Exam 1

Question 1

best and worst study designs in vetmed

Answer 1

best - meta-analysis and systemic reviews
worst - case reports, opinion papers and letters

Question 2

which study shows strongest evidence about clinically important questions

Answer 2

systemic reviews and meta-analyses

Question 3

which study provide the greatest control of bias and confounding but are not clinically applicable

Answer 3

randomized controlled trials

Question 4

which study is clinically applicable but do not have great control of bias and confounding

Answer 4

observational studies

Question 5

which study has Strongest evidence for cause-effect

Answer 5

randomized controlled traisl

Question 6

which study has a follow-up; temporal cause-effect

Answer 6

cohort study

Question 7

type of bias:
veterinarian using a patient’s signalment, history, comorbid conditions, and
other variables to develop diagnostic and treatment plans

Answer 7

selection bias

Question 8

type of bias:
when the degree of scrutiny differs among animals or groups; occur when certain animals or groups of animals are observed more closely, with different observation or monitoring methods, or for a longer period than other animals or groups of animals because of characteristics such as breed, age, housing conditions, severity of clinical signs, or convenience

Answer 8

information bias

Question 9

type of bias:
factors are associated with each other but not evenly distributed among the subjects evaluated, making it difficult to identify which factor is truly associated with the outcome of interest; when clinical observations are used to make assumptions about disease causation or treatment effectiveness

Answer 9

confounding bias

Question 10

type of bias:
“false positive” rejects a null hypothesis that is actually true in the population

Statistical association is found, but are false

Answer 10

type I error

Question 11

type of bias:
“false negative” fails to reject a null hypothesis that is actually false in the population
NO statistical association

Answer 11

type II error

Question 12

type of bias:
controlled by a good diagnostic test; individual is assigned to a different category than the one to which they should be assigned

Answer 12

misclassification bias

Question 13

type of bias:
gatekeepers are the “journals” deciding what to publish and what not to publish

Answer 13

publication bias

Question 14

adverse event, which is “an unintended injury caused by medical management that resulted in measurable disability.

Answer 14

medical error

Question 15

the failure to exercise the standard of care that a reasonably prudent person would have exercised in a similar situation

Answer 15

negligence

Question 16

a failure of one charged with exercising ordinary diligence, care and skill commensurate with members of his profession

Answer 16

malpractice

Question 17

list 6 intrinsic errors

Answer 17

1. time pressure
2. overconfidence
3. faulty or incomplete data gathering
4. knowledge gap or inexperience
5. physical factors
6. conscious or unconscious bias by the doctor (appearance, behavior, body language, prejudice, gender bias, etc.)

Question 18

list 7 systemic errors

Answer 18

1. wrong site surgery
2. failure of clinician/nurse/tech to recognize documented drug interactions or patient allergies
3. miscommunication/ misunderstanding of verbal orders
4. mislabeling of syringes, fluids, or other items contains meds
5. improper rate of administration of fluids or CRI
6. equipment failure
7. poor lay out of the facility

Question 19

Concluding evidence gathering and making a diagnosis prior to thorough reflection on all the data. The error is commonly associated with pattern recognition

Answer 19

premature closure

Question 20

form of premature closure; limited analysis and/or information because you believe others have reached an identical conclusion

Answer 20

false consensus

Question 21

The tendency to seek or favor data that confirms one’s preferred diagnosis while ignoring or disregarding data that would disfavor the diagnosis; run diagnostics first – tests/treatment

Answer 21

confirmatory bias

Question 22

Pertinent information is unintentionally omitted by someone on the team, e.g., clinical sign, previous medical history, etc

Answer 22

Unintentional sequestration of data

Question 23

associated to the way people store/retrieve knowledge; deceptive sense of security that because you’re working with a team, someone before you got all the data that you need (e.g. someone must have read the chart)

Answer 23

Illusory transactive memory system

Question 24

Respect for authority or desire for consensus allows data to be interpreted as valid by others; usually associated someone with a position of power

Answer 24

contagious illusion

Question 25

expectations influence your senses such that you can feel, hear or see something that you expect to hear

Answer 25

selective perception

Question 26

initial events in the patient’s medical history or disease are weighted more heavily than events that occur later

Answer 26

primacy effect

Question 27

most recent events in the patient’s medical history or disease are weighted more heavily than the events that occurred earlier

Answer 27

recency effect

Question 28

estimating what is more likely by what is most available in your memory, which is inherently biased toward vivid, unusual, or emotionally charged examples

Answer 28

availability heuristic

Question 29

if someone has already made a medical error are they more likely to make another in the future

Answer 29

yes - functional impairment distressed after an error are at an increased risk of making medical errors in the future

Question 30

are males or females more affected by medical errors

Answer 30

females - women report more work-related stress, anxiety, depression, and burnout than men; higher incidence of psychological distress, including suicidal ideation and depression, in female versus male veterinarians

