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Flashcards in 3/21 BS Deck (78)
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1
Q
Case control study
-prospective or retrospective?
-odds ratio or relative risk?
A
-retrospective
-odds ratio
2
Q
Clinical trial: Phase 1
-who are the subjects?
-what are you testing?
A
-Small number of healthy volunteers.
-“Is it safe?” Assesses safety, toxicity, and pharmacokinetics.
3
Q
Clinical trial: Phase 2
-who are the subjects?
-what are you testing?
A
-Small number of patients with disease of interest.
-“Does it work?” Assesses treatment efficacy, optimal dosing, and adverse effects.
4
Q
Clinical trial: Phase 3
-who are the subjects?
-what are you testing?
A
-Large number of patients randomly assigned either to the treatment under investigation or to the best available treatment (or placebo).
-“Is it as good or better?” Compares the new treatment to the current standard of care.
5
Q
Clinical trial: Phase 4
-who are the subjects?
-what are you testing?
A
-Postmarketing surveillance trial of patients after
approval.
-“Can it stay?” Detects rare or long-term adverse effects. Can result in a drug being withdrawn from market.
6
Q
Vaccine
-whats reduced, incidence or prevalence?
A
Both
7
Q
Precision
-aka?
-define
-relationship to standard deviation?
A
-Reliability
-The consistency and reproducibility of a test.
-More precise a test, the smaller the standard deviation.
8
Q
Accuracy
-aka?
-define
A
-Validity
-The trueness of test measurements. The absence of systematic error or bias in a test.
9
Q
Internal validity:
A
How well the conclusion corresponds to the real situation in the sample population.
10
Q
Berkson bias
-what type of bias?
-what is it?
A
-Selection & sampling bias.
-A study looking only at inpatients.
11
Q
Hawthorne effect
-what type of bias?
-what is it?
A
-Measurement bias
-Groups who know they’re being studied behave differently than they would otherwise.
12
Q
Pygmalion effect
-aka?
A
-Observer-expectancy bias
13
Q
Lead-time bias
-what is it?
A
Early detection confused w/inc. survival.
-seen w/improved screening techniques.
14
Q
Lead-time bias
-how do you reduce this bias?
A
Measure “back-end” survival (adjust survival according to
the severity of disease at the time of diagnosis).
15
Q
Crossover studies
-what is it?
A
-subjects act as their own controls.
16
Q
Matching
-what is it?
A
-patients with similar characteristics in both treatment and control groups.
*the matching variables should be the confounders of that study.
-a way to reduce confounding bias.
17
Q
standard error of mean (SEM)
-relationship w/sample size
A
As (n) increases, SEM decreases.
18
Q
Skew:
-define it
A
Think of normal bell curve but you grab one side and pull
it a little. If you pull it to the right, its positive skew. And
in ABC order, you drag the Mean, Median, and Mode along with it.
19
Q
Power of a study
-equation:
-what is it?
-aka?
A
-(1 – β)
-ability to detect a difference btwn groups when a difference truly exists.
-like "true positive".
20
Q
Chi-square (χ²)
-what is it?
-mnemonic?
A
-Checks difference between 2 or more percentages or proportions of categorical outcomes (not mean values).
-"Pronounce Chi-tegorical"

-Example: comparing the percentage of members of 3 different ethnic groups who have essential hypertension.
21
Q
Coefficient of determination =
A
-r^2 (value that is usually reported).
-r = Pearson correlation coefficient
22
Q
Disease prevention
-mnemonic?
A
PST:
-Prevent
-Screen
-Treat
23
Q
Disease prevention: primary
A
-Prevent disease occurrence (e.g., HPV vaccination).
24
Q
Disease prevention: tertiary
A
-Treatment to reduce disability from disease (e.g., chemotherapy).
25
Q
Disease prevention: Quaternary
A
-Identifying patients at risk of unnecessary treatment, protecting from the harm of new interventions.
26
Q
Informed consent requires what 4 things?
A
-Disclosure
-Understanding
-Mental capacity
-Voluntariness
27
Q
Therapeutic privilege
-what is it?
A
-withholding information when disclosure would severely
harm the patient or undermine informed decision-making capacity.
28
Q
Situations in which parental consent is usually not required for minors:
A
-Sex (contraception, STDs, pregnancy)
-Drugs (addiction)
-Rock and roll (emergency/trauma)

