Term
Match each of the following measures to their appropriate study type.
1) Odds ratio (OR)- ad/bc
2) Relative Risk (RR)- [a/(a+b)]/[c/(c+d)]
3) Disease Prevalence |
|
Definition
1) Case-control ("what happened")
ex) "Patients with COPD had higher odds of a history of smoking than those without COPD"
2) Cohort Study ("what will happen?")
ex) "Smokers had a higher risk of developing COPD than did nonsmokers
3) Cross-sectional ("what is happening?")
ex) "Shows risk factor association with disease, but not causality. |
|
|
Term
What phase of a clinical trial is associated with each of the following purposes?
1) Comparing new treatment to gold standard
2) Assessing safety, toxicity and pharmacokinetics
3) Detecting rare or long-term adverse effects
4) Assessing treatment efficacy, optimal dosing and adverse effects |
|
Definition
1) Phase 3- large number of patients randomly assigned either to treatment or placebo
2) Phase 1- Small number of healthy volunteers
3) Phase 4- Postmarketing surveillance trial of patients under approval
4) Phase 2- Small number of patients with disease of interest. |
|
|
Term
| Which measure of diagnostic reliability tells you the proportion of people without a disease who test negative? |
|
Definition
Specificity= TN/ (TN+FP)
Value approaching 1 is desirable for ruling in disease and indicates LOW FALSE POSITIVE.
ex) HIV ELISA is low specificity (high sensitivity), while Western Blot is high specificity (low sensitivity) |
|
|
Term
| Which measure of diagnostic reliability tells you the proportion of people who test positive for a disease that actually have it? |
|
Definition
PPV= TP/(TP+FP)
Probability that person who tests positive for disease actually has it.
- Remember, PPV and NPV VARY WITH PREVALENCE (don't use with low prevalence |
|
|
Term
| Which measure of diagnostic reliability tells you the proportion of people with a disease who test positive? |
|
Definition
Sensitivity= TP/(TP+FN)
- >>1 indicates low false-negative rate and is important for RULING OUT a disease
- Good for diseases of low prevalence |
|
|
Term
| Which measure of diagnostic reliability tells you the proportion of people who test negative for a disease who actually do not have the disease? |
|
Definition
NPV= TN/(TN+FN)
- Remember, PPV and NPV VARY WITH PREVALENCE (don't use with low prevalence) |
|
|
Term
| How does HIV testing relate to sensitivity/specificity? |
|
Definition
1) HIV screening ELISA is high sensitivity, but low specificity
2) Western blot is low sensitivity, but high specificity |
|
|
Term
| How does prevalence relate to incidence in terms of acute vs. chronic diseases? |
|
Definition
1) Point prevalence: total cases at point in time/total population at that time
2) Incidence: # new cases over time period/total population during that time period
Prevalence= incidence x disease duration
Prevalence > Incidence for chronic (Diabetes)
Prevalence= incidence for acute disease (common cold) |
|
|
Term
10 people with HIV had used IV drugs and 4 people with HIV had not. 30 people without HIV used IV drugs and 15 did not.
What is the odds that someone who used IV drugs will have HIV? |
|
Definition
OR= ad/bc= (10)(15)/(30)(4)= 1.25
Since prevalence is low, OR approximates the RR in this case (they are 1.25 times as likely to contract HIV) |
|
|
Term
15 smokers got COPD in a cohort study, while 35 smokers did not. 3 non-smokers got COPD, while 47 did not.
What is relative risk of smokers vs. non-smokers developing COPD? |
|
Definition
Remember, RR is used in cohort studies (vs. OR for case-control).
RR= [a/(a+b)] / [c/(c+d)]
**probability of getting a disease in an exposed group divided by probability of getting disease in unexposed group.**
(15/50)/ (3/50)= (0.3)/(0.06)= 5
So, smokers are 5x as likely as non-smokers to get COPD. |
|
|
Term
15 smokers got COPD in a cohort study, while 35 smokers did not. 3 non-smokers got COPD, while 47 did not.
