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Step 1 > Behavioral Science > Flashcards

Behavioral Science Flashcards

1
Q

Definition of sublimation:

A

Shift unacceptable impulses towards a socially aceptable activity

Writing on your diary when your friend dies
Play aggressive sport to release anger
Art

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2
Q

Define type 1 alpha error:

A

You reject the null when it is true (you say something is significant when it is not)

Given by the p-val

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3
Q

Define type 2 beta error:

A

You don’t reject the null when it is false (you say something is not significant with it is)

Given by the power (power=1-beta)

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4
Q

What is Hawthorne effect?

A

It is a measurement bias. Effect where subjects change their behavior because they are being observed

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5
Q

What is Berkson bias?

A

Is a selection bias where samples drawn from a hospital are more likely to be sick
Berkson went to the hospital

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6
Q

What does a cross-sectional study do?

A

Looks at the prevalence of a variable of interest at a specific point in time.

For example the prevalence of depression in patients with Alzheimer.

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7
Q

Definition of introjection or identification:

A

Adopt characteristics form others (dress like an attending)

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8
Q

What is a confounding bias?

A

When the effect being examined is modified based on other factors that you don’t care about. Goes away when you stratify the data
You think A -> B but actually C controls both

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9
Q

What is effect modification?

A

When the effect being examined is just present on a subgroup of your sample. It goes away on one subgroup after stratification but not on the other subgroup

The effect is there and it is real but something else modifies it

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10
Q

What is Pygmalion effect?

A

Also called observer or expectancy bias. When an observer expecting recovery is more likely to document positive outcomes

Eliminated by double-blind design

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11
Q

% of sample that falls into 1,2,3 and 4 standard deviations:

A 
68-95-99.7 rule:
1SD: 34%, 84th percentile
2SD: + 13.5%, 95th percentile
3SD: + 2.4%
4SD: + 0.15%
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12
Q

Biomarkers for recent alcohol intake:

A

GGT (gamma-glutamyltransferase)

EtG (ethyl glucuronide)

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13
Q

Definition of reaction formation:

A

When you adopt the opposite behavior of your feelings or intentions

Sadist condemns sadists behaviors
Mom that doesn’t love her kid declares her love to him

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14
Q

Definition of splitting:

A

When someone things everything is either great or horrible. Mom

Happens in borderline personality disorder and psychosis

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15
Q

Main characteristic of schizotypal personality disorder:

A

Magical thinking
Also odd, social anxiety
Bryan’s gf

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16
Q

Main characteristic of schizoid personality disorder:

A

Voluntary social withdrawal, sex indifferent

David Gong

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17
Q

Main characteristic of avoidant personality disorder:

A

Hipersensible to rejection, thinks is socially inept
Wants to be with people but shy
Matt

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18
Q

Main characteristic of antisocial personality disorder:

A

Breaks the law

Conduct disorder if below 18 (bad kid in toy story)

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19
Q

Definition of displacement:

A

Put an emotion on someone that has not created it

I get fired and yell at my husband instead of at my boss

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20
Q

Definition of projection:

A

Attribute your thoughts and desires to someone else

Girl says her doll has belly pain
Cheating wife ACUSEs husband of cheating

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21
Q

Which drugs cause REM rebound when stopped?

A 
Alcohol
Barbiturates (no benzos! if you stop bezos you just cannot sleep)
SSRIs, phenelzine (MAOi)
Phenothiazine (antipsychotic)
Lithium
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22
Q

Difference between repression and suppression:

A

In both you intentionally withhold an idea
In repression you do not remember you are withholding it (traumatized kid), in suppression you do it to focus and be a better professional…
Suppression is more mature, R comes before S

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23
Q

Types of errors and difference with violations:

A

Errors, 3 types:
Laps (memory): omissions, missed actions (FORGET to add K in a patient with furosemide)
Slip (attention): actions not carried out as intended (give a drug IV instead of IM, cut the ureter even if you identified it)
Mistakes: the intended action was wrong due to a bad plan or incorrect intention (order wrong drug)

Violations: not follow the rules and know it (not to take clinical history)

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24
Q

Types of patient safety events:

A

Adverse: causes harm to the patient (preventable if prevented by following evidence-based guidelines)
No-harm: reaches the patient but does not cause harm
Close-calls=Near-miss: corrected before reaches the patient
Hazardous conditions: increase the probability of an adverse event
Sentinel event~never event: death/serious injury that requires immediate investigation (root cause analysis). Sentinel is unexpected, unrelated to illness
Malpractice: legal determination, not a category of medical error

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25
Q

What is the pathogen most frequently transmitted by healthcare workers due to accidental needlestick injuries?

A

HCV (more common, more amount in blood, vaccine not always effective), more than HBV and HIV

26
Q

Negative vs positive pressure rooms:

A

Negative: keeps air in, in airborne disease
Positive: keeps unfiltered air out, in recent bone marrow transplant and severe allergic asthma

27
Q

Main characteristic of dependent personality disorder:

A

Needs to be taken care of
Belittling yourself and pessimistic
Battered woman

28
Q

Differences between lead-time and lenght-time bias:

A

Lead: screening detects earlier but cannot do anything so you believe survival is longer
Length: screening detects benign (slowly progressive) illnesses more than really bad ones

29
Q

Drug trial phases:

A

Preclinical: non-human

Phase 0: very small group of healthy

SWIM:
Phase 1: Safe? Will kill you? small group of healthy -> toxic, kinetics and dynamics

Phase 2: Works? Efficacy? SE? small group (100-200) of SICK-> check if works, what is the best dose, SIDE EFFECTS, EFFECTIVE!

