Crush Step2 Epi Biostats Gyn Peds Ophtho Pharm

Front 1

Normal changes in the elderly include?
(9)

Back 1

Slightly impaired immune response
Presbyopia
Presbycusis
Less muscle mass
More fat deposits
Osteroporosis
Decreased brain wt
Enlarged ventricles
Slightly less ability to learn new material

Front 2

Number of new cases of disease in a given time?

Back 2

Incidence
Incidence = absolute rish

Front 3

Total number of cases of disease that exist? (New & old)

Back 3

Prevalence

Front 4

Start screening for colorectal CA?
How often?

Back 4

Age 50
q5yrs for colonscopy
q1yr occult blood

Front 5

Screen for prostate/colon by DRE?

Back 5

Age 40
q1yr

Front 6

PSA: start and how often?

Back 6

Age 50
?q1yr

Front 7

PAP smear?

Back 7

Age 21-65
q1yr; q3yrs after 2 nrmls

Front 8

Pelvic exam?

Back 8

Age 20-40 q3yrs
Age >40 q1yr

Front 9

Endometrial Bx?

Back 9

Only at menopause

Front 10

Breast exam?

Back 10

Age 20-40 q3yrs
Age >40 q1yr

Front 11

Mammogram?

Back 11

Start age 40
q1yr

Front 12

A/(A+C)

Back 12

Sensitivity

Front 13

D/(B+D)

Back 13

Specificity

Front 14

Stats term than has ability to detect DISEASE.
If high, used for screening
Low false negative rate

Back 14

Sensitivity

Front 15

Stats term than has ability to detect HEALTH.
If high, used for disease confirmation
Low false positive rate

Back 15

Specificity

Front 16

A/(A+B) or
TP/(FP+TP)
How likely the pt has the dz
Probability of having the condn, given a +test

Back 16

PPV

TP/All P

Front 17

D/(C+D)
TN/(FN+TN)
How likely is it the pt is healthy
Prob of NOT having condn, given a -test

Back 17

NPV

TN/All N

Front 18

(A x D)/(B x C)
Used only for retrospective studies (Case-ctrl)
→ Is this OR, RR, or AR?

Back 18

Odds ratio

Front 19

[A/(A+B)]/[C/(C+D)]

Back 19

Relative risk

Front 20

[A/(A+B)]/[C/(C+D)]

Back 20

Attributable risk

Front 21

Compares exposed and unexposed poplns, dz and non-dz in both
Asks: Is there a difference?
→ Is this OR, RR, or AR?

Back 21

Odds ratio

Front 22

Compares dz RISK in exposed vs dz RISK in unexposed poplns
If >1, is clinically significant
Needs prospective or xptl study
→Is this OR, RR, or AR?

Back 22

Relative risk

Front 23

Is the am’t by which you can expect the incidence to decrease if you remove a risk factor.
Think: smoking!!
→ Is this OR, RR, or AR?

Back 23

Attributable risk

Front 24

Measures reproducibility and consistency of a test
Random error reduces this

Back 24

Reliability = Precision

Front 25

Measures trueness of measurement. Does test measure what it claims to?
Systematic error reduces this

Back 25

Validity = Accuracy

Front 26

% of 1SD? 2SD? 3SD?

Back 26

68% 95% 99.7%

Front 27

The average

→ Mean, median, or mode?

Back 27

Mean

Front 28

The middle value

→ Mean, median, or mode?

Back 28

Median

Front 29

The most common value

→ Mean, median, or mode?

Back 29

Mode

Front 30

Distribution with xs of high values on the right

Mean > Median > Mode

Back 30

Positive skew

Front 31

Distribution in which mean = median = mode

Back 31

Normal distribution

Front 32

Distribution with xs of high values on the left

Mean < Median < Mode

Back 32

Negative skew

In skewed: SD and mean are less meaningful!