Question 31

what is the most commonly reported beneficial outcome of medical errors

Answer 31

a desire to improve oneself to prevent something similar from happening again

Question 32

reasons to report near misses and adverse events

Answer 32

- ethically correct - preempt potential legal ramifications - system change or feedback or advice - trust with supervisor and client

Question 33

reasons people do not report near misses and adverse events

Answer 33

- no need since nothing actually happened - dislike confrontation or not wanting to upset supervisor - not wanting to upset client and damage relationship

Question 34

4 pillars of quality improvement

Answer 34

1. system-based approach 2. leadership commitment to quality - safety culture 3. medical error reporting 4. improvement & implementation science

Question 35

epidemiological triad

Answer 35

host, agent, environment

Question 36

sharp rise in cases followed by rapid decline

Answer 36

point source

Question 37

series of progressive peaks of illness

Answer 37

propagated outbreak

Question 38

no temporal or spatial pattern

Answer 38

sporadic

Question 39

around all the time

Answer 39

endemic

Question 40

widespread occurrence of an infectious disease in a community at a particular time

Answer 40

epidemic

Question 41

variable associated with increased risk of disease or infection

Answer 41

risk factor

Question 42

variable associated with a decreased risk of disease or infection

Answer 42

protective factor

Question 43

any causal factor (host, agent, environment), “piece of pie”

Answer 43

component

Question 44

set of component causes capable of causing disease; when sufficient cause is present, disease can occur

Answer 44

sufficient cause

Question 45

component cause that is required for disease to occur

Answer 45

necessary cause

Question 46

what do each measure odds ratio relative risk attributable risk attributable fraction

Answer 46

strength strength effect effect

Question 47

identifies at risk groups at the start of the outbreak

Answer 47

attack rate

Question 48

what do you use in case-control studies, odds ratio or relative risk?

Answer 48

odd's ratio

Question 49

explain 95% CI

Answer 49

CI overlaps 1 → non-sig CI below or less 1 → significant

Question 50

The ability of the test to correctly identify individuals who HAVE the disease used for screenings fewer false negatives

Answer 50

sensitivity

Question 51

The ability of the test to correctly identify individuals who do NOT have the disease diagnostic tests fewer false positives

Answer 51

specificity

Question 52

Predictive Values are NOT fixed, they depend on...

Answer 52

1. Se & Sp 2. prevalence of disease in population

Question 53

the proportion of individuals who test positive who actually have the disease

Answer 53

PPV

Question 54

the proportion of individuals who test negative who are actually free of disease

Answer 54

NPV

Question 55

higher the PPV means...

Answer 55

fewer false positives

Question 56

higher the NPV means...

Answer 56

fewer false negatives

Question 57

every test run must be positive to classify individual as positive; individual is classified as positive if each test is positive

Answer 57

testing in series

Question 58

every test run must be negative to classify individual as negative; individual is classified as positive if a single test is positive

Answer 58

testing in parallel

Question 59

Proportion of disease positive animals that test positive

Answer 59

Se

Question 60

Proportion of non-diseased animals that test negative

Answer 60

Sp

Question 61

parts of periodontium

Answer 61

gingiva periodontal ligament cementum alveolar bone

Question 62

how much should the attached gingiva have

Answer 62

2-3 mm each

Question 63

horse occlusal angle

Answer 63

10-15 degrees

Question 64

rabbit occlusal angle

Answer 64

0 degrees

Question 65

guinea pig occlusal angle

Answer 65

30-40 degrees

Question 66

which part of periodontal disease can be prevented

Answer 66

plaque accumulation

Question 67

how long does calculus take to accumulate

Answer 67

within 3-5 days of plaque formation

Question 68

what stage of periodontal disease is reversible?

Answer 68

stage 1 gingivitis

Question 69

most common cause of endodontic disease? what are key features of ED?

Answer 69

tooth fracture 1. wide pulp chamber 2. periapical lucency 3. root end resorption

Question 70

understand the current knowledge of the correlation between systemic disease and dental disease in dogs and cats.

Answer 70

Strong associations between periodontal disease and chronic inflammatory lesions in the kidneys & hearts of dogs

Question 71

conditions related to overgrowth in horses (preventable)

Answer 71

buccal lacerations lingual lacerations hooks steps/waves

Question 72

what other pathologies can equine get besides PD and ED

Answer 72

equine caries EOTRH (equine odontoclastic tooth resorption and hypercementosis)

Question 73

goals of preventative equine dentistry

Answer 73

Remove causes of pain Maintain tooth alignment and jaw range of motion Identify disease Prevent 2o complications

Question 74

what should odontoplasty not exceed

Answer 74

no more than 3-4 mm every 3 months

Question 75

what is the most common cause of dental disease in small mammal species

Answer 75

poor diet (e.g. rabbits should be fed hay too not just pellets)

Question 76

is PD or ED more commonly found in pet ferrets

Answer 76

periodontal disease