Term
| What type of study generates an odds ratio? |
|
Definition
|
|
Term
| T/F A case control study is considered observational and prospective. |
|
Definition
| false; it is observational and retrospective |
|
|
Term
| What type of study generates a relative risk? |
|
Definition
|
|
Term
| What type of study collects data from a group of people to assess frequency of disease (and related risk factors) at a particular time? |
|
Definition
|
|
Term
| A cross sectional study generates what type of statistic? |
|
Definition
|
|
Term
| What type of study can measure heritability? |
|
Definition
| twin concordance study or adoption study |
|
|
Term
| What is an adoption study? |
|
Definition
| compares siblings raised by biologic versus adoptive parents |
|
|
Term
| What phase of clinical trial assess treatment efficacy, optimal dosing and adverse effects? |
|
Definition
|
|
Term
| What phase of clinical trial compares the new treatment to the current standard of care? |
|
Definition
|
|
Term
| What is phase III clinical trial? |
|
Definition
| large number of patients randomly assigned either the treatment under investigation or to the best available treatment (or placebo) |
|
|
Term
| How is sensitivity calculated? |
|
Definition
=TP/(TP+FN)
=1 - false negative rate |
|
|
Term
| High sensitivity is used for screening in diseases with (low/high) prevalence. |
|
Definition
|
|
Term
| How do you calculate specificity? |
|
Definition
= TN/(TN-FP)
= 1 - false positive rate |
|
|
Term
| What is the specificity if everyone with a positive test result has the disease tested for? |
|
Definition
|
|
Term
| What is the diference between the test used to screen for HIV and the test used to diagnose HIV? |
|
Definition
| screening test is ELISA which is sensitive, with high false positive rate and low threshold; confirmatory test is western blot which is specific, high false-negative rate, and high threshold |
|
|
Term
| How do you calculate positive predictive value? |
|
Definition
|
|
Term
| How is negative predictive value calculated? |
|
Definition
|
|
Term
| Which of the following values vary based on the prevalence of a disease in a certain population: sensitivity, specificity, PPV, NPV. |
|
Definition
|
|
Term
| How do you calculate point prevalence? |
|
Definition
| total cases in a population at a given time/total population at a given time |
|
|
Term
| How do you calculate incidence? |
|
Definition
| (new cases in a population over a given time period)/(total population at risk during that time period) |
|
|
Term
| T/F When calculating incidence of breast cancer, women who have breast cancer are counted as part of the "at risk" denominator and not a part of the "new case" numerator. |
|
Definition
| false; when calculating incidence, don't forget that people currently with the disease or those previously positive for it are not considered at risk. |
|
|
Term
| What is the relationship between the prevalence and the incidence for chronic disease? |
|
Definition
|
|
Term
| T/F For acute disease teh incidence > prevalence. |
|
Definition
| false; it is impossible to have a higher incidence than prevalence. For acute disease incidence= prevalence |
|
|
Term
|
Definition
| odds of having disease in exposed group divided by odds of having disease in unexposed group (calculated from data from case-control studies) |
|
|
Term
| When does the odds ratio approximate the relative risk? |
|
Definition
| if prevalence of disease is not too high |
|
|
Term
|
Definition
| probability of getting a disease in teh exposed group divided by the probability of getting a disease in the unexposed group (from cohort studies) |
|
|
Term
| What is attributable risk? |
|
Definition
| difference in risk between exposed and unexposed; or the proportion of disease occurrences that are attributable to the exposure |
|
|
Term
| How do you calculate the number needed to treat? |
|
Definition
| 1/absolute risk reduction |
|
|
Term
| How do you calculate the number needed to harm? |
|
Definition
|
|
Term
| How do you calculate absolute risk reduction? |
|
Definition
| risk without treatment subtracted from risk with treatment |
|
