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Behavioral USMLE Step 1 First Aid
Behavorial flashcards
391
Medical
Undergraduate 4
11/27/2011

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Cards

Term
Are hallucinations common in
narcolepsy patients?
Definition
Yes. Both hypnagogic (just
before sleep) and
hypnopompic (with
awakening) are both
common.
Term
Define cataplexy.
Definition
Sudden collapse (falls asleep)
while awake.
Term
Define sleep apnea
Definition
Person stops breathing for at
least 10 seconds during
sleep.
Term
Distinguish between central
and obstructive sleep apnea.
Definition
"In central sleep apnea, there
is no respiratory effort. In
Obstructive sleep apnea,
there is respiratory effort
against airway obstruction."
Term
Does narcolepsy have a
genetic component?
Definition
Yes. Studies have shown a
strong genetic component of
narcolepsy.
Term
Does REM sleep increase or
decrease with age?
Definition
Decreases
Term
Extraocular movements
during REM sleep are due to
what portion of the brain?
Definition
Parapontine Reticular
Formation/Conjugate Gaze
Center
Term
How often does REM sleep
occur?
Definition
Every 90 minutes (duration
may increase during the
night)
Term
Name 1 neurotransmitter
change associated with
Alzheimer's disease
Definition
Decreased Ach
Term
Name 1 neurotransmitter
change associated with
Parkinson's disease
Definition
Decreased Dopamine
Term
Name 1 neurotransmitter
change associated with
Schizophrenia
Definition
Increased Dopamine
Term
Name 2 effects of stress on
the body.
Definition
"1. Induces production of
FFA, 17-OH corticosteroids,
lipids, cholesterol, and
catecholamines 2. Affects
water reabsorption, muscular
tonicity, gastrocolic reflex,
and mucosal circulation
Term
Name 2 neurotransmitter
changes associated with
depression.
Definition
Decreased NE and serotonin
(5-HT)
Term
Name 2 neurotransmitter
changes associated with
Huntington's disease.
Definition
Decreased GABA and Ach
Term
Name 3 changes in sleep
stages often found in people
with depression.
Definition
1. Reduced slow-wave sleep
2. Decreased REM latency 3.
Early morning awakening
(important screening
question)
Term
Name 3 possible findings in
non-REM sleep.
Definition
Sleepwalking, night terrors,
and bedwetting"
Term
Name 4 physiological actions
found in REM sleep.
Definition
"Increased/variable pulse,
rapid eye movements,
increased/variable blood
pressure, and penile/clitoral
tumescence"
Term
Name 5 possible findings in
REM sleep.
Definition
"Dreaming, loss of motor
tone, possible memory
processing function, erection,
and increased brain 02 use"
Term
Name 5 possible waveform
patterns seen in the various
sleep/wake stages.
Definition
"Alpha, Beta (highest
frequency, lowest amplitude),
Theta, Delta (lowest
frequency, highest
amplitude), Sleep spindles
with K-complexes"
Term
Name 7 functions of the
frontal lobe.
Definition
"Concentration, Orientation,
Language, Abstraction,
Judgment, Motor regulation,
Mood"
Term
Name a possible chronic
outcome of sleep apnea
Definition
Chronic fatigue
Term
Name five findings associated
with sleep apnea.
Definition
"Obesity, loud snoring,
systemic/pulmonary HTN,
arrhythmias, and possibly
sudden death."
Term
What 3 things does the
differential diagnosis for
sexual dysfunction include?
Definition
"1. Drugs (e.g. antiHTN,
neuroleptics, SSRIs, and
ethanol) 2. Diseases (e.g.
depression and diabetes) 3.
Psychological (e.g.
performance anxiety)
Term
What is a common treatment
for narcolepsy?
Definition
Stimulants (e.g.
amphetamines)
Term
What is a helpful mnemonic
for the order of the
corresponding waveform
patterns in each stage of
sleep?
Definition
At night, BATS Drink Blood."
Term
What is considered the key to
initiating sleep?
Definition
Serotonergic predominance of
the raphe nucleus
Term
What is narcolepsy?
Definition
Person falls asleep suddenly
Term
What is the most notable
change in function in a
frontal lobe lesion?
Definition
Lack of social judgment
Term
What is the principal
neurotransmitter involved in
REM sleep?
Definition
Ach
Term
What medication shortens
stage 4 sleep and can be
used to treat enuresis?
Definition
Imipramine
Term
What medication shortens
stage 4 sleep and is useful in
the treatment of night terrors
and sleepwalking?
Definition
Benzodiazepines
Term
What neurotransmitter can
reduce REM sleep?
Definition
NE
Term
What percentage of time is
spent in REM sleep?
Definition
0.25
Term
What percentage of time is
spent in stage 1 sleep?
Definition
0.05
Term
What percentage of time is
spent in stage 2 sleep?
Definition
0.45
Term
What percentage of time is
spent in stage 3-4 sleep?
Definition
0.25
Term
What phenomenon caused
REM sleep to be known as
'paradoxical' or
'desynchronized' sleep?
Definition
The EEG pattern during REM
sleep is the same as the EEG
of a person that is awake and
alert.
Term
"What waveform pattern is
seen in a young adult who is
awake (eyes open), alert, and
has active mental
concentration?"
Definition
Beta waves
Term
What waveform pattern is
seen in a young adult who is
awake but has his/her eyes
closed?
Definition
Alpha waves
Term
What waveform pattern is
seen in a young adult who is
in deeper (stage 2) sleep?
Definition
Sleep spindles and Kcomplexes
Term
What waveform pattern is
seen in a young adult who is
in light (stage 1) sleep?
Definition
Theta waves
Term
What waveform pattern is
seen in a young adult who is
in REM sleep?
Definition
Beta waves
Term
"What waveform pattern is
seen in a young adult who is
in the deepest, Non-REM
(stage 3-4) sleep? "
Definition
Delta waves
Term
A person who is unable to
remember things that
occurred after a CNS insult?
Definition
Anterograde Amnesia
Term
Anterograde amnesia caused
by thiamine deficiency?
Definition
Korsakoff's amnesia
Term
Are DT's life threatening?
