Epi and Ethics MCQ Flashcards
Practice MCQ Questions (27 cards)
13 yo M found to have nonspecific lytic lesions in his femur. After thorough discussion of the risks, benefits, etc, he says he does not want a biopsy. His dad agrees, but his mom is not sure. What should you do?
a) Contact CPS
b) Have the boy and his dad sign a letter stating that they refuse further investigation.
c) Arrange to have a capacity assessment of the boy
d) Refer to Psychology
Arrange to have a capacity assessment of the boy
A 4 year old sustained a severe TBI following a car accident with an initial GCS of 4. Despite one week of maximal therapy he has shown minimal improvement. His parents would like to withdraw life sustaining support. Before you do that you must.
a. Meet with the parents again and obtain a second opinion from another colleague or the ethics board
b. Wait until two ECG 24 hours apart are isoelectric
c. Obtain a cerebral angiogram to confirm brain death
d. Neurology consultation for a brain death exam
Meet with the parents again and obtain a second opinion from another colleague or the ethics board
You are tasked with determining the relative risk of testing positive after receiving one Covid-19 vaccine as compared to receiving two Covid-19 vaccines. A total of 100,000 individuals were included in the study. 70,000 people received two doses of the Covid vaccine, 7 of whom later tested positive for Covid.
30,000 received one dose of the vaccine, of whom 30 later tested positive for Covid 19. What is the relative risk of testing positive for Covid-19 after receiving one dose of the Covid-19 vaccine as compared to receiving two doses of the Covid-19 vaccine?
a) 0.8
b) 10
c) 2.2
d) 4.23
RR = [a/ (a+b)] / [c/ (c+d)]
= 0.001 / 0.0001
= 10
What’s the negative predictive value?
a) 39/51
b) 33/55
c) 33/45
d) 39/61
39/(39+12) = 39/51
What is the meaning of the Jordan Principle?
a) To make sure children living on Reserves get access to public services
b) To guarantee that FIrst Nations have equal access to public services
c) To finance hospital care for Indigenous children without provincial coverage
To guarantee that First Nations have equal access to public services
What is the sensitivity of the following test?
a) 72/100
b) 72/88
Sensitivity = 72/(72+16) = 72/88
2-year old with acute onset of touching perineum after spending weekend with dad. On exam, erythema at introitus, no vaginal distance, intact crescent hymen, normal anus. What do you do?
a. Exam findings not indicative of abuse, therefore don’t need to report to CAS
b. Exam findings indicative of abuse, so call CAS
c. Call CAS because of concern of possible abuse
d. Interview child and call CAS if discloses abuse
Exam findings not indicative of abuse, therefore don’t need to report to CAS
You are a community pediatrician and you are approached by a pharmaceutical company in your office. They are offering you pens and pads of paper for your admin, as well as samples of a medication and a paid for dinner to attend and learn about their products.
What are three principles to consider and your approach to industry and medicine in this scenario?
Beneficence, Professionalism and Non-maleficence
Do not accept the pens/pads bc they don’t directly benefit patients
Do not accept samples unless you have a patient that otherwise wouldn’t receive treatment
paid dinner is only permitted if the setting is purely educational (not marketing) and the speakers are NOT chosen by the company, and if the dinner is modest
According to Canadian law What is the maximum age of a partner that a 14 year old girl can consent to having sex with?
a 14 yr old girl can have sex with someone <5 yrs older than her
According to Canadian law in what situation can a 16 year old girl NOT consent to have sex with someone who is older?
16 yr old cannot consent to sex with a person in a position of authority (eg teacher or coach)
You are planning a study looking at children with asthma with a new treatment. Name 4 ways to minimize systematic bias
- perspective-taking (the cognitive aspect of compassion that can reduce bias and deter unconscious stereotypes and prejudices)
- emotional self-regulation (experiencing positive emotions during patient encounters to build rapport, trust, and connection)
- partnership building (working collaboratively with patients toward a common goal).
- blinded outcomes
- Minimize interrater variability
Boy with CP was in a motor vehicle accident and has had a GCS of 4 for the last week. Parents want to withdraw. What do you do?
a. Consult ethics
b. Call CAS
c. Withdraw if the parents are reasonable and understand the situation
Consult ethics
What size does a child need to be to switch from a booster seat to a normal seat belt?
a. 18 kg, 120 cm
b. 36 kg, 120 cm
c. 36kg, 145 cm
d. 45 kg, 150 cm
36kg, 145 cm
please match the following study descriptions with the appropriate study design (pick from case control study, meta-analysis, cohort study, or systematic review).
Babies with PPHN were matched with same age babies without PPHN and checked for ???
Case-control
please match the following study descriptions with the appropriate study design (pick from case control study, meta-analysis, cohort study, or systematic review).
14 RCTs were reviewed and compiled
metaanalysis
please match the following study descriptions with the appropriate study design (pick from case control study, meta-analysis, cohort study, or systematic review).
a group of students were followed – some who worked for pay and some who did not. The rates of cigarette smoking in each group were documented
Cohort study (prospective)
A 9 year old was just diagnosed with leukemia but does not know it and her parents ask you not to tell her.
You decide not to tell her. Name the ethical principle and explain.
Autonomy
A 9 year old was just diagnosed with leukemia but does not know it and her parents ask you not to tell her.
You decide to tell her. Name the ethical principle and explain.
Beneficence & Non-Maleficence
Calculate the sensitivity and PPV on this test. Should this test be used as a screening tool and why?
PPV = TP/(TP+FP) = 85/(85+45) = 0.65
A 14y boy presents with his third relapse of ALL. An experimental form of chemotherapy is proposed as a potential treatment. He refuses the treatment. Which is true?
a. He can refuse the treatment is he is deemed capable
b. Treatment must proceed
c. Parents should decide if treatment should proceed
d. An ethics committee should decide if treatment should proceed
He can refuse the treatment is he is deemed capable
Boy involved in MVA intubated. Pedestrian killed. EtOH smell. Police asked you for alcohol levels report
a) give it to them
b) ask for a warrant
c) Call CMPA
d) Call CAS
Ask for a warrant
for police investigations, a legislative provision, search warrant, or other court order MUST be provided (or consent given by the patient) to disclose to police
Age of consent to sexual activity (non-coercive); oldest individual a 13 year-old child can have consenting sex with?
14yrs - 13 yr old can have sex with someone <2 yrs older than them (ie <15
List 3 situations in which you would breach confidentiality.
- Suspected child abuse or neglect
- Imminent danger to patient or others
- Communicable diseases
- Warning a third party (possible)
In a new study looking at the effect of steroid treatment in preventing meningitis-related hearing loss, it was shown that those treated with steroid developed hearing loss in only 10% of cases whereas those not treated with steroid developed hearing loss in 30% of cases. Define ‘number needed to treat’
The number of patients who need to be treated in order to prevent an additional bad outcome