|
Term
| What kind of error reduces precision in a test? |
|
Definition
|
|
Term
| What type of error reduces accuracy of a test? |
|
Definition
|
|
Term
| What is another term synonymous with validity? |
|
Definition
| accuracy (trueness of test measurement) |
|
|
Term
| What is precision a measurement of? |
|
Definition
| the consistency and reproducibility of a test (reliability) |
|
|
Term
| What do you call nonrandom assignment to a study group? |
|
Definition
|
|
Term
|
Definition
| another name for selection bias |
|
|
Term
| What are ways to reduce bias in a study? |
|
Definition
| blind studies; placebo responses; crossover studies (each subject acts as own control to limit confounding bias), randomization to limit selection bias and confounding bias |
|
|
Term
|
Definition
| knowledge of presence of disorder alters recall by subjects |
|
|
Term
|
Definition
| subjects are not representative relative to general population; therefore, results are not generalizable |
|
|
Term
|
Definition
| information gathered at an inappropriate time; e.g. using a survey to study a fatal disease (only those patients still alive will be able to answer survey) |
|
|
Term
|
Definition
| subjects in different groups are not treated the same |
|
|
Term
| What kind of bias occurs when more attention is paid to a treatment group stimulating greater compliance? |
|
Definition
|
|
Term
| What is confounding bias? |
|
Definition
| occurs with 2 closely associated factors; the effect of 1 factor distorts or confuses the effect of the other |
|
|
Term
|
Definition
| early detection confused with increase survival; seen with improved screening (natural history of disease is not changed; but early detection makes it seem as though survival increases) |
|
|
Term
| What is the pygmalion effect? |
|
Definition
| occurs when a researcher's belief in the efficacy of a treatment changes teh outcome of that treatment |
|
|
Term
| What is the Hawthorne effect? |
|
Definition
| occurs when the group being studied changes its behavior owing to the knowledge of being studied |
|
|
Term
| What is the symbol for standard deviation? |
|
Definition
|
|
Term
| How do you measure SEM (standard error of the mean)? |
|
Definition
| standard deviation divided by the square root of your sample size |
|
|
Term
| What is the letter used for sample size? |
|
Definition
|
|
Term
| The average +/- 1 SD means that ___% of your population falls within that range. |
|
Definition
|
|
Term
| The average +/- 2 SD means that ___% of your population falls within that range. |
|
Definition
|
|
Term
| The average +/- 3 SD means that ___% of your population falls within that range. |
|
Definition
|
|
Term
| What happens to mean, median and mode if there is a positive skew? |
|
Definition
|
|
Term
| What happens to mean, median, and mode if there is a negative skew? |
|
Definition
|
|
Term
|
Definition
| null hypothesis (hypothesis of no difference) |
|
|
Term
|
Definition
| alternative hypothesis (hypothesis that there is some difference) |
|
|
Term
|
Definition
| probability of making a type 1 or "alpha" error |
|
|
Term
|
Definition
| stating that ther is not an effect or difference when one exists |
|
|
Term
| What is the probability of making a type II error called? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the probability of rejecting a null hypothesis when it is in fact false? |
|
Definition
|
|
Term
| What does power depend on? |
|
Definition
| total number of end points experienced by population; differences in compliance between treatment groups (differences in the mean values between groups), size of expected effect |
|
|
Term
| What is a confidence interval? |
|
Definition
| range of values in which a specified probability of the means of repeated samples would be expected to fall |
|
|
Term
| CI is the range from ___ to ____. |
|
Definition
| mean-Z(SEM) to mean+Z(SEM) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| If the 95% confidence interval for a mean difference between two variables includes 0, then... |
|
Definition
| there is no significant difference and the null hypothesis is not rejected |
|
|
Term
