Usmle Step 1 Flashcards - Behav Science

Front 1

Phase III clinical trial?

Back 1

Patients randomly assigned to new treatment or current standard of care.

Front 2

Phase I clinical trial?

Back 2

Studies small number of healthy volunteers to assess safety, toxicity, and pharmacokinetics.

Front 3

Phase II clinical trial?

Back 3

Small number of patients with disease of interest. Assesses treatment efficacy, optimal dosing, and adverse effects.

Front 4

Phase IV clinical trial?

Back 4

Post-marketing surveillance after approval. Detects rare or long-term adverse effects.

Front 5

Under what circumstance can odds ratio approximate relative risk?

Back 5

If the prevalence of the disease is not too high

Front 6

What do precision and accuracy correspond to?

Back 6

Precision: reliability (reproducibility/consistency)

Accuracy: validity (trueness)

Front 7

Random error leads to reduced what?

Back 7

Reduced precision

Front 8

Systematic error leads to reduced what?

Back 8

Reduced accuracy

Front 9

4 ways to reduce bias?

Back 9

1. Blind studies (double blind)
2. Placebo responses
3. Crossover studies
4. Randomization

Front 10

Bias when a researcher's belief in the efficacy of a treatment changes the outcome of the treatment?

Back 10

Pygmalion effect

Front 11

Problem with late look bias?

Back 11

Information is gathered at an inappropriate time (ie: using a survey to study a fatal disease: only patients still alive will be able to answer)

Front 12

When knowledge of presence of disease alters information recall by subjects?

Back 12

Recall bias

Front 13

Other names for procedure bias (more attention paid to one group than the other)?

Back 13

Detection or ascertainment bias

Front 14

Selection/susceptibility vs sampling/referral bias?

Back 14

Selection: nonrandom assignment to study group

Sampling bias: subjects are not representative relative to general population

Front 15

Primary, secondary, and tertiary disease prevention?

Back 15

Primary: prevent disease
Secondary: early detection
Tertiary: reduce disability
("PDR": prevent, detect, reduce disability)

Front 16

Correlation coefficient vs coefficient of determination?

Back 16

Correlation coefficient: r (-1 to 1)

Coefficient of determination: r^2 (reported value)

Front 17

Confidence interval calculation?

Back 17

CI = mean +/- Z (SEM)
Z = 1.96 for 95% CI
SEM = std dev/sqr root n

Front 18

Type I (alpha) error?

Back 18

"False positive"
- Mistakenly accept the experimental hypothesis and reject the null
- p = probability of making type I error

Front 19

Type II (beta) error?

Back 19

"False negative"
- Stating that there's not an effect when one does exist

Front 20

Power of a test and what it depends on?

Back 20

Power is (1 - beta)
- depends on total number of end points, difference in compliance between groups, size of expected effect
- increases with sample size

Front 21

Leading causes of death in 65+?

Back 21

Heart disease, cancer, stroke

Front 22

Leading causes of death in 25-64?

Back 22

Cancer, heart disease, injury

Front 23

Leading causes of death in 15-24?

Back 23

Injuries, homicide, suicide

Front 24

Leading causes of death in 1-14?

Back 24

Injuries, cancer, congenital anomalies, homicide, heart disease

Front 25

Part A Medicare?

Back 25

- Inpatient care in hospitals
- Skilled nursing
- Hospice
- Home health care

Front 26

Part B Medicare?

Back 26

- Outpatient care
- Doctors' services
- PT/OT

Front 27

Infectious diseases reportable in all states?

Back 27

- AIDS
- chickenpox
- gonorrhea
- hepatitis A/B
- measles
- mumpes
- rubella
- salmonella
- shigella
- syphilis
- TB

Front 28

Normal vs pathologic grief?

Back 28

Pathologic: >2 mo, depression, delusions, hallucinations

Normal: <2 mo, can have illusions, guilt, denial, somatic sx

Front 29

Tanner stages of sexual development?

Back 29

1. Childhood
2. Pubic hair (adrenarche), breasts enlarge
3. Dark/curly pubic hair, penis length increases
4. Increased penis width, dark scrotal skin, development of glans, raised areolae
5. Adult, flat areolae

Front 30

Kubler-Ross grief stages?

Back 30

Denial, Anger, Bargaining, Grieving (Depression), Acceptance

Front 31

Affects of stress?

Back 31

Increased 17-OH corticosteroids, FFAs, lipids, cholesterol, catecholamines
- affects water absorption, muscular tone, gastrocolic reflex, mucosal circulation

Front 32

What does APGAR stand for?

Back 32

Appearance, Pulse, Grimace, Activity, Respiration

Front 33

Perfect APGAR score?

Back 33

A: Pink
P: >100
G: Grimace & cough
A: Active
R: Regular

Front 34

Most sleep is in what stage?

Back 34

Stage 2 (45% of sleep)

Front 35

EEG waves of each sleep stage?

Back 35

Beta (awake, eyes open)
Alpha (awake, eyes closed)
Theta (stage 1)
Sleep spindles/K complexes (stage 2)
Delta (stage 3-4)
Beta (REM)
("BATS Drink Blood" at night)

Front 36

Stage of sleep with bruxism?

Back 36

Stage 2
- deep sleep, sleep spindles & K complexes

Front 37

Highest and lowest frequency and amplitude sleep waves?

Back 37

Beta: lowest amplitude, highest frequency

Delta: highest amplitude, lowest frequency

Front 38

What happens during REM sleep?

Back 38

Dreaming
Loss of motor tone
Variable BP and pulse
Memory processing function
Erections
Increased brain O2 use
Extraocular movements (PPRF)

Front 39

Why does imipramine help to treat enuresis?

Back 39

Decreases stage 4 sleep

Front 40

What happens during stage 3 and 4 sleep?

Back 40

Deepest non-REM sleep (slow wave sleep)
- Sleepwalking
- Night terrors
- Bedwetting

Front 41

What compounds/meds decrease REM and delta sleep?

Back 41

Alcohol, Benzos, and Barbs
- Benzos: useful for night terrors and sleepwalking

Front 42

Neurotransmitters involved in REM sleep?

Back 42

ACh: principal neurotransmitter
NE: REDUCES REM sleep

Front 43

Changes in sleep pattern with depression?

Back 43

Decreased slow wave sleep (stage 3-4)
Decreased REM latency, increased REM in sleep cycle (increased total REM)
Nighttime and early-morning awakenings

Front 44

Children screaming in the middle of the night with no memory of arousal. Disorder and sleep stage?

Back 44

Sleep terror disorder
- Stage 4 (slow wave) sleep

Front 45

Treatment of narcolepsy?

Back 45

Stimulants (amphetamines, modafinil) and sodium oxybate (GHB)

Front 46

Circadian rhythm regulation?

Back 46

Light from retina --> SCN of hypothalamus --> NE release --> pineal gland --> melatonin
- also controls ACTH and PRL release

Front 47

Toilet training age?

Back 47

Between 18 mo and 3 years ("pee at three")

Front 48

Stranger vs separation anxiety ages?

Back 48

Stranger: 5-9 mo
Separation: 10-18 mo (object permanence is 12-24 mo)

Front 49

Age of core gender identity and parallel play?

Back 49

12-24 mo

Front 50

Cognitive/social milestones at age 4?

Back 50

Cooperative play
Imaginary friends
Grooms self
Brushes teeth
Buttons and zips