USMLE-Behavioral and Biostatistics
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- when both a living will and power of attorney exist, which supersedes the other?
- power of attorney
- stages of grief
- denial, anger, bargaining, grieving, acceptance
- how do you treat DTs?
- benzodiazapenes
- what are the characteristics of DTs?
- autonomic system hyperactivity (tachycardia, tremors, axiety), psychotic sx (hallucinations, delustions), confusion
- sleep patterns of depressed patients?
- decreased slow-wave sleep, decreased REM latency, early morning awakening
- what is malingering?
- patient conciously fakes or claims to have a disorder in order to attain a specific gain
- what is a facticious disorder?
- conciously creates sx in order to assume 'sick role' and get medical attention - motivation is unconscious
- what is gamophobia?
- fear of marriage
- what is algophobia?
- fear of pain
- what is acrophobia?
- fear of height
- what are the characteristics of an adjustment disorder?
- emotional symptoms (anxiety, depression) causing impairment following an identifiale psychosocial stressor (e.g. divorce, moving), and lasting <6 months
- what do you call a false blief not shared with other members of culture/subculture that is firmly maintained in spite of obvious proof to the contrary?
- delusion
- what the difference between a hallucination and an illusion?
- hallucination - perception in the absence of external stimuli; illusion - misinterpretations of actual stimuli
- when does hypnagogic hallucination occur?
- when GOing to sleep
- tactile hallucinations are common when?
- Dts, cocaine abusers
- when do hypnopompic hallucinations occur?
- while waking from sleep
- how do you treat narcolepsy?
- stimulants, e.g. amphetamines
- what is a schizoaffective disorder?
- a combination of schizophrenia and a mood disorder
- paranoid, schizoid, schizotypal personality disorders fall into what cluster?
- cluster A - weird
- antisocial, borderline, histrionic, narcissistic personality disorders fall into what cluster?
- cluster B - wild
- avoidant, obsessive-compulsive, dependent personality disorders fall into what cluster?
- cluster C - worried
- cluster A personality disorders are characterized by what?
- odd or eccentric, can't develop meaningful social relationships' no psychosis, but genetic association with schizophrenia
- personality disorder characterized by distrust and suspiciousness; projection is main defense mechanism
- paranoid
- personality disorder characterized by voluntary social withdrawal, limited emotional expression
- schiziod
- personality disorder characterized by interpersonal awkwardness, odd beliefs or magical thinking, eccentric appearance
- schizotypal
- characteristics of cluster B personality disorders?
- dramatic, emotional, or erratic; genetic association with mood disorders and substance abuse
- personality disorder characterized by disregard for and violation of rights or others, criminality
- antisocial
- personality disorder characterized by unstable mood and interpersonal relationships, impulsiveness, sense of emptiness
- borderline
- personality disorder characterized by excessive emotionality, attention seeking, sexually provocative
- histrionic
- personality disorder characterized by grandiosity, sense of entitlement; may react to criticism with rage; may demand 'top' physician/best health care
- narcissistic
- personality disorder characterized by sensitivity to rejection, social inhibition, timid, feelings of inadequacy
- avoidant
- what are the characteristics of cluster C personality disorders?
- anxious or fearfull; genetic association with anxiety disorders
- personality disorder characterized by submissive and clinging, excessive need to be taken care or, low self-confidence
- dependent
- personality disorder characterized by preoccupation with order, perfectionism, and control
- obsessive-compulsive
- moro reflex
- can be elicited by any startling event; extension and abduction of the arms, followed by adduction of arms - normally disappears between 3-6 months
- palmar grasp reflex
- infant's hand closing over an object that is placed in palm of hand - normally disappears at 2 months
- tonic neck reflex
- extension of ipsilateral leg and flexion of the contralateral arm when the head is turned - normally disappears between 7-8 months
- what is prosopagnosisa and what causes it?
- inability to recognize faces - usually caused by a bilateral lesion of the visual association cortex
- what is anosagnosia and what causes it?
- deficit in cognition about one's illnes, or the lack of awareness that one is suffering from a certain condition - related to large lesions of hte nondominant parietal lobe, which causes the pateint to be confused and unaware of motor and sensory deficits
- what is confabulation?
- fabrication of stories and events that never happened in order to fill in memory gaps; seen mostly in dementias
- what is conversion disorder?
- characterized by one or more neurologic symptoms (motor, sensory, or changes in consciousness such as pseudoseizures) associated with unresolved psychological conflicts - sx are unconscious and develop as a result of repressed anxiety about the unacceptable impulses
- what is Ganser syndrome?
- dissociative disorder NOS - giving approximate answers instead of exact ones - associated with other sx like amnesia, disorientation, and perceptual disturbances. seen most commonly in prison inmates
- dissociative disorder defined by combination of amnesia plus travel
- psychogenic fugue - patient typically regains awareness after traveling to a different locale but retains no memory of the trip of the decision to go on it
- what is somnambulism?
- sleep walking - disorder of stage 4 sleep
- what is mobius syndrome?
