?

a. Radiationb. Fallc. Burnsd. Lead exposure

2. What is a major job-related hazard for pregnant officers?a. Firearms trainingb. Physical workloadc. Radiation exposured. Pesticide exposure

3. What level of respiratory protection is indicated for the entry team in a currently active methamphetamine laboratory?

a. Air-purifying respirator APRb. Self contained breathing apparatus (SCBA)c. N 95 maskd. No protection needed

4. According to NFPA 1582, what is the MET requirement for fire fighters with no coronary artery disease (CAD)?a. 12 METsb. 10 METsc. 8 METsd. 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. 130/85b. 150/95c. 170/95d. 180/95

9. What is the best test to detect LVH?a. Echocardiogramb. EKGc. Chest X-rayd. Coronary artery calcium score

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Session 2313 2:15pm-5:45pm 3 ABPM MOC CreditsLegislative Advocacy for Physicians: An Interactive Workshop1. 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 benefitsb. Doctors are not being fairly compensated for the time they spend on these more complex casesc. Doctors will leave they system if fees aren’t increasedd. Specialists each have their own needs bases on difficulty of procedure and other economic issues and

should each present their specific arguments for increased fees2. 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/False3. Which of the following is most likely to be true regarding political issues?

a. Money alone controls the political outcomeb. Once a statute has passed you should give up. It is unlikely that actively participating at state

regulatory hearings will have any impactc. Working with legislators on health issues they view as important can help you gain support for more

esoteric, specially interest bills you are strongly supportingd. 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” area. Used to silence oppositionb. Something of value given to another party to offset what they are giving up in a negotiationc. An illegal form of influencing legislatorsd. Discount junkets to Vegas

7. Which of the following is the most accurate statement about the development of successful legislationa. The approach taken by the author of the bill is the only one that can be considered in addressing the

issueb. Amendments to the approach of taken by the author of the bill can be adopted by one legislative body

and forced on the otherc. The most direct and obvious approach to a problem is always bestd. 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 stakeholders8. The governor can only sign a bill after the entire legislature has agreed to final language. True/False9. A zero sum game

a. Almost always generates opposition for proposal legislationb. Is a necessary component of any billc. Provides the regulator with explicit instructions for implementationd. Refers to the budgetary process

WEDNESDAY, MAY 5, 2010

Meal Session 7400 7:00am-8:15am 1 ABPM MOC Credits

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H1N1 – Impact on Businesses1. Which of the following is (are) recurrent challenges in emergency responses?

a. Communicationsb. Relief of ICSc. Compliance with PPEd. All of the above

2. The weekly absenteeism rate among select US companies exceeded 50%. True/False3. Lesson learned at Cisco from their experience with the H1N1 flu included

a. Providers not good at protecting themselvesb. People accepted the tiered risk group rulesc. Having pandemic plans which provide structure with flexibility helpedd. Knowledgeable people in collaboration makes a big differencee. All of the above

Meal Session 7401 7:00am-8:15am 1 ABPM MOC CreditsNavigating the Workers’ Compensation Payment Maze1. The rules and funding of workers’ compensation fall under the control of the United States government.

True/False2. This session explained the different structures in workers’ compensation to assist providers in navigating the

maze for patients with occupational injuries. True/False3. 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 CreditsMonitoring On-site Clinic Performance Utilizing a Cost-benefit Tool1. The average ROI of an on-site clinic increases to “break-even” at

a. Six months post clinic openingb. One year post clinic openingc. One and a half years post clinic openingd. Three years post clinic opening

2. Average ROI of an on-site clinic increases to 1.6 at _____ months leveling off thereaftera. Nine months post clinic openingb. One year post clinic openingc. One year and three months post clinic openingd. One year and six months post clinic opening

3. The magnitude of the ROI is a function ofa. Number of visitsb. Size of the plant populationc. Penetration/Utilization rated. A and Be. A, B, and C