Front 33

Measures degree of relationship btw 2 values.
Ranges -1 to +1
Zero means no assocn
+1 means perfect +assocn
-1 means perfect –assocn

Back 33

Correlation coefficient

Front 34

What value gives you the strength of a correlation

Back 34

Absolute value (-0.3 is stronger than +0.2)

Front 35

Test used to compare %s or proportions
Non-numeric data

Back 35

Chi-square test

Front 36

Test used to compare 2 means

Back 36

T-test

Front 37

Analysis test used to compare 3+ means

Back 37

ANOVA

Front 38

Says that you are _% confident that a population mean is within a certain range

Back 38

Confidence Interval (usu 95%)

Front 39

What does p<0.05 mean?

Back 39

There is less than a 5% chane that these data were obtained by random error or chance

Front 40

Three caveats for p-values:

Back 40

1. study still may have serious flaws
2. low p-value doesn’t imply causation
3. statistical signif doesn’t mean clinical signif!

Front 41

What is “null hypothesis”?

Back 41

For example, for a drug study, the null is that the drug doesn’t work – there is no difference btw drug and no drug.
If null hypothesis is INcorrect, this means that the difference is NOT due to chance

Front 42

Which type of error:
Claim an effect or difference when none exists

Back 42

Type I

Front 43

Which type of error:
Accepting null hypothesis when it is false

Back 43

Type II

Front 44

Probability of rejecting the null with it is false
Increase this by increasing sample size

Back 44

Power

Front 45

Unmeasured variable that affects both independent and dependent variables

Back 45

Confounding variable

Front 46

Bias due to lack of blinding. Often 2/2 $$ for the study, so person wants to find a difference btw cases and ctrls

Back 46

Interviewer bias

Front 47

Pts in xpts want to be acceptable to the person conducting the study, so might not admit to embarrassing behavior or pretend to take meds when they don’t

Back 47

Unacceptability bias

Front 48

Primary amenorrhea +
Not pregnant
Normal breasts
No pubes or axillary hair

Back 48

Androgen insensitivity syndrome

Uterus = absent

Front 49

Primary amenorrhea +
Not pregnant
Nrml breasts, hair, uterus
High PRL

Back 49

Get MRI – likely pituitary adenoma

Front 50

Primary amenorrhea +
Not pregnant
Nrml breasts, hair, uterus
Nrml PRL

Back 50

Give Progesterone & w/u as for secondary amenorrhea

Front 51

Secondary amenorrhea +
Not pregnant
Low GnRH

Back 51

Athletics or anorexia

Front 52

Secondary amenorrhea +
Not pregnant
High PRL

Back 52

Tumor
Antipsychotics
Previous chemo

Front 53

Secondary amenorrhea +
Not pregnant
Nrml PRL
Prog + blding in 2 wks
High LH

Back 53

PCOS

Front 54

Secondary amenorrhea +
Not pregnant
Nrml PRL
Prog + blding in 2 wks
Low/Nrml LH

Back 54

HoTH (check TSH)
Pit Adenoma

Front 55

Secondary amenorrhea +
Not pregnant
Nrml PRL
Prog + NO blding in 2 wks
High FSH

Back 55

Premature ovarian failure
Check for AI, karyotpye abns, Chemo Hx

Front 56

Secondary amenorrhea +
Not pregnant
Nrml PRL
Prog + blding in 2 wks
Low/Nrml FSH

Back 56

Craniopharygioma or CNS tumor → get MRI of brain

Front 57

Drugs safe in pregnancy

(13: A2CDEH3ILMNP)

Back 57

Acetaminophen
Antacids
Cephalosporins
Docusate
Erythromycin
Heparin
H2 blockers
Hydralazine
Insulin
Labetoaol
Methyldopa
Nitrofurantoin
PCN

Front 58

Acute abdomen localized to:
RUQ

Back 58

Gallbladder: cholecystitis, cholangitis
Liver: abscess

Front 59

Acute abdomen localized to:
LUQ

Back 59

Spleen (2/2 blunt force trauma)

