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29 Cards in this Set

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A normal child can walk up stairs one foot at a time, but when told to copy a circle, he just scribbles on paper. On the playground, he often moves away from his mother, but then comes right back to her. With respect to verbal skills, this child is most likely to be able to:
use about 10 words
This child's motor skills (e.g., walking up stairs one foot at a time, scribbling when told to copy a circle) and social skills (e.g., moving away from and then toward his mother) indicate that this child is about 1.5 years old. With respect to verbal skills, children of this age are able to use about 10 individual words. Children 3 years of age use about 900 words, understand about 3,500 words, and speak in complete sentences. At about 4 years of age, children use prepositions (e.g., below, under) in speech.
A mother brings her 3-year-old son to the pediatrician for a well-child checkup. The physician observes that the child relates well to his mother and is able to speak in complete sentences. In speaking to the mother, the physician determines that the child has a tricycle but cannot pedal it, and he does not play cooperatively with other children. Select the best description of this child's development in language, motor, and social skills, respectively.
Normal (language), needs evaluation (motor), normal (social skills)
Most normal 3-year-old children can ride a tricycle, speak in complete sentences, and play in parallel with (next to) other children. They generally do not play cooperatively with other children until about 4 years of age. Thus, this child may need evaluation in motor skills (e.g., he should be able to peadal a tricycle), but appears to be normal in language and social skills.
A 49-year-old sexually active woman tells her physician that she is experiences hot flashes and has not menstruated in four months. She asks the physician when she can discontinue use of birth control. The physician's most correct response is:
1 year after the last menstrual period
One year after the last menstrual period usually signals the end of menopause, and the use of birth control can be discontinued. The age of menopause and the occurrence of hot flashes vary considerably among women and thus cannot be used to predict the end of fertility.
Of the following people, which one is likely to use the most Medicare services and funds during his or her lifetime?
white female nonsmoker
Because Medicare coverage lasts for life and because she has the longest life expectancy, a white female nonsmoker is likely to use more Medicare services and funds than men, African Americans, and smokers during her lifetime.
A 26-year-old woman believes that she is pregnant with Michael Jackson's child. She has never met the singer and two pregnancy tests are negative. There is no evidence of a thought disorder. This woman is most likely to have:
delusional disorder
This woman who believes that she is preganant with the child of a celebrity probably has another type of delusional disorder, the erotomanic type
Doctor A is aware that Doctor B has made a serious mistake in treating a very ill hospitalized patient. Dr. B refuses to admit that he has made a mistake. Most appropriately, Doctor A should:
report Dcotor B's action to Dr. B's superior at the hospital
The most appropriate action for Doctor A to take is to report Doctor B to his or her superior at the hospital. Reporting of a lapse by a colleague is required ethically because patients must be protected. Talking to Doctor B about his lapse again, warning him, reporting to the police, or recommending a transfer is not likely to accomplish the immediate goal of protecting patients.
An infant's ability to roll over from back to belly and belly to back usually begins at what age?
5-6 months
Normally, infants begin to roll over from back to belly and belly to back at about 5 months of age.
Of the following agents, which is the most appropriate heterocyclic antidepressant for a 45-year-old air traffic controller who must stay alert on the job?
desipramine
Desipramine is less sedating and thus is the most appropriate heterocyclic antidepressant for someone who must stay alert on the job. While fluoxetine is also unlikely to be sedating, it is a selective serotonin reuptake inhibitor (SSRI), not a heterocyclic agent.
A 70-year-old woman reports that she has difficulty sleeping through the night because of persistent muscular contractions in her legs. Which of the following sleep disorders best matches this picture?
nocturnal myoclonus
This elderly woman who reports that she has difficulty sleeping through the night because of muscular contractions in her legs is showing evidence of nocturnal myoclonus.
