Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CMS100- Foundations of clinical medicine > Test 1- Lecture 1-5 > Flashcards

Test 1- Lecture 1-5 Flashcards

(78 cards)

Start Studying
1
Q

a naturopathic Dr just obtained some initial info from a px about her main concern, what is the next step

A

consider what information is still needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

If a practitioner is seeking to obtain valuable medical information while exposing the patient to minimal harm, discomfort or inconvenience, what aspect of the diagnostic process will they engage in?

A

history taking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In what section of a medical chart would we be most likely to include information about symptoms?

A

subjective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What term is used to describe a mental summary of a practitioner’s knowledge of a disease?

A

illness script

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What single attribute of a test will best help a practitioner determine its value as evidence as it relates to a particular condition?

A

likelihood ratio (LR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

of total cases within a given time period within a specific population AKA how common a Cx is in a certain population

A

prevalence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

diagnostic process wheel contains what 3 factors

A
  1. hypothesis
  2. gathering
  3. interpret info
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hx taking
pt-centered interview

A

step 1 of the diagnostic process diagram: obtain info from px

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

factors when considering what might be going on with the px and what info you still need in order to take action

A

illness scripts, DDx, probability, evidence, testing thresholds, treatment thresholds (could be px education, diagnostic imaging etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hx taking
pt centered interview
PE

A

step 2 of the diagnostic process diagram: get this information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

purpose of px-centered interview

A

focus on C/C, feelings, fears, impact, expectations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

manifestation of disease found by the clinician and charted in the OBJECTIVES

A

signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

DDx

A

list of potential Cx associated with the px concenrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

premature closure

A

failure to consider all possibilities after the initial diagnosis is made and could lead to misdiagnosis
- px often assume their first thoughts of Cx is always correct ( subject to bias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ways memory is assessed, clinically-relevant memories where knowledge is recalled including: predisposing Cx, who’s more vulnerable

A

illness scripts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

when are illness scripts used?

A

to describe summary of practitioner’s knowledge of disease or to compare/ contrast Cx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

probability

A

the likelihood of different Cx presented in order to make the right decisions of what to do next

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Evidence using likelihood ratios

A

infos that helps update your estimate of probabilities from evidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how do you gather evidence to increase LR

A

History taking for pre test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

when do you use LR

A

to estimate one’s probability of a Cx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

threshold

A

probabilities beyond a point you stop gathering info, but never 100% certainty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

parts of an illness script

A
  1. Disease
  2. epidemiology
  3. timing
  4. S/S
  5. Mechanism: pathophysiological
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

demographic, age, sex, ethnicity, SES, predispositions, exposures, social, FHx

A

Epidemiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

time course (3)