Session 2400 8:30am-10:00am 1.5 ABPM MOC CreditsPsychosocial Factors in the Management of Chronic Pain in Workers’ Compensation1. 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 factorsb. Pain beliefsc. Socioeconomic statusd. 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 measuresb. By behavioral observation during physical examc. By conducting a complete psychiatric history

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d. By administering a patient self-report questionnaire4. 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 painb. Hypochondriasisc. A maladaptive pain coping strategy involving worry, alarm, and lack of controld. A prognostic indication that pain is purely of psychological origins

Session 2401 8:30am-12Noon 3 ABPM MOC CreditsFatigue Risk Management1. Fatigue risk can be effectively managed through the development of good shift schedules and overtime

guidelines. True/False2. In managing fatigue, the time of day that one sleeps is as important as the time of day one is awake.

True/False3. 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 fatigueb. To determine if an employee is telling the truth when they complain of fatiguec. To provide an estimate of the fatigue consequence of alternate work schedulesd. To quantify the precise level of effectiveness of each individual

4. The only way to reduce fatigue is to work less. True/False5. 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 dayb. 2 daysc. 7 daysd. 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 isa. Sleepy, drowsy and having unrefreshing sleepb. Fatigues, lacking in stamina and needing restc. Depressed and lacking in motivationd. 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 sleepingb. Regardless of CPAPc. Even if they are not hypertensived. If they demonstrated a high apnea-hypopnea index (AHI) at baseline

9. Screening for sleepinessa. May be accomplished with a questionnaire and/or a deviceb. Always identifies severe sleep-disordered breathingc. Is not necessary under the age of 50d. Always identifies fatigue

Session 2402 8:30am-12Noon 3 ABPM MOC CreditsReal-World Spirometry in the Workplace1. If a worker’s BMI increases significantly over time, his pulmonary function may begin to exhibit a restrictive

impairment pattern. True/False2. 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/False3. Calibration checks of flow-type spirometers should be performed using only one speed of injection of the

calibration syringe. True/False4. 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/False5. 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

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use. True/False7. 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/False8. 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/False9. 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 CreditsHands on Clinical: Foot and Ankle1. Foot and ankle problems are frequently evaluated and treated in the Occupational Medicine settings.

True/False2. Drs. Joseph Funk and Wiernik are from the Orlando Orthopedic Center in Orlando, FL. True/False3. This session addressed proven and new evaluation and treatment options using the ACOEM Guidelines as

reference. True/False4. This session consisted of a lecture on TBI. True/False5. 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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Answer Key2010 AOHC Distance Learning Activity

SUNDAY, MAY 2, 2010

Session 7000 7:00am-8:15am 0 ABPM MOC CreditsNew Member Orientation – ABPM MOC Credit is not available for this session.

Session 7102 7:00am-8:15am 0 ABPM MOC CreditsInternational Environmental Health – CANCELED

Session 2000 8:30am-10:00am 1 ABPM MOC CreditsAOHC Opening Session: C.O. Sappington Memorial Lecture1. True2. False (Michael Grunwald is the winner of the award)3. True

Session 2100 10:30am-12Noon 1.5 ABPM MOC CreditsElectrodiagnosis (EMG/NCS) in Low Back Pain and CTS1. True2. True3. True4. False5. True

Session 2101 10:30am-12Noon 1.5 ABPM MOC CreditsChanging Behaviors: Achieving Results with an Effective Integrated Health and Productivity Strategy1. D2. E3. B4. C5. C