*they can get prenatal care BUT 2/3 of the states require parental consent for abortions.
29
Q
Medical power of attorney
-Can a pt revoke it even if hes not competent?
A
-Yes. Can be revoked anytime patient wishes (regardless of competence).
30
Q
Surrogate decision maker
-order:
A
Spouse, adult children, parents, adult siblings, other relatives.
31
Q
ƒ Reportable diseases
-examples:
A
-STDs, TB, hepatitis, food poisoning.
32
Q
The Tarasoff decision
-what is it?
A
-Scenario when Dr can break pt. confidentiality.
-California Supreme Court decision requiring physician to directly inform and protect potential victim from harm.
33
Q
Can a Dr. break confidentiality to report impaired automobile drivers (e.g., epileptics)?
A
Yes
34
Q
Apgar score
-whats apgar stand for?
-what do scores mean?
-at which time intervals?
A
-Appearance, Pulse, Grimace, Activity, and Respiration.
-(≥ 7 = good; 4–6 = assist and stimulate; < 4 = resuscitate).
-1 & 5 min.
35
Q
Low birth weight
-definition:
-associated w/inc risk of what?
A
-Defined as < 2500 g.
-inc. risk of SIDS
36
Q
Low birth weight
-potential complications:
A
-Infections, respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, and persistent fetal circulation.
37
Q
#1 killer of 65+ in USA
A
Heart disease
-cancer = #2
38
Q
#1-#3 killers of 35-44 in USA
A
Unintentional injury = #1
-Cancer = #2
-Heart disease = #3
39
Q
Deltoid
-innervation?
A
axillary n
40
Q
What % of the coronary lumen do atheromas need to obstruct to produce angina?
A
75%
41
Q
Langerhans cell histiocytosis
-presentation?
A
-child w/lytic bone lesions & skin ras
or
-recurrent otitis media w/mass involving the mastoid bone.
42
Q
Bleomycin
-S/E:
A
pulm fibrosis, skin discoloration, mucositis.
*minimal myelosuppression.
43
Q
Echinocandins
-mech:
-examples:
-use:
A
-inhibits cell wall synth by inhibiting synth of beta-glucan.
-"-fungin"
-invasive aspergillosis, candida
44
Q
How does capsaicin reduce pain?
A
reduces substance P in PNS
45
Q
Most commonly injured rotator cuff tendon?
A
supraspinatus
-can be impinged btwn humeral head and acromion.
46
Q
Name an important flexor of humerus
A
ant. deltoid.
47
Q
main adductor of humerus
A
latissimus dorsi
48
Q
Rb two hit mutation leads to what cancer?
A
retinoblastoma & osteosarcoma
49
Q
Rb protein
-active form: phosphorylated or not phosphorylated?
-which form allows cell division?
A
not phosphorylated.
-phosphorylation inactivated Rb => allowing cell division.
50
Q
Unilat. dmg to recurrent laryngeal =>
Bilat damage =>
A
-Unliateral = hoarsness

-Bilateral = resp difficulty due to airway obstruction by immobile vocal cords
51
Q
Succinylcholine
-phase 1: antidote?
-phase 2: antidote?
A
-phase 1: no antidote
-phase 2: cholinesterase inhibitors
52
Q
actin-containing fibroblasts
-aka?
A
myofibroblasts
53
Q
Berylliosis
-what type of inflammation?
A
granulomatous
54
Q
etoposide
-which topoisomerase does it block?
A
topoisomerase 2
55
Q
Relative Risk Reduction (RRR)
-equation:
A
RRR = 1 - RR
56
Q
ARPexposed =
A
ARPexposed = 100 * [(RR-1)/RR]
57
Q
Number needed to treat
-equation:
A
1/ARR
58
Q
Number needed to harm
-equation:
A
1/AR
59
Q
Type I error (α)
A
-false positive error
-saying there is a difference when there isn't one.
-null hypothesis incorrectly rejected in favor of alternative hypothesis.
60
Q
False positive error
-type 1 or type 2 error?
-alpha or beta?
A
type 1
-alpha
61
Q
Type II error (b)
A
-false-negative error.
-saying there is no difference when one really does exist.
-null hypothesis is not rejected when it is in fact false.
62
Q
How to increase power? (aka decrease beta)
A
-inc sample size
-inc. expected effect size
-inc. precision of measurement
63
Q
true positive rate
-equation:
-is this sensitivity or specificity?
A
= 1 - FN
-sensitivity
64
Q
true negative rate
-equation:
-is this sensitivity or specificity?
A
= 1 - FP
-positivity
65
Q
For the 95% CI, Z =
A
Z = 1.96.
66
Q
For the 99% CI, Z =
A
Z = 2.58.
67
Q
somatosensation from ant. 2/3 of tongue
-which nerve?
A
trigeminal n. => mandibular n. => lingual n.
68
Q
somatosensation from post. 1/3 of tongue
-which nerve?
A
CN 9
69
Q
somatosensation & taste from post. 1/3 of tongue
-which nerve?
A
CN 9
70
Q
taste from pharynx and epiglottus
A
CN 10
71
Q
humeral midshaft injury
-which nerve?
A
radial n.
72
Q
how do tumor cells die?
-apop or necrosis?
A
apoptosis
73
Q
What % of normal adults have patent foramen ovales?
A
20-30%
74
Q
Li-Fraumeni syndrome
-what is it?
-inheritance pattern?
A
-germline p53 mutation.
-auto dom.
75
Q
BRCA-1
-associated w/which cancers?
A
breast & ovary
76
Q
CD34
-stain for what?
A
endothelial cells
77
Q
light stools and dark urine
-whats it mean?
A
direct hyperbili via bile obstruction.
-no bile getting into intestines so no bilirubin in stool BUT bilirubin getting into blood so urine will be dark.
78
Q
Most common type of childhood neoplasm?
-2nd most common?
A
leukemia = #1
brain tumor = #2