What is the attributable risk of smoking in the development of COPD? What is the number needed to harm? |
|
Definition
AR= EER-CER= a/(a+b) - c/(c+d)
- (15/50) - (3/50)= 0.3- 0.06= 0.24
NNH= 1/AR= 1/0.24= approximately 4.
For every 4 people who smoke, 1 will develop COPD |
|
|
Term
15 people with diabetes who took drug A were cured while 35 people on the drug were not. 2 people with diabetes who did not receive drug A also got better, while 48 did not.
What is the absolute risk reduction associated with taking drug A in treating diabetes? What is the number needed to treat? |
|
Definition
ARR= CER-EER= c/(c+d) - a/(a+b)
- (2/50)- (15/50)= 0.04-0.3= -0.26
NNT= 1/ARR= 1/-0.26= approximately -4
So, for every 4 people with diabetes who are given drug A, 1 should get better. |
|
|
Term
True or False,
Random error reduces the accuracy of a test |
|
Definition
False
Random error reduces the precision (i.e. reproducibility) or a test.
Systematic error (such as selection bias, recall bias, procedure bias, ect) reduce the accuracy of a test (i.e. trueness of test measurements). |
|
|
Term
| What are 4 was to reduce systematic errors due to bias in an experimental protocol? |
|
Definition
Remember, systematic errors reduce accuracy, not precision of measurements.
1) Blind studies
2) Placebo responses
3) Crossover studies (subject acts as own control)
4) Randomization (limit selection bias and confounding bias) |
|
|
Term
What type of systematic experimental error involves nonrandom assignment of subjects to a study group?
a. Late-look
b. Confounding
c. Lead-time
d. Selection
e. Procedure |
|
Definition
| D- Selection bias such as those subjects lost to follow-up or "Berkson's" bias |
|
|
Term
What type of systematic experimental error involves a researchers' belief in the efficacy of a treatment changing the outcome of that treatment?
a. Confounding
b. Pygmalion effect
c. Lead-time
d. Hawthorne effect
e. Procedure |
|
Definition
B- Pygmalian effect
- Hawthorne occurs when group being studies changes its behavior owing to the knowledge of being studied.
- Lead-time bias occurs when early detection is confused with survival
- Procedure bias occurs when subjects in different groups are treated differently
- Confounding bias occurs when in the case of 2 closely associated factors, one distorts the effect of the other |
|
|
Term
What type of systematic experimental error occurred when an investigator uses a survey to study a fatal disease?
a. Confounding
b. Pygmalion effect
c. late-look
d. lead-time
e. Procedure |
|
Definition
C- late-look error where information is gathered at the wrong time. In this case, only people who are still alive will be able to answer the survey
- Pygmalion effect an experimenter's belief about a treatment changes the course of that treatment
- Lead-time bias occurs when early detection is confused with survival
- Procedure bias occurs when subjects in different groups are treated differently
- Confounding bias occurs when in the case of 2 closely associated factors, one distorts the effect of the other |
|
|
Term
What type of systematic experimental error has occurred when early detection of a disease is confused with increased survival time?
a. Confounding bias
b. Pygmalion effect
c. Lead-time bias
d. Hawthorne effect
e. Procedure bias |
|
Definition
C- Lead-time bias
- Pygmalion effect an experimenter's belief about a treatment changes the course of that treatment
- Late-look bias occurs when information is gathered at an inappropriate time (fatal disease survey when only alive can respond)
- Procedure bias occurs when subjects in different groups are treated differently
- Confounding bias occurs when in the case of 2 closely associated factors, one distorts the effect of the other |
|
|
Term
What type of systematic error occurs when subjects are not representative relative to the general population?
a. Confounding bias
b. Selection bias
c. Sampling bias
d. Late-look bias
e. Recall bias |
|
Definition
C- sampling bias
a. Confounding bias occurs in the case of 2 closely related factors, where 1 influences the effects of the other
b. Selection bias occurs when there is nonrandom assignment to study groups
d. Late-look occurs when information is gathered at wrong time
e. Recall bias occurs when knowledge of presence of disorder alters recall by subjects (similar to Hawthorne effect in terms of knowledge of being studied) |
|
|
Term
| How is recall bias similar to the hawthorne effect? |
|
Definition
Both are systematic errors that relate to subjects knowledge of their condition (disease or experimental condition)
Recall bias occurs when knowledge on the part of subjects of their disease condition effects how they recall events.
Hawthorne effect occurs when group being studies knows about this fact, and changes their behavior because of it. |
|
|
Term
| How does power relate to the probability of making a type II error and what are its 3 major determinants? |
|
Definition
1) Power= 1-B, were B is the probability of incorrectly accepting the null hypothesis. Thus, the higher the value of Power, the greater the likelihood of noticing a significant difference where one exists.
2)
- Total number of end points experienced by population,
- Difference in compliance between treatment groups
- Size of expected effect (inversely related) |
|
|
Term
| The CI for an OR of 2 is +/- 1.2. Can the null hypothesis be rejected? |
|
Definition
Z= 1.96 DOES corresponds to p= 0.5, but if a confidence interval for an OR or RR includes 1, the difference is not significant
For Mean differences, the same is true if a CI includes 0! |
|
|
Term
You have data on the percentage of people who smoke in two distinct nationalities and want to determine whether the difference is significant.
What statistical test is appropriate? |
|
Definition
| Comparing 2 groups demands T-test (for sample means) or Chi-Square (for percentage/proportion) |
|
|
Term
| What are the primary, secondary and tertiary principles of disease prevention? |
|
Definition
PDR
1) Prevent disease (vaccinate for HPV)
2) Detect disease early (pap smear)
3) Reduce disability from disease (chemotherapy) |
|
|
Term
True or False:
Medicare is federal support for elderly people (>65) |
|
Definition
True.
MedicaiD is for Destitute
MedicarE is for Elderly (> 65 or < 65 with disabilities or ESRD) |
|
|
Term
| What are the 4 core ethical principles of healthcare? |
|
Definition
All Bagels Need Jam
1) Autonomy
2) Beneficience- Act in patients' best interest
3) Nonmaleficience- do no harm
4) Justice- treat fairly |
|
|
Term
All of the following are core legal principles of informed consent, except:
1. Discussion of pertinent information
2. Patient's voluntary agreement to plan of care
3. Patient's family must be informed
4. Freedom from coercion |
|
Definition
3.
They must have an intelligent understanding of risks/benefits and alternatives (including NO intervention)
Patient's family does not need to be informed, except in case of minor (<18), and even then, in cases of birth control, pregnancy management, treatment of STDs and management of drug addiction, they should not be informed. |
|
|
Term
Which of the following is not an exception to the regulations of informed consent?
1. Patient lacks decision-making capacity
2. Patient has been convicted of 3 previous cases of arson
3. Therapeutic Privilege
4. Waiver
5. Implied consent in an emergency |
|
Definition
| 2. Legal history is not taken into account unless it poses immediate danger to the patient or someone else and is impinging upon decision making capacity in the form of a psychiatric disorder. |
|
|
Term
Under which of the following conditions IS parental consent for minors required?
a. treatment of STDs
b. medical treatment during pregnancy
c. vaccination
d. management of drug addiction
e. prescribing contraceptives |
|
Definition
C. Almost all things require consent <18, EXCEPT
Contraceptives, STD treatment, Pregnancy treatment, Drug addiction management |
|
|
Term
True or False:
Under certain circumstances, a patients' family can require that the doctor withhold medical information from the patient. |
|
Definition
|
|
Term
All of the following elements are included in determining decision-making capacity for the purposes of informed consent, EXCEPT:
a. Decision is not result of delusions of hallucinations
b. Patient makes and communicates a choice
c. Patient knows and understands their choices available
d. Patient's decision is stable over time
e. Decision is consistent with patient's values and goals
f. Patient's choice is in accordance with their best interest |
|
Definition
F
To have DMC, the patient must communicate a choice that they understand, that is consistent with their own values, that remains stable over time, and that is not a result of delusions or hallucinations.
