Behavioral Science

Question 1

Cross sectional study

Answer 1

collects data at particular point in time from group of people o assess freq of disease and related risk factors.

Question 2

Case control study

Answer 2

Compares group of people with disease/condition with group that does not. Purpose is to determine risk factors. Retrospective. Good for rare diseases.

Question 3

Cohort study

Answer 3

Examines large group and watches it evolve over time based on different exposures. Prospective.

Question 4

Types of Bias

Answer 4

Confounding, Sampling, Recall, Selection, Late-Look

Question 5

Confounding bias

Answer 5

Variable closely related to another. E.g. people who drink coffee more likely to have certain types of cancer. (Confounder–people who drink coffee are more likely to smoke.)

Question 6

Sampling bias

Answer 6

Sample of people chosen for study not representative. (E.g. study that only looks at men or healthy patients)

Question 7

Recall bias

Answer 7

When people asked to recall information, might be basied based on new knowledge, e.g. if they were told they were on the placebo, less likely to say they felt a difference.

Question 8

Selection bias

Answer 8

Investigators chose how to group participants for purpose of study. E.g. disproportionately assigning patients with more severe disease the experimental treatment.

Question 9

Late-look bias

Answer 9

Results recorded at wrong time, skewing outcomes.

Question 10

Main ways to reduce bias

Answer 10

Blinding and randomization

Question 11

Sensitivity

Answer 11

How often the test will detect the presence of the disease in people who truly have the disease, i.e. how reliable it is in identifying people who have the disease.

Question 12

Specificity

Answer 12

How often the test will detect the absence of a disease in those who do not have the disease, i.e. how well it identifies disease-free individuals

Question 13

Positive predictive value

Answer 13

Likelihood that a positive test result truly means that the patient has the condition

Question 14

Negative predictive value

Answer 14

Likelihood that a negative test result truly means that a patient does not have a given condition

Question 15

Absolute risk

Answer 15

Likelihood of outcome over time without comparison to another group

Question 16

Attributable risk

Answer 16

How much risk is actually due to the condition being studied. Attrib risk=Absolute risk (if exposed)-Absolute risk (not exposed)

Question 17

Relative risk

Answer 17

Comparison of risks between two different conditions or groups of people

Question 18

Odds ratio

Answer 18

Probablility of event happening/probability of event not occuring

Question 19

Precision

Answer 19

Reproducibility

Question 20

Accuracy

Answer 20

How close a measurement is to the true value

Question 21

Systematic error

Answer 21

Errors that occur the same way every time a measurement is taken. Precise, but not accurate.

Question 22

Random error

Answer 22

Unavoidable. Different each time a measurement is taken.

Question 23

Positive skew

Answer 23

Tail on right

Question 24

Type I error

Answer 24

False positive

Question 25

Type II error

Answer 25

False negative

Question 26

Power

Answer 26

Probability of rejecting null hypothesis when it is in fact false.

Question 27

T-test

Answer 27

Compares means of two groups to see if a difference exists

Question 28

ANOVA

Answer 28

Determines statistical difference between means of three or more groups

Question 29

Chi-squared

Answer 29

Determines statistical difference btween two or more percentages or proportions of categorical outcomes (not mean values)

Question 30

Correlation coefficient

Answer 30

Between 1 and -1. Indicates strength and direction of a linear relationship between 2+ different and independent variables.

Question 31

Secondary disease prevention

Answer 31

Seeks to detect disease early in course before clinically apparent. E.g. cervical cancer screening. Screening tests usually very sensitive.

Question 32

Tertiary disease prevention

Answer 32

Aims to reduce disability or morbidity from a disease

Question 33

Reportable infectious diseases

Answer 33

Hep B, hep A, salmonella, shigella, syphilis, measles, mumps, AIDS, rubella, TB, chicken pox, gonorrhea

Question 34

Leading causes of death-infants

Answer 34

Congenital abnormalities, short gestation/low birth weight, SIDS, maternal complications, RDS

Question 35

Leading causes of death-ages 1-14

Answer 35

Injuries, cancer, congenital abnormalities, homicide, heart disease

Question 36

Leading causes of death-ages 15-24

Answer 36

Injuries, homicide, suicide, cancer, heart disease

Question 37

Leading causes of death-25-64

Answer 37

Cancer, heart disease, injuries, suicide, stroke

Question 38

Leading causes of death-ages 65+

Answer 38

Heart disease, cancer, stroke, COPD, pneumonia, influenza

Question 39

Medicare Part A

Answer 39

Covers certain costs for hospitalization, skilled nursing facilities, home health care, hospice care. Requires monthly premium. Available for >65 Y.O.A. or those with chronic renal disease and in need of dialysis or transplantation or those who are disabled.