Definition
Yes
Term
Are the illness production and
motivation in somatoform
disorders consicous drives?
Definition
No
Term
Bipolar I describes?
Definition
manic
Term
Bipolar II describes?
Definition
hypomanic
Term
Define a Manic episode.
Definition
Distinct period of abnormally
and persistently elevated,
expansive, or irritable mood
lasting at least 1 week"
Term
Define a panic disorder.
Definition
Discrete period of intense
fear and discomfort peaking
in 10 minutes with 4/5
characteristics
Term
Define Anosognosia.
Definition
being unaware that one is ill
Term
Define a panic disorder
Definition
Discrete period of intense
fear and discomfort peaking
in 10 minutes with 4/5
characteristics
Term
Define Anosognosia.
Definition
being unaware that one is ill
Term
Define Autotopagnosia.
Definition
Being unable to locate one's
own body parts
Term
Define Conversion disorder.
Definition
symptoms suggest motor or
sensory neurologic or
physical disorder, but tests
and PE are negative"
Term
Define depersonalization.
Definition
body seems unreal or
dissociated
Term
Define Personality disorder
Definition
"when patterns become
inflexible and maladaptive,
causing impairment in social
or occupational functioning
or subjective distress"
Term
Define Personality trait.
Definition
"an enduring pattern of
perceiving, relating to, and
thinking about the
environment and oneself that
is exhibited in a wide range
of important social and
personal contexts"
Term
Delusions are…
Definition
false beliefs not shared by
other memebers of culture/
subculture that are firmly
maintained in spite of
obvious proof to the contrary
Term
Describe a Paranoid
Personality
Definition
distrustful and suspicious;
projection is main defense
mech
Term
Describe a Schizoid
Personality.
Definition
voluntary social withdrawl; no
psychosis; limited emotional
expression
Term
Describe a Schizotypal
Personality.
Definition
"interpersonal awkwardness,
odd thought patterns and
appearance"
Term
Does the person who has the
phobia recognize their fear as
excessive?
Definition
yes, they are exhibiting
insight"
Term
Does the phobic fear interfere
with normal routine?
Definition
yes
Term
Hallucinations are….
Definition
perceptions in the absence of
external stimuli
Term
How are Cluster A
personalities described?
Definition
as odd or ecentric; cannot
develop meaningful social
relationships; Weird
Term
How are Cluster B
personalities described?
Definition
Dramatic, emotional, or
erratic; Wild"
Term
How are Cluster C
personalities described?
Definition
Anxious and fearful,
'Worried'"
Term
How is a major depressive
disorder characterized?
Definition
Recurrent-requires 2 or more
depressive episodes with a
symptom free interval of 2
months
Term
How is a major depressive
episode characterized?
Definition
5 of the following for 2 weeks,
including (1) depressed mood or
(2) anhedonia: Sleep
disturbances, Loss of Interest,
Guilt, Loss of Energy, Loss of
Concentration, Change in
Appetite, Psychomotor
retardation, Suicidal ideation,
Depressed mood"
Term
How is maladaptive pattern of
substance abuse defined?
Definition
3 or more of the above signs
in 1 year
Term
How is Schizophrenia
described?
Definition
periods of psychosis and
disturbed behavior lasting
>6months,
Term
How long does the
disturbance due to PSSD last?
Definition
> 1 month and causes
distress or social/
occupational impairment
Term
How many criteria sets exist
for bipolar disorder?
Definition
6 separate criteria exist for
bipolar disorders with
combinations of manic,
hypomanic, and depressed
episodes"
Term
How many hallucination types
are there? Name them.
Definition
"7; Visual, Auditory,
Olfactory, Gustatory, Tactile,
Hypnagogic, Hypnopompic
Term
How many heroin addicts are
there in the US?
Definition
"~500,000"
Term
How would you decribe a
dependent personality?
Definition
"submissive and clinging,
excessive need to be taken
care of, low self-confidence"
Term
How would you decribe an
obsessive-compulsive?
Definition
preoccupation with order,
perfectionism and control"
Term
How would you describe a
Borderline personality?
Definition
unstable mood and behavior;
impulsive, sense of
emptiness"
Term
How would you describe a
histrionic personality?
Definition
"excessive emotionally,
somatization, attention
seeking, sexually provocative"
Term
How would you describe an
Antisocial?
Definition
as having a disregard for and
violation of rights of others,
criminality"
Term
How would you describe an
avoidant personality?
Definition
"sensitive to rejection,
socially inhibited, timid,
feelings of inadequacy"
Term
How would you desribe a
Narcissistic personality?
Definition
"grandiosity; sense of
entitlement, many demand
'top' physician/best health
care"
Term
"If a patient consciously fakes
or claims to have a disorder
in order to attain a specific
gain, how is this behavior
described?"
Definition
Malingering
Term
Illusions are….
Definition
"misinterpretation of actual
external stimuli, ex.
Mistaking coat rack for man"
Term
In what kind of disorder does
a person consciously create
symptoms in order to assume
a sick role and get medical
attention?
Definition
Factitious Disorder
Term
Is Heroin prescribable?
Definition
NO, it is schedule I (ie. not
prescribable)"
Term
Is the motivation concious in
Munchausen's by proxy?
Definition
NO
Term
Name the 5 subtypes of
schizophrenia.
Definition
Disorganized, Catatonic,
paranoid, Undifferentiated,
Residual"
Term
Name the types of Cluster B
personalities.
Definition
"Antisocial, Borederline,
Histrionic, Narcissistic"
Term
To be a manic episode what
characteristic behaviors must
be present?
Definition
"3 or more of the following:
Distractibility, Insomnia,
Grandiosity, Flight of Ideas,
Inc in Activity/pyschomotor
agitation, Pressured Speech,
Thoughtlessness"
Term
Whar are the signs of
barbituate withdrawl?
Definition
Anxiety, seizures, delirium,
life-threatening CV collapse"
Term
Whar are the signs of nicotine
withdrawl?
Definition
Irritablility, headache,
anxiety, weight gain, craving,
tachycardia"
Term
Whare are the 4 A's of
schizophrenia?