A
  1. duration: hyper acute (same day), acute (few days), subacute, chronic
  2. persistence/ pattern: constant, stable, progressive
  3. episodic: waxing (increasing in intensity over time), waning (decreasing in intensity overtime or becomes more mild), intermittent (comes and goes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
syndromes
collection of S/S grouped in a medical Cx with recognizable patterns
26
between 2-3 diseases, organized chart
comparing and contrasting illness scripts
27
px illness script vs disease illness script
what is happening with the px vs the disease illness script where the ND transcribes in medical terminology and compares/ contrasts potential Cx - representation of px concerns matching to a disease illness script
28
when comparing disease illness scripts, which of the following should you do?
create a table with illness scripts in adjacent columns/ rows
29
allows for the possibility that the initial beliefs about the diagnosis were incorrect
DDx
30
A process at which clinicians think about the possible causes of the px S/S before making a final diagnosis after obtaining information from the px→ compare the information to one’s understanding of different conditions to generate multiple hypothesis that could answer the S/S
DDx
31
what is one problem that people may fail to consider after arriving at an initial guess of a Cx
involve considering that you might have been wrong
32
process of DDX
obtain px info, create problem representation and px illness script, compare px illness script to a # of disease illness scripts
33
what often occurs for beginners in terms of errors
higher % of missing a serious diagnosis the first guess is often wrong because the most common Cx are not usually the most serious
34
availability heuristic
"jumping the gun" a type of cognitive error--> a person would use an initial guess from info that comes quickly & easily that could worsen diagnostic performance
35
Possibilism
a type of error when you make a list of all possibilities, but the list could be too long, unnecessary testings with no use of probability
36
2 types of errors
1. availability heuristic 2. possibilism
37
prediction based on available medical info, the expected outcome for person's health & Cx, the healthcare provider will predict what will happen, if its going to improve or get worse
prognosis
38
philosophically; what Cx have the best benefit to harm ratio if treated healthcare providers make decisions about px care, need to consider what research is most effective and practical for improving px'x health
pragmatism
39
what is the difference between pragmatism and prognosis
pragmatism is a philosophical approach that guides decision-making based on practically and real-world consequences, whereas prognosis is a medical term that describes the predicted outcome of px's medical condition
40
how is pragmatism and prognosis related
the pragmatic approach to healthcare decision-making could involve considering the prognosis as one of the factors when determining the most practical and effective course of action for the px
41
the steps for DDx illness scripts
1. make a problem list, list everything found from case study 2. processed problem list of what's key factors 3. Px illness script (epidemiology, timing, syndrome statement, other history) 4. other history 5. DDX- Final Cut with the epidemiology, timing, syndrome, mechanism
42
what is measured as likelihood ratios (Lrs)
the strength of evidence that is measured
43
what does LR represent
numerical value of information from a test
44
LR=1 indicates what
are useless ( don't change probability)
45
LR> 1, to infinity indicates what?
increases the probability
46
LR<1 indicates (fractions or decimals down to 0)
decreases the probability
47
how much the evidence changes your mind depends on the strength of evidence
but the change in probability isn't linear
48
pre-test probability
likelihood a person has a particular condition/ disease BEFORE a diagnostic test is preformed, an estimate of how likely that px has that condition based on their Sx, Hx, risk factors
49
if you're initial probability is closer to 0% or 100% what is most likely to happen?
it would be more difficult to change your mind
50
how much more likely a person WITH a medical condition will test positive compared to a person without a condition - higher LR+ = strong indication that a person has a condition - how probability of disease shifts when the finding is present
positive LR (LR+)
51
how much more less likely it is for a person with a medical condition to have a negative test compared to a person without the condition - a lower LR- means that a negative test is a good indicator that the condition is not present
negative LR (LR-)
52
probability
how likely something is to happen, not possible to reach 100%
53
define biases
not a personal shortcoming, but a human trait that people use "common representatives" to make judgements
54
how do people use their biases to make judgements?
assessing how closely something/someone matches their perceived ideologies/stereotypes, probabilities or likelihoods based on similarities of perceived ideas
55
the degree to something is representative or similar to a stereotype, " must be this because it fits the stereotype"
bias automatic assessment of representativeness
56
pre-test probability
best estimate of a disease probability before doing any diagnostic testing
57
post testing probability
from the pre-test probability with diagnostic tools to calculate post-testing probability
58
best reference class
set of patients that reflects the px in a population.
59
prevalence
epidemiological measure portion of the population that has the condition RIGHT NOW
60
what is the difference of prevalence and incidence
prevalence: portion of the population that currently has the condition without a. timeline incidence: rate of new cases of a condition developing in a population over a defined period
61
what are the pros of prevalence
easy to research, can specify subpopulations, more accurate estimates, take into account the presenting Sx to provide more accurate initial judgement of potential Cx
62
what are the cons of prevalence
underestimate if something people may frequently seek attention for, which in database may increase the prevalence OR does not accurately reflect acute conditions bc research is uncommon
63
base rate neglect
aka base rate fallacy: cognitive error when people focus too much on specific information ( ex: results of diagnostic test) and underestimate the broader context of " base rate"
64
what can occur if a person neglects base rate?
erroneous (incorrect) conclusions bc it disregards the overall likelihood of a probability of Cx - ex" hearing about a rare disease that has very severe Sx, "google self diagnosis" and causes misdiagnosis
65
what are 3 types of cognitive biases
1. anchoring bias 2. confirmation bias 3. base rate neglect
66
cognitive bias where people rely heavily on first piece of information "anchoring" to make decisions/ estimations
ANCHORING BIAS -ex: if a seller sets a high price for a used car it can influence the buyer's perception of the cars value, making them more likely to agree to a higher price than they may have, anchoring their judgement without rationally thinking it through
67
confirmation bias
seek, interpret info that confirms pre-existing beliefs/ hypotheses while ignoring or downplaying info that contradicts them -ex: someone strongly believes in a particular political ideology may only pay attention to news sources that align with their beliefs, while dismissing opposing perspectives
68
what is room for improvement concept and how does it relate to biases
overestimates the probability of a diagnosis stemming from 3 biases: base rate neglect. anchoring bias, confirmation bias
69
what s the consequence of overestimation
overuse of medication, excessive procedures, corrupt shared decision making with patient.
70
what should you NOT use to for probabilities
1. incidence in the population 2. lifetime prevalence: chances of developing the disease overestimated, not general representation of the population - use epidemiology instead
71
which if the following would make for the best reference class for use in estimating pretest probability?
research on the eventual diagnosis group that is similar to the. symptoms that the px seems to be presenting
72
Double counting evidence
findings are closely correlated or included in each other's findings Ex: increased patellar reflex and increased ankle jerk reflex
73
px who have the disease (numerator), the probability that the test will be positive
Sensitivity- TRUE POSITIVE LR+ : (ex: probability that you would see certain evidence if your hypothesis were true)
74
in px, who don’t have the disease, probability that your test will be negative
specificity - TRUE NEGATIVE (if you were to see the same evidence if your hypothesis was false)
75
PPV: positive predictive value
probability that disease is PRESENT given the test was POSITIVE
76
PPV: negative predictive value
probability that disease is ABSENT given that the test was NEGATIVE
77
pathgnomonic
high LR+, not necessarily sensitive but highly specific
78
sine qua non
findings if absent strongly decreases the probability of a condition (Low LR- close to 0)

CMS100- Foundations of clinical medicine (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions