Step 2: First Aid Rapid Review (Epidemiology & Ethics)

Front 1

bias introduced into study when a clinician is aware of pt's tx type.

Back 1

observational bias

Front 2

bias introduced when screening detects a disease and thus lengthens time from dx to death.

Back 2

lead-time bias

Front 3

you want to know if race affects infant mortality, but most of the variation in infant mortality is predicted by SES, then SES is a ...?

Back 3

confounding variable

Front 4

number of true positives divided by the number of pts w/ disease is called...

Back 4

sensitivity

Front 5

highly sensitive tests have a low number of false positives or false negatives? what are these tests used for?

Back 5

low false negatives

rule out disease

Front 6

PPD reactivity is used as a screening test b/c most people w/ TB (except those who are anergic) will have a pos. PPD. highly sensitive or specific?

Back 6

highly sensitive for TB

Front 7

chronic diseases such as SLE - higher prevalence or incidence?

Back 7

higher prevalence

Front 8

cross-sectional survey - incidence or prevalence?

Back 8

prevalence

Front 9

epidemics such as influenza - higher prevalence or incidence?

Back 9

higher incidence

Front 10

cohort study - incidence or prevalence?

Back 10

incidence and prevalence

Front 11

case-control study - incidence or prevalence?

Back 11

neither

Front 12

describe a test that consistently gives identical results, but wrong ones.

Back 12

high reliability, low validity

Front 13

difference b/w cohort and case-control study?

Back 13

cohort studies can be used to calculate relative risk (RR), and/or odds ratio (OR). case-control studies can be used to calculate an OR.

Front 14

attributable risk?

Back 14

incidence rate (IR) of a disease in exposed minus the IR of disease in unexposed

Front 15

relative risk?

Back 15

the IR of a disease in a population exposed to a certain factor divided by the IR of those NOT exposed

Front 16

odds ratio?

Back 16

likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed

Front 17

number needed to treat?

Back 17

1 divided by (rate in untreated group - rate in treated group)

Front 18

in which pts do you initiate colorectal CA screening early?

Back 18

pts with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal CA (HNPCC); and those who have first-degree relatives with adenomatous polyps (<60 yrs of age) or colorectal CA

Front 19

most common CA in men and most common cause of death from CA in men?

Back 19

prostate CA is most common CA

lung CA is most common cause of CA death

Front 20

percentage of cases w/in 1 SD, 2 SD, 3 SD of the mean?

Back 20

68%
95.5%
99.7%

Front 21

birth rate?

Back 21

number of live births per 1,000 population

Front 22

fertility rate?

Back 22

number of live births per 1,000 women 15-44 yrs of age

Front 23

mortality rate?

Back 23

number of deaths per 1,000 population

Front 24

neonatal mortality?

Back 24

number of deaths from birth to 28d per 1,000 live births

Front 25

postnatal mortality?

Back 25

number of deaths from 28d to 1yr per 1,000 live births

Front 26

infant mortality?

Back 26

number of deaths from birth to 1yr of age per 1,000 live births (neonatal / postnatal mortality)

Front 27

fetal mortality?

Back 27

number of deaths from 20wks' gestation to birth per 1,000 total births

Front 28

perinatal mortality?

Back 28

number of deaths from 20wks' gestation to 1mo of life per 1,000 total births

Front 29

maternal mortality?

Back 29

number of deaths during pregnancy to 90d postpartum per 100,000 live births

Front 30

T or F: after pt gives consent, he must continue tx

Back 30

False. pts may change their mind at any time; exceptions to requirement of consent are emergencies and lack of decision-making capacity

Front 31

15yo pregnant girl needs hospitalization for preeclampsia. inform parents?

Back 31

No. parental consent is not necessary for med tx of pregnant minors

Front 32

is there a problem? doc refers pt for an MRI at facility he/she owns

Back 32

conflict of interest

Front 33

involuntary psych hospitalization can be done for what 3 reasons?

Back 33

1. pt danger to self
2. pt danger to others
3. pt gravely disabled (can't provide for basic daily needs)

Front 34

T or F: withdrawing life-sustaining care is ethically distinct from withholding sustaining care.

Back 34

False. withdrawing and withholding life are the same, ethically.

Front 35

when can a doc refuse to continue treating a pt on grounds of futility?

Back 35

when no rationale for tx,
maximal intervention is failing,
a given intervention has already failed, and
tx will not achieve goals of care

Front 36

8yo child in serious accident. needs transfusion, but parents aren't around.

Back 36

treat immediately. consent is implied in emergencies

Front 37

conditions when confidentiality must be overridden?

Back 37

real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse

Front 38

involuntary commitment or isolation for med tx may be undertaken for what reason?

Back 38

when tx noncompliance represents a serious danger to public health (eg. active TB)

Front 39

10yo child presents in status epilepticus, but her parents refuse tx on religious grounds

Back 39

treat b/c disease represents immediate threat to child's life; then seek court order

Front 40

son asks that his mom not be told about her recently discovered CA.

Back 40

pt's family cannot require that a doc withhold info from the pt