That decision can contrast what a doctor perceives to be in their best interest! |
|
|
Term
| What are the 3 major types of Advance directives? |
|
Definition
1) Oral Directive- most valid if directive was specific and was repeated over time to multiple people (validity can be an issue)
2) Living Will (written)- informs to withhold/withdraw treatment in case of terminal disease or persistent vegetative state
3) Durable power of attorney- Patient designates surrogate in the even that they lose DMC. CAN BE REVOKED by patient, IF they have DMC. |
|
|
Term
| In the event that a patient loses DMC and has not designates advanced directives, in what order does power of surrogacy fall? |
|
Definition
| Spouse>Adult Children>Parents>Siblings>Other relatives |
|
|
Term
Which of the following is NOT an exception to confidentiality?
a. Potential harm to others is serious
b. Patient's family is extremely worried about them.
c. No alternative means exist to warn or to protect those at risk
d. Physicians can take steps to prevent harm (i.e. reporting diseases, abuse, impaired automobile drivers)
e. Likelihood to harm self is great |
|
Definition
| B- ONLY if they are in serious danger related to the decision to withhold information. |
|
|
Term
| What did the Tarasoff Decision change about regulations on confidentiality in medical care? |
|
Definition
| Law requiring physician to directly inform and protect potential victims from harm; may involve breach of confidentiality. |
|
|
Term
A patient is having difficulty taking medications.
What should you do? |
|
Definition
| Provide written instructions; attempt to simplify treatment regimens |
|
|
Term
| What should you do if a patient desires an unnecessary procedure? |
|
Definition
| Try and understand why and address underlying concerns. Do not refuse to see the patient or refer him/her, but avoid performing unnecessary procedures. |
|
|
Term
A child comes into your clinic and asks about their chronic illness.
What should you tell them? |
|
Definition
| Ask them what their parents have explained to them, but to not tell him/her things that the parents have not. |
|
|
Term
A 17-year old girl wants an abortion.
How do you handle the situation? |
|
Definition
- Unless she is at medical risk, do not advise a patient to have an abortion regardless of age,
- Many states require parental notification or consent for minors. |
|
|
Term
A terminally ill patient requests physician assistance in ending her life.
What can you do as her physician? |
|
Definition
Physician-assisted suicide is ILLEGAL.
- You CAN provide medications that coincidentally shorten the patient's life. |
|
|
Term
A patient who recently had a mastectomy tells you that she feels "ugly."
How can you respond? |
|
Definition
| Find out why she feels this way and do not offer false-reassurance. |
|
|
Term
A drug company offers a "referral fee" for every patient physician enrolls in a study.
Is this ever reasonable and if so, when? |
|
Definition
- Never acceptable for physicians to receive compensation from drug companies.
- Patients must be told of any referral fees. |
|
|
Term
| If a patient requires a treatment not covered by his insurance, what should you do? |
|
Definition
| Never limit or deny care because of expense, and discuss all treatment options with patients, regardless of coverage. |
|
|
Term
Match the EEG waveform with each of the following stages of sleep.
1. Awake (eyes open), active alert
2. Awake (eyes closed)
3. (5% of sleep)- light
4. (45%)- deeper; bruxism
5. (25%)- deepest, non-REM
6. REM. (25%) |
|
Definition
at night, BATS Drink Blood
1. Beta (highest frequency, lowest amplitude)
2. Alpha
3. Theta
4. Sleep spindles and K complexes
5. Delta
6. Beta |
|
|
Term
All of the following notable changes occur during REM sleep, EXCEPT:
1) Dreaming
2) Loss of motor tone
3) Memory formation
4) Erections
5) Increased brain oxygen use
6) Decreased brain co2 use |
|
Definition
|
|
Term
| How do Benzodiazepines, Alcohol and Barbiturates affect sleep stages? |
|
Definition
They reduce REM (25%) and delta (deepest non-REM) sleep
**Benzos treat night terrors, which occur in delta sleep** |
|
|
Term
| Why is imipramine given for enuresis (inability to control urination during sleep)? |
|
Definition
It decreases stage 3 (delta) sleep.
