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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 Can result in a drug being withdrawn from market.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