Behavioral Science Epidemiology & Bio Statistics

Q0001:Woman with anxiety about a gynecological exam is
told to relax and imagine going through the steps of the

exam;What process does this exemplify?
Systematic desensitization.
Q0002:65-year old man is diagnosed with incurable metastatic
pancreatic adenocarcinoma. His family asks you; the doctor;
not to tell the patient;What do you do?
Assess whether telling the patient will negatively affect his
health. If not; tell him.
Q0003:Man admitted for chest pain is medicated for
ventricular tachycardia. The next day he jumps out of bed and
does 50 pushups to show the nurses he has not had a heart
attack;What defense mechanism is he using?
Denial.
Q0004:You find yourself attracted to your 26-year-old
patient;What do you say?
Nothing! The tone of the interview must be professional ; if
you feel your actions may be misinterpreted; have a
chaperone in the room.
Q0005:Large group of people is followed over 10 years.
Every 2 years; it is determined who develops heart disease
and who does not;What type of study is this?
Cohort study.
Q0006:Girl can groom herself; can hop on 1 foot; and has an
imaginary friend;How old is she?
4 years old.
Q0007:Man has flashbacks about his girlfriend's death 2
months ago following a hit-and-run accident. He often cries
and wishes for the death of the culprit;What is the diagnosis?
Normal bereavement.
Q0008:36-year old woman with a strong family history of
breast cancer refuses mammogram because she heard it
hurts;What do you do?
Discuss the risks and benefits of not having a mammogram.
Each patient must give her own informed consent to each
procedure. If the patient refuses; you must abide by her
wishes.
Q0009:During a particular stage of sleep; man has variable
blood pressure; penile tumescence; and variable EEG;What
stage of sleep is he in?
REM sleep.
Q0010:15 year old girl of normal height and weight for her age
has enlarged parotid glands but not other complaints. The
mother confides that she found laxitives in the daughter's
closet;What is the diagnosis?
Bulimia.
Q0011:11-year old girl exhibits Tanner stage 4 sexual
development (almost full breats and pubic hair);What is the
diagnosis?
Advanced stage; early development.
Q0012:4 year old girl complains of a burning feeling in her
genitalia; otherwise she behaves and sleeps normally. Smear of
discharge shows N. gonorrhoeae;How was she infected?
Sexual abuse.
Q0013:72 year old man insists on stopping treatment for his
heart condition because it makes him feel "funny";What do
you do?
Although you want to encourage the pt to take his meds; the
pt has the final say in his own rx regimen. you should
investigate the "funny" feeling and determine if there are drugs
available that won't elicit this particular side effect.
Q0014:Person demands only the best and most famous doctor
in town;What is the personality disorder?
Narcissism.
Q0015:Nurse has episodes of hypoglycemia; blood analysis
reveals no elevation in C-protein;What is the diagnosis?
Factitious disorder; self scripted insulin.
Q0016:55 year old businessman complains of lack of
successful sexual contacts with women and an inability to
reach a full erection. Two years ago he had a heart
attack;What might be the cause of his problem?
Fear of sudden death during intercourse.
Q0017:Observational Study. Sample chosen on presence of
absence of disease. Information collected about exposure.
Case-control Study.
Q0018:Observational study. sample chosen based on
presence of absence of risk factors. Subjects followed over
time for development of disease.
Cohort Study.
Q0019:Pooling data from several studies (often via a literature
searach) to acheive greater statistical power.
Meta-analysis.
Q0020:Experimental study. compares therapeutic benefit of 2
or more treatments; or treatment and placebo.
clinical trial.
Q0021:List 4 ways to reduce bias in a study.
1. Blind studies;2. Placebo responses;3. Case-crossover
design;4. Randomization
Q0022:When the subjects choose the groups it may lead to
what type of bias?
Selection bias.
Q0023:When knowledge of the presence of the disease alters
recall by the subjects what type of bias is likely?
Recall bias.
Q0024:When subjects are not representative of the
population and results are not generalizable; what type of bias
is this?
Sampling bias.
Q0025:When information gathered on subjects is done so at
an inappropriate time; what bias is likely?
Late-look bias.
Q0026:The total proportion of cases in a population at a
given time.
Prevalence.
Q0027:The rate of new cases in a population in a given time.
Incidence.
Q0028:Incidence x Disease Duration
Prevalence
Q0029:For chronic diseases; which is larger - prevalence or
incidence?
Prevalence > Incidence for Chronic Disease
Q0030:When does prevalence = incidence?
For acute disease (ie the common cold)
Q0031:What is sensitivity?
TP/(TP+FN) x 100 = Sensitivity
Q0032:When is high sensitivity desirable?
In a screening test.
Q0033:What is 1-sensitivity?
False negative ratio.
Q0034:What is specificity?
TN/(TN+FP) x 100 = specificity
Q0035:What is 1-specificity?
False positive ratio.
Q0036:When is high specificity desirable?
In a confirmatory test.
Q0037:What is the PPV?
The probability of having a condition given a positive
test;TP/(TP+FP) = PPV
Q0038:What is NPV?
The probability of not having the condition given a negative
test;TN/(TN+FN) = NPV
Q0039:Unlike sensitivity and specificity; the predictive
values are ;
dependent on the prevalence of disease. The higher the
prevalence of disease; the higher the predictive value of the
test.
Q0040:a/(a+c)
sensitivity
Q0041:d/(b+d)
specificity
Q0042:a/(a+b)
PPV
Q0043:d/(c+d)
NPV
Q0044:(a/b)/(c/d)
OR - approximates RR if prevalence of disease is not too
high.
Q0045:[a/(a+b)]/[c/(c+d)]
RR - relative risk
Q0046:Attributable risk formula?
[a/(a+b)]-[c/(c+d)]
Q0047:The consistency and reproducibility of a test is the ;
Precision.
Q0048:Absence of random variation in a test ;
Precision.
Q0049:The trueness of the test measurements is the ;
Accuracy
Q0050:Reduced precision means
increase in random error
Q0051:Reduced accuracy means
increase in systematic error
Q0052:Number needed to treat
NNT = 1/(Ic-Ie);The number of pts that need to be treated to
prevent 1 additional bad outcome.
Q0053:Reliability is ;
the reproducibility of a test. a Test is reliable if repeat
measurements are the same.
Q0054:Validity is ;
whether the test truly measures what it purports to measure.
A test is valid if it measures what it is supposed to measure.
Q0055:Gaussian distribution is ;
a normal distribution (bell curve) (mean=median=mode)
Q0056:A bimodal distribution ;
has 2 humps
Q0057:A positive skew distribution ;
is asymmetry with the tail to the right; hump on the left
(mean>median>mode)
Q0058:a Negative skew distribution ;
is asymmetry with the tail to the left; hump on the right
(mean<median<mode)
Q0059:A null hypothesis is ;
There is no association (ie between the risk factor and the
disease in the popuation.)
Q0060:The alternative hypothesis is ;
There is some difference (ie between the disease and the risk
factor in the population)
Q0061:Type 1 error (alpha)
Stating there IS an effect or difference where none really
exists.
Q0062:Type II error (beta)
Stating there IS NOT an effect or difference when one really
exists.
Q0063:Power
the probability of rejecting the null hypothesis when it is in
fact false.
Q0064:Power in a study depends on what two things ;
1. total number of endpoints experienced by the population;2.
difference in compliance between treatment groups
Q0065:How do you increase study power
increase the sample size.
Q0066:Confidence interval
mean +/- 1.96 (SEM);If the CI includes 0; H0 is accepted.
Q0067:Normal (Gaussian) distribution has what percentage of
the population in each standard deviation?
68% within 1 SD; 95% within 2 SDs; 99.7% within 3 SDs.
Q0068:what does a t-test measure
the difference between the means of two groups
Q0069:What does ANOVA measure
the difference between means of 3 or more groups
Q0070:What does a Chi square measure?
the difference between 2 or more proportions of categorial
outcomes (NOT mean values)
Q0071:Correlation coefficient indicates
the strength of the correlation between two variables. The sign
indicates a positive or negative.
Q0072:What is Primary Disease Prevention?
Prevent the disease from occuring.
Q0073:What is Secondary Disease Prevention?