Night terrors also occur in stage 3 sleep (delta), and are treated with benzos |
|
|
Term
Why is REM sleep called "de-sychronized" and "paradoxical" sleep?
What are the defining features? |
|
Definition
It has the same EEG pattern as wakefulness (beta).
REM is like sex, Increase Pulse and Penile tumescence that decrease with age.
1. ACh principle NT
2. NE inhibits REM
3. Extra-ocular movements (PPRF)
4. Every 90 minutes through night |
|
|
Term
All of the following sleep changes are seen in depressed patients, EXCEPT:
1. Decreased slow-wave sleep
2. Increased REM latency
3. Increased REM early in sleep cycle
4. Increased total REM sleep
5. Repeated awakenings
6. Early-morning awakening |
|
Definition
2- REM latency DECREASES, and patients have more of it.
**early awakenings is an important screening tool for depression** |
|
|
Term
A patient has been experiencing Cataplexy, as well as hypnagogic hallucinations. They are excessively sleepy during the day.
How do you treat? |
|
Definition
The Cataplexy, daytime sleepiness and hallucinations just before sleep are classic NARCOLEPSY (sleep-wake cycle disorder), which has a strong genetic component.
Treat with stimulants (amphetamines, modafinil) and sodium oxybate (GHB) |
|
|
Term
| Which physiological processes are regulated by the SCN? |
|
Definition
SCN is hypothalamic nucleus that is regulated by environment (light)
1) Circadian Rythms (CRs)
2) ACTH, prolactin, melatonin, nocturnal NE release
** The SCN releases NE at night, which binds in the pineal gland and causes it to release melatonin. |
|
|
Term
A child has been screaming in the middle of the night, but has no memory of arousal. These episodes tend to be triggered by emotional stress during the previous day and by lack of sleep.
What stage of sleep is associated with this condition? |
|
Definition
| Sleep Terror Disorder (unknown cause) occurs during slow-wave, delta sleep. |
|
|
Term
Which of the following measures it NOT part of the Apgar scoring system?
a. Grimace
b. Pulse
c. Activity
d. Reflexes
e. Appearance
f. Respiration |
|
Definition
D.
APGAR= Appearance, Pulse, Grimace, Activity, Respiration
- 10-point scale evaluated at 1-5 minutes after birth (>=7 is good, 4-6= assist and stimulate, <4= resuscitate) |
|
|
Term
| What are the common causes of low birth weight, and what is the cutoff? |
|
Definition
<2500 grams associated with greater incidence of physical and emotional problems
- caused by prematurity or intrauterine growth retardation. |
|
|
Term
All of the following are associated with a birth weight <2500 g, EXCEPT:
a. Respiratory distress syndrome
b. Persistant foramen ovale
c. Infection
d. Necrotizing enterocolitis
e. Intraventricular hemorrhage
f. Persistent fetal circulation |
|
Definition
| B- this is a developmental defect that can be serious, but is not associated with low birth weight. |
|
|
Term
| What are the major Motor, Social and Verbal/Cognitive milestones associated with infants ages birth-3 mo? |
|
Definition
Motor- Rooting reflex, holds head up, Moro disappears
Social- Smile socially
V/C- Orients and responds to voice. |
|
|
Term
| What are the major Motor, Social and Verbal/Cognitive milestones associated with infants ages 7-9 mo? |
|
Definition
M- Sits alone, crawls, transfers toys from hand to hand
S- Stranger anxiety
V/C- Responds to name and simple instructions, uses gestures |
|
|
Term
| What are the major Motor, Social and Verbal/Cognitive milestones associated with infants ages 12-15 mo? |
|
Definition
M- Walks, Babinski dissapears
S- Separation anxiety
V/C- Few words |
|
|
Term
| What are the major Motor, Social and Verbal/Cognitive milestones associated with toddlers ages 12-24 mo? |
|
Definition
M- Climbs stairs, stacks 3 blocks at 1 year, 6 blocks at 2 years (number of blocks stacked= age in years X 3)
S- Rapprochement (moves away from and then returns to mother)
V/C- Object permanence; 200 words and "2-word sentences at age 2". |
|
|
Term
| What are the major Motor, Social and Verbal/Cognitive milestones associated with toddlers ages 24-36 mo? |
|
Definition
M- Feeds self with fork and spoon, kicks ball
S- Core gender identity, parallel play
V/C- Toilet training ("pee at age 3") |
|
|
Term
| What are the major Motor, Social and Verbal/Cognitive milestones associated with Pre-schoolers at age 3? |
|
Definition
M- Rides tricycle (rides 3-cycle at age 3); copies line or circle drawings
S- Comfortably spends part of day away from mother
V/C- 900 words and complete sentences |
|
|
Term
| What are the major Motor, Social and Verbal/Cognitive milestones associated with Pre-schoolers at age 4? |
|
Definition
M- Uses buttons and zippers, grooms self, hops on 1 foot, makes simple drawings (stick figures)
S- Cooperative play, imaginary friends
V/C- Can tell detailed stories and use prepositions |
|
|
Term
Which of the following changes does NOT take place in elderly men?