Definition
"Ambivalence(uncertainty),
Autism(self-preoccupation
and lack of communication),
Affect(blunted), Associations
(loose)"
Term
Whare are the characteristics
of Dementia?
Definition
development of mulitple
cognitive deficits: memory,
apahasia, apraxia, agnosia,
loss of abstract thought,
behavioral/personality
changes, impaired
judgement"
Term
Whare are the signs of
Benzodiazepine intox?
Definition
Amnesia, ataxia,
somnolence, minor resp
depression"
Term
Whare are the signs of
caffeine intox?
Definition
restlessness, insomina,
increased diuresis, muscle
twitching, cardiac
arrhythmias"
Term
Whare are the signs of
Marijuana intox?
Definition
Euphoria, anxiety, paranoid
delusions, perception of
slowed time, impaired
jugdment, social withdrawl,
increased appetite, dry mouth
and hallucinations"
Term
Whare are the signs of PCP
intoxication?
Definition
Belligerence, impulsiveness,
fever, psychomotor agitation,
vertical and horizontal
nystagmus, tachycardia,
ataxia, homicidality,
psychosis and delirium"
Term
What are 2 opioid
comptetitive inhibitors?
Definition
Naloxane and Naltrexone
Term
What are some common
causes of delirium?
Definition
substance use/abuse or
medical illness
Term
What are some related
diagnoses of Heroin addicts?
Definition
"Hepatitis, abscesses, OD,
hemorrhoids(reason enough
to shy away), AIDS, and rightsided
endocarditis"
Term
What are the 5 characteristics
of panic?
Definition
Palipitations, Abdominal
distress, Nausea, Increased
perspiration, Chest pains,
chills and choking"
Term
What are the 6 somatoform
disorders?
Definition
conversion, somatoform pain
disorder, hypochondriasis,
somatization disorder, body
dysmorphic disorder,
pseudocyesis"
Term
What are the characteristics
of Delirium?
Definition
"Decreased attention span
and level of arousal,
disorganized thinking,
hallucinations, illusions,
misperceptions, disturbance
of sleep-wake cycle, cognitive
dysfxn"
Term
What are the etiologic factors
for schizophrenia?
Definition
genetics and environment,
genetics outweigh env"
Term
What are the maladaptive
signs of substance use?
Definition
"Tolerance, Withdrawl, Substance
taken in larger amounts than
intended, Persistent desire or
attempst to cut down, lots of
energy spent trying to obtain
substance, withdrawl from
responsibility, used continued in
spite of knowing the problems
that it cause"
Term
What are the negative
symptoms of schizophrenia?
Definition
flat affect, social withdrawl,
thought blocking, lack of
emotion"
Term
What are the Positive
symptoms of Schizophrenia?
Definition
Hallucinations, delusions,
strange behavior and loose
associations"
Term
What are the signs of alcohol
use?
Definition
"Disinhibition, emotional
lability, slurred speech,
ataxia, coma, blackouts"
Term
What are the signs of alcohole
withdrawl?
Definition
Tremor, Tachycardia, HTN,
malaise, nausea, seizures,
delirium tremens,
tremulousness, agitation,
hallucinations"
Term
What are the signs of
Amphetamine intoxication?
Definition
"Psychomotor agitation,
impaired judgement,
pupillary dilation, HTN,
tachycardia, euphoria,
prolonged wakefulness and
attention, cardiac
arrhythmias, delusions,
hallucinations, fever"
Term
What are the signs of
Amphetamine withdrawl?
Definition
Post-use crash, including
anxiety, lethargy, headache,
stomach cramps, hunger,
severe depression, dysphoric
mood, fatigue, insomnia/
hypersomnia"
Term
What are the signs of
Barbiutate intox?
Definition
respiratory depression
Term
What are the signs of benzo
withdrawl?
Definition
Rebound anxiety, seizures,
tremor, insomnia"
Term
What are the signs of caffeine
withdrawl?
Definition
"Headache, lethargy,
depression, weight gain"
Term
What are the signs of cocaine
intoxication?
Definition
"Euphoria, psychomotor
agitation, impaired judgment,
tachycardia, pupillary
dilation, HTN, hallucinations
(including tactile:bugs on
skin), paranoid ideations,
angina, and sudden cardiac
death"
Term
What are the signs of cocaine
withdrawl?
Definition
Hypersomnolence, fatigue,
depression, malaise, severe
craving, suicidality"
Term
What are the signs of LSD
intoxication?
Definition
"Marked anxiety and
depression, delusions, visual
hallucinations and
flashbacks"
Term
What are the signs of narcotic
abstinence syndrome?
Definition
dilated pupils, lacrimation,
rhinorrhea, sweating,
yawning, irritability, and
muscle aches"
Term
What are the signs of opioid
intoxication?
Definition
CNS depression, nausea and
vomiting, constipation,
pupillary constriction,
seizures"
Term
What are the signs of opioid
withdrawl?
Definition
Anxiety, insomnia, anorexia,
sweating/piloerection(cold
turkey), fever, rhinorrhea,
nausea, stomach cramps,
diarrhea, flu-like symptoms,
yawning"
Term
What are the signs of PCP
withdrawl?
Definition
"Recurrence of intoxication
symptoms due to
reabsorption in GI tract,
sudden onset of severe,
random, homicidal violence"
Term
What are the symptoms of
DT's(in order of appearance)?
Definition
"ANS Hyperactivity
(tachycardia, tremors, and
anxiety), Psychotic symptoms
(hallucinations, delusions),
confusion"
Term
What are the symptoms of
nicotine intoxication?
Definition
"Restlessness, insomnia,
anxiety, arrhythmias"
Term
What are the types of Cluster
A personalities?
Definition
"Paranoid, Schizoid,
Schizotypal"
Term
What are the types of Cluster
C personalities?
Definition
Avoidant, Obsessive-
Compulsive, Dependent"
Term
What are treatment options of
phobias?
Definition
systematic desensitization
Term
What can be confused with
dementia in elderly?
Definition
depression
Term
What complication result from
ECT?
Definition
complications associated with
anesthesia and retrograde
amnesia
Term
What does exposure to object
of phobia evoke?
Definition
an anxiety response
Term
What drug is used for long
term maintenance of heroin
detox?
