Abnormality Flashcards
Add samplex after lecture
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Deep tendon reflex grade 0 (no response), 1+ (somewhat diminished), 2+ (normal), 3+ (brisker than average), and 4+ (every brisk)
A. Interval-- continuous B. Dichotomous C. Nominal D. Ordinal E. Interval-- Discrete
D
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Cancer recurrent/not recurrent 5 years after initial treatment
A. Interval-- continuous B. Dichotomous C. Nominal D. Ordinal E. Interval-- Discrete
B
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Serum sodium 139 mg/dL
A. Interval-- continuous B. Dichotomous C. Nominal D. Ordinal E. Interval-- Discrete
A
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Three seizures per month
A. Interval-- continuous B. Dichotomous C. Nominal D. Ordinal E. Interval-- Discrete
E
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Causes of upper gastrointestinal bleeding
A. Interval-- continuous B. Dichotomous C. Nominal D. Ordinal E. Interval-- Discrete
C
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When it is not possible to verify measurement of a phenomenon, such as itching, by the physical senses, which of the following can be said of its validity?
A. It is questionable, and one should rely on “hard measures” such as laboratory tests.
B. It can be established by showing that the same value is obtained when the measurement is repeated by many different observers at different times.
C. It can be supported by showing that the measurement is related to other measures of phenomena such as the presence of diseases that are known to cause itching
D. It can be established by showing that measurement results in a broad range of values
E. It cannot be established
C
This approach, called construct validity, is one of the ways of establishing the validity of a measurement.
COMPLETE SAMPLEX
A physician or nurse measures a patient’s hear rate by feeling the pulse for 10 seconds each time she comes to the clinic. The rates might differ from visit to visit because of all the following except:
A. The patient has different pulse rate at different times
B. The measurement may misrepresent the true pulse by chance because of the brief period of observation
C. The physician and nurse use different techniques (e.g., pressure on the pulse)
D. The pulse rate varies among patients
E. An effective treatment was begun between visits
D
All except D are reasons for variation in measurements on a single patient, whereas D is about variation among patients.
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“Abnormal” is commonly defined by all of the following except:
A. The level at which treatment has been shown to be effective
B. The level at which death rate is increased
C. Statistically unusual values
D. Values that do not correspond to a normal distribution
E. The level at which there is an increased risk of symptoms
D
Because clinical distributions do not necessarily follow a Normal distribution, abnormality should be defined by whether or not they do.
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The normal distribution describes the distribution of most naturally-occurring phenomena. T/F
F
Naturally-occurring distributions may or may not resemble the Normal curve.
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The normal distribution includes 2.5% of people in each tail of the distribution (beyond 2 standard deviations from the mean). T/F
T
This is a property of the Normal curve.
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The normal distribution is unimodal and symmetrical. T/F
T
Normal distribution do have a single hump (mode) and are symmetrical around that mode.
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The normal distribution is the best basis for defining abnormal. T/F
F
Being associated with disease or response to treatment are sounder definitions of abnormality than statistical unusualness.
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A patient is found to have a single serum cholesterol above 200 mg/dL, which is in the 65th percentile for adults in the United States and above a widely-accepted threshold or considering drug treatment.
A patient is likely to have a lower serum cholesterol the next time it is measured. T/F
T
This is a reason for regression to the mean.
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A patient is found to have a single serum cholesterol above 200 mg/dL, which is in the 65th percentile for adults in the United States and above a widely-accepted threshold or considering drug treatment.
This patient may have been above the threshold by chance, T/F
T
This can happen because of moment-to-moment variation.
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A patient is found to have a single serum cholesterol above 200 mg/dL, which is in the 65th percentile for adults in the United States and above a widely-accepted threshold or considering drug treatment.
This patient should be treated based on the observation that her cholesterol is higher than her peers. T/F
F
Simply being unusually high on one measurement is not a sound reason for calling a patient abnormal and considering treatment.
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The child’s height was unremarkable for the first 3 months. During the fourth month, her height was 58 cm. In the 5th month, her height was 60 cm.
http://www.who.int/childgrowth/standards/cht_lfa_girls_z_0_6.pdf - Graph
Mrs. Whoever’s fears of abnormality in the height of her granddaughter assumes that characteristics such as height and weight are
a. bell-shaped in distribution
b. normally distributed
c. skewed to the left
d. skewed to the right
B
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Reliability is the extent to which repeated measurements of a stable phenomenon get similar results. Validity on the other hand ________:
a. is the ability to register very low or very high values of the condition being measured
b. is the ability to detect change as conditions change
c. is the degree to which the data measure what is intended to be measured
C
a is range
b is responsiveness
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It is the ability of the instrument to detect change as conditions change
a. Validity
b. Reliability
c. Range
d. Responsiveness
D
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Which of the following is a disadvantage of applying the statistical definition of abnormality?
A. Not all health measurements (indicators or variables) are normally distributed.
B. The middle 95% of normally distributed variable regardless of patient’s health is defined as abnormal.
C. Extreme percentiles are defined as abnormal for variables that are not normally distributed.
D. Distribution of variable of interest can be generated for a specific group when there are reasons to believe that the groups differ (e.g. growth charts for Caucasians and Filipinos)
A
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The concept of defining abnormal as statistically unusual:
a. is based on the Gaussian distribution and can not be applied for skewed distribution
b. is recommended since there is a general relationship between the degree of statistical unusualness and clinical disease
c. will result in all disease having the same frequency if values beyond a particular statistical limit is considered abnormal
d. is a good concept since many laboratory test are related to risk of disease over a broad range of values
C
A. It can be applied to a skewed distribution. If the distribution is not normal, unusual can be defined as values above a certain percentile (e.g. values above the 95th percentile are considered abnormally high)
B. Limitation of the Gaussian and Percentile definition of normality: there is no general relationship…
C. Limitation of the Gaussian and Percentile definition of normality: frequency or prevalence of the diseases will be the same
D. Is a limitation (hence, not a good point).
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The concept of defining abnormal as associated with disease defines abnormal
a. as observation that are clinically meaningful departures from good health
b. Based on Gaussian distribution
c. Only if its treatment leads to better outcome
d. Based on extreme percentiles for skewed distribution
A
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The concept of defining abnormal as treatable defines abnormal
a. as observation that are clinically meaningful departures from food health
b. based on the Gaussian distribution
c. only if its treatment lead to better outcome
d. based on extreme percentiles for skewed distribution
C