Early detection of the disease.
Q0074:What is Tertiary Disease prevention?
Reduce mobidity from the disease.
Q0075:What are important preventative measure for patients
with DM?
Eye exams; foot exams; urine tests.
Q0076:What are important preventive measures for pts with
drug abuse problems?
HIV test; TB test; Hep immunizations.
Q0077:What are important prevetive measures for pts with
alcoholism?
influenza; pneumococcal immunizations and TB testing
Q0078:What is an important preventive measure to offer
obese pts?
Blood sugar testing for diabetes.
Q0079:What is an important preventive measure to offer
homeless pts or recent immigrants?
TB tests
Q0080:What tests are important for pts engaging in high risk
sexual behavior?
HIV; Hep B; Syphilis; gonorrhea; chlamydia tests.
Q0081:List the Reportable Diseases
1. Hep B;2. Hep A;3. Salmonella;4. Shigella;5. Syphilis;6.
Measles;7. Mumps;8. AIDS;9. Rubella;10. TB;11.
Chickenpox;12. Gonorrhea
Q0082:Is HIV reportable?
While AIDS is reportable in all states; HIV reporting laws are
state dependent.
Q0083:What are the leading causes of death for infants in the
US?
1. Congenital anomalies;2. Short gestation/LBW;3. SIDS;4.
Maternal complications of pregnancy;5. RDS
Q0084:What are the leading causes of death for children age 1-
14 in the US?
1. Injuries;2. Cancer;3. Congenital anomalies;4. Homicide;5.
Heart disease
Q0085:What are the leading causes of death for people 15-24
years of age in the US?
1. Injuries;2. Homicide;3. Suicide;4. Cancer;5. Heart disease
Q0086:What are the leading causes of death for adults 25-64
yo in the US?
1. Cancer;2. Heart disease;3. Injuries;4. Suicide;5. Stroke
Q0087:What are the leading causes of death for adults over
the age of 65 in the US?
1. Heart disease;2. Cancer;3. Stroke;4. COPD;5. Pneumonia;6.
Influenza
Q0088:Define autonomy
The obligation to respect patients as individuals and to honor
their preferences in medical care.
Q0089:Informed consent implies pts must understand the
risks; benefits; and alternatives which include no
intervention;What is legally required for IC?
1. discussion of pertinent information;2. patient's agreement
to the plan of care;3. freedom from coercion
Q0090:In what circumstances is there an exception to the
mandates of informed consent?
1. Patient lacks decision making capacity;2. Implied consent is
an emergency;3. Therapeutic privledge;4. Waiver - pt waives
the right to informed consent
Q0091:What is Therapeuic Privledge
Withholding information when disclosure would severely
harm the patietn or undermine informed decision making
capacity.
Q0092:True or False: A patients family cannot require that a
doctor withhold information from the patient.
True
Q0093:What are some variables in determining a patients
decision making capacity?
1. pt makes and communicates a choice;2. pt is informed;3.
decision remains stable in time;4. decision is consistent with
pt values and goals;5. decision is not a result of hallucinations
or delusions
Q0094:Define Transference.
When the patient projects feelings stemming from their
personal life onto their physician.
Q0095:Define Countertransference.
When the doctor projects feelings stemming from their
personal life onto the pt.
Q0096:Define classical conditioning.
Leaning where a natural response is elicited by a contitioned
stimulus that was previously presented in conjuction with an
unconditional natural stimulus.
Q0097:Define operant conditioning.
learning in which a particular action is elicited because it
produces a reward.
Q0098:Define positive reinforcement.
desired reward produces action
Q0099:Define negative reinforcement.
removal of averse stimuli incresases the behavior.
Q0100:True or False: reinforcement schedules determine how
quickly a behavior is learned or extinguished.
True
Q0101:Describe a continuous reinforcement schedule.
reward received after every response. rapidly extinguished.
Q0102:Define a variable ratio reinforcement schedule.
reward received after random number of responses. slowly
extinguished.
Q0103:What are Stanfornd-Binet and Wechsler?
Intelligence tests.
Q0104:How does the Stanford Binet test calculate
intelligence?
IQ as (mental age/chronological age) x 100
Q0105:How does Wechsler (WAIS) measure intelligence?
11 subtests (6 verbal; 5 performance); Mean is 100; SD - 15.
Q0106:What is the IQ cuttoff for diagnosis of mental
retardation?
IQ < 70 or 2 SD below mean.
Q0107:True or False: IQ tests are objective test.
True ; but they are NOT projective tests.
Q0108:Are IQ scores correlated with genetic factors or school
achievement?
Yes to both ; but more highly correlated to school
achievement.
Q0109:What is an oral advanced directive?
In an incapacitated state; a pts prior oral statement is
commonly used as a guide.
Q0110:What is a written advanced directive?
a living will.
Q0111:What is a durable power of attorney?
pt desingnates a surrogate to make a medical decision in the
event that the patient loses decision making capacity. pt can
specify decisions in certain clinical situations; and can revoke
power.
Q0112:What is nonmaleficence.
"do no harm". However; if benfits of an intervention outweigh
the risks; a patient may make an informed decision to
proceed.
Q0113:Define beneficence
The physicians ethical responsibility to act in the patients
best interest (as a fiduciary). Can conflict with autonomy.
Q0114:What should guide the physicans decision to disclose
information to family and friends?
What the patient wants; or would want.
Q0115:In what circumstances can a physician break
confidentiality?
1. potential harm to others is serious;2. liklihood of harm to
self is great;3. no alternative means exist to warn and protect
those at risk
Q0116:What steps may a physician take to prevent harm
caused by a patients infectious disease?
Physician may have a duty to warn public health officials
(reportable diseases) and identify people at risk.
Q0117:What is the Tarasoff decision?
A law requiring physician to directly inform and protect a
potential victim from harm; may involve a breach of
confidentiality.
Q0118:May a physician break confidentiality if they suspect
child or elder abuse?
Yes.
Q0119:May a physician break confidentiality if in cases of an
automobile accident?
Only if they suspect that the driver was imparied.
Q0120:How may a physician handle a suicidal or homicidal
patient?
The physician may hold the patient involuntarily for a period
of time ; or until psychiatric evaluation is completed.
Q0121:A civil suit under negligence requires what 3 things?
1. Physician breach of duty to patient (Dereliction);2. patient
suffers harm (damage);3. Breach of duty causes harm (Direct)
Q0122:What is the most common factor leading to litigation
between the physician and pt?
poor communication.
Q0123:In a criminal suit the burden of proof is "beyond a
reasonable doubt" ; in a malpractice suit the burden of proff is
;
"more likely than not"
Q0124:Define Anosognia
unaware that one is ill
Q0125:Define Autotopagnosia
unable to locate ones own body parts
Q0126:Define depersonalization
body seems unreal or dissociated
Q0127:What is involved in orienting the patient
person; place; and time
Q0128:What is the order of orientation loss in a disoriented
patient?
time goes first; then place; and last person
Q0129:Define anterograde amnesia
the inability to remember things that occred AFTER an CNS
insult ; cannot make new memories
Q0130:Define retrograde amnesia
inability to remember things that occured before a CNS insult
Q0131:What is Korsakoff's anmesia
classic anterograde anmesia caused by a thymine deficiency.
Q0132:A alcoholic patient presents with anterograde amnesia;
and confabulations;What is the likely diagnosis?
Korsakoffs amnesia
Q0133:List some maladaptive patterns of substance use.
1. Tolerance;2. Withdrawal;3. Substance taken in larger than
intended amounts;4. Persistent desire or attempts to cut
down;5. lots of energy spent trying to obtain the substance;6.
important social; occupational; or recreational activites
reduced because of substance abuse;7. continued use in spite
of knowing the problems it's causing
Q0134:How many signs of maladaptive substance abuse must
be present in a years time to diagnose substance dependance?
3 or more.
Q0135:What is the difference between substance dependence
and substance abuse?
substance abuse is maladaptive patterns leading to clinicall or
socially significant impairment or distress that have not met
the criteria for substance dependence.
Q0136:What are some indications of substance abuse?