a. Slower erection/ejaculation
b. Decreased REM/Slow-wave sleep
c. Increased awakenings
d. Decreased sexual interest
e. Decreased renal, pulmonary and GI function
f. Decrease muscle/increase fat |
|
Definition
D
Older men have slower erections/ejaculations and longer refractory periods, but they do NOT lose sexual interest or intelligence
- Decreased REM/Slow-wave sleep and increased awakenings/latency is common
- Decreased renal/pulmonary/Gi is common
- Decreased vision, hearing, immune response, bladder control also occur.
- Muscle/Fat balance changes do occur
** LOOK OUT FOR SUICIDE RATE** |
|
|
Term
Which of the following changes does not take place in elderly women?
a. Increased latency of sleep and number of awakenings
b. Decreased vision and hearing
c. Increased suicide rate
d. Vaginal dryness
e. Delusions |
|
Definition
E- Delusions CAN occur, but are not a function of normal aging
Sensory and physiological changes mentioned do occur |
|
|
Term
| How can you tell between normal and pathological bereavement? |
|
Definition
Pathological increased prolonged episodes lasting >3 months, or grief that is delayed, inhibited or denied.
Delusions, depressive symptoms and hallucinations may occur
** Normal is <2 months, with shock, denial, guilt and somatic symptoms |
|
|
Term
Which of the following features is not found in normal bereavement?
a. shock
b. inhibited/delayed grief
c. denial
d. guilt
e. somatic symptoms |
|
Definition
| b- inhibited/delayed/denied guilt that lasts >2 months is pathological and may present with depressive symptoms, delusions and/or hallucinations. |
|
|
Term
Which of the following is not associated with the stress response?
a. decreased mucosal circulation
b. increased free fatty acids
c. increased 17-OH corticosteroids
d. catecholamine production
e. increased muscular tone |
|
Definition
a- You see INCREASED mucosal
Also see gastrocolic reflex and affected water absorption. |
|
|
Term
| What should be on the differential in cases of sexual dysfunction such as ED, anorgasmia and sexual pain? |
|
Definition
DDP
1) Drugs (anti-hypertensives, neuroleptics, SSRIs, ethanol)
2) Disease (depression, diabetes)
3) Psychological (performance anxiety) |
|
|
Term
What is the BMI range for each of the following
1. Underweight
2. Normal
3. Overweight
4. Obese
5. Morbidly obese |
|
Definition
kg/m2 (weight adjusted for height)
1. <18.5
2. 18.5-24.9
3. 25-29.9
4. 30-39.9
5. >40.0 |
|
|
Term
Which evaluative measure is useful for each of the following?
1. Ruling IN the disease
2. Ruling OUT disease |
|
Definition
1) Specificity (TN/TN+ FP)- SPIN (Sp rules in)
- Tells the probability that test indicates non-disease when disease is absent.
