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First Aid 31-54 Flashcards

1
Q

Collects data from a group of people to assess frequency of a disease/related risk factors at one point in time

A

Cross-sectional study

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2
Q

A study that assesses disease prevalence

A

Cross-sectional study

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3
Q

Compares a group of people with disease to a group of people without disease; looks for prior exposure or risk factor

A

Case control study

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4
Q

A study that measures odds ratio

A

Case-control study

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5
Q

Compares a group of people with a given exposure or risk to a group of people without; can be prospective or historical

A

Cohort study

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6
Q

A study that looks to see if exposure affects the likelihood of disease

A

Cohort study

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7
Q

A study that measures relative risk

A

Cohort study

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8
Q

Compares the frequency with which both momozygotic or both dizygotic twins develop the same disease

A

Twin concordance study

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9
Q

Compares siblings raised by biological vs adoptive parents

A

Adoption study

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10
Q

Phase I clinical trial

A

Small number of healthy volunteers;

Is it safe?

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11
Q

Phase II clinical trial

A

Small number of patients with disease of interest;

Does it work?

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12
Q

Phase III Clinical trial

A

Large number of patients randomly assigned either to treatment or placebo/best available treatment;

Is it as good or better?

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13
Q

Phase IV clinical trial

A

Postmarketing surveillance of patients after treatment is approved;

Can it stay?

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14
Q

PPV equation

A

TP/(TP + FP)

proportion of people with the disease who test positive

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15
Q

NPV equation

A

TN/(TN + FN)

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16
Q

PPV and NPV vary based on

A

disease prevalence

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17
Q

Sensitivity equation

A

TP/(TP+FN)

the probability that all people with the disease will test positive

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18
Q

High sensitivity test used in screening in diseases with

A

low prevalence

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19
Q

Specificity equation

A

TN/(TN+FP)

Proportion of all people without the disease who test negative

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20
Q

High specificity test used when

A

A sensitivity screening test was positive

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21
Q

What is point A? B? C?

A

A = 100% sensitivity cutoff

B = practical compromise between sensitivity and specitificity

C = 100% specificity cutoff

**Lower B –> increase FP, lower FN –> increase sensitivity and NPV

Raise B –> increase FN, lower FP –> increase specificity and PPV

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22
Q

new cases/# people at risk

A

Incidence

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23
Q

of existing cases / population total

A

Prevalence

Prevalence is about the pre-test probability

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24
Q

(a/c) / (b/d)

A

Odds ratio

Odds people with disease were exposed / odds the group without disease was exposed;

Case-control studies

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25
Q

a/(a+b) / c/(c+d)

A

relative risk

cohort studies

risk of developing disease in exposed group divided by risk in unexposed group

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26
Q

When prevalence is low, OR is about equal to

A

RR

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27
Q

a/(a+b) - c/(c+d)

A

Attributable risk;

difference in risk between exposed and unexposed groups

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28
Q

The proportion of risk reduction attributable to the intervention as compared to the control

A

Relative risk reduction;

1-RR = 1- a/(a+b) / c/(c+d)

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29
Q

The difference in risk attributable to the intervention as compared to the control

A

Absolute risk reduction

c/(c+d) - a/(a+b)

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30
Q

NNT

A

1/ARR

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31
Q

NNH

A

1/AR

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32
Q

An increase in precision leads to

A

An increase in statistical power = 1-ß

The absense of random variation in a test

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33
Q

The absence of systematic error or bias in a test

A

Accuracy

The trueness of a measurement

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34
Q

Sampling bias is an example of

A

Selection bias;

Fix with randomization

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35
Q

Confounding bias

A

When a factor is related to both the disease and the outcome, but is not causal

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36
Q

Lead-time bias

A

Early detection is confused with increased survival

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37
Q

1 SD includes

A

68%

2 SDs –> 95%

3 SDs –> 99.7%

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38
Q

Give an example of bimodal distribution

A

Fast vs slow acetylators

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39
Q

Stating that there is an effect or difference when none exists

A

Type I error (alpha error);