1. recurrent use resulting in failure to fulfill major obligations
at work; school; or home;2. recurrent use in physically
hazardous situations;3. recurrent substance related legal
problem;4. continued use in spite of persistent problems
cause by use.
Q0137:What are Freud's three structures of the mind?
Id; Ego; Superego
Q0138:Define the Id.
Primal urges; sex and aggression.
Q0139:Define the Superego.
Moral values and concience.
Q0140:Define the Ego.
Mediator between unconcious mind and external world.
Q0141:The Topographic thoery of the mind deals with what
three topographys?
Concious; preconcious; and unconcious.
Q0142:Define Concious.
What you are aware of.
Q0143:Define preconcious.
What you are able to make consious with effort
Q0144:Define unconcious
what you are not aware of.
Q0145:What is an Oedipus complex?
repressed sexual feelings of a child for the opposite sex
parent; accompanied by a rivalry with same sex parent.
Q0146:hallucinations; delusions; strange behavior; and loose
associations are positive symptoms of what disorder?
Schizophrenia.
Q0147:What are some negative symptoms of schizophrenia?
flat affect; social withdrawal; thought blocking; lack of
motivation
Q0148:How long must a patient experience symptoms of
schizophrenia for a diagnosis?
Periods of psychosis or disturbed behavior lasting > 6
months.
Q0149:What are the 5 types of schizophrenia?
1. Disorganized;2. Catatonic;3. paranoid;4. Undifferentiated;5.
Residual
Q0150:What are the 4 A's of schizophrenia described by
Bleuler?
1. Ambiavlence;2. Autism;3. Affect (blunted);4. Associations
(loose)
Q0151:What is schizoaffective disorder?
a combination of schizophrenia and a mood disorder.
Q0152:What is the lifetime prevalence of schizophrenia?
1.5% (males=females; blacks=whites)
Q0153:Are genetic or envionmental factors stronger in the
etiology of schizophrenia
Genetic factors outweigh environmental factors
Q0154:In one word; describe Clusters A; B; and C
personality disorders.
A = weird;B = wild;C = worried
Q0155:Describe a pt with a Cluster A personality disorder.
odd or eccentric; cannot develop meaningful social
relationships;No psychosis; but genetic associations with
schizophrenia.
Q0156:What are 3 types of Cluster A personality disorders?
1. Paranoid;2. Schizoid;3. Schizotypal
Q0157:What is a Paranoid personality disorder?
distrust and suspiciousness; projection is main defense
mechanism
Q0158:What is a Schozoid peronality disorder?
voluntary social withdrawal; limited emotional expression
Q0159:What is a Schizotypal personality disorder
interpersonal awkwardness; odd thought patterns and
appearance
Q0160:Personality disroders that lead pts to be erratic;
emotional; or dramatic and have a genetic association with
mood disorders are classified as ;
Cluster B
Q0161:What are the 4 types of Cluster B personality
disorders
1. Antisocial;2. Borderline;3. Histrionic;4. Narcissistic
Q0162:Describe an antisocial personality disorder.
disregard for and violation of rights of others; crimilatiy; males
more often affected than females.
Q0163:Describe a borderline personality disorder
unstable mood and behavior; impulsiveness; sense of
emptiness. women more often affected than men.
Q0164:Describe a Histrionic personality disorder.
excessive emotionality; somatization; attention seeking;
sexually provacative.
Q0165:Describe a Narcissistic personality disorder.
gradiosity; sense of entitlement; may demand "top"
physician; or best health care
Q0166:Pts with personality disorders that leave them anxious
or fearful and have a genetic association with anxiety disorders
are classified as ;
Cluster C personality disorders
Q0167:List 3 types of Cluster C personality disorders
1. Avoidant;2. Obsessive-Compulsive;3. Dependent
Q0168:Describe an avoidant personality disorder.
sensitive to rejection; socially inhibited; timid; feelings of
inadequacy
Q0169:Describe OCD
preoccupation with order; perfectionism; and control
Q0170:Describe a dependent personatliy disorder.
submissive and clinging; excessive need to be taken care of;
low self confidence
Q0171:What are Medicare and Medicaid?
federal health care programs that originated from
ammendments to the Social Security Act.
Q0172:Who does MedicarE provide for?
The Elderly
Q0173:Who does MedicaiD provide for?
The Destitute. Medicaid is federal and state assistance for
very poor people.
Q0174:Ethically; what do you do if your patient is non-
compliant?
Work to improve the physician patient relationship.
Q0175:Ethically; what do you do if your patient has
difficulty taking medication?
Provide written instructions; attempt to simplify the
treatment regimen.
Q0176:What do you do if a family member asks for
information about a patient's prognosis?
avoid discussing issues with relatives without permission of
the patient.
Q0177:What do you do if a 17 year old girl is pregnant and
asks for an abortion.
informthe patient that most states require parental conset for
minors for an abortion.
Q0178:What do you do if a terminallyl ill patient requests
assistance in ending his life?
refuse involvement in any form of euthanasia. physician may
however prescribe appropriat analgesics that may
coicidentally shorten a patient's life.
Q0179:What do you do if a patient states that he finds you
attractive?
ask direct; closed ended questions and use a chaperone if
necessary.
Q0180:What do you do if a patient refuses a necessary
procedure or desires and unnecessary one?
attempt to understand why the patient wants/does not want
the procedure. address underlying concerns. avoid performing
unnecessary procedures.
Q0181:What do you do if a patiend is angry about the amount
of time he spent in the waiting room?
apologize for any inconvenience. stay away from efforts to
try to explain the delay.
Q0182:what do you do if the patietn is upset with the way he
was treated by another doctor?
suggest that the patient speak directly to the physician
regarding the concerns. if the problem is weith a member of
the office staff ; tell the patient you will speak to that
individual.
Q0183:What do you do if a child wishes to know more about
his illness?
Ask what the parents have told the child about his illness.
Parents of a child decide what information can be relayed
about the illness.
Q0184:What do you do if a patient continues to smoke;
believing that cigarettes are good for him?
Ask how the pt feels about his smoking. Offer advice on
cessation if the patient seems willing to make an effort to quit.
Q0185:A child puts everything in their mouth. How old are
they?
1st year of life.
Q0186:An infant sits with support; how old is she?
4 months
Q0187:An infant stands with help; how old is he?
8 months
Q0188:A baby is crawling; how old is she?
9 months
Q0189:A little girl just learned to walk on her own; how old is
she?
13 months
Q0190:A child has just learned to climb the stairs alone; how
old is he?
18 months
Q0191:At what age does an emergence of hand preference
first appear?
18 months
Q0192:A child has lots of energy; can walk backwards; turn
doorknobs; unscrew jars; and scribble with crayons. How old
is she?
2 years
Q0193:A child can ride a tricycle; go up the stairs normally;
draw recognizable figures and has just started toilet training.
How old is he?
3 years.
Q0194:A child can descend the stairs normally and hop on
one foot. How old is she?
4 years
Q0195:At what age will a child develop complete sphincter
control (toilet trained)?
5 years
Q0196:At 5 years of age; what percentage of the adult brain
mass does the child have?
75%
Q0197:A child has most of her permanent teeth; how old is
he?
11 years
Q0198:True or False: Boys and girls have roughly the same
height to weight ratio between ages 6-12 years?
False: boys are heavier than girls.
Q0199:At what age does the adolescent growth spurt usually
kick in?
Around 12 years; earlier for girls than for boys.
Q0200:A child plays patty cake and peek a boo; how old is
she?
10 months
Q0201:A baby is experiencing stranger anxiety; how old is he?
6 months
Q0202:A baby has started showing signs of normal separation
anxiety; how old is she?
1 year.
Q0203:The parent is the central figure and issues of trust are
key; how old is the child?
1st year of life.
Q0204:A toddler will engage in parallel play; but "no" is still
her favorite word; how old is she?
1 year
Q0205:A toddler is selfish and self centered; aggresive; and
tends to immitate mannerisms and activities; how old is he?
2 years
Q0206:A baby can follow objects to midline; how old is she?
4 months
Q0207:A baby is putting his feet in his mouth; how old is he?
5 months
Q0208:A baby will approach a toy with one hand; and then
change hands with the toy; how old is she?
1st year of life
Q0209:A baby first laughs outloud; how old is she?