| If the 95% CI for odds ratio or relative risk includes 1, then... |
|
Definition
| the null hypothesis is not rejected |
|
|
Term
| What does a chi-square test do? |
|
Definition
| checks difference between 2 or more percentages or proportions of categorical outcomes (not mean values) |
|
|
Term
| What is the correlation coefficient? |
|
Definition
| "r" which is always between -1 and +1 |
|
|
Term
| What does it mean as the absolute value of "r" gets closer and closer to 1? |
|
Definition
| the stronger the correlation between the two variables |
|
|
Term
| What is the coefficient of determination? |
|
Definition
| r squared (the correlation coefficient squared) |
|
|
Term
| What is primary prevention? |
|
Definition
| preventing disease occurence |
|
|
Term
| What is secondary prevention? |
|
Definition
| early detection of disease |
|
|
Term
| What is tertiary prevention? |
|
Definition
| reduce disability from disease |
|
|
Term
| Who is eligible for medicare? |
|
Definition
| patients over 65, patients less than 65 with certain disabilities and those with ESRD |
|
|
Term
| What does informed consent legally require? |
|
Definition
| discussion of pertinent information, patient's voluntary agreement to the plan of care; freedom from coercion |
|
|
Term
| What are the exceptions to informed consent? |
|
Definition
| patient lacks decision making capacity or is legally incompetent, implied consent in an emergency, therapeutic privilege (withholding information when disclosure would severely harm the patient or undermine informed decision-making capacity), waiver (patient waives the right of informed consent) |
|
|
Term
| Under which circumstances is a minor considered "emancipated" and parental consent is no longer needed for treatment? |
|
Definition
| married, self-supporting, has children, or is in the military |
|
|
Term
| When is parental consent not required for their children? |
|
Definition
| emergences, when prescribing contraceptives, or in treatment involving STDs, medical care during pregnancy, or the management of drug addiction |
|
|
Term
| What are the components of decision making capacity? |
|
Definition
| patient makes and communicates a choice, patien is informed, decision remains stable over time, decision is consistent with patient's values and goals, decision is not a result of delusions or hallucinations |
|
|
Term
|
Definition
| written advance directive that describes treatments the pt wishes to recieve if she/he becomes incapacitated and cannot communicate about treatment decisions |
|
|
Term
| What is durable power of attorney? |
|
Definition
| patient designates a surrogate to make medical decisions in the event that he/she loses decision making capacity |
|
|
Term
| What is the priority of surrogates? |
|
Definition
| spouse, adult children, parents, siblings, other relatives |
|
|
Term
| What is the tarasoff decision? |
|
Definition
| law requiring physicians to directly inform and protect potential victim from harm; may involve breach of confidentiality |
|
|
Term
| Can you break confidentiality of a patient who was in an MVA and is legally drunk in order to report them to the police? |
|
Definition
|
|
Term
| When are Apgar scores taken and what are the components of the apgar score? |
|
Definition
| 1 and 5 minutes after birth; appearance, pulse, grimace, activity, respiration |
|
|
Term
| What is a normal, healthy apgar score? |
|
Definition
|
|
Term
| At what Apgar score should you assist and stimulate a neonate? |
|
Definition
|
|
Term
| At what Apgar score do you need to resuscitate the child? |
|
Definition
|
|
Term
| What is the definition of a low birth weight? |
|
Definition
|
|
Term
| What are the complications associated with low birth weight? |
|
Definition
| infection, RDS, necrotizing enterocolitis, intraventricular hemorrhage, persistent fetal circulation |
|
|
Term
| What re the developmental milestones reached by 3 months? |
|
Definition
| rooting reflex, holds head up, moro reflex disappears, social smile, oreients and responds to voice |
|
|
Term
| What milestones are reached by 7-9 months of age? |
|
Definition
