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ACP Board Basics 3 > General IM > Flashcards

General IM Flashcards

1
Q

Calculated as (all true-positive test results) / (true-positive and false-negative test results)

A

Sensitivity

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2
Q

Calculated as (all true-negative results) / (true-negative and false-positive results)

A

Specificity

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3
Q

Calculated as (true-positive test results) / (all positive test results)

A

Positive predictive value

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4
Q

Calculated as (true-negative test results) / (all negative test results)

A

Negative predictive value

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5
Q

The probability that the patient has the disease if the test is positive

A

Positive predictive value

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6
Q

The probability that the patient does not have the disease if the test is negative

A

Negative predictive value

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7
Q

A receiver operating characteristic curve is a graph of this relationship between sensitivity and specificity

A

Sensitivity vs. (1 - specificity)

it is a graph of the true-positive rate [y] vs. false-positive rate [x]

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8
Q

Direction of change in positive predictive value as prevalence of the disease increases

A

Increases

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9
Q

Direction of change in negative predictive value as prevalence of the disease increases

A

Decreases

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10
Q

A measurement of the odds of having a disease independent of the disease prevalence

A

Likelihood ratio

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11
Q

Formula for positive likelihood ratio

A

Sensitivity / (1 - specificity)

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12
Q

Formula for negative likelihood ratio

A

(1 - sensitivity) / specificity

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13
Q

A likelihood ratio of 2 increases the probability of disease by approximately this percentage

A

15%

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14
Q

A likelihood ratio of 5 increases the probability of disease by approximately this percentage

A

30%

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15
Q

A likelihood ratio of 10 increases the probability of disease by approximately this percentage

A

45%

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16
Q

A likelihood ratio of 0.5 decreases the probability of disease by approximately this percentage

A

15%

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17
Q

A likelihood ratio of 0.2 decreases the probability of disease by approximately this percentage

A

30%

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18
Q

A likelihood ratio of 0.1 decreases the probability of disease by approximately this percentage

A

45%

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19
Q

In this study design, the presence of the presumed risk factor and presence of the outcome are measured at the same time in a population

A

Cross-section

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20
Q

In this study design, subjects are divided into groups based on the presence or absence of the outcome of interest and then the frequency of risk factors in each group is compared

A

Retrospective (case control)

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21
Q

In this study design, subjects are divided into groups based on the presence or absence of the presumed risk factor and followed for a period of time; frequency of the outcome is compared at the end of the study

A

Prospective (cohort)

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22
Q

In this study design, subjects are randomly divided into groups; one group receives the intervention and followed forward in time; frequency of the outcome is compared at the end of the study

A

Randomized controlled trial

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23
Q

In this study, multiple small clinical trials using similar randomization techniques and interventions are combined into one large analysis to address very precise clinical questions

A

Systematic review

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24
Q

The difference in absolute risk of patients who received the intervention and those who did not

A

Absolute risk reduction (ARR)

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25
Q

The ratio of the absolute risk of patients who received the intervention and those who did not

A

Relative risk

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26
Q

A type of relative risk (RR) that calculates the risk of an outcome in a group exposed to a risk compared with a control group not exposed to the risk

A

Hazard ratio

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27
Q

Calculated as (1 / absolute risk reduction)

A

Number needed to treat

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28
Q

A type of error wherein it is incorrectly concluded that a statistically significant difference exists between the experimental and control groups

A

Type I error

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29
Q

A type of error wherein it is incorrectly concluded that no difference exists between the experimental and control groups

A

Type II error

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30
Q

A study that uses a P value of <0.5 will have this chance of type I error

A

<5%

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31
Q

Smoking cessation reduces all-cause mortality by up to this percentage

A

50%

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32
Q

This pharmacologic therapy increases smoking cessation rates about 3.5 times more than control; it has been associated with suicidal ideation and increased risk of cardiovascular events

A

Varenicline

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33
Q

This pharmacologic therapy increases smoking cessation rates about 2 times more than control; should be avoided with seizure disorder and eating disorder; may be associated with suicidal ideation

A

Buproprion

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34
Q

HPV vaccines are indicated in male and female patients of this age regardless of sexual activity, presence of genital warts, or previous postiive HPV infection

A

9-26 years

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35
Q

Inactivated influenza vaccine is contraindicated in patients with allergy to this food

A

Eggs

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36
Q

Inactivated influenza vaccine is contraindicated in patients with a history of this neurologic condition

A

Guillain-Barré syndrome

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37
Q

Vaccine indicated in smokers

A

Pneumococcal vaccine

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38
Q

Tdap vaccine is given to patients with a dirty wound if this number of years has elapsed since primary series