4 months
Q0210:A baby has started saying "ma-ma-ma" and "da-da-
da"; how old is he?
10 months
Q0211:Sensation and movement are most important; schemas
are being developed; and assimilationand accomidation are
priorities at what age in Piaget's development?
1st year of life.
Q0212:In Piaget's Cognitive Development; at what age does a
baby acheive object permanence?
1 year
Q0213:A baby kicks and throws a ball; how old is he?
1 year
Q0214:A baby can stack three cubes; how old is she?
18 months.
Q0215:A todler is using two word sentences and has a
vocabulary of about 250 words; how old is he?
1 year
Q0216:A todler has started using pronouns and shows great
variations in timing of language. Her parents seem to
understand her better. How old is she?
2 years
Q0217:A toddler is using complete sentences and has a
vocabulary of 900 words; although he appears to understand
4x tht many words. Strangers can understand him. How old is
he?
3 years
Q0218:A child tells stories; uses prepositions; plurals; and
has discovered compound sentences; how old is she?
4 years
Q0219:A child can stand on her tiptoes; how old is she?
30 months
Q0220:A child is able to aim and throw a ball and stack 6
cubes; how old is he?
2 years
Q0221:In Piaget's view; a child who can use symbols and has
concrete use of objects and use of symbols along with a strong
egocentrism is how old?
2 years
Q0222:At what age is gender identity fixed?
3 years
Q0223:A child knows her full name and what sex she is; how
old is she?
3 years
Q0224:Two children are observed to be taking turns with a
toy; how old are they?
3 years
Q0225:At what age is a child likely to start grooming
themselves and brushing their own teeth?
4 years
Q0226:A toddler can catch a ball; stack 9 cubes; cut paper
with scissors and keeps unbottoning his shirt buttons; how
old is he?
3 years
Q0227:A child can point to and count three objects; repeat
four digits; and name colors correctly; how old is she?
4 years
Q0228:A child has an imaginary friend and this is entirely
normal for this age group; how old is she?
4 years
Q0229:Two children are caught "playing doctor"; at what age
does this curiosity manifest?
4 years
Q0230:A child is having terrible nightmares and needs the
light left on at night for fear of monsters; how old is he?
4 years
Q0231:At what age does a child adopt personal speach
patterns?
adolescence (12+)
Q0232:At what age does communication become the focus of
friendships?
adolescence (12+)
Q0233:A child repeatedly asks for the meaning of words; how
old is she?
5 years
Q0234:A child can count 10 objects correctly; how old is she?
5 years
Q0235:A child is having terrible nightmares and needs the
light left on at night for fear of monsters; how old is he?
4 years
Q0236:At what age does a child adopt personal speach
patterns?
adolescence (12+)
Q0237:At what age does communication become the focus of
friendships?
adolescence (12+)
Q0238:A child repeatedly asks for the meaning of words; how
old is she?
5 years
Q0239:A child can count 10 objects correctly; how old is she?
5 years
Q0240:At what age will a child first express romantic feelings
towards others; perhaps as an Oedipal phase?
5 years
Q0241:A child can draw a recognizable man; dress and
undress herself; and catch a ball with two hands; how old is
she?
5 years
Q0242:A child can ride a bicycle; print letters; and her father
is excited because she is gaining athletic skill and coordination.
How old is she?
6-12 years
Q0243:By age 12; about how many words will a child have in
their vocabulary?
About 50;000
Q0244:A child shows a shift from egocentric to social speech
and incomplete sentences decline; how old is he?
6-12 years
Q0245:Identity is the critical issue in what age range?
adolescence (12+)
Q0246:Conformity is most important for what age range?
11-12 years
Q0247:When do cross gender relationships first take off?
adolescence (12+)
Q0248:A teacher has noticed many of her kids are quitting
oragnized sports; how old is her class likely to be?
adolescents (12+)
Q0249:A teacher has noticed that for her kids; the "rules of
the game" are paramount. How old is her class?
6-12 years
Q0250:At what age range are organized sports first possible?
6-12 years
Q0251:Demonstrating competence is key for what age group?
6-12 years
Q0252:At this age there is a separation of the sexes and sexual
feelings are not apparent.
6-12 years
Q0253:At this age there is an adherence to logic; concrete
operations; and no hypotheticals.
6-12 years
Q0254:Children of this age group can use seriation; and have a
personal sense of right and wrong.
6-12 years
Q0255:At this age; children can handle hypotheticals; being
systematic problem solving and deal with the past; present;
and future.
adolescence (12+)
Q0256:APGAR stands for what?
Appearance (color);Pulse;Grimace;Activity;Respiration
Q0257:How do you calculate aan APGAR score?
Score 0-2 at 1 and 5 inutes in each of 5 categories.
Q0258:What is a perfect APGAR score?
10
Q0259:What the three levels of appearance (color) on the
APGAR scale?
0 = blue/pale;1=trunk pink;2=all pink
Q0260:What describes the three levels of pulse on the
APGAR score?
0= 0;1= <100;2= >100
Q0261:What describes the three levels of reflex irritability
(grimace) on the APGAR scale?
0= none;1= grimace;2 = grimace + cough
Q0262:Describe the 3 levels of muscle tone on the apgar scale.
0 = limp;1 = some;2 = active
Q0263:Describe the three levels of respiratory effort on the
APGAR scale.
0 = none;1= irregular;2 = regular
Q0264:What is the definition of low birth weight in grams?
< 2500 g
Q0265:List some complications of low birth weight.
infections;respiratory distress syndrome;necrotizing
enterocolitis;intraventricular hemorrhage;persistent fetal
circulation
Q0266:What are two likely etiologies for low birth weight?
prematurity and intrauterine growth retardation
Q0267:True or False: Low birth weight is associated with a
greater RR of physical and emotional problems.
True
Q0268:Long term infant deprivtaion of affection results in the
4 W's ;
Weak; Wordless; Wanting; Wary
Q0269:How long does deprivation of affection need to
continue before changes may be irreversible?
> 6 months
Q0270:List some effects of long term deprivation of affection
in infants.
1. Decreased muscle tone;2. Poor language skills;3. Poor
socialization skills;4. Lack of basic trust;5. Anaclitic
depression;6. Weight loss;7. Physical illness
Q0271:True or False: severe deprivation of affection may
result in infant death.
True
Q0272:What is anaclitic depression?
Depression in an infant owing to continued separation from
caregiver - it can result in failure to thrive.
Q0273:An infant becomes withdrawn and unresponsive when
left in a crowded daycare for a few weeks; what may be the
problem?
Anaclitic depression
Q0274:What stimuli may cause children to regress to younger
behavior?
Stress: physical illness; birth of a new sibling; tiredness.
Q0275:When a child is found to be physically abused; who is
typically the abuser?
usually female and the primary caregiver.
Q0276:When a child is found to be sexually abused; who is
typically the abuser?
A male who is known to the victim.
Q0277:Healed fractures on x-ray; cigarette burns; subdural
hematoma; multiple brusies; and/or retinal hemorrhage in a
child are all signs of ;
physical abuse
Q0278:Gential/anal trauma; STIs; and UTIs in a child are all
evidence of ;
sexual abuse.
Q0279:How many children die each year in the United States
from physical abuse?
about 3000.
Q0280:At what age are most children sexually abused?
9-12 years.
Q0281:Describe autistic disorder
pts have severe communication problems and difficulty
forming relationships. repetative behavior; savants; and below
normal intelligence.
Q0282:Describe Asperger syndrome
a milder form of autism involving problems with social
relationships and repetative behavior. Children are of normal
intelligence and lack social or cognitive deficits.
Q0283:Describe Rett disorder
X-linked disorder seen only in girls. Characterized by loss of
development and mental retardation appearing at about 4
years.
Q0284:Describe ADHD
limited attention span and hyperactivity. children are
emotionally labile; impulsive; and prone to accidents. Normal
intelligence
Q0285:What is the current treatment for autism?
increase communication and social skills
Q0286:Why aren't boys seen with Rett syndrome?
With this X-linked disorder; boys die in utero.
Q0287:What is the treatment for ADHD?
methylphenidate (Ritalin)
Q0288:Describe conduct disorder
continued behavior violating social norms.
