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Beh Sci

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Tanner stage1 : childhood
nipples may be slightly elev in fem
Tanner stage 2
scant, straight, pubic hair
Boys: testes enlarge, scrotal texture
Girls: slight elev of breast
Tanner Stage 3
pubic hair more, curly
boys: penis inc length, testes enlarge
Tanner Stage 4
boys: penis inc width, glans develops, scrotum darkens
girls: areola rises above rest of breast
Tanner Stage 5: Adulthood
pubic hair on thighs
girls: areola no longer rises above the rest of the breast
What do you give to stabilize the autonomic nervous system during opiate withdrawal?
clonidine
BMI
wt(kg) / ht^2 (m)
Developmental Milestones
3 mos
Motor: hold head up, no Moro (startle reflex)
Social: social smile
Developmental Milestones
4-5 mos
Motor: rolls front to back, sits when propped up
Social: recognizes people
Developmental Milestones
7-9 mos
Motor: sits alone
Social: stranger anxiety, orients to voice, can respond to own name
Developmental Milestones
10 mos
Motor: can transfer object from one hand to the other
Developmental Milestones
12-14 mos
Motor: Babinski gone
Developmental Milestones
15 mos
Motor: walks
Social: a few words, separation anxiety
Developmental Milestones
12-24 mos
Motor: climbs stairs, stacks 3 blocks
Cognitive: object permanence
Developmental Milestones
18-24 mos
Motor: stacks 6 blocks
Cognitive: Rapprochement
Developmental Milestones
2-4 years
parallel play, core gender identity
When does toilet training usual occur?
30-36 mos
Developmental Milestones
3 yrs
Motor: rides TRIcycle, draw a circle
Social: group play
Developmental Milestones
4 yrs
Motor: simple line drawings, hops on 1 foot
Social : cooperative play (role-playing)
Developmental Milestones
6-11 yrs
Motor: development of superego (conscience), same-sex friends, identification with same sex parent
Developmental Milestones
Puberty/Adolescence
Boys: 13
Girls: 11
abstract reasoning, formation of personality
APGAR
Appearance (color)
Pulse
Grimace (reflex irritability)
Activity (muscle tone)
Respiration
When do you not need parental consent? (4)
1. Emergency (can get court order if time and parents refuse)
2. Pregnancy/the pill
3. STD
4. Drug addiction
(Don't Say Enything to Parents )
Advance directive
-Oral directive considered valid (may be most important factor to consider if patient was informed, repeated wishes over time)
-Power of Attorney (surrogate) overrides living will (if surrogate was pre-appointed, like making a "living" living will)
Chi square test
compares percentages or proportions (people are grouped and # of people in each group are compared)
T test
the data must be numbers b/c you have to be able to compare means
What kind of information is collected in a Case-Control study?
Risk factors
-participants are chosen based on whether or not they have a disease
-Retrospective
What kind of information is collected in a Cohort study?
Disease development
-participants chosen based on presence/absence or risk factors
-Prospective, followed over time
Cohort study: Odds ratio or Relative Risk?
Relative risk!
disease risk in exposed group / disease risk in unexposed group
RR is the easy calc:
[a/(a+b)] / [c/(c+d)]
To calculate attributable risk, subtract
a/(a+b) - c/(c+d)
Case-Control study: Odds ratio or Relative Risk?
Odds ratio
(is an approximation of rel risk - but only if prevalence of dz is not too high)
To calculate: Cross Multiply! (ad / bc)
{case contROl, cROss multipy, Odds Ratio}
Positive Predictive value
positives / positive tests
a/(a+b)
Negative Predictive value
disease free / negative tests
d/(c+d)
PREdictive values depend on PREvalence: how?
Inc prevalence -> Inc PPV
Dec prevalence -> Inc NPV
Sensitivity
a/(a+c)
true positives / all w/ dz
PID (pos in dz) is Sensitive
SeNsitivity rules out (SNOUT)
Specificity
d/(b+d)
true negatives / all people w/o dz
-good for a confirmatory test
(SPIN: specificity rules in)
Does incidence include everyone in the population?
Not necessarily - only the people who could conceivably have the dz. For one thing, you have to subtract out those who already have the disease.
What percentage of a normally distributed population is w/in 1 std dev of the mean? 2 std dev? 3 std dev?
68% w/in one std dev (1/2 above, below mean)
95% w/in 2 std dev
99.7 w/in 3 std dev

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