Session 2102 10:30am-12Noon 1.5 ABPM MOC CreditsOccupational Health Surveillance with the Healthcare Personnel Safety Component of the NHSN1. A: 36% of cases were attributed to overexertion; 26% to slips, trips, or falls; 5% to violent events; and 2% to

repetitive motion2. B3. C: The additional modules listed in option “D” are still under consideration for development4. C: Vaccine uptake among healthcare personnel was under 50% from 2004-2008; OSHA does not mandate

influenza vaccination for HCP; the NHIS provides population-based estimates (not facility specific)5. A: The proposed additional NHSN HPS modules will supplement, not replace data collection efforts by BLS; “C”

and “D” will not be features of the proposed new modules

Session 2103 10:30am-12Noon 1.5 ABPM MOC CreditsCritical Appraisal of Occupational and Environmental Health Literature1. B2. Consistency of association, Strength of association, Specificity of association, Dose response, Temporal

relationship, Biologic plausibility, Coherence3. False: Cross-sectional studies generate prevalence data4. Dermal and inhalational5. True: Non-caseating granulomas

Session 2104 10:30am-12Noon 1.5 ABPM MOC CreditsWhat Constitutes Excellence: Corporate Health Achievement Award Winner Presentations1. E2. True3. E4. True

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5. True

Meal Session 7103 12Noon-1:15pm 0 ABPM MOC CreditsBecoming 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 CreditsLegal Update: ADA, HIPAA, and GINA1. D2. B3. C

Meal Session 7105 12Noon-1:15pm 1 ABPM MOC CreditsOSHA Record Keeping1. True2. A3. B

Session 2105 1:30pm-5:00pm 3 ABPM MOC CreditsA Practical Approach to Occupational Asthma1. D2. C3. B4. B5. C6. C7. D8. C9. B

Session 2106 1:30pm-5:00pm 3 ABPM MOC CreditsRelating HPM and Value-Based Design to Both the Private Practice and Corporate Medicine Physician1. B2. False: The value-based design considers much more than medical claims. In fact, for any specific condition,

and for prevention and wellness, the medical claims may increase in the first and/or second year, due to better engagement and use of the services.

3. False: Many cities, counties and states are implementing value-based designs, and there are more companies under 100 employees offering these designs. Fully insured products are available in many areas.

4. D5. True6. National Health Care Reform, mandating coverage of workplace preventive services; expansion of OSHA

regulations requiring physician involvement in safety planning; GINA; HPA7. Possible correct answers: general fitness, smoking cessation, migraines, seasonal allergic rhinitis, depression8. True9. True

Session 2107 1:30pm-5:00pm 3 ABPM MOC CreditsExposure Concerns of Veterans Returning from Afghanistan and Iraq1. D2. False: Perception is reality; although a veteran’s perception of risk may be influenced by so-called

misinformation, their perceptions are not misperceptions – just different than those of the expert.3. A4. False: Veterans report concerns about in theater deployment at least as far back as Vietnam.5. C6. B7. A8. D9. C

Session 2108 1:30pm-5:00pm 3 ABPM MOC Credits

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Hands on Orthopedics1. Answers will be provided at the session.2. Answers will be provided at the session.3. Answers will be provided at the session.4. Answers will be provided at the session.5. Answers will be provided at the session.6. Answers will be provided at the session.7. Answers will be provided at the session.8. Answers will be provided at the session.9. Answers will be provided at the session.

Session 2109 1:30pm-5:00pm 3 ABPM MOC CreditsEmerging Infectious Diseases1. C2. A, B, C, D3. A, C, D4. B5. D: All listed medications are used for the treatment of active TB. Others include Pyrazinamide, Streptomycin6. True7. D8. False9. B

MONDAY, MAY 3, 2010

Meal Session 7200 7:00am-8:15am 1 ABPM MOC CreditsMetrics to Manage By1. A2. B3. C, D, E

Meal Session 7201 7:00am-8:15am 0 ABPM MOC CreditsACOEM’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 CreditsPractical Steps to Establish On-site Employee Clinics and Managing Data to Demonstrate a Positive ROI1. C: Program should be linked to business objectives and health plan savings2. C: (S=specific; M=measureable; A=achievable; R=realistic; T=time-dependent)3. D

