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usmle/ step one > Behavioral > Flashcards

Behavioral Flashcards

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USMLE® Step 1 flashcards
1
Q

Describe a Case control study. What does it compare and ask?

A

Compares a group with a disease to another group w/o disease.

Looks for prior exposure or risk factor

asks: “What happened?”

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2
Q

What is measurement for case control study?

A

Odds ratio

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3
Q

What does a Cohort study ask?

A

If prospective: “Who will develop disease?”

If retrospective: “Who developed the disease [exposed vs nonexposed]?”

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4
Q

What does cohort study look at?

A

See if exposure increases chances of disease

Compares group with exposure to group w/o it

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5
Q

Measure used in cohort study?

A

Relative Risk

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6
Q

Describe a cross-sectional study

A

Collects data from a group of people to assess frequency of disease (and related risk factors) at a particular point of time

Disease prevalence & risk factor association w/ disease (but not established casually)

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7
Q

What is a Adoption study?

A

Compares siblings raised by biological Vs. Adoptive parents

Measures heritability influence and environmental influence

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8
Q

Describe Twin concordance study

A

Compares frequency to develop same disease between monozygotic twins or both dizygotic twins

Measures heritability

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9
Q

what is double-blinded characteristic of a clinical trial?

A

Neither patient nor doctor knows whether patient is in the Tx or control group

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10
Q

What is a triple-blinded characteristic of a clinical trial?

A

Neither patient nor doctor knows whether patient is in the Tx or control group

PLUS, researchers analyzing data are blinded

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11
Q

What improves a clinical trial quality?

A
  • Randomized
  • Controlled
  • Double-blinded
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12
Q

What does a clinical trial look at?

A

Compares therapeutic benefits between:

  • 2 or more treatments
  • or bwn treatment & placebo
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13
Q

What does phase 1 of study look at?

Sample size?

A

Looks at

  • safety
  • toxicity
  • pharmacokinetics

size: small # healthy volonteers

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14
Q

Phase II of a study purpose and size

A

assess

  • Tx efficacy (the ability to produce a desired or intended result.)
  • Optimal dosing
  • S/E

size: small # of patients w/ interested disease

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15
Q

Phase III study purpose and size

A

Compares new Tx to current standard of care

size: large # pts, randomly assigned to:
- tested Tx or current Tx
- tested Tx or placebo

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16
Q

Describe phase 4 study size and purpose

A

Detect rare or long term S/E

size: Postmarketing surveillance trial of patients AFTER APPROVAL

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17
Q

Formula for Sensitivity?

A

= TP/ (TP+FN)

= 1- FP rate

18
Q

What is sensitivity for test?

A

Proportion of all people with disease (TP + FN) who test positive for disease (TP)

Sensitivity Rules out (SNOUT!)

19
Q

What does a test near 100% sensitivity mean?

A

Low FN rate

If it = 100%, then FN = 0

20
Q

Formula for Specificity?

A

= TN/ (TN + FP)

= 1- FP rate

21
Q

What is Specificity?

A
  • Proportion of all people w/o disease tested negative

- Ruling In, “SPIN”!

22
Q

meaning of test with near or exact 100% specificity?

A

Indicates low FP rate. If = 100%, then FP = 0

23
Q

When is specificity used? (What type of test)

A

Confirmatory test!

i.e. for HIV, Western blot has highly specific w/ a high false negative rate

(compare to ELISA, w/ high FP and more sensitive)

24
Q

Whast is PPV formula?

A

TP/ (TP +FP)

25
Q

What is PPV?

A

% of positive test results that are truley positive

high pretest probability -> high PPV
varies directly w/ prevalence or pretest

26
Q

What is Negative predictive value?

A

proportion of negative results that are actually negative

TN/ (TN+ FN)

varies inversly with prevalence or pretest probability; high prestest %-> low NPV

27
Q

What test do you use with high sensitivity?

A

Screening test!

Disease w/ low prevalence
i.e. ELISA for HIV

28
Q

What is APGAR score purpose?

A

Assessment of newborn vital signs @ 1min & 5mins after born

29
Q

Explain APGAR scoring

A

> /= 7: good
4-6: assist & stimulate
<4, increase risk of neurological damage long-term

30
Q

List APGAR score components

A 
Appearance
Pulse
Grimace
Activity
Respiration
31
Q

Low birth weight #.

Caused by?

A

<2500g
Causes:
-Prematurity
-Intrauterine growth retardation

32
Q

What diseases associated w/ low birth weight?

Neurological & immune

A
  • impaired thermoregulation & immune function

- Impaired neurocognitive/emotional development

33
Q

What diseases associated w/ low birth weight?

Cardiovascular & Respiratory

A
  • SIDS
  • RDS
  • Intraventricular hemorrhage
  • Persistent fetal circulation
  • Polycythemia Vera
34
Q

What diseases associated w/ low birth weight?

GI related

A
  • Hypoglycemia

- Necrotizing enterocolitis

35
Q

Developmental milestones from birth-> 3 months

Motor, Social, Verbal/cognitive

A

M: Rooting reflex, holds head up, moro reflex disappears)

S: Social Smile

V/C: Orients, responds to voices

36
Q

Developmental milestones from 7-9 months

Motor, Social, Verbal/cognitive

A

M: Sits alone, crawls, transfers toys between hands

S: Stranger anxiety

V/C: Responds to name and somple instructions, use gestures. plays peek-a-boo

37
Q

Developmental milestones from 12-15 months

Motor, Social, Verbal/cognitive

A

M: Walks, babinski disapepars

S: Separation anxiety

V/C: Few words

38
Q

Developmental milestones from 1yr-2yrs

Motor, Social, Verbal/cognitive

A

M: Climbs stairs, stacks blocks
(age X 3, i.e.- 2yrs old stacks 6)

S: Rapproachment (moves away from then returns to mom)

V/C: 200 words, 2-word phrase, age 2

39
Q

Developmental milestones from 2-3yrs

Motor, Social, Verbal/cognitive

A

M: Kicks balls, feeds self w/ utensils

S: Core gender identity, parallel play

V/C: toilet training (“pee @ 3)

40
Q

Developmental milestones from 3yrs

Motor, Social, Verbal/cognitive

A

M: Rides tricycle. copies line or circle

S: can spend part of day away from mom

V/C: 900 words, complete sentences

41
Q

Developmental milestones from 4yrs

Motor, Social, Verbal/cognitive

A

M: Self-grooms, use buttons & zipper, hops on 1 foot, draws stick figures

S: Cooperative play, imaginary friends

V/C: can tell detailed stories & use prepositions

usmle/ step one (20 decks)

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