Q0289:Describe oppositional definant disorder.
A form of conduct disorder when the child is noncompliant in
teh absence of criminality.
Q0290:Describe Tourette's syndrome.
motor/vocal tics and involuntary profanity. Onsent < 18
years.
Q0291:What is the treatment for Tourette's?
haloperidol
Q0292:Describe separation anxiety disorder.
fear of loss of attachment figure leading to factitious physical
complaints to avoid going to school. Common in children ages
7-8.
Q0293:Describe Anorexia nervosa.
abnormal eating habits; body image distortion; and increased
excercise.
Q0294:Severe weight loss; amennorrhea; anemia and
electrolyte disturbances in an adolescent girl are signs of ;
anorexia nervosa.
Q0295:Describe Bulimia nervosa.
binge eating followed by self-induced vomiting or use of
laxitives. Body weight is usually normal.
Q0296:Parotitis; tooth enamel erosion; incrase amylase; and
esophageal varicies in an adolescent girl at normal weight are
signs of ;
Bulimia nervosa.
Q0297:What are hallucinations?
perceptions in the absence of external stimuli.
Q0298:What are Illusions?
misinterpretations of actual external stimuli.
Q0299:What are Delusions?
false beliefs not shared with other members of
culture/subculture that are firmly maintained despite obvious
proof to the contrary.
Q0300:Desribe the difference between a delusion and a loose
association.
A delusion is a disorder in the content of thought (the actual
idea); while a loose association is a disorder in the form of the
thought (how the ideas are tied together)
Q0301:Patients with schizophrenia commonly experience
what kind of hallucinations?
Visual and auditory hallucinations.
Q0302:Patients with psychomotor epilepsy will commonly
experience what kind of hallucination?
olfactory hallucination.
Q0303:True or False: Gustatory hallucination is rare.
True
Q0304:Patients with DTs or cocaine abusers may experience
what kind of hallucinations?
tactile hallucinations
Q0305:What is a hypnagogic hallucination?
A hallucination that occurs when going to sleep.
Q0306:What is a hypnopompic hallucination?
A hallucination that occurs when waking from sleep.
Q0307:How many heroin addicts are there in the United
States?
About 500;000
Q0308:A diagnosis of hepatitis; abscesses; overdose;
hemorrhoids; AIDS; or right sided endocarditis (especially in
the presence of track marks) should lead the physician to
consider
heroin addiction.
Q0309:What two drugs are used to treat heroin addicts?
Naloxone and Methadone.
Q0310:How can Naloxone help a heroin addict?
Naloxone (Narcan) and naltrexone competitively inhibit
opiods.
Q0311:How can Methadone help a heroin addict?
Methadone is a long acting oral opiate used for heroin
detoxification and long term maintenance.
Q0312:What is Delirium tremens?
Life threatening alcohol withdrawal syndrome that peaks 2-5
days after the last drink.
Q0313:tachycardia; tremors; and anxiety followed by
halluciantions; delusions; and confusion in an alcoholic may be
signs of ;
delirium tremens.
Q0314:What is the treatment for delirium tremens?
benzodiazepines.
Q0315:List risk factors for suicide completeion.
"SAD PERSONS": Sex (male); Age; Depression; Previous
attempt; Ethanol; RAtional thought; Sickness; Organized
plan; No spouse; Social support lacking.
Q0316:Which gender attempts suicide more often?
Women
Q0317:Which gender is sucessful at suicide more often?
Men
Q0318:What is a personality trait?
An enduring pattern of perceiving; relating to; and thinking
about the environment and oneself that is exhibited in a wide
range of important social and personal contexts.
Q0319:What is a personality disorder?
When personality traits become inflexible and maladaptive;
causing impariment in social or occupational functioning or
subjective distress
Q0320:True or False: A patient with a personality disorder is
usually aware of the problem.
False: a person with a personality disorder is usually NOT
aware of the problem.
Q0321:What does the phrase "Mature women wear a SASH"
indicate
Mature ego defenses: Sublimation; Altruism; Supression; and
Humor
Q0322:What are ego defenses?
automatic and UNCONCIOUS reactions to psychological
stress.
Q0323:Describe altruism as an ego defense.
guilty feelings alleviated by unsolicited generosity toward
others.
Q0324:Describe humor as an ego defense.
appreciating teh amusing nature of an anxiety provoking or
adverse situation.
Q0325:a mafia boss making a large donation to charity is an
example of what ego defense?
altruism.
Q0326:a cancer patient laughing about their condition is an
humor
Q0327:aggressive impulses used to succeed in sports is an
sublimation.
Q0328:What is sublimation as an ego defense?
process whereby one replaces an unacceptable wish with a
course of action that is similar to the wish but does not
conflict with one's value system.
Q0329:describe supression as an ego defense.
VOLUNTARY withholding of an idea or feeling from
concious awareness.
Q0330:choosing not to think about your taxes until april 13th
is an example of what ego defense?
suppression.
Q0331:Describe acting out as an ego defense.
unacceptable feelings and thoughts are expressed through
actions.
Q0332:Describe dissociation as an ego defense.
temporary; drastic changes in personality; memory;
conciousness; or motor behavior to avoid emotional stress.
Q0333:Describe denial as an ego defense.
avoidance of awareness of some painful reality.
Q0334:Describe displacement as an ego defense.
process whereby avoided ideas and feelings are transferred to
some neutral person or object.
Q0335:Describe fixation as an ego defense.
partially remaining at a more childish level of development.
Q0336:describe identification as an ego defense.
modeling behavior after another person.
Q0337:describe isolation as an ego defense.
separation of feelings from ideas or events.
Q0338:describe projection as an ego defense.
an unacceptable internal impulse is attributed to an external
source.
Q0339:describe rationalization as an ego defense.
proclaiming logical resons for actions actually performed for
other reasons; usually to avoid self blame.
Q0340:Describe reaction formation as an ego defense.
process whereby a warded off idea or feeling is replaced by an
unconciously derived emphasis on it's opposite.
Q0341:Describe regression as an ego defense.
turning back the maturational clock and going back to earlier
modes of dealing with the world.
Q0342:Describe Repression as an ego defense
involuntary withholding of an idea or feeling from conscious
awareness.
Q0343:Describe splitting as an ego defense
Belief that people are good or bad ; extremes.
Q0344:A patient with libidinous thoughts enters a monastary.
This is an example of what ego defense?
Reaction formation.
Q0345:An 8 year old child under stress begins bed wetting
again. This is an example of what ego defense?
Regression.
Q0346:What is the basic underlying mechanism for all ego
defenses?
repression.
Q0347:a patient says that one doctor is a miracle worker; but
another is totally incompetent. this is an example of what ego
defense?
splitting.
Q0348:What is dysthymia?
A milder form of depression lasting at least 2 years.
Q0349:Describe a major depressive episode.
characterized by at least 5 of the following for 2 weeks;1.
sleep disturbances;2. loss of interest;3. guilt;4. loss of
energy;5. loss of concentration;6. change in appetite;7.
psychomotor retardation;8. suicidal ideation;9. depressed
mood
Q0350:A major depressive episode MUST include one of two
symptoms; these are ;
1. depressed mood; or 2. anhedonia
Q0351:A patients has experienced 2 major depressive
episodes with a symptom free interval of 2 months; what is
the diagnosis?
Recurrent Major Depressive Disorder.
Q0352:What is teh lifetime prevalence of major depressive
disorder in women? in men?
10-25% in women and 5-12% in men.
Q0353:What is indicated by "SIG E CAPS"?
Symptoms of major depression: Sleep; Interest; Guilt;
Energy; Concentration; Appetite; Psychomotor; Suicidal.
Q0354:What is dementia?
the development of multiple cognitive defects including
memory; aphasia; apraxia; agnosia; loss of abstract thought;
behavioral and personality changes; imparied judgement.
Q0355:What is the key to diagnosing dementia?
Ruling out delirium.
Q0356:In an elderly person who seems to apparently have
dementia; what other condition should be considered?
Depression.
Q0357:Describe the difference between dementia and
delirium.
Delirium= changes in sensorium while Dementia = changes in
memory. Dementia is commonly irreversible.