A patient reports that despite the fact that he goes to sleep at 11:00 p.m. and wakes up at 7:00 a.m., he does not fell fully awake until about noon each day. His wife states that he appears to be sleeping soundly at night. The patient denies substance abuse and physical examination is normal. Which of the following sleep disorders best matches this picture?
sleep drunkenness
This patient who has a full night's sleep but does not feel fully awake until hours after he first wakes up is showing evidence of a sleep disorder known as sleep drunkenness. This condition is rare and the diagnosis can only be made in the absence of other more common problems during sleep (e.g., sleep apnea) or substance abuse.
Normal infants begin visually following faces and objects with their eyes (tracking) at what age?
0-3 months
Infants can visually track a human face and objects starting at birth.
A 35-year-old man comes to the physician's office dressed all in bright yellow. He reports that he felt like he had a "knife in his ear" and says that he feels so hot that he "must be dying." Physical examination reveals mild otitis externa (inflammation of the ear canal) and temperature of 99.6. This patient's behavior is most closely associated with which of the following personality disorders?
histrionic personality disorder
This behavior is most closely associated with the histrionic personality disorder. Persons with this disorder are dramatic when reporting their symptoms to physicians, and call attention to themselves with dress and behavior.
A 24-year-old patient is experiences intense hunger as well as tiredness and headache. This patient is most likely to be withdrawing from which of the following agents?
amphetamine
Intense hunger, tiredness, and headache are all signs of withdrawal from an amphetamine.
A 55-year-old man, who has been taking medications for depression and insomnia, is brought to the ER with signs of severe respiratory depression. The agent most likely to be responsible for these symptoms is:
secobarbital
The history of insomnia indicates that this patient may have been given a prescription for a barbiturate, such as secobarbital (Seconal). His history of depression indicates that he may have taken an overdose of the drug in a suicide attempt.
During an ophthalmologic examination, a 40-year-old schizophrenic female patient is found to have retinal pigmentation. This patient is most likely to be taking which one of the following antipsychotic agents?
Thioridazine
Retinal pigmentation is associated primarily with the use of the low-potency antipsychotic agent thioridazine.
In a laboratory study, it is shown that the uterus rises in the pelvic cavity during sexual activity. In which stage of the sexual response cycle does this phenomenon first occur?
excitement
Rising of the uterus in the pelvic cavity with sexual activity (i.e., "the tenting effect") first occurs during the excitement phase of the sexual response cycle.
A study was carried out to determine whether exposure to liquid crystal display computer screens in the first timester of pregnancy results in miscarriage. To do this, 50 women who had miscarriages and 100 women who carried to term were questioned the day after miscarriage or delivery, respectively, about their exposure to LCDs during pregnancy. If 10 women who had miscarriages and 8 women who carried to term used LCDs during their pregnancies, the odds-risk ratio associated with LCDs in pregnancy is approximately:
2.9
The odds-risk ratio (odds ratio) of 2.9 in this case-control study is calculated as follows: (A*D)/(B*C)=(10*92)/(40*8)=2.9
In a cohort study, the ratio of the incidence rate of miscarriage among women who use liquid crystal display computer screens to the incidence rate of miscarriage among women who do not use LCD computer screens is the:
relative risk
In a cohort study, the ratio of the incidence rate of a condition (e.g., miscarriage) in exposed people to the incidence rate in unexposed people is the relative risk.
In a study, the incidence rate of tuberculosis in people who have someone with TB living in their home is 5 per 1000. The incidence rate of TB in people who have no one with TB living in their home of 0.5 per 1000. What is the risk for getting TB attributable to living with someone who has TB (attributable risk)?
4.5
The attributable risk is the incidence rate in exposed people (5.0) minus the incidence rate in unexposed people (0.5) = 4.5. Therefore, 4.5 is the additional risk of getting TB associated with living with someone with TB.
In a study, the incidence rate of tuberculosis in people who have someone with TB living in their home is 5 per 1000. The incidence rate of TB in people who have no one with TB living in their home of 0.5 per 1000. How many times higher is the risk of getting TB for people who live with a patient with TB than for people who do not live with a TB patient (the relative risk)?