- congenital facial diplegia - face is expressionless, and ocular palsy may be present. frequently accompanied by clubfoot and syndactyly and MR
- what is pseudodementia?
- major depression in an elderly person - all of the symptoms of a depressive disorder without hallmarks of an organic condition
- what is the Tarasoff I decision?
- requires that physicians warn a potential victim if they truly believe the patient will cause harm to that person
- what is the Tarasoff II decision?
- states that even though physicians must warn a potential victim, they must also protect the patient from harm from that person
- the irresistible impulse rule and the McNaughten rule are involved in what?
- insanity defenses
- the combination of an MAOI with what drug produces a severe reaction, including delerium, hyperpyrexia, convulsions, and hypertension
- meperidine
- intelligence scale best for younger children since it doesn't rely exclusively on language
- stanford-binet
- scale used to assess the attainment of developmental milestones in children younger than 2 years
- denver developmental scale
- age group for which WAIS-R is used
- 17 and older (think rated R)
- age group for which WISC III is used
- 16-Jun
- age group for which WPPSI is used
- 6-Apr
- person acts out dreams in what sleep disorder?
- REM sleep disorder - normal paralysis of muscles during REM sleep is absent; content of dreams often violent or aggressive
- what sleep disorder encompasses both night terrors and sleepwalking?
- non-REM sleep disorder - people do not act out dreams in either condition
- child's awareness of the conservation of volume occurs between what ages and is what stage?
- 7-11 years - concrete operations
- between what ages is the preoperational stage?
- 2-7 years
- the sensorimotor stage corresponds to what ages?
- 0-2
- learning by reinforcement is what type of conditioning?
- operant
- toilet training is not possible before what age?
- 18 months
- stranger anxiety, orientation to voice occurs at approximately what age?
- 7-9 months
- when does separation anxiety occur?
- between 10-12 months
- when does the social smile appear?
- 2-3 months
- what is the infant mortality rate equal to?
- the number of deaths occuring until the first birthday divided by the total number of live births
- this is a projective test htat uses pictures depicting ambiguous interpersonal situations that the examinee is asked to interpret
- the thematic apperception test
- this is the most popular objective personality test; it uses true and false items
- minnesota multiphasic personality inventory
- a relationship between what neurotransmitter and aggression has been found?
- serotonin
- a study that is chosen based on presence or absence of disease and then information collected about risk factors
- case-control study
- a cohort study is what kind of study?
- observational
- in this type of study, the sample is chosen about presence or absence of risk factors and subjects are followed over time for development of disease
- cohort study
- define prevalence
- total cases in population at a given time/ total population
- define incidence
- new cases in population over a given time period/total population at risk during that time
- for what type of diseases is prevalence greater than incidence?
- chronic diseases
- for what type of diseases does prevalence equal incidence?
- acute diseases
- for what type of test is high sensitivity desirable?
- screening
- define sensitivity and give formula
- number of true positives divided by number of all people with the disease: a/a+c
- how do you calculate the false negative rate?
- 1-sensitivity
- for what type of test is high specificity desirable for?
- confirmatory test
- define specificity and give formula
- number of true negatives divided by number of all people without the disease: d/b+d
- 1-specificity is equal to what?
- false positive rate
- what is positive predictive value and how do you calculate it?
- probability of havinig a condition given a positive test - number of true positives divided by number of people who tested positive for the disease: a/a+b
- what is negative predictive value and how do you calculate it?
- probability of having a condition given a negative test - number of true negatives divided by number of people who tested negative for a disease: d/c+d
- which are dependent on the prevalence of disease: sensitivity/specificity or predictive values?
- predictive values
- when prevalence is higher, what increases?
- positive predictive value
- when prevalence is lower what increases?
- negative predictive value
- what is an odds ratio?
- odds of having disease in exposed group divided by odds of having disease in unexposed group (odds calculated within group as number with disease divided by number without disease)
- what is the formula for odds ratio?
- (a/b)/(c/d) = ad/bc
- what is relative risk?
- disease risk in exposed group dividd by disease risk in unexposed group - risk is calculated within a group as number with disease divided by total number of people in group
- what is the formula for relative risk?
- a/(a+b)/c/(c+d)
- what is a type I error?
- stating that there is an effect when none exists; equal to p
- what is a type II error?
- stating that there is not an effect of difference when one exists (power= 1-type II)
- what does Z equal for the 95% confidence interval?
- 1.96
- what is the formula for confidence interval?
- CI=range from (mean-Z(SEM) to (mean+Z(SEM)
- what does standard error of the mean equal?
- standard deviation/square root of n
- a t-test checks the difference between what?
- the means of 2 groups
- what does ANOVA check?
- the difference between the means of 3 or more groups
- what does chi square check?
- difference between 2 or more percentages or proportions of categorical outcomes (not means)
- mean > median > mode is what kind of skew?
- positive - tail on right
- mean < median < mode is what kind of skew?
- negative - tail on left
- mean < median < mode is what kind of skew?
- negative - tail on left
- mean < median < mode is what kind of skew? negative - tail on left
- mean < median < mode is what kind of skew? negative - tail on left