A

> 5 years

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39
Q

Yellow fever vaccine is indicated for patients travelling to these regions (2)

A

Africa and South America

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40
Q

Meningococcal vaccine is indicated for patients travelling to this region

A

Sub-Saharan Africa

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41
Q

Frequency of blood pressure screening in the general population

A

Every 2 years

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42
Q

Screen for diabetes mellitus if blood pressure is at this level

A

> 135/80 mmHg

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43
Q

Starting age and frequency of screening total and HDL cholesterol

A

Men 35 years, women 45 years

Every 5 years

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44
Q

Starting age and frequency of screening mammogram with or without clinical breast examination

A

50 years, every 1-2 years

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45
Q

Starting age and frequency of screening Pap test

A

21 years, every 3 years until age 65

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46
Q

Frequency of screening when Pap test is combined with HPV testing

A

Every 5 years

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47
Q

Abdominal aortic aneurysm screening recommendation

A

One-time screening for men 65-75 years of age who have ever smoked

48
Q

Chlamydia screening is recommended for sexually active women of this age

A

24 years or less

may also screen older at-risk women

49
Q

Starting age to screen for bone mineral density

A

Women 65 years
(<65 years if fracture risk is equal to or greater than that of a 65-year old white woman who has no additional risk factors for fracture using the WHO FRAX algorithm)

50
Q

Most common causes of secondary obesity (3)

A

Hypothyroidism, Cushing syndrome, polycystic ovary syndrome

51
Q

BMI definition of overweight

A

25-29.9

52
Q

BMI definition of obese class I

A

30-34.9

53
Q

BMI definition of obese class II

A

35-39.9

54
Q

BMI definition of obese class III

A

40 or more

55
Q

Average weight reduction with orlistat

A

2.9 kg

56
Q

Drug treatment for obesity is offered if this threshold in weight loss is not reached by the end of 3 months using dietary and exercise interventions

A

5%

57
Q

A selective serotonin receptor agonist that induces the feeling of early satiety; associated with average weight loss of 5.8 kg and improvement in glycemic control

A

Locaserin

58
Q

This combination of an appetite suppressant and an anticonvulsant with a weight-loss effect has been approved for pharmacological treatment of obesity

A

Phentermine-topiramate

59
Q

Indications for the use of locaserin or phentermine-topiramate for obesity

A

BMI 30 or more, or 27 with 1 or more obesity-related comorbidity

60
Q

Indications for bariatric surgery

A

BMI >40, or >35 with serious obesity-related comorbidities (severe sleep apnea, diabetes, severe joint disease)

61
Q

Mortality reduction with bariatric surgery

A

29%

62
Q

Most common cause of involuntary weight loss in the young

A

Malignancy

63
Q

Most common causes (4) of involuntary weight loss in extended care facilities

A

Depression, medications, dehydration, issues related to dementia

64
Q

Vitamin deficiencies (2) associated with coiled, corkscrew hair

A

Vitamins A and C

65
Q

Vitamin deficiency associated with skin desquamation

A

Riboflavin

66
Q

Vitamin deficiency associated with petechiae and perifollicular hemorrhage

A

Vitamin C

67
Q

Vitamin deficiency associated with skin pigmentation, cracking, and crusting

A

Niacin

68
Q

Vitamin deficiency associated with acro-orificial dermatitis (erythematous, vesiculobullous, and pustular)

A

Zinc

69
Q

Vitamin deficiency associated with ophthalmoplegia and foot drop

A

Thiamine

70
Q

Vitamin deficiency associated with memory disturbance and depressed vibratory and position senses

A

Vitamin B12

71
Q

Gold standard for diagnosing white coat hypertension

A

Ambulatory BP measurement

72
Q

Elevated blood pressure detected by ambulatory BP measurement but with normal office BP measurement; associated with increased risk of sustained hypertension and increased cardiovascular mortality

A

Masked hypertension

73
Q

Cyclosporine-induced hypertension is a compelling indication for the use of this antihypertensive agent class

A

Calcium channel blocker

74
Q

With an ACE inhibitor or ARB, an increase in serum creatinine by this percentage is acceptable and not a reason to discontinue therapy for hypertension

A

33%

75
Q

GFR at which thiazide diuretics are not effective as antihypertensives

A

<30 mL/min/1.73 m2

76
Q

Most readily modifiable risk factor for falls

A

Medications

77
Q

Leading cause of drugs implicated in falls

A

Psychotropic agents

78
Q

“Timed Up and Go” test associated with increased risk for falls

A

> 10 seconds (high risk if >14 seconds)