You “a”bserved a difference that did not exist

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40
Q

p is judged against a pretest alpha level. If p<0.05 then

A

there is a less than 5% chance the study shows something that is not really there

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41
Q

alpha is the probability of

A

making a type I error

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42
Q

Beta is the probability of

A

making a type II error

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43
Q

Ways in increase the power of a study

A

increase sample size;

increase expected effect size

increase precision of measurement

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44
Q

The closer the absolute value of r is to +1, then

A

the stronger the linear correlation between the two variables;

Positive r value –> one variable up means other variable up and vice versa

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45
Q

Moro reflex disappears by

A

3 months

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46
Q

Rooting reflex disappears by

A

4 months

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47
Q

Palmar reflex disappears by

A

6 months

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48
Q

Babinski reflex disappears by

A

12 months

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49
Q

lifts head up by

50
Q

rolls and sits by

51
Q

crawls by

52
Q

stands by

53
Q

walks by

A

12-18 months

54
Q

passes toy from hand to hand by

55
Q

pincer grasp by

56
Q

points to objects by

57
Q

social smile by

58
Q

stranger anxiety by

59
Q

separation anxiety by

60
Q

orients to mom/dad voice by

61
Q

orients to name and gestures by

62
Q

object permanence by

63
Q

says mama and dada by

64
Q

climbs stairs by

65
Q

feeds self with fork and spoon by

66
Q

kicks ball by

67
Q

rapprochment - moves away from mom and then returns by

68
Q

gender identity by

69
Q

200 words and 2 word sentences by

70
Q

rides a tricycle by

71
Q

drawings, copies lines or circles by

72
Q

hops on one foot by

73
Q

uses buttons/zippers, grooms oneself by

74
Q

comfortabily spends part of day away from mom by

75
Q

cooperative play, has imaginary friends by

76
Q

1000 words by

77
Q

uses complete sentences with prepositions by

A

age 4;

can tell detailed stories by age 4

78
Q

Sensorineural hearing loss due to destruction (often high frequency) of hair cells at cochlear base (preserved low frequency hearing at apex)

A

Presbycusis

change in elderly

79
Q

If you are <65 and on Medicare, what are the two possible reasons?

A

End stage renal disease or certain disabilities

80
Q

Histones are rich in what amino acids?

A

Lysine, Arginine

81
Q

Nucleosome made of

A

H2A, H2B, H3, H4 all x 2

82
Q

H1 stabilizes

A

DNA wrapped around histone

83
Q

Why methylate template strang cytosine and adenine?

A

During DNA replication, allows mismatch repair enzymes to identify the old strand (in prokaryotes)

84
Q

DNA methylation at CpG islands has what effect?

A

Represses transcription

CpG Methylation Makes DNA Mute

85
Q

Histone methylation

A

Usually reversibly represses DNA transcription but can activate it in some cases (depending on location)

86
Q

Histeone acetylation

A

Relaxes DNA coiling –> allows for transcription

87
Q

Base + deoxyribose (sugar)

A

Nucleoside

88
Q

Base + deoxyribose + phosphate

A

Nucleotide

89
Q

Purines

A

2 rings

Adenine

Guanine

90
Q

Pyramidines

A

1 ring

Cytosine

Uracil (deaminated cytosine)

Thymine

91
Q

Amino acids necessary for purine synthesis

A

Glycine

Aspartate

Glutamine

(and THF)

92
Q

MOA Leflunomide and pathway it acts in

A

Inhibits Dihydroorate dehydrogenase

Pathway: Pyrimidine base production

93
Q

Pyrimidine base production requires

94
Q

MOA and pathway for:

Methotrexate, Trimethoprine, Pyrimethamine

A

Inhibit Dihydrofolate reductase

Disrupt pryamidine synthesis

reduce dTMP being made

95
Q

MOA and Pathway

5-fluorouracil

A

Disrupts pyrmidine synthesis

forms 5-F-dUMP

inhibits thymidylate synthase –> lowers dTMP

96
Q

What drug disrupts both purine and pyramidine synthesis?