Question 40

Medicare Part B

Answer 40

Available for patients who elect to pay a separate monthly premium. Covers medical expenses for physician services, physical/occupational/speech therapy, med equipment, diagnostic tests, preventive care. Outpatient meds and eye, hearing, dental not covered.

Question 41

Medicare Part D

Answer 41

Administered by private insurance companies to cover prescription drugs. Only for those who are eligible for A or B.

Question 42

Medicaid

Answer 42

State-sponsored but feds pay 50-80%. Hopsital fees, physician services, lab services, radiographs, prenatal care, preventive care, nursing home care, home health services.

Question 43

Autonomy

Answer 43

People have the right to accept/refuse treatments. Can be breached if pt is infected with highly infectious and dangerous disease, greatly impaired decision-making capacity, autonomy legally waived by US gov't (e.g. epidemics). Also does not count if emergency when pt is unconscious and action needs to be taken before consent may be obtained.

Question 44

Informed consent

Answer 44

Voluntarily chooses to seek treatment and has capacity, receives full objective disclosure, idea where pt and physician are able to engage in conversation which negotiation and conflict resolution of differences are welcomed to enhance patient autonomy

Question 45

Autonomy-fetus

Answer 45

Pregnant women can refuse tx for fetus but cannot refuse life-saving tx once child is born

Question 46

Types of advance directives

Answer 46

Living will, medical durable power of attorney

Question 47

Exceptions to confidentiality

Answer 47

1. Indicates may harm self or someone else 2. Child abuse or elder abuse. (Spousal abuse laws vary by state) 3. Infectious diseases that pose significant health hazards...also "contact tracing" i.e. notification of individuals at risk, e.g. partner of someone recently dx'd with HIV 4. Patients driving under the influence 5. protection of individuals at risk for some harm that cannot be accomplished by some other means other than breaking confidentiality 6. Cases in which there is a reasonable change that by breaking confidentiality the physician may be able to prevent some sort of harm

Question 48

Tarasoff case

Answer 48

Highlighted limits of confidentiality. (Jealous lover confessed he was going to kill flirtatious gf and therpaist said nothing due to confidentiality. So the boy did kill his girlfriend, whose family then sued the University for not preventing her death)

Question 49

Malpractice

Answer 49

Due to negligence, malfeasance, nonfeasance by physician or direct subordinate that has caused some type of harm to patient. Four Ds of malpractice: Duty (physician accepts duty to patient), Derelection, Damage, Direct

Question 50

Apgar Scoring

Answer 50

Appearance (0-cyanotic 1-cyanotic extremities 2-normal) Pulse (0-Absent 1-100) Grimace-reflex irritability/response to simulation (0-no response 1-grimace 2-grimace and cough, pull away and/or sneeze) Activity-muscle tone (0-none 1-weak, irregular 2-strong, regular) 8-10 normal (perfect 10 not usually given) 4-7 some resuscitation may be needed 0-3 immediate resuscitation necessary. Low score usually related to inadequate ventilation as opposed to cardiac pathology.

Question 51

Low birth weight

Answer 51

<2500g. Caused by premature birth or intrauterine growth restriction.

Question 52

Risks of low birth weight

Answer 52

``` Sepsis Infant resp distress syndrome (aka hyaline membrane disease) Necrotizing enterocolitis Intraventricular hemorrhage Persistent pulmonary hypertension ```

Question 53

Premature birth

Answer 53

Before 37 weeks

Question 54

Newborn reflexes

Answer 54

Moro (spreads and unspreads arms when startled). Babinski Palmar Rooting

Question 55

Normal changes in aging

Answer 55

Sexual changes (Men-slower erection and ejaculation, longer refractory period; women-vaginal shortening, thinning, and dryness) Sleep pattern changes-decreased REM and slow wave sleep, increased sleep latency Increased frequency of certain medical conditions Psychiatric problems common Higher suicide rate Thinking becomes less theoretical and more practical

Question 56

Stages of Grief

Answer 56

Denial, Anger, Bargaining, Despair/Depression, Acceptance

Question 57

IQ-mild retardation

Answer 57

55-69

Question 58

IQ-moderate retardation

Answer 58

40-55

Question 59

IQ-severe retardation

Answer 59

25-40

Question 60

IQ-profound retardation

Answer 60

<25

Question 61

Operant conditioning

Answer 61

Reinforcements (pos or neg) or punishments (pos or neg)

Question 62

Mature Defense Mechanisms

Answer 62

Altruism, humor, sublimation, suppression

Question 63

Immature Defense Mechanisms

Answer 63

Acting out, dissociation, denial, displacement, fixation, identification, intellectualization, isolation, projection, rationalization, reaction formation, regression, repression, splitting