Definition
Methadone
Term
What else is classically
associated with Korsakoff's?
Definition
Confabulations, ie. Making it
up as you go along"
Term
What is a hallmark sign of
heroin addiction?
Definition
track marks
Term
What is a Hypomanic Episode?
Definition
it is like a manic episode
except mood disturbance is
not severe enough to cause
marked impairment in social
and/or occupational
functioning or to necessitate
hospitalization; no psychotic
features
Term
What is a pain somatoform
disorder?
Definition
pain that is not explained
completely by illness
Term
What is a phobia?
Definition
fear that is excessive or
unreasonable, cued by the
presence or anticipation of a
specific object or entity"
Term
What is a schizoaffective
disorder?
Definition
a combo of schizophrenia
and a mood disorder
Term
What is a somatization
disorder?
Definition
Varitey of complaints in
multiple organ systems
Term
What is Cyclothymic disorder?
Definition
milder form of bipolar lasting
at least 2 years
Term
What is dementia
characterized by?
Definition
commonly irreversible
memory loss
Term
What is destroyed in
Korsakoff's Amnesia?
Definition
Mamillary bodies(bilaterally
Term
What is drug of choice for
bipolar?
Definition
Lithium
Term
What is Dysthymia?
Definition
milder form of depression
lasting at least 2 years
Term
What is Electroconvulsive
Therapy(ECT)?
Definition
a tx option for major
depressive disorder refractory
to other tx. It is painless and
produces a seizure with
transient memory loss and
disorientation.
Term
What is Hypochondriasis?
Definition
misinterpretation of normal
physical findins, leading to
preoccupation with and fear
of having a serious medical
illness in spite of medical
reassurance"
Term
What is it called when a
parent causes their child to
become ill in order to receive
attention?
Definition
Munchausen's by proxy
Term
What is post-traumatic stress
disorder?
Definition
when a person experienced or
witnessed an event that involoved
actual or threatened death or
serious injury. The traumatic
event is reexperienced; person
persistently avoids stimuli
associated with the trauma and
experiences persistent symptoms
of increas
Term
What is primary gain?
Definition
what the symptom does for
the patient's internal psychic
economy
Term
What is retrograde amnesia a
complication of?
Definition
ECT-electroconvulsive
therapy(shock)
Term
What is secondary gain?
Definition
What the symptoms gets the
patient(sympathy or
attention)
Term
What is tertiary gain?
Definition
what the caretaker gets
Term
What is the criterion for dx of
substance abuse?
Definition
One or more of the following
in 1 year: Recurrent use
resulting in failure to complete
responsiblities, recurrent use in
physically hazardous situations,
recurrent legal problems,
continued use in spite of
persistent problems of use"
Term
What is the definition of
substance abuse?
Definition
maladaptive pattern of use
leading to clinically
significant impairment or
distress, symptoms have not
met criteria for dependence"
Term
What is the difference
between delusions and loos
associations?
Definition
delusion is a disorder in the
content of thought(the actual
idea) where a loose
association is a disorder in
the form of thought(the way
the idea is tied together)
Term
what is the fear of heights?
Definition
acrophobia
Term
what is the fear of marriage?
Definition
gamophobia
Term
what is the fear of open
places?
Definition
agoraphobia
Term
what is the fear of pain?
Definition
algophobia
Term
What is the Fifth A?
Definition
Auditory hallucinations
Term
What is the inability to
remember things that
happened before CNS insult?
Definition
Retrograde Amnesia
Term
What is the key to delirium
diagnosis?
Definition
Waxing and waning level of
conciousness that develops
rapidly
Term
What is the key to dementia
diagnosis?
Definition
rule out delirium-patient is
alert, no change in level of
conciousness. More often
gradual onset.
Term
What is the lifetime
prevalence for Major
Depressive Disorder in Males
and Females:
Definition
13% for males, and 21% for
females"
Term
What is the lifetime
prevalence for schizophrenia?
Definition
1.5%-(males/females,
blacks/whites) presents
earlier in men"
Term
What is the most common
psych illness on medical and
surgical floors?
Definition
Delirium, often reversible"
Term
What is the order of loss or
orientation?
Definition
Time, place, and Person"
Term
What is the response to the
traumatic event?
Definition
intense fear, helplessness or
horror"
Term
What is the trigger for DT's?
Definition
alcohols withdrawl
Term
What patient population will
you see Korsakoff's?
Definition
Alcoholics
Term
What questions do you have
to answer when assessing an
patient's orientation?
Definition
Is the patient aware of him/
herself as a person? Does the
patient know his/her name?
Term
What syndrome is manifested
by a chronic history of
multiple hospital admissions
and willingness to receive
invasive procedures?
Definition
Munchausen's
Term
Whate is body dysmorpic
disorder?
Definition
patient is convinced that part
of one's own anatomy is
malformed
Term
Whate is pseudocyesis?
Definition
false belief of being pregnant
associated with objective
signs of pregnancy
Term
When are the halluinations
common?
Definition
Visual(acute organic brain
syndrom), Auditory
(Schizophrenia), Olfactory(aura of
psychomotor epilepsy), Gustatory
(rare), Tactile(DT's and Cocaine
abusers), Hypnagogic(while going
to sleep), Hypnopmpic(while
waking from sleep)"
Term
When do DT's peak?
Definition
2-5 days after last drink
Term
When must a painc disorder
be dx?
Definition
in the context of the
occurrence
Term
"Who are more likely to be
antisocial, male or female?"
Definition
male
Term
Who are more likely to be
borderline, male or female?"
Definition
female
Term
Who do you need to see to
witness caffeine withdrawl
approx every six weeks?
Definition
Blake Williams
Term
Define Autonomy.
Definition
Obligation to respect pts as
individuals and to honor their
preferences in medical care
Term
Legally, what does informed
consent require?"
Definition
"- discussion of pertinent
information- obtaining the
patient's agreement to the
plan of care- freedom from
coercion"
Term
Pt autonomy vs. beneficence:
when does autonomy win
out?
Definition
"If pt makes an informed
decision, ultimately, the pt.
has the right to decide."