- Indicates low False Positive rate (1- false positive rate) and helps to confirm positive screening test
2) Sensitivity (TP/TP + FN)- SNOUT (sen rules out)
- Probability that positive test indicates disease when disease is present.
- Indicates low False Negative rate (1-FNR) and is helpful for screening. |
|
|
Term
| How can you tell if a distribution is normal/Gaussian? |
|
Definition
| Bell-shaped, where mean= median= mode) |
|
|
Term
A study is conducted to evaluate intelligence quotient (IQ) scores for patients with various types of schizophrenia. Twenty patients were dropped from the sample because they could not complete two or more portions of the test. Four additional patients refused to take the test. Results for the 100 patients who completed the test showed an average IQ of 110 with a standard deviation of 20. Which of the following is the best estimate of the 95% confidence interval for this sample?
A. 70 to 130
B. 70 to 150
C. 85 to 115
D. 90 to 130
E. 105 to 115
F. 106 to 114 |
|
Definition
For 95%, Z= 2. For 99%, Z- 2.58
CI= range from (mean - Z(SEM)) to (mean + Z(SEM))
Mean= 110
SEM= 20/ sqrt (100)= 2
110 - 2(2) to 110 + 2(2)= 106-114
Choice F is correct |
|
|
Term
| Distinguish between r and r2 |
|
Definition
R is the correlation coefficient
R2 is the coefficient of determination (causality)
R2 tells you what percent of the independent variable (x) "explains" what happened to the dependent variable. The closer r squared is to 1, the better x explains y. |
|
|
Term
| What are the major "reportable" diseases that are exempt from confidentiality restrictions? |
|
Definition
For these, physicians have duty to warn public officials and identifiable people at risk.
1) STDs
2) TB
3) Hepatitis
4) Food poisoning |
|
|
Term
Describe the basics of an Apgar score. Which of the following is false?
1. Evaluated at 1 and 5 min after birth
2. >=7 is "good"
3. Apgar < 4 at later time points indicates possibility of long-term neurological damage.
4) Includes evaluation of birth weight |
|
Definition
4= Weight is not directly part of the APGAR
Newborn health 10-point scale evaluated at 1 min and 5 min. <4 needs resuscitation!, 4-6 assist and stimulate
Appearance, Pulse, Grimace, Activity, Respiration |
|
|
Term
What is the Apgar score of an infant with evident cyanosis of their extremities (body is pink), a pulse of 75 bpm, some gasping breaths and reduced muscle tone.
His reflex irritability seems normal |
|
Definition
Score of 5= stimulate and assist
Appearance Pulse Grimace Activity Respiration
Gets 1 points for Appearance, Pulse, Activity and Respiration
Gets 2 points for Grimace |
|
|
Term
All of the following are characteristics of REM sleep, EXCEPT.
1. 5-HT is principle neurotransmitter
2. Inhibited by NE
3. Extra-ocular movements (PPRF)
4. Occurs 90 minutes, with increased duration through night
5. Penile/clitoral tumesence |
|
Definition
1- ACh is the principle NT!
REM is like sex with increased pulse, penile/clitoral tumescence, decreasing with age. |
|
|
Term
Describe the type of sleep that occurs with each of the following waveform types.
1. Lowest frequency, highest amplitude
2. Theta waves
3. Sleep spindles and K complexes
4. Beta waves |
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Definition
1. Delta waves (25% of time) in deep, stage 3 sleep
2. Early (5%), light sleep
3 Deeper, stage 2 sleep (bruxism- teeth grinding)
4. Wakefulness with eyes open AND REM (why REM is called "paradoxical sleep" |
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Term
Which of the following is NOT characteristic of the SCN.
1. Regulated by light
2. Controls nocturnal NE release
3. Regulates melatonin release
4. Drive REM sleep
5. Controls ACTH release
6. Controls prolactin release |
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Definition
4- the SCN drives Circadian rhythms, but is not known to control REM sleep specifically.
The SCN is a light-regulated, hypothalamic nucleus that controls hormone release (prolactin, melatonin, ACTH) and nocturnal NE release (binds pineal gland and causes melatonin release). |
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