Front 60

Acute abdomen localized to:
RLQ

Back 60

Appendix (appendicitis)
Ileitis (Crohn’s)
Adnexal pathology

Front 61

Acute abdomen localized to:
LLQ

Back 61

Sigmoid colon: diverticultis
Adnexal pathology

Front 62

Acute abdomen localized to:
Epigastric

Back 62

Stomach (penetrating ulcer)
Pancreas (pancreatitis)

Front 63

Hernia more cmn in f
Goes through femoral ring into ant thigh
Most susceptible to incarceration and strangulation

Back 63

Femoral

Front 64

Most cmn hernia in m & f
Sac goes through inner and outer inguinal rings (Lat to inf epig vsls)
Into scrotum/labial region 2/2 patent processus vaginalis

Back 64

Indirect

Front 65

Hernia (no sac) goes medial to inf epig vsls
2/2 wknss in abd muscles in Hesselbach’s triangle

Back 65

Direct

Front 66

Epigastric pain, radiates to back
Elevated lipase and amylase
Hx of EtOH or gallstones
+/- fewer/no BS, local ileus, n/v/anorexia

Back 66

Pancreatitis

Front 67

Epigastric pain, radiates to back
Hx of EtOH or gallstones
Elevated amylase, nrml lipase
AXR: free air under diaphragm
Hx of PUD

Back 67

Perforated ulcer

Front 68

Cause of neonatal conjunctivitis that:
Starts w/in first 24 hours of life

Back 68

Chemical (silver nitrate drops)

Front 69

Cause of neonatal conjunctivitis that:
Extremely purulent d/c
2-5 d/o

Back 69

Gonorrhea

Tx: Erthyro topical + IV/IM 3rd cephalo

Front 70

Cause of neonatal conjunctivitis that:
Mild to svr sx
5-14 d/o

Back 70

Chlamydia

Tx: PO erythro

Front 71

Conjunctivitis sx:
Itching, bilateral, seasonal, long duration

Back 71

Allergic

Tx w/ vc meds

Front 72

Conjunctivitis sx:
Very contagious
Preauricular adenopathy
Clear, watery d/c

Back 72

Viral

Tx: supportive; wash hands!!

Front 73

Conjunctivitis sx:
Purulent d/c

Back 73

Bacterial

Tx: topical abx

Front 74

Retinal/fundal changes:
Dot-blot hmrgs
Microaneurysms
Neovascularization

→ 2/2 DM or HTN??

Back 74

DM!

Front 75

Retinal/fundal changes:
Arteriolar narrowing
Copper/silver wiring
Cotton wool spots
Papilledema if svr
→ 2/2 DM or HTN??

Back 75

HTN!

Front 76

BSFX of thiazides
(8: 3 H, 3 Ho, 1 Met + 1 ion)

Back 76

HGlyc + HUri + HLipi
Met Alk + Ca Retn
HoNa + HoK + HoVol

Front 77

Loops BSFX
(5: 2Ho, 1 tox, 1 Met + 1 ion)

Back 77

HoK + HoVol
Ototox
MetAlk + Ca Excrtn

Front 78

Carbonic anhydrase inhibitors BSFX (1)

Back 78

Met acid!

Front 79

Drug interactions:
MAOi + Meperidine
→ can cause?

Back 79

Coma

Front 80

Drug interactions:
Aminoglycosides + Loops
→ can cause?

Back 80

Enhanced ototoxicity

Front 81

Drug interactions:
Thiazides + Li
→ can cause?

Back 81

Lithium tox!

Front 82

BSFX of:
Methoxyflurane
Demeclocycline
Li

Back 82

DI

Front 83

BSFX of:
Dideoxyinosine

Back 83

Pancreatitis
Peripheral Neuropathy

Front 84

BSFX of:
Ethambutol

Back 84

Optic neuritis

Front 85

BSFX of:
Isoniazid

Back 85

Vit B6 defcy
Liver tox

Front 86

BSFX of:
Metronidazole

Back 86

Disuliram-like rxn w/ EtOH

Front 87

BSFX of:
Quinolones

Back 87

Teratogen
Cartilage dmg?