Term
What 3 proofs are required
for a sucessful malpractice
civil suit for neglegence?
Definition
"- Dr. breach of duty to
patient- pt. suffers harmbreach
of duty causes harm
Note--beyond reasonable
doubt not needed, just more
likely than not"
Term
What are the 4 exceptions to
confidentiality?
Definition
potential harm to others is
serious- likelihood of harm is
great- no alternative means
exist to warn or to protect
those at risk- Drs. Can take
steps to prevent harm"
Term
What are the 4 exceptions to
informed consent?
Definition
pt. lacks decision-making
capacity (not letally competent)-
implied consent in an emergencytherapeutic
privelege--
withholding information when
disclosure would severly harm the
pt or undermine informed
decision-making capacitywaver--
pt. waves "
Term
What are the 5 signs of a pt's
decision-making capacity?
Definition
"- pt. makes and
communicates a choice- pt. is
informed- decision remains
stable over time- decision
consistent w/ pt's values and
goals- decision not a result
of delusions or
hallucinations"
Term
What are the types of written
advance directives?
Definition
"- LIVING WILLS--pt. directs Dr.
to withhold/withdraw lifesustaining
tx if the pt develops
terminal disease or enters a
persisitent vegative state-
DURABLE POWER OF ATTORNEY--
pt designates a surrohate to
make medical decisions in an
event pt. loses deci"
Term
What is beneficence?
Definition
Dr. have special ethical
responsibility to act in the
pt's best interest. Pt.
autonomy may conflict with
beneficience
Term
What is confidentiality?
Definition
Confidentiality respects pt.
privacy and autonomy.
Disclosure to family and
friends should be guided by
what pt. would want. Pt can
waive right to confidentiality
(i.e. to insurance co.)
Term
What is nonmaleficence?
Definition
Do no harm. But, if benefits
of intervention outweigh
risks, pt may make an
informed decision to
proceed."
Term
What must patients
understand in informed
consent?
Definition
"- risks- benefitsalternatives,
which includes
no intervention"
Term
When is an oral directive
valid?
Definition
Incapacitated patient's prior oral
statements commonly used as
guide, but problems arise from
variance in interpretation. if pt
was INFORMED, directive is
SPECIFIC, pt. MAKES A CHOICE
and decision is REPEATED over
time, the oral directive is more
valid."
Term
At what ages does sexual
abuse in children peak?
Definition
9 to 12 years of age
Term
At what time (minutes after
birth) do you run an APGAR
score?
Definition
"after 1 min. and 5 min.,
score 0-2 in 5 categories (10
is perfect score)"
Term
Define low birth weight
Definition
less than 2500g
Term
Irreversible changes of long
term deprivation of affection
occurs after how long?
Definition
6 months
Term
Physical abuse in children
leads to how many deaths in
the U.S.?
Definition
~3000 deaths/yr.
Term
What are evidence of physical
abuse in children?
Definition
"- healed fractures on x-raycigarette
burns- subdural
hematomas- multiple
bruises- retinal hemorrhage
or detachment"
Term
At what ages does sexual
abuse in children peak?
Definition
9 to 12 years of age
Term
At what time (minutes after
birth) do you run an APGAR
score?
Definition
"after 1 min. and 5 min.,
score 0-2 in 5 categories (10
is perfect score)"
Term
Define low birth weight
Definition
less than 2500g
Term
Irreversible changes of long
term deprivation of affection
occurs after how long?
Definition
6 months
Term
Physical abuse in children
leads to how many deaths in
the U.S.?
Definition
~3000 deaths/yr.
Term
What are evidence of physical
abuse in children?
Definition
"- healed fractures on x-raycigarette
burns- subdural
hematomas- multiple
bruises- retinal hemorrhage
or detachment"
Term
What are evidence of sexual
abuse in children?
Definition
genital/anal trauma, STDs,
UTIs"
Term
What are the 5 changes in the
elderly?
Definition
1. sexual changes: sexual
interest does NOT decrease (men:
slower erection/ejaculation,
longer refractory period; women:
vaginal shortening, thinning,
dryness) 2. sleep patterns:
decreased REM, decreased slowwave
sleep, increased sleep
latency, increase"
Term
What are the 5 components of
the APGAR score at birth?
Definition
"- A= Apperance (color)- P=
Pulse- G= Grimace (reflex
irritability)- A= Activity
(muscle tone)- R=
Respiration"
Term
What are the 7 effects of
long-term deprivation of
affection?
Definition
1. Weak 2. Wordless 3.
Wanting (socially) 4. Wary
(lack trust) 5. Weight loss 6.
anaclitic depression 7.
physical illness [Hint: 5 W's
and 2 more]"
Term
What are the development
milestones at about 3 years
old in preschool?
Definition
group play- rides tricyclecopies
line or circle drawing"
Term
What are the development
milestones at about 4 years
old in preschool?
Definition
"- cooperative play- simple
drawings (stick figure)- hops
on 1 foot"
Term
What are the developmental
milestones at about 12-14
months old in infancy?
Definition
#NAME?
Term
What are the developmental
milestones at about 15
months old in infancy?
Definition
"- walking- few wordsseparation
anxiety"
Term
What are the developmental
milestones at about 3 months
old in an infant?
Definition
"- holds head up- social
smile- Moro reflex
disappears"
Term
What are the developmental
milestones at about 4-5
months old in an infant?
Definition
"- rolls on back- sits when
propped"
Term
What are the developmental
milestones at about 7-9
months old in infancy?
Definition
"- stranger anxiety- sits
alone- orients to voice"
Term
What are the developmental
milestones during
adolescence?
Definition
"- abstract reasoning (formal
operations)- formation of
personality"
Term
What are the developmental
milestones during the
schoolage years (6-11y/o)?
Definition
"- development of conscience
(superego)- same-sex
friends- identification with
same-sex parent"
Term
What are the Kubler-Ross
dying stages?
Definition
Denial-Anger-Barganing-
Grieving-Acceptance, don't
occur necessarily in this order
[Hint: Death Arrives Brining
Grave Adjustments]"
Term
What are the risks of low birth
weight?