Meal Session 7207 7:00am-8:15am 1 ABPM MOC CreditsComputer Users: Update on Preventing Vision and Musculoskeletal Symptoms1. True2. True3. True

Session 2200 8:30am-10:00am 1.5 ABPM MOC CreditsLegal Implications Associated with Corporate Medical Department Responses to Pandemics, Including H1N11. OSHA has stated that its inspections will be based largely on CDC Healthcare Personnel Guidelines and

information on OSHA’s website.2. The PREP Act authorizes the Secretary of the Department of Health and Human Services to issue a declaration

that provides immunity from tort liability for certain claims of loss caused, arising out of, relating to, or resulting from a public health emergency.

3. A private individual performing duties in compliance with orders or instructions of a state or local health authority generally is not liable for the death of or injury to a person or for damage to property, except in the case of willful misconduct or gross negligence.

4. Employers with a legitimate business need or objective can require employees to obtain vaccinations against

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various illnesses as a legitimate job qualification, subject to certain exceptions.5. Many states permit practitioners to dispense medications to their patients with some limitations. All states

permit physicians and other practitioners to dispense medications in public health emergencies under certain limitations and conditions. However, not all states deemed the H1N1 pandemic to be a public health emergency sufficient to waive prohibitions on dispensing. Consequently, physicians and other practitioners were permitted to dispense medications to their patients only in those states where permitted.

Session 2201 8:30am-10:00am 1.5 ABPM MOC CreditsEmerging and Contemporary Issues in Military OEM1. False: Irritation is the most common acute effect2. False: Most of the bottles do not contain chlorine3. C and/or D4. False5. False

Session 2202 8:30am-12Noon 3 ABPM MOC CreditsUpdate and Case Studies in Commercial Driver Medical Fitness1. False2. C3. C4. C5. C6. False7. C8. E9. D

Session 2203 8:30am-12Noon 3 ABPM MOC CreditsProtection of Healthcare Workers from Novel H1N1 Influenza: Public Health Guidance and the Debate Over Airborne Viral Transmission1. True2. True3. False4. False5. False6. False7. True8. True9. True

Session 2204 8:30am-12Noon 3 ABPM MOC CreditsCurrent Research in OEM and Resident Research1. False2. B3. B4. C5. A6. D7. D: 37 weeks, since surfactant in the lungs does not come into full production after this time. 8. A, C, and D: These have been noted in many prior studies to be associated with preterm delivery in pregnant

women. High levels of emotional stress have been associated with preterm delivery rather than low levels.9. True

Session 2205 10:30am-12Noon 1.5 ABPM MOC CreditsElectronic Medical Records in Occupational Medicine Practice: A State-of-the-Art Review1. A, B, and D2. B3. C4. B5. A

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Session 2206 10:30am-12Noon 1.5 ABPM MOC CreditsStrategic Use of Occupational Medicine Reviews in Federal Workers’ Compensation Cases1. C2. D3. A4. C5. B

Meal Session 7203 12Noon-1:15pm 1 ABPM MOC CreditsOperationalizing HPM: The Value of Integrated Data Management1. D: All components are important considerations for an effectively integrated strategy. If only one or two of these

are present, the effectiveness of integration can be significantly impaired2. D: While all other responses represent clear opportunities to leverage the shared information, integration of

personal health records (employee and family member-entered data) with absence data represents an unacceptable violation of HIPAA

3. C: The more integrated the data, the more effective collaborative decision-making can be with respect to organizational planning. As such, data integration should increase collaborative communications between health and productivity management personnel

Meal Session 7204 12Noon-1:15pm 1 ABPM MOC CreditsLeave and Reasonable Accommodation Claims in Federal Civil Service Workers1. A2. B3. A

Meal Session 7205 12Noon-1:15pm 1 ABPM MOC CreditsThe Independent Medical Examination1. A2. C3. D

Meal Session 7206 12Noon-1:15pm 1 ABPM MOC CreditsUpdate on Vision Issues in the Workplace1. False: The polarized lenses are used in theatres; an alternating type is commonly used for 3D on TV2. True: This statement is true and one of the primary distinguishing features of e-ink displays3. False: Hand held devices are not necessarily or usually dimmer than other reading materials. They are held

closer to the eyes because the text is smaller.

Work-site Visit 8100 1:00pm-5:00pm 3 ABPM MOC CreditsLights, Camera, Action – Explore Digital Media1. False: HOM is the world most experienced2. B3. True4. C5. A6. E7. True8. A and B9. True

Work-site Visit 8101 1:00pm-5:00pm 3 ABPM MOC CreditsSeaWorld – Where Worlds Connect1. B and D2. True3. False4. True5. False6. False7. False

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8. True9. False

Session 2207 1:30pm-3:00pm 1.5 ABPM MOC CreditsOccupational Health Services: Organization and Competencies1. C: Vertical integration is about production and a single owner controlling the whole up and down process of

creating a product or service. Creating alliance is a technique for horizontal integration. Vertical integration is not about marketing and selling into new segments.

2. A: Horizontal integration supports marketing and selling into new segments often with creating alliances, it is not about controlling, owning or buying components of your production process.

3. C: When competitors are sharing and treating the same population of employees, benchmark data will be more controlled and accurate. Close competition works against revenue and growth and business expansion.

4. True5. True

Session 2208 1:30pm-3:00pm 1.5 ABPM MOC CreditsInside the Mysterious Realm of Utilization Review1. D2. C3. C4. A5. B

Session 2209 1:30pm-3:00pm 1.5 ABPM MOC CreditsIndividual Scientific Abstract Oral Presentations1. False2. B3. C4. D5. C

Session 2210 1:30pm-5:00pm 3 ABPM MOC CreditsMRO Controversies1. False2. A, C, and E3. True4. A and D5. D6. A7. B8. B9. D

Session 2211 1:30pm-5:00pm 3 ABPM MOC CreditsRespirators and FIT Testing: Current and Future Approaches1. D2. B3. C4. C5. C6. A7. B8. A9. B

Session 2212 3:30pm-5:00pm 1.5 ABPM MOC CreditsHeavy Metals…Not Your Typical Metallica!1. F2. G3. C

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4. C5. G

Session 2213 3:30pm-5:00pm 1.5 ABPM MOC CreditsIntegrating Environment, Social and Health Impact Assessments1. True2. False: The integrated ESHIA assists the company by improving relationships with stakeholders and the

community, facilitates compliance with laws and regulations, and improves project planning and execution.3. C: This is the critical first step to determine if the project has potentially significant impacts and ensures the

impact assessment is fit-for-purpose and scaled appropriately.4. B: The health of employees and contractors in the workforce is managed thru fitness for work and medical

surveillance processes. Community health is promoted by identifying and mitigating potentially negative impacts of the project and identifying and enhancing potentially positive impacts from the project.

5. True: the HIA works to integrate the entire ESHIA process by mapping these important linkages.

Session 2214 3:30pm-5:00pm 1.5 ABPM MOC CreditsIndividual Scientific Abstract Oral Presentations1. False2. True3. True4. Yes5. Yes6. False7. B: This study found that a decrease in health risk behaviors by 0.1% would yield a medical cost reduction of

$200,000+. C and D are incorrect because these risk reduction scenarios were not evaluated in this study.

TUESDAY, MAY 4, 2010

Meal Session 7300 7:00am-8:15am 1 ABPM MOC CreditsTravel Health Consultation Services in the Occupational Health Clinic1. C2. B3. C

Meal Session 7301 7:00am-8:15am 1 ABPM MOC CreditsThe Company Doctor Game1.2.3.

Meal Session 7302 7:00am-8:15am 1 ABPM MOC CreditsMedical Issues in Diverse and Underserved Populations: Benchmark Activities in South Florida1. A2. A3. D

Meal Session 7303 7:00am-8:15am 1 ABPM MOC CreditsBeing Smart About Your Financial Security1. B2. A3. False

Work-site Visit 8200 8:00am-12Noon 3 ABPM MOC CreditsThe Nature Conservancy’s Disney Wilderness Preserve1. True2. True3. B4. A

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5. E6. False7. True8. False9. B

Work-site Visit 8201 8:00am-12Noon 3 ABPM MOC CreditsRosen Shingle Creek – Under the Mattress1. True2. True3. True4. B5. B6. True7. A8. True9. A

Session 2300 8:30am-10:00am 1.5 ABPM MOC CreditsQuantifying the Return on Investment for Worksite Clinics1. D: ROI for worksite clinics is difficult to accurately measure, with no consistent approach currently available.

One constant, however, is that lost work time for travel for off-site is routinely included in ROI calculations.2. True: Jean Baptiste Say was a 17th Century French economist. Say’s Law applies to most products and

services available in the US and not just healthcare.3. D: Survey respondents had worksite clinic software to track utilization. However, a minority used HEDIS or

CPT codes in ROI calculations and only a minority offered full services primary care.4. E: All the identified costs should be at least considered as part of a ROI calculation for worksite healthcare

clinics. Although not included here, pharmaceuticals, maintenance of professional licensure, facility licensure fees should also be included.

5. C: The bottom line is the impact of worksite clinic use on overall healthcare costs. While the other metrics included in this question are important considerations, the most important measure from a business standpoint for employers is healthcare cost reduction.

Session 2301 8:30am-10:00am 1.5 ABPM MOC CreditsACOEM Code of Ethics1. B2. E3. False4. False5. D

Session 2302 8:30am-10:00am 1.5 ABPM MOC CreditsThe ACOEM Hand, Wrist, and Forearm Disorder Practice Guidelines1. B2. B3. C4. C5. C

Session 2303 8:30am-10:00am 1.5 ABPM MOC CreditsIndividual Scientific Abstract Oral Presentations1. B: The biopsychosocial model study the effect of stressful work conditions on aggravation of work related

diseases and the development of psychological impairments. The biosychosocial model doesn’t focus on social life events outside work and also biopsychosocial model is not only a psychosocmatic model. Biopsychosocial model is the interplay between psychological condition of one worker, his medical illness and his work life.

2. A: Ergonomic stressors act as stressful work conditions which might aggravate MSDs and might lead to development of psychological impairment and thus the biopsychosocial model will take place.

3. B 4. C5. D

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Session 2304 8:30am-12Noon 3 ABPM MOC CreditsEverything You Always Wanted to Know About Seaman Medical Examinations but Were Afraid to Ask1. B: CG-719K records medical history and physical examination including vision and hearing2. False: If the mariner has normal hearing then no audiogram is required3. False: The medication section requires the “none” box to be checked if the mariner is not on any current

medications, either prescription or over the counter4. False5. B6. C7. B8. C9. D

Session 2305 10:30am-12Noon 1.5 ABPM MOC CreditsThe Patient-centered Medical Home, Worksite Clinics, and the OEM Clinician1. C: While implementation costs will increase expenditures for employees in the near term, this is certainly not a

point of appeal for employers2. B: The medical home model as outlined does not include patient incentives for use, which may be an employer

decision to provide through benefits design (such as IBM has done)3. C: All other findings have been demonstrated in medical home pilots. Healthcare costs, particularly for

hospitalizations and emergency department use, have declined4. C: Independent medical treatment by worksite clinics can contribute to further fragmentation of care, and

interfere with the care coordination provided by the patient centered medical home5. E: Closer patient-provider relationships appear to be beneficial from a number of perspectives, including all

listed

Session 2306 10:30am-12Noon 1.5 ABPM MOC CreditsHazards in Drinking Water from Private and Municipal Wells1. False: Municipal water sources have strict standards for allowable levels of contaminants and additives.