Q0358:What is the most common psychiatric illness on
medical and surgical floors?
Delirium.
Q0359:If a patient on a hospital ward presents with delirium;
what drugs should you check for in their med list?
Drugs with anticholinergic effects.
Q0360:A patient presents with a decreased attention span
and decreased level of arousal; disorganized thinking;
hallucinations; illusions; and cognitive dysfunction ; what is
the likely diagnosis?
Delirium
Q0361:What is the key to diagnosis of delirium?
Waxing and waning level of conciousness; develops rapidly.
Q0362:A man who has lost his wife appears to be in shock;
and expresses denail; guilt and somatic symptoms for the past
4 months. What is the diagnosis?
Normal bereavement.
Q0363:How long does normal bereavement last?
Typically 6 months to a year.
Q0364:When does grief become pathologic?
When it becomes excessively intense or prolonged; delayed;
inhibited; or denied.
Q0365:What are the functions of the frontal lobe?
concentration;orientation;language;abstraction;judgement;moto
r regulation;mood
Q0366:What deficit is most notable in frontal lobe lesions?
lack of social judgement.
Q0367:How is REM sleep like sex?
increase pulse; penile/clitoral tumescence; decreases with age.
Q0368:how often does REM sleep occur while sleeping?
every 90 minutes;duration of REM sleep increases throughout
the night.
Q0369:What is the principal neurotransmitter involved in
REM sleep?
ACh.
Q0370:What are the neurotransmitter changes associated with
anxiety?
increase in NE;decrease in GABA and 5HT
Q0371:What neurotransmitter changes are associated with
Depression?
decrease NE and 5HT
Alzheimers dementia?
decreases ACh
Huntington's Disease?
decrease GABA and ACh
Schizophrenia?
increase DA
Parkinson's disease?
decrease in DA.
Q0376:Name the 4 reflexes that are present at birth.
1. Mono;2. Rooting;3. Palmar;4. Babinski
Q0377:What is the Mono reflex?
extension of limbs when startled
Q0378:What is the rooting reflex?
nipple seeking
Q0379:What is the palmar reflex?
grasps object in palm
Q0380:What is the Babinski reflex?
large toe dorsiflexes with plantar stimulation.
Q0381:When do the reflexes present at birth typically
disappear?
Within the 1st year of life.
Q0382:What are the Kubler-Ross dying stages?
1. Denial;2. Anger;3. Bargaining;4. Grieving;5. Acceptance
Q0383:True or False: Kubler Ross stages of dying always
occur sequentially?
False: more than one stage may be present at a time and they
may not proceed in order.
Q0384:What does "Death Arrives Bringing Grave
Adjustments" indicate.
The Kubler-Ross stages of dying. Denial; Anger; Bargaining;
Grieving; Acceptance.
Q0385:Describe "substance abuse"
Maladaptive pattern leading to clincally significant
impairment or distress - 1 or more symptom must be present
for 1 year - do not meet criteria for substance dependence.
Q0386:What are the symptoms of substance abuse?
1. recurrent use = failure to fulfill major obligation;2. recurrent
use in physically hazardous situation;3. recurrent use related
legal problems;4. continued use despite persistent problems
Q0387:What is substance dependence?
Maladaptive pattern of substance use defined as 3 or more of
the defining symptoms for at least a year.
Q0388:What are the symptoms of substance dependence?
1. tolerance;2. withdrawal;3. taken in larger than needed
amounts;4. persistent desire or attempt to cut down;5. lots of
energy spent trying to obtain substance;6. important activities
reduced because of substance use;7. continued use despite
awareness of problems
Q0389:Describe adjustment disorder.
emotional symptoms causing impairment following an
identifiable psychosocial stressor lasting < 6 months.
Q0390:Describe generalized anxiety disorder.
uncontrollable anxiety unrelated to a specific person;
situation; or event. May include GI symptoms; fatigue; and
difficulty concentrating.
Q0391:Describe post traumatic stress disorder.
intense fear; helplessness; or horror; in which a person who
experienced or witnessed an event that involved actual or
threatened death or injury persistently reexperiences the
event.
Q0392:What is the difference between acute stress and
PTSD?
acute stress lasts 2-4 weeks; PTSD lasts > 1 month and
causes distress or social/occupational impairment.
Q0393:What is Gamophobia?
fear of marriage.
Q0394:What is algophobia?
fear of pain.
Q0395:what is acrophobia?
fear of heights.
Q0396:What is agoraphobia?
fear of open places.
Q0397:What is a specific phobia?
fear that is excessive or unreasonable; cued by presence or
anticipation of a specific object or entity.
Q0398:Does a person with a specific phobia recognize that
their fear is excessive?
Yes.
Q0399:What are treatment options for specific phobias?
systematic desensitization; flooding.
Q0400:In reference to a somatoform disorder; describe a
primary; secondary; and tertiary gain.
Primary gain = what symptom does for patients internal
psyche;Secondary gain = what symptom gets for patient (ie
sympathy);Tertiary gain = what the caretaker gets (MD on an
interesting case)
Q0401:What does "PANIC" indicate.
The symptoms of a panic attack: palpiations; abdominal
distress; nausea; increased perspiration; chest pain; chills;
choking.
Q0402:What is panic disorder?
discrete period of intense fear and discomfort; peaking in 10
minutes; including 4 symptoms; and must be diagnosed in the
context of the occurence.
Q0403:Does sexual interest decline in the elderly?
No; sexual interest does not decline.
Q0404:What sexual changes to elderly men experience?
slower erection/ejaculation; longer refractory period
Q0405:What sexual changes do elderly women experience?
vaginal shortening; thinning; dryness.
Q0406:Describe changes in sleep patterns with advanced age.
decrease REM sleep; slow wave sleep;increase sleep latency;
wakings during the night.
Q0407:What are the most common medical conditions due to
advanced age?
arthritis; HTN; CVD.
Q0408:True or False: Depression is more prevalent in the
elderly?
True: depression is more prevalent and the suicide rate is
increased.
Q0409:What percent of time is spent in stage 1 sleep?
5%
Q0410:What percent of time is spent in stage 2 sleep?
45%
Q0411:What percent of time is spent in stage 3-4 sleep?
25%
Q0412:What percent of time is spent in REM sleep?
25%
Q0413:When do you experience a Beta waveform?
When awake; alert; active mental concentration with your
eyes open.
Q0414:When do you experience an alpha waveform?
awake; but drowsy with eyes closed.
Q0415:In light sleep; what waveform predominates?
theta
Q0416:in deeper sleep; stage 2; what waveform
predominates?
Sleep spindles and K complexes.
Q0417:In stage 3-4 sleep; the depenst non REM sleep; what
waveforms predominate?
delta waves (lowest frequency; highest amplitude)
Q0418:When will a person sleepwalk; have night terrors; or
wet the bed?
In delta sleep (stage 3-4)
Q0419:What waveform predominates in REM sleep?
Beta waves (the same as being awake)
Q0420:when does dreaming occur?
in REM sleep
Q0421:Describe REM sleep.
dreaming; loss of motor tone; possibly a memory processing
function; erections; increased brain oxygen consumption.
Q0422:What does "At night; BATS Drink Blood" indicate
waveforms of sleepstages: Beta; Alpha; Theta; Spindles and
K forms; Delta; Beta.
Q0423:What is the key to initiating sleep?
5HT predominance of raphe nucleus
Q0424:What neurotransmitter reduces REM sleep?
NE
Q0425:What are EOM movements during REM sleep due to?
activity of the PPRF (paramedian pontine reticular formation
/ conjugate gaze center)
Q0426:What do the terms "paradoxical sleep" and
"desynchronized sleep" apply to
REM sleep having the same EEG pattern as awake and alert
Q0427:Why are benzodiazepines good for night terrors and
sleep walking?
They shorten stage 4 sleep.
Q0428:What drug shortens stage 4 sleep and is used to treat
enuresis?
Imipramine.
Q0429:What is a conversion disorder?
A somatoform disorder where symptoms suggest motor or
sensory neurologic or physical disorder - but tests and
physical examination are negative.
Q0430:What is somatoform pain disorder?
prolonged pain that is not explained completely by illness.