Definition
assoc. w/ gtr. Incidence of
physical and emotional
problems. Complications
include:- infectionsrespiratory
distress
syndrome- necrotizing
entercolitis- persistent fetal
circulation"
Term
What can cause regression to
younger behavior in children?
Definition
Stress:- physical illnesspunishment-
birth of new
sibling- tiredness"
Term
What causes low birth weight?
Definition
prematurity or intrauterine
growth retardation
Term
What is anaclitic depression?
Definition
depression in an infant owing
to continued separation from
caregiver--can result in
failure to thrive. Infant
becomes withdrawn and
unresponsive
Term
What is grief?
Definition
"normal bereavement
characterized by shock,
denial, guilt, and somatic
symptoms, Typically lasts
6mo. to 1yr."
Term
What is pathologic grief?
Definition
includes excessively intense
or prolonged grief or grief
that's delayed, inhibited, or
denied"
Term
What is the result of severe
long-term deprivation of
affection?
Definition
death
Term
When can a child parallel
play?
Definition
Toddler, 24-48 months old"
Term
When does a child achieve
core gender identity?
Definition
Toddler, 24-36 months old"
Term
When does a child achieve
object permanence?
Definition
Toddler, 12-24 months old"
Term
When does a child achieve
rapprochement?
Definition
Toddler, 18-24 months old"
Term
When does a child become
toilet trained?
Definition
Preschool, 30-36 months
old"
Term
When is adolescence for boys
and for girls?
Definition
Boys: 13 years old Girls: 11
years old"
Term
Who is usually the abuser in
physical abuse in children?
Definition
female primary caregiver
Term
Who is usually the abuser in
sexual abuse in children?
Definition
known to victim, usually
male"
Term
Case-control studies are
often?
Definition
Retrospective (case control)
Term
Characteristics of a normal
statistical distribution?
Definition
Gaussian = Bell Shaped
( mean=median=mode )
Term
Country with highest divorce
rate
Definition
U.S.
Term
Define a bimodal distribution
Definition
Peaks on either side of the
median
Term
Define a Meta-analysis
Definition
Pooling data from several
studies to achieve greater
statistical power
Term
Define a negative skew
Definition
Asymmetry with the tail on
the left
(mean
Term
Define a positive skew
Definition
Asymmetry with the tail on
the right
(mean>median>mode)
Term
Define Accuracy
Definition
The trueness of test
measurements
Term
Define Alternate Hypothesis
Definition
Hypothesis that there is some
difference
Term
Define Coefficient of
Determination
Definition
r^2 (Correlation coefficient
squared)
Term
Define Correlation coefficient
(r )
Definition
Always between -1 and 1.
Absolute value indicates the
strength of correlation.
Term
Define Negative Predictive
Value
Definition
Number of true negatives /
number that tested neg. for
disease
Term
Define Positive Predictive
Value
Definition
Number of true positives /
number that tested pos. for
disease or the prob. Of
having a condition, given a
pos. test"
Term
Define Precision
Definition
"The consistency of a test
(reliability), absence of
random error"
Term
Define Primary Disease
Prevention
Definition
Prevent occurrence, e.g.,
vaccination"
Term
Define Relative Risk
Definition
Disease risk in exposed
group / disease risk in
unexposed group; a/a+b / c/
c+d
Term
Define Reliability
Definition
Reproducibility of a test;
repeat measurements are the
same
Term
Define Secondary Disease
Prevention
Definition
Early detection of disease,
e.g., Pap smear"
Term
Define SEM
Definition
Standard Error of the Mean;
standard deviation / square
root of n (sample size)
Term
Define sensitivity
Definition
Number of true positives / all
people with disease
Term
Define specificity
Definition
Number of true negatives /
number of all people w/o the
disease
Term
Define Tertiary Disease
Prevention
Definition
"Reduce disability form
disease, e.g. insulin for
diabetics"
Term
Define the Power of a study
Definition
Probability of rejecting a null
hypothesis when it is false
Term
Define Validity
Definition
Whether a test truly measures
what it purports to measure;
the appropriateness of a test
Term
Do divorcees remarry
frequently?
Definition
Yes
Term
How do disease prevalence
and positive predictive value
relate?
Definition
Higher prevalence = Higher
Positive Predictive Value
Term
How do prevalence and
incidence relate to disease
length?
Definition
P>I for chronic diseases; P=I
for acute diseases
Term
How do SEM and Standard
Deviation relate?
Definition
SD > SEM; as n increases,
SEM decreases"
Term
How do you measure the
'power' of a study or the
probability that the study will
see a difference if one exists?
Definition
1-beta
Term
How does alpha relate to the
Type I error?
Definition
"It is the probability of
making a Type I error, is
equal to p (p is usually <.05)"
Term
How does beta relate to the
Type II error?
Definition
Beta is the probability of
making a Type II error
Term
How many people >65
Definition
35,000,000 (approx. 13%)"
Term
"If the 95% confidence interval
for OR of RR includes 1, what
does this mean?"
Definition
That the study is inconclusive
Term
In what age group will the
greatest population increase
be seen in?
Definition
Those >85
Term
Increasing sample size will
affect the Power of a study
how?
Definition
By increasing the Power
Term
Is divorce related to
industrialization?
Definition
No
Term
Is HIV positivity a reportable
disease?
Definition
No
Term
Marriages at high risk
Definition
Teenage marriages, Mixed
religions, Low socioeconomic
status"
Term
Memory aid for Medicare/
Medicaid
Definition
MedicarE=Elderly;
MedicaiD=Destitute
Term
Preventive services needed
for Alcoholism
Definition
"Influenza, pneumococcal
immunizations; TB test"
Term
Preventive services needed
for Diabetes
Definition
"Eye, foot exams; Urine test"
Term
Preventive services needed
for Drug Abuse
Definition
"HIV, TB tests; hepatitis
immunization"
Term
Preventive services needed
for High-risk sexual behavior
Definition
"HIV, Hep B, syphilis,
gonorrhea, chlamydia tests"
Term
Preventive services needed
for Homeless, Refugee, or
Immigrant"
Definition
TB test
Term
Preventive services needed
for Obesity
Definition
Blood glucose test
Term
Random error yields poor?