| sits alone, crawls, transfers toy from hand to hand, stranger anxiety, responds to name and simple instructions, uses gestures |
|
|
Term
| What are the milestones reached by 12 to 15 months of age? |
|
Definition
| walks, babinski reflex disappears, separation anxiety, few words |
|
|
Term
| What are the milestones reached at 12 to 24 months? |
|
Definition
| climbs stairs; stacks 3 blocks at 1 year, 6 blocks at 2 years; rapprochement (moves away from and then returns to mother), object permanence, 200 workds and 2 word sentances at age 2 |
|
|
Term
| What are the milestones reached by 24 to 36 months? |
|
Definition
| feeds self with fork and spoon, kick ball, core gender identity, parallel play, toliet training at 3 |
|
|
Term
| What are th emilestones at three years? |
|
Definition
| rides tricycle, copies lines or circle drawings, comfortably spends part of day away from momother, 900 words and complete sentances, toliet training |
|
|
Term
| What are the milestones of age 4? |
|
Definition
| uses buttons and zippers, grooms self (brushes teeth), hops on 1 foot, makes simple drawings (stick figures), cooperative play, imaginary friends, can tell detailed stories and use prepositions |
|
|
Term
| Narcoleptic sleep episodes begin with what stage of sleep? |
|
Definition
|
|
Term
| What are the stages of normal sleep? |
|
Definition
| 1. light sleep, 2. deeper sleep; bruxism, 3. deepest, non-REM sleep (slow wave sleep); REM |
|
|
Term
| What is the EEG waveform in patients who are awake? |
|
Definition
|
|
Term
| What EEG waveform is present while you're awake with your eyes open? |
|
Definition
|
|
Term
| What are the characteristics of beta waveforms on EEG? |
|
Definition
| highest frequency, lowest amplitude |
|
|
Term
| What EKG waveform is present while you're awake with your eyes closed? |
|
Definition
|
|
Term
| What percent of sleep is spent in light sleep? |
|
Definition
|
|
Term
| What is the EEG wave form of light sleep? |
|
Definition
|
|
Term
| What percent sleep is spent in stage 2 sleep (bruxism)? |
|
Definition
|
|
Term
| What are the EEG waveforms found in stage 2 sleep: bruxism? |
|
Definition
| sleep spindles and K complex |
|
|
Term
| What percent of sleep is spent in stage 3 sleep (the deepest, non REM sleep)? |
|
Definition
|
|
Term
| In what stage of sleep does sleepwalking occur? |
|
Definition
|
|
Term
| In what stage of sleep do night terrors occur? |
|
Definition
|
|
Term
| In what stage of sleep does bedwetting occur? |
|
Definition
|
|
Term
| In what stage of sleep does dreaming occur? |
|
Definition
|
|
Term
| In what stage of sleep do erections occur? |
|
Definition
|
|
Term
| In what stage of sleep is there an increase in brain oxygen use? |
|
Definition
|
|
Term
| What EEG waveform is present during REM sleep |
|
Definition
|
|
Term
| Describe delta waveforms on EEG? |
|
Definition
| lowest frequency, highest amplitude |
|
|
Term
| What percent of sleep is spent in REM? |
|
Definition
|
|
Term
| What must happen in the brain to initiate sleep? |
|
Definition
| serotonergic predominance of raphe nucleus |
|
|
Term
| Why is imipramine used to treat enuresis? |
|
Definition
| it decreases stage 3 sleep |
|
|
Term
| In what stage of sleep does bruxism occur? |
|
Definition
|
|
Term
| Name some drugs that are associated with reduced REM and delta sleep? |
|
Definition
| alcohol, benzodiazepines are barbiturates |
|
|
Term
| What drug is useful for night terrors and sleepwalking? |
|
Definition
|
|
Term
| What is the principle neurotransmitter in REM sleep? |
|
Definition
|
|
Term
| What neurotransmitter reduces REM sleep? |
|
Definition
|
|
Term
| What happens to the pulse and blood pressure during REM sleep? |
|
Definition
|
|
Term
| Extraocular movements during REM sleep are due to the activity of what structure in the brain? |
|
Definition
| the PPRF (paramedian pontine reticular formation/conjugate gaze center) |
|
|
Term
| How often during sleep does REM occur? |
|
Definition
| once every 90 minutes; duration increases throughout the night |
|
|
Term
| What happens to your sleep patterns as you age? |
|
Definition
| you have decreased time spent in REM |
|
|
Term