A

Hydroxyurea

Inhibits ribonucelotide reductase

97
Q

Orotic aciduria is a failure of what pathway

A

Pyrimidine synthesis pathway;

can’t make UMP from orotic acid

98
Q

MOA and Pathway of 6-mercaptopurine

A

(and its prodrug azathioprine)

inhibit de novo purine synthesis

inhibit step from PRPP –> IMP (inosine monophosphate)

99
Q

MOA and Pathway for Mycophenolate and Ribavarin

A

Inhibit IMP (inosine monophosphate) dehydrogenase

Inhibit step from IMP –> GMP

Purine synthesis pathway

100
Q

Xanthine oxidase:

Pathway, steps, inhibitors

A

Purine salvage pathway;

Catalyzes hypoxanthine –> xanthine and xanthine –> uric acid

Inhibited by Allopurinol, Febuxostat

101
Q

Adenosine deaminase:

Pathway, step, pathology

A

Purine salvage pathway;

Catalyzes Adenosine –> Deoxyadenosine;

ADA deficiency major form of AR SCID –> dATP leads to toxicity in lymphocytes

102
Q

HGPRT:

Pathway, step, pathology

A

Purine salvage pathway;

Needed for both Hypoxanthine + PRPP –> IMP and Guanine + PRPP –> GMP;

Deficiency is Lesch Nyan syndrome –> hypoxanthine gets shunted to uric acid production (X-linked recessive)

103
Q

Promotors and origins of replication are rich in what bases

104
Q

Unwinds DNA template at replication fork

105
Q

Prevents unwound strands from re-annealing

A

single-stranded binding proteins

106
Q

Create single or double-stranded breaks in helix to add or remove supercoils

A

DNA topoisomerases

107
Q

What two drugs inhibit eukaryotic topoisomerase II?

A

Etoposide, Teniposide

108
Q

What drugs inhibit prokaryotic topoisomerase II (DNA gyrase) and topoisomerase IV?

A

Fluoroquinolones

109
Q

Primase makes an RNA primer on which ____ can initiate replication

A

DNA Pol III

110
Q

DNA Pol III is found in

A

prokaryotes only

111
Q

Catalyzes phosphodiester bonds between Okazaki fragments

A

DNA ligase

112
Q

Telomerase is found

A

in eurkaryotes only;

often disregulated in cancer cells –> unlimited replication

113
Q

Common silent mutation

A

Base pair change in 3rd position of codon (tRNA wobble)

114
Q

Sickle cel disease, what mutation and what KIND of mutation?

A

glutamic acid –> valine;

Missense mutation - nucleotide substitution resulting in changed amino acid

115
Q

Two examples of frameshift mutations

A

Duchenne MD;

Tay-Sachs

116
Q

When does nucleotide excision repair occur?

117
Q

Nucleotide excision repair defective in

A

Xeroderma pigmentosum - cannot repair thymidine (pyramidine) dimers from forming with UV light exposure

118
Q

Base-specific glycosylase removes altered base and creates AP site;

AP endonuclease cleaves 5’ site; Lyase cleaves 3’ site;

DNA polymerase-beta fills gap, DNA ligase seals

A

Base excision repair;

Occurs throughout cell cycle;

Important for repair of toxic or spontaneous deamination

119
Q

Newly synthesized strand recognized, and mismatched nucleotides removed

A

Mismatch repair;

predominantly occurs during G2

Defective in Lynch syndrome (hereditary nonpolyposis colorectal cancer)

120
Q

Brings together 2 ends of DNA fragments to repair ds breaks

A

Nonhomologous end joining;

Mutated in ataxia telangectasia and Fanconi anemia

121
Q

Stop codons

A

UGA

UAA

UAG

122
Q

Start codon for prokaryotes

A

AUG (same for eukaryotes) but codes for N-formylmethionine (fMET)

**fMET is chemotactic for neutrophils

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