Definition
Precision
Term
Relative Risk is used for what
kind of study?
Definition
Cohort
Term
Systematic error yields poor?
Definition
Accuracy
Term
U.S. population in 2000
Definition
"300,000,000"
Term
Unlike specificity and
sensitivity, what are
predictive values dependent
on?"
Definition
Prevalence of disease in the
population
Term
What are risk factors for
suicide?
Definition
"White, male, alone, prior
attempts, presence and
lethality of plan, medical
illness, alcohol or drug use,
on 3 or more prescription
meds."
Term
What are the leading causes
of death in AGE 1-14?
Definition
Injuries, cancer, congenital
anomalies, homicide, heart
disease"
Term
What are the leading causes
of death in AGE 15-24?
Definition
"Injuries, homicide, suicide,
cancer, heart disease"
Term
What are the leading causes
of death in AGE 25-64?
Definition
Cancer, heart disease,
injuries, stroke, suicide"
Term
What are the leading causes
of death in AGE 65+?
Definition
"Heart disease, cancer,
stroke, COPD, pneumonia"
Term
What are the leading causes
of death in INFANTS?
Definition
Congenital anomalies, SIDS,
short gestation, respiratory
distress syndrome, maternal
complications during
pregnancy"
Term
What are the most common
surgeries?
Definition
"Dilation and curettage,
hysterectomy, tonsillectomy,
sterilization, hernia repair,
oophorectomy, cesarean
section, cholecystectomy"
Term
What are the reportable
diseases?
Definition
"AIDS, chickenpox,
gonorrhea, hepatitis A and B,
measles, mumps, rubella,
salmonella, shigella, syphilis,
and tuberculosis"
Term
What does a t-test check?
Definition
The difference between two
means (Mr. T is mean)
Term
What does an ANOVA
analyze?
Definition
Variance of 3 or more
variables (Analysis of
Variance)
Term
What does SAD PERSONS
represent?
Definition
Sex (male), Age, Depression,
Previous attempt, Ethanol,
Rational thought, Sickness,
Organized plan, No spouse,
Social support lacking"
Term
What factors influence the
Power of a study?
Definition
1)The total # of endpoints
experienced by a population;
2) Difference in compliance
between treatment groups
Term
What is a case-control study?
Definition
Observational study. Sample
chosen based on presence or
absence of disease. Info
collected about risk factors.
Term
What is a Clinical trial?
Definition
Experimental study.
Compares benefit of 2 or
more treatments.
Term
What is a Cohort study?
Definition
Observational study. Sample
chosen based on presence or
absence of Risk Factors.
Subjects followed over time
for disease development.
(Framingham study)
Term
What is a memory key for
suicide risk factors?
Definition
SAD PERSONS
Term
What is a Null Hypothesis?
Definition
Hypothesis of no difference,
e.g., no assoc. between
disease and risk factor"
Term
What is a pitfall of Metaanalysis?
Definition
Cannot overcome limitations
of individual studies or bias
in study selection
Term
What is a Type I error (alpha)?
Definition
Stating that an effect of
difference exists when one
really does not
Term
What is a Type II error (beta)
Definition
Stating that there is not an
effect or difference when
actually there is
Term
What is an Odds Ratio used
for?
Definition
Approximates relative risk
when prevalence is not too
high; OR = ad/bc
Term
What is Chi-Square test used
for?
Definition
To check differences between
2 or more percentages or
proportions of categorical
outcomes
Term
What is desirable for
confirmatory tests?
Definition
High specificity
Term
What is desirable for
screening tests?
Definition
High sensitivity is desirable
for a screening test
Term
What is incidence?
Definition
Number of new cases in a
population per unit time
Term
What is Medicaid?
Definition
Fed. And State assistance for
those on welfare or who are
indigent
Term
What is Medicare Part A?
Definition
Hospital related
Term
What is Medicare Part B?
Definition
Supplemental
Term
What is Medicare?
Definition
Fed. Program for the Elderly
Term
What is prevalence?
Definition
Total number of cases in a
population at a given time
(incidence x disease duration)
Term
What is the False Negative
Ratio?
Definition
1-sensitivity
Term
What is the False Positive
Ratio?
Definition
1-specificity
Term
What is the highest quality
study?
Definition
What is the highest quality
study?
Term
What is the p value?
Definition
The probability of making a
Type I error.
Term
What percent of medical costs
will those >35 incur?
Definition
30%
Term
What type of studies are Odds
Ratios used for?
Definition
Retrospective (case control)
Term
When do divorces peak?
Definition
During the 2nd to 3rd year.
Term
Which sex has the most
surgeries?
Definition
Females
Term
Are intelligence tests
objective or projective tests?
Definition
Objective
Term
Define acting out.
Definition
Unacceptable feelings and
thoughts are expressed
through actions
Term
Define altruism.
Definition
Guilty feelings alleviated by
unsolicited generosity toward
others
Term
Define classical conditioning.
Definition
Learning in which a natural
response is elicited by a
conditioned stimulus that
previously was presented in
conjunction with an
unconditioned stimulus
Term
Define denial.
Definition
Avoidance of awareness of
some painful reality
Term
Define displacement.
Definition
Process whereby avoided
ideas and feelings are
transferred to some neutral
person or object
Term
Define dissociation.
Definition
Temporary, drastic change in
personality, memory,
consciousness, or motor
behavior to avoid emotional
stress"
Term
Define ego defenses.
Definition
automatic and unconscious
reactions to phychological
stress
Term
Define fixation.
Definition
Partially remaining at a more
childish level of development
Term
Define humor.
Definition
Appreciating the amusing
nature of an anxietyprovoking
or adverse
situation
Term
Define identification.
Definition
Modeling behavior after
another person
Term
Define isolation.
Definition
Separation of feelings from
ideas and events
Term
Define operant conditioning.
Definition
Learning in which a particular
action is elicited because it
produces a reward
Term
Define projection.
Definition
An unacceptable internal
impulse that is attributed to
an external source
Term
Define rationalization.
Definition
"Proclaiming logical reasons
for actions actually performed
for other reasons, usually to
avoid self-blame"
Term
Define reaction formation.