Alternatively, bottled water does not have to adhere to the same standards.2. C: Drinking water standards have been delineated for 20 contaminants including arsenic, nitrate, bacteria,

radioactivity, heavy metals such as lead and mercury, and several pesticides3. False: There is no requirement that private wells meet safe drinking water standards. Private well owners are

encouraged to use federal drinking water standards as a guide for assessing their water quality.4. B: Ingestion of too much nitrate, particularly in baby formula prepared with well water, can result in “baby blue”

syndrome which is an abnormality of oxygen distribution through the blood. Excess nitrates in well water are frequently the result contamination with human and/or animal waste that may result from septic system failure, problems at the well head and drainage from animal herds into the water source.

5. Bacteria are the number one cause of rural well contamination. This typically results from inappropriate placement and/or failure of a home septic system. The remaining products are all very real sources of contamination, however, they do not approach the widespread contamination due to bacteria.

Session 2307 10:30am-12Noon 1.5 ABPM MOC CreditsLate Breaker: Health Care Reform1. True2. True3. False4. True5. True

Session 2308 10:30am-12Noon 1.5 ABPM MOC CreditsThe Collaborative MSD Program1. C2. C3. C4. B5. D

Session 2500 12Noon-2:00pm 0 ABPM MOC Credits

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ACOEM Annual Membership Meeting and Luncheon - ABPM MOC Credit is not available for this session.

Session 2309 2:15pm-5:45pm 3 ABPM MOC CreditsA Primer on Osteopathy and Osteopathic Manual Manipulation1. C2. E3. A4. C5. C6. D7. C8. D9. A

Session 2310 2:15pm-5:45pm 3 ABPM MOC CreditsQuestions of Causation/Questions of Practice: Investigations by OSHA and NIOSH1. B2. False3. True4. D5. C6. B7. True8. B9. False

Session 2311 2:15pm-5:45pm 3 ABPM MOC CreditsBioaerosols, Disease, and Toxicity: What Does Science Tell Us1. B2. True3. A, B, and C4. E5. A and B6. A, B, C, and D7. False8. False9. True3

Session 2312 2:15pm-5:45pm 3 ABPM MOC CreditsState-of-the Art Update in Public Safety Medicine1. C2. A3. B4. D5. A6. B7. B8. D9. A

Session 2313 2:15pm-5:45pm 3 ABPM MOC CreditsLegislative Advocacy for Physicians: An Interactive Workshop1. A2. False3. C4. C5. False6. B7. D

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8. True9. A

WEDNESDAY, MAY 5, 2010

Meal Session 7400 7:00am-8:15am 1 ABPM MOC CreditsH1N1 – Impact on Businesses1. D2. False3. E

Meal Session 7401 7:00am-8:15am 1 ABPM MOC CreditsNavigating the Workers’ Compensation Payment Maze1. False2. True3. True

Meal Session 7402 7:00am-8:15am 1 ABM MOC CreditsMonitoring On-site Clinic Performance Utilizing a Cost-benefit Tool1. A2. B3. E

Session 2400 8:30am-10:00am 1.5 ABPM MOC CreditsPsychosocial Factors in the Management of Chronic Pain in Workers’ Compensation1. C2. B3. D4. True5. C

Session 2401 8:30am-12Noon 3 ABPM MOC CreditsFatigue Risk Management1. False2. True3. C4. False5. B6. False7. D8. D9. A

Session 2402 8:30am-12Noon 3 ABPM MOC CreditsReal-World Spirometry in the Workplace1. True2. True3. False4. True5. True6. False7. False8. True9. True

Session 2403 10:30am-12Noon 1.5 ABPM MOC CreditsHands on Clinical: Foot and Ankle1. True

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2. True3. True4. False5. False