| What are the changes in sleep patterns that occur in depressed patients? |
|
Definition
| decreased slow-wave sleep, decreased REM latency, increased REM early in sleep cycle, increased total REM sleep, repeated nighttime awakenings, early-morning awakening |
|
|
Term
| What is the primary characeteristic of narcolepsy? |
|
Definition
| excessive daytime sleepiness |
|
|
Term
| What are the hallucinations just before sleep that are assiciated with narcolepsy called? |
|
Definition
|
|
Term
| What do you call the hallucinations just before awakening associated with narcolepsy? |
|
Definition
|
|
Term
| In patient's with narcolepsy, what is their first stage of sleep? |
|
Definition
| they go directly into REM |
|
|
Term
|
Definition
| loss of all muscle tone following a strong emotional stimulus (seen in narcolepsy) |
|
|
Term
| T/F There is a strong genetic component of narcolepsy. |
|
Definition
|
|
Term
| What drugs are used to treat narcolepsy? |
|
Definition
| stimulants (amphetamines, modafinil) and sodium oxybate (GHB) |
|
|
Term
| What part of the brain controls the circadian rhythm? |
|
Definition
| suprachiasmatic nucleus (SCN) of the hypothalamus; controls ACTH, prolactin, melatonin and nocturnal NE release |
|
|
Term
| What causes the pineal gland to release melatonin at night? |
|
Definition
| NE release from the SCN of the hypothalamus |
|
|
Term
| What regulates the circadian cycle set by the SCN of the hypothalamus? |
|
Definition
| things in the environment like light |
|
|
Term
| What is sleep terror disorder? |
|
Definition
| periods of terror with screaming in the middle of the night; most common in children during slow-wave sleep; no memory of arousal; cause unknown but triggers may include emotional stress during the previous day, fever, or lack of sleep |
|
|
Term
| What should you do if a drug company offers a "referral fee" for every patient a physician enrolls in a study? |
|
Definition
| eligible patients who may benefit fromt he study may be enrolled but it is never acceptable for a physician to recieve compensation from a drug company. Patients must be told about the existence of a referral fee |
|
|
Term
| T/F No matter how serious or trivial a medical error, a physician is ethically obligated to inform a patient tha ta mistake has been made. |
|
Definition
|
|
Term
| What are the changes in sexual function with aging? |
|
Definition
men- slower erection/ejaculation; longer refractory period
women- vaginal shortening, thinning and dryness |
|
|
Term
| What are the sleep pattern changes as you age? |
|
Definition
| decreased REM, slower wave sleep; increased latency and awakenings |
|
|
Term
| What group has the highest suicide rates in the US? |
|
Definition
|
|
Term
| What organ systems lose function as you age? |
|
Definition
|
|
Term
| T/F Decreases in vision, hearing, immune response, and bladder control are a normal part of aging. |
|
Definition
|
|
Term
| T/F Decrease in intelligence is a normal part of aging. |
|
Definition
|
|
Term
| T/F Decrease in sexual interest is a normal part of aging. |
|
Definition
|
|
Term
| What is pathologic grief? |
|
Definition
| excessively intense greif, prolonged frief lasting > 2 months, or grief that is delayed, inhibited or denied; may experience depressive symptoms, delusions and hallucinations |
|
|
Term
|
Definition
| characterized by shock, denial, guilt, and somatic symptoms, can last up to 2 months, may experience illusions |
|
|
Term
| What are the effects of stress on the GI tract? |
|
Definition
| affects water absorption, gastrocolic reflex, and mucosal circulation |
|
|
Term
| What substances are increased in circulation with stress? |
|
Definition
| 17-OH corticosteroids, lipids, cholesterol, catecholamines |
|
|
Term
| T/F Muscular tone is affected by stress. |
|
Definition
|
|
Term
| Name some sexual pain disorders. |
|
Definition
| dyspareunia and vaginismus |
|
|
Term
| Name some different types of drugs that can cause sexual dysfuncton? |
|
Definition
| SSRIs, antihypertensives, antipsychotics, ethanol, |
|
|
Term
| What BMI is considered underweight? |
|
Definition
|
|
Term
| What BMI is considered morbidly obese? |
|
Definition
|
|
