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mix Flashcards

1
Q

how to calculate Positive likelihood ratio and negative likelihood ratio?

A 
PPV = sensitivity / (100-specificity)
NPV = (100-sensitivity) / specificity
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2
Q

what is incidence?

A

number of new cases of disease in healthy population

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3
Q

How do you calculate relative risk

A

PPV / NPV
RR >1 treatment increases risk of outcome
RR <1 treatment decreases the risk of outcome

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4
Q

difference between odds and probability/risk?

A

odds is the the event occurring and not occurring.
Probability is the chance of an event occurring in relation to the options.
E.g. the odds and probability of having a girl or boy
odds 1:1
probability 0.5

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5
Q

what is type 1 error and how can it be reduced?

A

rejects a null hypothesis when it is true (false positive).

reduced by lower p value (increasing sample size)

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6
Q

what is type 2 error and how can it be best reduced?

A

failure to reject the null hypothesis when it is wrong (false negatives). it can be reduced by increasing the power of a study - population size, size effect, variance

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7
Q

what car seat should a 4-7 year old be in

A

back seat, forward facing, booster, seat belt

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8
Q

what car safety seat should a baby be placed in

A

back seat, rear facing, booster with 5-6 point harness

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9
Q

polysaccharide conjugate vaccines

A

Hib, meningococcal, pneumococcal

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10
Q

protein subunit vaccines / recombinant

A

Hep B, influenza, pertussis, HPV

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11
Q

toxoid vaccines

A

diptheria tenanus

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12
Q

which vaccines are inactivated/killed

A

polio, Hep A, rabies, Rotateq

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13
Q

what are the phases of clinical trials

A 
phase 0 = pharmacokinetics / pharmacodynamics
phase 1 = safety
phase 2 = dose range, safety
phase 3 = efficacy vs gold standard
phase 4 = post marketing surveillance
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14
Q

what is intention to treat?

A
  • analysis irrespective of adherence to treatment
  • avoids crossover and dropout which may break random assignment
  • provides information on potential effects of treatment.
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15
Q

how can you improve internal validity

A

randomisation, blinding, intention to treat, appropriate comparator, published protocol

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16
Q

how can you improve external validity

A

multi-centre, wide inclusion, limit exclusion criteria, selection of patients, differences protocol to routine practice.

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17
Q

how do you reduce performance bias

A

blinding

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18
Q

how do you reduce detection bias

A

double blinding

19
Q

how do you reduce attrition bias

A

randominsation and intention to treat

20
Q

what is the Cohen effect size

A

used in forrest plots
<0.2 small
0.5 mod
0.8 large

21
Q

wha is chi squared in the forrest plot

A

assesses heterogeneity between studies

high value >50% = less sure the intervention will consistently have effect

22
Q

what is an ecological study?

A

population based, not individual, decriptive

23
Q

what is a case-control study?

A

retrospective, good for rare diseases
subject to recall bias and selection bias
confounding

24
Q

what is a cross-sectional study?

A

good for prevalence

single time point

25
Q

what is cohort study?

A

begins with exposed persons and monitors for disease
can calculate relative risk
good for common disease, rare exposure
biggest threat = loss to follow-up

26
Q

what drugs cause gynecomastia?

A

digoxin, spironolactone, cyclosporin

27
Q

Side effects methotrexate?

A

mucositis
myelosuppression
hepatotoxicity
pulmonary fibrosis

28
Q

Digoxin side effects?

A

yellow vision and blurred vision

29
Q

what is potential serious side effect of Vitamin A

A

pseudomotor cerebri

30
Q

what is the mechanism of action for beta-lactam antibiotics

A

time above MIC

31
Q

what are the glycopeptide antibiotics?

A

vanc
teicoplanin
bleomycin

32
Q

what increases the action of theophylline

A

eryhtromycin

33
Q

what increases the toxicity of phenytoin and lamotrigine

A

sodium valproate

34
Q

what will decrease the action of glucocorticoids

A

rifampicin

35
Q

what drugs are renally cleared

A 
metformin
allopurinol
lithium
digoxin
methotrexate
36
Q

what bacteria produce beta-lactamases

A

enterobacter
pseudomonas
h. influenza
neisseria

37
Q

what is anticlockwise hysteresis

A

delay is distribution of the drug to site of action

e.g. digoxin

38
Q

what is clockwise hysteresis

A

tacchyphylaxis - initial dose has good effect but effect diminished with repeat dosing
e.g. amphetamines

39
Q

side effects carbamazepine

A

SJS
DRESS
leukopenia
hyponatraemia

40
Q

side effects sodium valproate

A 
weight gain
pancreatitis 
hepatic failure 
lamotrigine interaction 
teratogenic
41
Q

side effects phenytoin

A

hissuitism
gum hypertrophy
serum sickness
osteoporosis

42
Q

what drugs are at greatest risk of SJS

A

carbamazepine, lamotrigine

43
Q

side effects vigabatrin

A

weight gain retinopathy, psychosis

44
Q

side effects topiramate

A

renal stones
weight loss
acidosis
glaucoma

Pharm/epi/community (1 decks)

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