79
Q

Supplementation of this vitamin reduces the frequency of falls in older patients who are deficient

A

Vitamin D

80
Q

Duration of chronic cough

A

8 or more weeks

81
Q

Most common causes (3) of chronic cough in patients who are nonsmokers, have a normal chest x-ray, and are not taking an ACE inhibitor

A

Upper airway cough syndrome (postnasal drip), asthma, and GERD

82
Q

Before additional evaluation, patients with chronic cough should stop smoking and discontinue ACE inhibitors for this duration

A

4 weeks

83
Q

Test for cough-variant asthma

A

Methacholine challenge

84
Q

A 4-point criteria to stratify adult patients according to risk of group A streptococcal pharyngitis

A

Centor criteria

85
Q

Components of the 4-point Centor criteria

A

Fever (subjective), absence of cough, tender anterior cervical lymphadenopathy, tonsillar exudates
(0-1: no testing/treatment; 2-3: do rapid antigen detection test or culture, but not both; 4: treat without testing)

86
Q

Septic thrombophlebitis of the internal jugular vein resulting in metastatic pulmonary infections; caused by Fusobacterium necrophorum

A

Lemierre syndrome

87
Q

Treatment for Fusobacterium necrophorum pharyngitis

A

Ampicillin-sulbactam

88
Q

Treatment for streptococcal pharyngitis in patients allergic to penicillin

A

Macrolide

89
Q

Acute bacterial sinusitis is defined as lasting for this duration

A

7 or more days

90
Q

First-line choice for suspected bacterial sinusitis

A

Amoxicillin-clavulanate

91
Q

Treatment for acute bacterial sinusitis in patients allergic to penicillin

A

Doxycycline

92
Q

Indication for imaging tests such as CT in sinusitis

A

Immunocompromised condition (e.g., AIDS)

93
Q

A Weber test that lateralizes to the bad ear is indicative of this type of hearing loss

A

Conductive hearing loss

sensorineural hearing loss if it lateralizes to the good ear

94
Q

Rinne test result in conductive hearing loss

A

Bone conduction > air conduction

95
Q

Most common cause of sudden sensorineural hearing loss

A

Idiopathic

96
Q

Most common cause of malignant external otitis

A

Pseudomonas aeruginosa

97
Q

Facial nerve paralysis, sensorineural hearing loss, and vesicular lesions on and in the ear canal caused by varicella-zoster virus

A

Ramsay Hunt syndrome

98
Q

Most common cause of red eye

A

Viral conjunctivitis

99
Q

Treatment for bacterial conjunctivitis

A

Topical fluoroquinolones or bacitracin-polymyxin

100
Q

Giant papillary conjunctivitis with itching and watery discharge, and preauricular lymphadenopathy

A 
Chlamydial conjunctivitis
(treat with oral tetracycline, erythromycin, or doxycycline)
101
Q

Chronic fatigue is defined as fatigue lasting for this duration

A

More than 1 month

102
Q

Chronic fatigue syndrome is defined as persistent or relapsing fatigue lasting for this duration

A

At least 6 months

103
Q

Superior among the two major BPH drug classes

A

Alpha-adrenergic blockers

104
Q

First-line drugs for treatment of erectile dysfunction

A

Oral sildenail, vardenafil, or tadalafil

105
Q

First-line therapy for premature ejaculation

A

SSRIs

106
Q

Second-line therapy for premature ejaculation

A

Clomipramine

107
Q

Treatment for erectile dysfunction when oral PDE-5 inhibitors are ineffective

A 
Intraurethral alprostadil
(if ineffective, give intracavernous alprostadil)
108
Q

Core components (3) of decisional capacity

A

Understanding the situation at hand, understanding the risks and benefits of the decisions being made, and being able to communicate a decision

109
Q

In this standard for decision making, the surrogate makes the decision that he or she believes the patient would have made

A

Substituted judgment standard

110
Q

In this standard for decision making, the surrogate selects the medical treatment that he or she personally feels is best for the patient

A

Best interests standard

111
Q

Reasoning error wherein the clinician who has encountered a similar presentation jumps to the conclusion that the current diagnosis must be the same as the previous

A

Availability heuristic

112
Q

Reasoning error wherein the clinician accepts at face value a previous diagnosis made by another clinician

A

Anchoring heuristic

113
Q

Reasoning error wherein there is acceptance of a diagnosis or plan made by another of higher authority

A

Blind obedience

114
Q

Reasoning error wherein full differential diagnosis is not considered

A

Premature closure

115
Q

Average number of system-related or cognitive factors that contribute to medical error in a single case

A

6

ACP Board Basics 3 (10 decks)

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