Front 88

BSFX of:
Tetracyclines

Back 88

Photosensitivity
Teeth stains in kids

Front 89

BSFX of:
Vanc

Back 89

Red man syndrome

Front 90

BSFX of:
AZT (zidovudine)

Back 90

BM suppression

Front 91

BSFX of:
Acetazolamide

Back 91

Met acidosis

Front 92

BSFX of:
Amiodarone

Back 92

Thyroid dysfxn
Pulmonary fibrosis

Front 93

BSFX of:
Chlorpropramide
Oxytocin

Back 93

SIADH

Front 94

BSFX of:
Clofibrate

Back 94

Increased GI neoplasms

Front 95

BSFX of:
Digitalis

Back 95

GI dsx
Vision changes
Arrythmias

Front 96

BSFX of:
HMG CoA-R xers

Back 96

Liver, muscle tox

Front 97

BSFX of:
Hydralazine
Isoniazid
Procainamide

Back 97

Lupus erythematosis

Front 98

BSFX of:
Methyldopa

Back 98

Hemolytic anemia (+Coombs)

Front 99

BSFX of:
Phenytoin

Back 99

Folate defcy
Teratogen
Hirsuitism

Front 100

BSFX of:
Quinine

Back 100

Tinnitus
Vertigo
= Cinchonism

Front 101

BSFX of:
Trimethadione

Back 101

Bad teratogen

Front 102

BSFX of:
Valproic acid

Back 102

NT defects

Front 103

BSFX of:
Warfarin

Back 103

Necrosis
Teratogen

Front 104

BSFX of:
Bleomycin
Busulfan

Back 104

Pulm fibrosis

Front 105

Other BSFX of:
Busulfan

Back 105

Adrenal failure

Front 106

BSFX of:
Cisplatin

Back 106

Nephrotox

Front 107

BSFX of:
Cyclophosphamide

Back 107

Hemorrhagic crisis

Front 108

BSFX of:
Doxorubicin

Back 108

Cardiomyopathy

Front 109

BSFX of:
Vincristine

Back 109

Peripheral neuropathy

Front 110

BSFX of:
Buproprion

Back 110

Sz

Front 111

BSFX of:
Clozapine

Back 111

Agranulocytosis

Front 112

Other BSFX of:
Li

Back 112

TH dysfxn

Front 113

BSFX of:
SSRIs

Back 113

Anxiety
Agitation
Insomnia
Sexual dysfxn

Front 114

BSFX of:
Thioridazine

Back 114

Retinal deposits
Cardiac tox

Front 115

BSFX of:
Cyclosporine

Back 115

Renal tox

Front 116

Antidote for:
Acetaminophen

Back 116

Acetylcysteine

Front 117

Antidote for:
Benzos

Back 117

Flumazenil

Front 118

Antidote for:
Beta-xers

Back 118

Glucagon

Front 119

Antidote for:
Cholinesterase xers

Back 119

Atropine
Pralidoxime

Front 120

Antidote for:
Cu or Au

Back 120

Penicillamine

Front 121

Antidote for:
Digoxin

Back 121

Normalize K and ‘lytes
Dig Abs

Front 122

Antidote for:
Pb

Back 122

Edetate

Front 123

Antidote for:
MeOH or ethylene glycol

Back 123

Ethanol

Front 124

Antidote for:
Muscarinic R xers

Back 124

Physostigmine

Front 125

Antidote for:
Opiods

Back 125

Naloxone

Front 126

Antidote for:
Quinidine or TCAs

Back 126

NaHCO3 (heart protxn)

Front 127

Which drugs induce hepatic enzymes?
(5)

Back 127

Barbiturates
Antiepileptics
Isoniazid
EtOH
Rifampin

Front 128

Which drugs inhibit hepatic enzymes?
(6)

Back 128

Cimetidine
Amiodarone
Macrolide Abx
Metro
Cyclosporine
Ketoconazole/other azoles