Phase 3: Improvement?-> big group of sick randomized into treated and CONTROL. 2 groups!

Phase 4: Market? long term

30
Q

What are the 4 different parts of medicare for?

A

A: HospitAl and hospice care
B: Basic medical bills, drugs administrated by doctor
C: Combo private; A+B
D: Drugs

31
Q

Types of disease prevention:

A

Primordial: Improve of the environment, socioeconomic (public health initiatives in specific communities, give access to healthcare to poor communities)

Harm reduction: needle exchange programs

Primary: health promotion=prevent in healthy (vaccine, education, exercise, never smoke, remove asbestos)

Secondary: Screen preclinical asymptomatics (colonoscopy, mammogram, pap smear, stop smoking, checking BP)

Tertiary: Treat symptomatics + post tto surveillance (decrease the impact of an illness, low dose aspirin in ❤️disease)

Quaternary: Quit unnecessary/harmful interventions or reduce medical mistakes (no Ab when no need, surgical timeouts, medication reconciliation)

32
Q

Main characteristic of histrionic personality disorder:

A

Flirty
Dramatic (exaggerate somatic symptoms)
Mom

33
Q

Definition and types of selection bias:

A

Problem sampling; just choose as last resource
Berkson: take sample form hospital
Attrition: lost in follow up are different between groups

34
Q

Definition and types of measurement bias:

A

Errors in info gathering

Hawthorne: patients act differently if observed

35
Q

Definition and types of observer-expectancy bias:

A

Pygmalion: observer expecting recovery is more likely to document positive outcomes

36
Q

Definition of procedure bias:

A

Subjects in different groups are not treated the same

37
Q

Definition of late-look bias:

A

Neyman bias; if a disease is rapidly fatal you can only get information/select subjects from the more indolent cases of that disease

38
Q

Definition of recall bias:

A

Recall: having the illness makes you remember the exposure

39
Q

What is the IQ cutoff for intellectual disability?

A

70

40
Q

Normal aging sleep changes:

A

↓ sleep time
Wakes up during the night
Goes to bed early and wakes up early
Day naps

41
Q

What is accumulation effect?

A

You need to be exposed to the risk factor or risk reducer for a bunch of time before you see an effect

42
Q

What is ascertainment bias?

A

Defined in 2 ways:

1) When the results of the study are distorted by knowledge about which intervention each participants is receiving
2) When the data that is collected is more likely to include some members of a population than others

43
Q

What is ecological fallacy?

A

When you assume that conclusions are made about individuals based on studies where the unit of analysis is a group

44
Q

Which are the most frequent child abuse injuries?

A

Soft tissue injuries

45
Q

Name and define the 5 stages of change (PCP AMy dR):

A

Precontemplation: denial

Contemplation: I have a problem but I cannot change it

Preparation, determination: I have a problem I am looking into how to change it

Action, willpower: change, start treatment

Maintenance: maintain change

Relapse: go back

46
Q

Define directive counseling:

A

When there is just one medically reasonable treatment the doctor can provide directive counseling offering just one treatment to the patient

47
Q

Define informed refusal:

A

Patient refuses a treatment after being informed

48
Q

Define substituted judgment:

A

Surrogate makes a decision for incapacitated patient

49
Q

How do you differentiate between phase 2 and 3 clinical trials?

A

Is there a control?

no: phase 2
yes: phase 3

50
Q

What is accurate and what is precise?

A

Accurate=valid=true but maybe disperse

Precise=reliable=consistent; the more measurements the more precise

51
Q

Explain the difference between availability heuristic, anchoring heuristic, blind obedience and framing biases:

A

Availability: dx based on PAST experience. You normally see available patients
Anchoring: stuck on initial impression, you read a question and pick the first thing you considered
Blind obedience: just reply on tests
Framing: biased decision-making because you are judging the patient

52
Q

How much you need to elevate the head of a patient on a ventilator?

A

30-45 degrees, to prevent ventilator-associated pneumonia

53
Q

What are the two categories related to failures of obtaining informed consent?

A

Battery action: you touch a patient without asking him/her

Negligent nondisclosure: you realize the initial diagnosis is not right and do not tell the patient

54
Q

What is brach of duty?

A

You do not meet minimal standard of care

55
Q

What is EMTALA?

A

Emergency Medical Treatment and Active Labor Act

Give emergency management to anyone needing care even of they do not have insurance

56
Q

What is the DD if you see hallucinations on a drug-addict?

A 
Alcohol withdrawal (delirium tremens, visual and auditory)
Cocaine intoxication (tactile)
57
Q

What is the timing of alcohol withdrawal symptoms?

A

Half day: insomnia, tremors, anxiety, autonomic instability

Half-2 days: seizures, hallucinations

2-3 days: delirium tremens; fever, disorientation, severe agitation

58
Q

Are case series investigational studies?

A

No, they are purely descriptive studies

59
Q

What is the rare disease assumption?

A

OR=RR in rare diseases; only circumstance where you can use RR in case control

60
Q

Mini-Mental State Exam (MMSE) score interpretation:

A

25-30: ok
24-20: mild dementia
20-13: moderate dementia
Less than 12: severe dementia

Montreal assessment (MoCA) scores range also between 0 and 30 and are very similar to mini-mental

61
Q

What do you do if you have an elderly that should not be driving?

A

Tell him/her your concerns and ask them to stop driving until evaluated by the DMV/driver rehabilitation specialist

62
Q

What is the leading cause of death under adults under 50 in the USA?

A

Synthetic opioids

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