10
The relative risk is the incidence rate in exposed people (5.0) divided by the incidence rate in unexposed people (0.5) = 10.0. Therefore, the chances of getting TB are 10 times greater when living with someone who has TB than when living in a household in which no one has TB.
A 50-year-old female high school teacher reports that she has been "feeling very low" for the past 3 months. She often misses work because she feels tired and hopeless and has trouble sleeping. When the physician interviews her she says, "Doctor, the Lord calls all his children home." This patient is most likely to have:
major depressive disorder
This patient is most likely to have major depressive disorder. Evidence for this is missing work, feeling hopeless and tired, and having trouble sleeping. Suicidal ideation is shown by her reference to death (i.e., "Doctor, the Lord calls all his children home.")
"Many people feel the way you do when they first need hospitalization" is an example of the interview technique known as:
validation
"Many people feel the way you do when they first need hospitalization" is an example of the interview technique known as validation. In validation, the interviewer gives credence to the patientt's feelings and fears.
After a patient has described his symptoms and the time of day that they intensify, the interviewer says, "You say that you felt the pain more in the evening?" This question is an example of the interview technique known as:
reflection
"You say that you felt the pain more in the evening?" is an example of the interview technique known as reflection.
The most appropriate diagnostic technique to evaluate hearing loss in a 3-month-old infant is:
evoked potentials
Auditory evoked potentials, the response of the brain to sound as measured by electrical activity, are used to evaluate loss of hearing in infants.
Following the loss of her job as a cashier, a 23-year-old patient reports, in a dispassionate way, the she has no sensation in her right arm. Physical examination fails to reveal evidence of a physiological problem. This patient is showing evidence of:
conversion disorder
Conversion disorder involves a dramatic loss of motor or sensory function with no medical cause. There is often a curious lack of concern ("la belle indifference") about the symptoms. Hypochondriasis is an exagerated convern with illness or normal bodily functions. People with body dysmorphic disorder feel that there is something seriuosly wrong with theirp appearance. In somatization disorder, patients have many different phyiscal symptoms over many years, which have no biological cause. In somatoform pain disorder, a patient has long-lasting, unexplainable pain.
Each time a 35-year-old man receives physical therapy for a shoulder injury, his pain lessens. This makes him return for more physical therapy sessions. This patient's behavior is an example of which of the following?
negative reinforcement
In this example of negative reinforcement, a patient increases his behavior (e.g., going to physical therapy sessions) in order to reduce an aversive stimulus (e.g., his shoulder pain).
A 29-year-old woman comes to the physican with symptoms of anxiety, which have been present for over 2 years and have no obvious precipitating event. The patient has never previously taken an antianxiety agent. Of the following psychoactive agents, the best choice for this woman is:
buspirone (BuSpar)
Because it is less likely than the benzodiazepines (e.g., diazepam) to cause dependence, the best choice of medication for this patient with generalized anxiety disorder (i.e., chronic anxiety) is buspirone. Lithium is used to treat bipolar disorder, and fluoxetine is used to treat depression and other anxiety disorders, such as panic disorder and obsessive-compulsive disorder.
In telling a physican about her younger sister's death in a car accident, a 33-year-old woman tries to speak but keeps breaking into tears. The best thing for the physician to say at this point is:
"Please take your time."
Most appropriately, the physican should tell the patient that shen can take her time and not try to speak while she is crying.
A 6-year-old child with an intelligence quotient of 50 is most likely to be able to do which of the following?
identify colors
Using the intelligence quotient formula [i.e. mental age/chronological age * 100 = IQ], the MA of this child is 3 years (MA/6 * 100 = 50). Like a normal 3-year-old child, someone with a mental age of 3 years can identify colors but cannot read, copy a triangle, ride a tw-wheeled bicycle, or understand the moral difference between right and wrong.