Q0431:What is hypochondriasis?
misinterpretation of normal physical findings; leading to
preoccupation with fear of having a serious illness in spite of
medical reassurance.
Q0432:what is somatization disorder?
variety of complaints in multiple organ systems.
Q0433:what is body dysmorphic disorder?
patient convinced that part of their own anatomy is
malformed.
Q0434:what is pseudocyesis?
a false belief of being pregnant associated with objective
physical signs of pregnancy.
Q0435:What is electroconvulsive therapy?
a painless procedure that results in a seizure. Complications
can result from anesthesia.
Q0436:What are the major adverse effects of ECT?
disorientation; and amnesia.
Q0437:When is ECT used?
For major depressive disorder refractory to all other
treatment.
Q0438:What is a hypomanic episode?
like a manic episode; except the mood disturbance is not
severe enough to cause marked impairment in the patients life.
it does not require hospitalization and there are no psychotic
features.
Q0439:What is malingering?
patient conciously fakes or claims to have a disorder in order
to attain a specific gain.
Q0440:What is facticious disorder?
a patient conciously creates symptoms in order to assume the
"sick" roll to get medical attention.
Q0441:What is Munchausen's syndrome?
manifests as a chronic history of multiple hosptital
admissions and willingness to receive invasive procedures.
Q0442:What is Munchausen's syndrome by proxy?
when the illness in a child is caused by a parent. the
motivation is unconcious.
Q0443:Describe bipolar disorder.
6 separate criteria sets exist for bipolar disorders with
combinations of manic; hypomanic; and depressed episodes.
Q0444:What is the treatment of choice for bipolar disorder?
Lithium.
Q0445:What is cyclothymic disorder
a milder form of bipolar disorder lasting at least 2 years.
Q0446:What is a manic episode?
distinct period of abnormally and persistently elevated;
expansive; or irritable mood lasting at least one week.
Q0447:During a manic episode; 3 or more symptoms are
present ; list the 7 symptoms;DIG FAST
1. distractability;2. insomnia;3. grandiosity;4. flight of ideas;5.
increase in activity/agitation;6. pressured speech;7.
thoughtlessness
Q0448:Disinhibition; emotional lability; slurred speech;
ataxia; coma; and blackouts are indicative of intoxication with
what substance?
alcohol.
Q0449:what symptoms may a patient withdrawing from
alcohol experience?
tremor; tachycardia; HTN; malaise; nausea; seizures; DTs;
tremulousness; agitation; hallucinations.
Q0450:A patients appears restless; and complains of
insomnia; anxiety; and shows signs of arrhythmias. You
suspect the patient is using what substance?
cigarettes ; nicotine intoxication.
Q0451:When a patient stops smoking cigarettes; what
symptoms might they expect during withdrawal?
irritability; headache; anxiety; weight gain; and cravings.
Q0452:a patient who consumes lots of coffee might
experience what symptoms?
restlessness; insomnia; increased diruesis; muscle twitching;
cardiac arrhythmias
Q0453:When a patient stops caffeine consumption; what
symptoms might they expect?
headache; lethargy; depression; weight gain.
Q0454:A patient presents to the ER with nausea and
vomiting; constipation; and pinpoint pupils. What substance
do you suspect?
opiods.
Q0455:When a patient ODs on opiods; what symptom are
you most concerned with?
seizures ; may be life threatening.
Q0456:a pt presents with amnesia; ataxia; somnolence; and
minor respiratory distress. They do not consume alcohol ;
what substance do you suspect?
Benzodiazepines.
Q0457:Are benzos addictive?
if consumed with alcohol.
Q0458:When a patient stops taking benzos; what symptoms
may they experience?
rebound anxiety; seizures; tremor; and insomnia
Q0459:a patient presents to the ER with major respiratory
depression; their friens state they "took something" ; what do
you suspect?
barbituates.
Q0460:In addition to anxiety; seizures; and delirium; what are
you concerned about in a patient who is withdrawing from
barbituates?
life threatening cardiovascular collapse.
Q0461:a patient presents with euphoria; anxiety; paranoid
delusions; imparied judgement; and the munchies ; what do
you suspect?
marijuana.
Q0462:Are there withdrawal symptoms from marijuana?
social withdrawal.
Q0463:a patient presents with marked anxiety; delusions;
visual hallucinations; flashbacks; and pupil dilation. what do
you suspect?
LSD.
Q0464:a pt presents with agitation; pupillary dilation; HTN;
tachycrdia; euphoria; fever; hallucinations and they have been
awake for 36 hours ; waht drug do you suspect?
amphetamines.
Q0465:what symnptoms can a patient withdrawing from
amphetamines expect?
post crash depression; lethargy; headache; stomach cramps;
hunger; hypersomnolence.
Q0466:a pt presents euphoric with psychomotor agitation;
tachycardia; pupillary dilation; hallucinations; and angina ;
what drug do you suspect?
cocain.
Q0467:what fatal effect of cocain are you worried about?
sudden cardiac death.
Q0468:what can a patient in withdrawal from cocain expect to
experience?
post crash depression and suicidality; hypersomnolence;
fatigue; malaise; and severe psychological craving.
Q0469:a pt presents with fever and psychomotor agitation;
he is belligerant and impulsive; and has horizontal and vertical
nystagmus. What drug do you suspect?
PCP.
Q0470:When a patient is withdrawing from PCP; what
symptoms are you concerned about?
sudden onset of severe; random; homicidal thought
Q0471:A patient recovering from a PCP intoxication appears
to be having a recurrence of intoxication symptoms; why?
reabsorption of PCP from the GI tract.
Q0472:What is the formula for BMI?
weight(kg)/(heightxheight(m))
Q0473:What is the BMI numerical cutoff for an obesity?
> 30.0
Q0474:A patient complains of sexual dysfunction; what 3
things are on your differential?
1. drugs;2. disease;3. psychological
Q0475:What diseases may lead to sexual dysfunction?
depression or DM
Q0476:What drugs can lead to sexual dysfunction?
anti-HTN; neuroleptics; SSRI; EtOH.
Q0477:Describe the physiological effects of stress.
Stress induces production of FFA; 17-OH corticosteroids;
lipids; cholesterol; and catecholamines. it affects water
absorption; muscular tonicity; gastrocolic reflex; and mucusal
circulation.
Q0478:A patient with depression will typically show these
three changes in their sleep stages:
1. decrease slow wave sleep;2. decrease REM latency;3. early
morning awakening
Q0479:What is the most important screening question for
depression?
Are you experiencing early morning awakening?
Q0480:Describe narcolepsy.
person falls asleep suddenly. May include hypnagogic or
hypnopompic hallucinations.
Q0481:A person with narcolepsy starts off their sleep cycle
with what sleep stage?
REM
Q0482:What is cataplexy?
sudden collapse while awake. may be present in some
patients with narcolepsy.
Q0483:What is the treatment for narcolepsy?
amphetamines.
Q0484:A patient stops breathing for at least 10 seconds
repeatedly during sleep; what is a possible diagnosis?
Sleep apnea
Q0485:What is the treatment for sleep apnea?
weight loss; CPAP; surgery
Q0486:Describe the difference between central and
obstructive sleep apnea.
Central sleep apnea involves no respiratory effort; obstructive
sleep apnea involves respiratory effort against an airway
obstruction.
Q0487:What symptoms and signs is sleep apnea associated
with:
obesity; loud snoring; systemic or pulmonary HTN;
arrhythmias; and possibly sudden death.
Q0488:woman w/ anxiety about gyn exam is told to relax and
imagine going through the steps of the exam. What process
does this exemplify
systematic desensitization
Q0489:65 y/o man is dx w/ incurable pancreatic
adenocarcinoma. His family asks you; the doctor; not to tell
the pt. What do you do?
assess whether telling the pt will negatively affect his health.
If not; tell him
Q0490:Man admitted for chest pain is medicated for
ventricular tachycardia. The nexxt day he jumps out of bed
and does 50 push ups to show the nurses he did not hav a
heart attack. What defense mechanism is he using
denial
Q0491:you find yourself attracted to your 26 y/o pt. What do
you say.
nothing! be professional. It is not acceptable to have a
relationship with your pts.
