LMBR Study Grp: MCQ Mash-up! (S1, S3 & S8) Flashcards
Sleep red flags include (select all that are true):
A. Less than 8 hours sleep duration
B. Irregular sleep timing eg. shift work
C. Poor sleep quality, despite being in bed seven hours or more
D. Caffeine or alcohol within three hours of bedtime
E. More than nine hours sleep
Answer B, C, E
A incorrect, should be 7 B. True C. True D. incorrect (this is part of a sleep hygiene assessment) E. True
To combat jetlag when travelling west, one should (select all that are true)
A. Get late afternoon and early evening bright light, ideally outdoors
B. Eat a hearty breakfast within 20 minutes of new ideal wake up time
C. Get bright light exposure close to new ideal wake-up time
D. Eat complex carbohydrate-rich dinner two to three hours before new ideal sleep time
E. Take melatonin 1mg sublingual one hour before new ideal sleep time
Answer A, D, E
pg 275 A. True B. False, should be 30-45 minutes after new ideal wake up time C. False, this is for travelling east D. True E. True
BDNF is:
A. A genetic variation in the DNA
B. A substance that triggers repair and regeneration of nerve tissue
C. Impaired by sleep quality but not sleep duration
D. Produced primarily during REM sleep
Answer: B is correct
p 272 (BDNF Brain Derived Neurotrophic Factor is affected by both sleep quality and duration; It is produced primarily during slow wave restorative sleep; SNP is a genetic variation in the DNA)
Lifestyle practices and health habits are the most important determinants of positive health outcomes. Select two key elements for improving health behaviour outcomes:
a) Measure processes and outcomes
b) Having a trusting relationship between the physician and patient
c) Performing lifestyle medicine focused history, physical and testing
d) Patient support from loved ones, the greater community and a multidisciplinary team
Answer b and d
(pg 17, section 1);
other two are 2 of the 15 competencies of lifestyle medicine, pg 26.
According to the Cochrane Collaboration, AHA and USPSFF Task Force, all of the following are lifestyle modifications shown to reduce morbidity and mortality from CVD, cerebrovascular disease and cancer in adults except:
a) Tobacco cessation
b) Counselling in excessive Alcohol use
c) Making dietary changes
d) Increasing Physical Activity
Answer b
pg 21
What is the first-line treatment for Insomnia ?
A) Alcohol
B) Cognitive Behaviour Therapy
C) Trazodone
D) Amben/Zolpidem
Answer B
Which of the following is false in the PDSA model:
A) Plan (Desired Improvement, What change will be tested, outcomes are we looking for?)
B) Study (Review the number of vitals collected and the total number of patients seen)
C) Act (Adapt the method based on the lessons learned)
D) Root cause analysis (conduct and ask why 2 times to get to the root cause of the issue)
Answer D
Ref 84-85
Blue light at night:
A) Increases Core Body Temperature b) Increases melatonin C) Increases parasympathetic tone D) Increases Blood Pressure E) A and D
Answer E.
Page 267
Blue light at night also causes:
- Suppression of melatonin
- Increased sympathetic tone (incr both BP and HR)
- Increased alertness
- Increased [cortisol]
- Inhibition of sleep sleep onset and shifts sleep cycle later.
Blue light at night causes:
- Increase melatonin
- Lowers sympathetic tone
- Increased alertness
- Inhibits sleep duration
Answer 3 – inhibits sleep onset
p267
Which of the following risk profiles are INCORRECT:
A. An Asian man with BMI 28 and waist circumference of 96cm has a high risk of hypertension, type 2 diabetes and cardiovascular disease.
B. Reducing BP by 3 mmHg reduces mortality from stroke by 12%
C. A non-Asian woman with BMI 30.5 and waist circumference 90cm has a very high risk of hypertension, type 2 diabetes and cardiovascular disease.
D. Reducing BP by 5 mmHg reduces mortality from coronary heart disease by 9%.
Answer B
p. 73
Reducing BP by 3 mmHg reduces stroke mortality by 8%
As part of lifestyle prescription for improving sleep by minimizing stress, which of the following are NOT recommended:
A. Stop doing stimulating activities 90 minutes before bed.
B. Settling down one hour before bed with music at 60 bpm
C. Bath/shower one hour before bed.
D. Use guided imagery and meditation.
E. All of the above are recommended.
Answer: E
p. 273
Which are not examples of lifestyle modification practices or programs:
A. Ornish Spectrum Program B. PDSA (Plan-Do-Study-Act) cycles C. Chronic Care Model D. Medical Fitness Collaboration E. Prescription for Health model.
Answer: B
p. 80-84
PDSA is a quality improvement process.
Cancers associated with short sleep include all of the following, except:
1-Breast 2-Endometrium 3-Ovary 4-Prostate colorectal 5-ALL
Answer 3.
Page 273
Which of the following intensive therapeutic lifestyle change programs used a purely whole food plant based diet approach?
1- Pritkin Program
2- McDougall program
3- CHIP program
4- Ornish program
Answer: 2, 3,
Page 14
Pritkin uses lean animal meats and low fat dairy.
Ornish uses some fish oil, salmon, dairy allowable.
Which statements are incorrect regarding behavioural determinants of positive outcomes?
- 60% of all premature deaths are due to poor diet, tobacco use and inactivity.
- Adverse childhood events increases risk of diabetes, cancer and respiratory disease.
- Health behaviour change is reliant on patient and physician relationship, but not of the support of community
- Health outcomes disparities are due to genetic predisposition, local environmental conditions, poorer care, different seeking behaviours, poor lifestyle choices.
Options: A. 2&4 B. 1&2 C. 1&3 D. 3&4
Answer C:
80% of all premature deaths are due to poor diet, tobacco use and inactivity.
Health behaviour change is reliant on patient and physician relationship and the support of community, loved ones and multidisciplinary teams.