Definition
Process whereby a wardedoff
idea or feeling is replaced
by an (unconsciously derived)
emphasis on its opposite
Term
Define regression.
Definition
Turning back the
maturational clock and going
back to earlier modes of
dealing with the world
Term
Define repression.
Definition
Involuntary withholding of an
idea or feeling from
conscious awareness.
Term
Define sublimation.
Definition
Process whereby one replaces
an unacceptable wish with a
course of action that is
similar to the wish but does
not conflict with one's value
system.
Term
Define suppression.
Definition
Voluntary (unlike other
defenses) withholding of an
idea of feeling from
conscious awareness
Term
Give an example of classical
conditioning.
Definition
Pavlov's dogs (ringing of a
bell provoked salivation in
dogs)
Term
Give an example of
continuous reinforcement
schedule.
Definition
A person gets upset when a
vending machine doesn't
work
Term
Give an example of negative
reinforcement of opperative
conditioining.
Definition
a mouse presses a button to
avoid shock (do not confuse
with punishment)
Term
Give an example of positive
reinforcement of opperative
conditioning.
Definition
a mouse presses a button to
get food
Term
Give an example of
preconscious topography.
Definition
remembering your phone
number
Term
Give an example of variable
ratio reinforcement
schedules.
Definition
A person continuing to play a
slot machine at a casino
Term
Is IQ testing more highly
correlated with genetics or
school achievement?
Definition
School achievement
Term
Name 4 characteristics of
psychoanalysis.
Definition
costly-lengthy-intensiveplaces
great demands on the
patient"
Term
What are Freud's three
structures of the mind
Definition
"-Id-Superego-Ego"
Term
What are the four factors in
hopelessness?
Definition
"-Sense of Impotence
(powerlessness)-Sense of
Guilt-Sense of Anger-Sense
of loss/Deprivation leading to
depression (Mnemonic
IGAD!)"
Term
What are the immature ego
defenses? (12)
Definition
Acting out, Disassociation,
Denial, Displacement,
Fixation, Identification,
Isolation, Projection,
Rationalization, Reaction
formation, Regression,
Repression"
Term
What are the MATURE ego
defenses? (4)
Definition
"-Sublimation-Altruism-
Suppression-Humor
(Mneumonic: Mature women
wear a SASH)"
Term
What are the two most
famous forms of intelligence
testing?
Definition
Stanford-Binet and Wechsler
Term
What are two factors with
which IQ scores are
correlated?
Definition
Genetics and school
achievement
Term
What is an example of acting
out?
Definition
Temper tantrums
Term
What is an example of
altruism?
Definition
Mafia boss makes large
donation to charity
Term
What is an example of denial.
Definition
A common reaction in newly
diagnosed AIDS and cancer
patients
Term
What is an example of
displacement?
Definition
Mother yells at child because
she is angry at her husband
Term
What is an example of
dissociation?
Definition
Extreme forms can result in
multiple personalities
(dissociative identity
disorder).
Term
What is an example of
fixation?
Definition
Men fixating on sports games
Term
What is an example of
humor?
Definition
Nervous medical student
jokes about the boards
Term
What is an example of
identification?
Definition
Abused child becomes an
abuser
Term
What is an example of
isolation?
Definition
Describing murder in graphic
detail with no emotional
response
Term
What is an example of
projection?
Definition
A man who wants another
woman thinks his wife is
cheating on him
Term
What is an example of
rationalization?
Definition
Saying the job was not
important anyway, after
getting fired"
Term
What is an example of
reaction formation?
Definition
A patient with libidinous
thoughts enters a monastery
Term
What is an example of
regression?
Definition
Seen in children under stress
(eg., bedwetting) and in
patients on dialysis (eg.,
crying)"
Term
What is an example of
sublimation?
Definition
Aggressive impulses used to
succeed in business ventures
Term
What is an example of
suppression?
Definition
Choosing not to think about
the USMLE until the week of
the exam
Term
What is negative
reinforcement?
Definition
the removal of an aversive
stimulus so as to increase
behavior
Term
What is positive
reinforcement?
Definition
the desired reward which
produces an action
Term
What is the basic mechanism
underlying all ego defenses?
Definition
Repression
Term
What is the central goal of
Freudian psychoanalysis?
Definition
To make the patient aware of
what is hidden in his/her
unconscious
Term
What is the IQ criteria for
diagnosis of mental
retardation?
Definition
IQ lower than 70 (or 2
standard deviations below the
mean)
Term
What is the topographical
term used in psychoanalysis
to describe what you are not
aware of?
Definition
Unconscious
Term
What is the topographical
term used in psychoanalysis
used to describe what you are
able to make conscious with
effort?
Definition
Preconscious
Term
What is the topographical
term used in psychoanalysis
used to describe what you are
aware of?
Definition
Conscious
Term
What number is defined as
the mean for standard IQ
testing?
Definition
100 (with a standard
deviation of 15)
Term
What term fist described by
Freud is used to refer to
repressed sexual feelings of a
child for the opposite-sex
parent, accompanied by
rivalry with same-sex
parent?"
Definition
Oedipus complex
Term
What term is used to describe
the form of insight therapy
developed by Freud which is
often used for changing
chronic personality problems?
Definition
Psychoanalysis
Term
What thought structures is
the Ego responsible for?
Definition
Bridge and mediator between
the unconscious mind and
the world (Think-Deals with
conflict)
Term
What thought structures is
the Id responsible for? (3
things)
Definition
" - Primal urges-sex agression
(Think-'I want it')"
Term
What thought structures is
the Superego responsible for?
(2 things)
Definition
Moral values-conscience
(Think-'You know you cant
have it')"
Term
What type of behavior
requires a continuous
reinforcement schedule?
Definition
behavior which shows the
most rapid extinction when
not rewarded
Term
What type of behavior
requires a variable ratio
reinforcement schedule?
Definition
behavior which shows the
slowest extinction when not
rewarded
Term
Which is the conditioned
(learned) stimulus in Pavlov's
experiment?
Definition
ringing bell
Term
Which is the natural response
in Pavlov's experiment?
Definition
salivation
Term
Which is the unconditioned
stimulus in Pavlov's
experiment?
Definition
food
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