Q0492:large group of people is followed over 10 years. Every
2 years. It is determined who develops heart dz and who does
not. What type of study?
cohort study
Q0493:girl can groom herself; hop on one foot and has an
amaginary friend. How old is she?
4 y/o
Q0494:man has flashbacks about his girlfriends death 2 mo.
ago follwooingt a hit-and-run accident. He often cries and
wishes for the death of the culprit. What is the dx?
normal bereavemnt
Q0495:36 y/o woman with strong family hx of breast CA
refuses mammogram because she heard it hurts. What do you
do?
discuss the risks and benefits of not havign a mammogram.
Each pt must give her own informed consent to each
procedure; if the pt refuses; you must abide by her wishes.
Q0496:4 y/o girl complains of burning feeling in her genetalia;
otherwise she behaves and sleeps normally. Smear of the
discharge shows N. gonorrhea. How was she infected
sexual abuse
Q0497:72 y/o man insists on stopping tx for his heart
conditon because it makes him feel "funny" What do you do?
encourage pt to take his meds but pt has final say in his tx
regimen. Investigate the "funny" feeling and determine if there
are drugs available that don't elicit this particular side effect.
Q0498:This is an observational study. The sample is chosen
based on presence (cases) or absence (controls) of dz. Info is
collected about risk factors. It is often retrospective
case control study
Q0499:this is an observational study. Sample is chosen based
on presence or absense of risk factors. Subjects are followed
over time for development of dz. Often prospective
cohort study
Q0500:Framingham heart study is an exampel of this type of
study
cohort study
Q0501:This involves pooling data from several studies (often
via a literature search) to achieve greater statistical
power;Limitations of individual studies prevail
meta-analysis
Q0502:this is an experimental study. It compares the
terapeutic benefits of 2 or more tx or tx & placebos
clinical trial
Q0503:highest quality clinical trials are double ______
blind
Q0504:this negative study finding occurs when 1 outcome is
systematically favored over another.
bias
Q0505:this type of bias is a nonrandom assignment to a study
group
selection bias
Q0506:this type of bias occurs when knowledge of the
presence of a disorder alters recall by the subjects
recall bias
Q0507:this type of bias occurs when subjects are not
representitive; tehrefore results are not generalizable
sampling bias
Q0508:this type of bias occurs when information is gathered
at an inappropriate time
late-look bias
Q0509:Give 4 ways to reduce bias:
1) blind studies (single/double);2) placebo responses;3)
crossover studies (each subject acts as own control;4)
randomixation
Q0510:this describes total cases in population at a given time
over total population
prevalence
Q0511:this describes new cases in population over a given
time over total population at risk during that time
incidence;mneu: incidence is new incidents;note: when
calculating incidence; don't forget that people previously
positive for dz are no longer considered at risk
Q0512:this is approximately equal to the incidence multiplied
by the dz duration
prevalence
Q0513:what is greater for chronic dzs like diabetes.
prevalence or incidence
prevalence.
Q0514:which is greater for acute dzs like the common cold.
prevalence or incidence
they are equal
Q0515:this describes the number of true positives divided by
the number of all the people with the dz. It is the probability
a positive test; given a person has the desease
sensitivity
Q0516:sensitivity rules ______
out;mneu: SNOUT
Q0517:this is equal to 1-sensitivity
false negative
Q0518:high sensitivity is desirable for this type of test
screening
Q0519:This is the number of true negatives divided by
number of all people without the desease. It is the probability
of a negative test given taht a person is free of the dz.
specificity.
Q0520:specificity rules _____
IN;mneu: SPIN
Q0521:this is equal to 1-specificity
false positive rate
Q0522:high specificity is desirable for this type of test
confirmatory test
Q0523:This is the number of true positives divided by
number of people who tested positive for the dz;It is the
probability of having a condition given a positive test
positive predictive value (PPV)
Q0524:This is the number of true negatives divided by
number of people who tested negative for the dz;It is the
probability of not having the condition given a negative test
negative predictive value (NPV)
Q0525:unlike sensitivity and specificity; predictive values are
dependent on this
prevalence of the dz;the higher the prevalence off the diz the
higher the positive predictive value of the test.
Q0526:this descrives the odds of having a dz in the exposed
gorup divided by the odds of having dz in unexposed group.
odds ratio (OR)
Q0527:how are odds are calculated within a group
as number with dz divided by number without the dz
Q0528:if the prevenance of the dz is not too high the OR
approximates this
relative risk
Q0529:OR is used in this type of study
case-control
Q0530:this describes the disease risk in exposed group
divided by dz risk in uneposed gorup
relative risk (RR)
Q0531:how is relative risk calculated within a group
number with dz divided by total number of people in the
gourp.
Q0532:relative risk is used for what type of studies
cohort studies
Q0533:the consistency and reproducibility of a test
(reliability);the absense of random variation in a test
precision
Q0534:the trueness of test measurements (validity)
accuracy
Q0535:random error leads to reduced this in a test
precision
Q0536:systematic error leads to reduced this in a test
accuracy
Q0537:In a normal /Gaussian/Bell shaped statistical
distribution curve; How are the mean; median; and mode
related
equal to each other
Q0538:bimodal distribution means
2 humps
Q0539:This type of skew describes tail on the right. The
mean>median>mode
positive skew
Q0540:This type of skew describes tail on the left. The
mean<median<mode
negative skew
Q0541:this describes a hypothesis of no difference. E.g; there
is no association between the dz and risk factor in the
population
null hypothesis (Ho)
Q0542:this describes a hypothesis that there is some
difference (e.g; there is some association between the dz and
the risk factor in the population
Alternative hypothesis (H1)
Q0543:This type of error is stating that there IS an effect or
difference when none exists (to mistakenly accept the
experimental hypothesis and reject the null hypothesis).
Type I error ((alpha))
Q0544:ρ is judged against (alpha); a preset level of
significance (usually <0.5). ρ=
probability of making a type I error
Q0545:if ρ < .05 then
there is less than a 5% chance that the data will show
something that is not really there
Q0546:(alpha)=
you saw a difference that idd not exist--for example;
convicting an innocent man
Q0547:This type of error states that there IS NOT an effect
or difference when one exists (to fail to reject the null
hypothesis when in fact Ho is false.
type II error ((beta))
Q0548:(beta)=
the probably of making a type II error;you did not "see" a
difference that does exist--for example; setting a guilty man
free
Q0549:This is the probability of rejecting a null hypothesis
when it is in fact false.
power (1-(beta))
Q0550:Power depends on:
1) total number of end points experienced by population;2)
difference in compliance b/n tx groups (differences in the mean
values between groups);3) size of expected effect
Q0551:what is the most common way you can increase the
power of the study
increase sample size;mneu: there is power in number
Q0552:n=
sample size
Q0553:Theta=
standard deviation
Q0554:SEM=
standard error of the mean:theta√n
Q0555:SEM is __ than σ;SEM ______ as n increases
less than;decreases
Q0556:this describes the range of values in which a specified
probability of the means of repeated samples would be
expected to fall
confidence interval (CI)
Q0557:CI=
range from [mean-Z(SEM)] to [mean + Z(SEM)].
Q0558:what CI is often used
95% (corresponding to p=.05)
Q0559:what is the Z for 95% CI
Z=1.96
Q0560:If the 95% CI for a mean difference between 2
variables includes 0; then
there is no significant difference and Ho is not rejected
Q0561:If the 95% CI for odds ratio or relative ris includes 2;
Ho is _____
not rejected
Q0562:this type of test checks the difference between the
means of 2 groups
t- test;mneu: Mr. T is MEAN
Q0563:this checks the difference between the means of 3 or
more groups
ANOVA;mneu: ANalysis Of VAriance of 3 or more variables
Q0564:this checks the difference between 2 or more
percentages or proportions of categorical outcomes (not mean
values)
χ^2
Q0565:always between -1 and 1. Absolute value indicates
strenghth of correlation b/n 2 variables
coorelation coefficient
Q0566:r^2
coefficient of determination
Q0567:Describe primary; secondary; and tertiary dz
prevention
primary-prevent dz occurance (e.g; vaccination);secondary-
early detection of dz (e.g; Pap smear);tertiary- reduce
disability from dz (e.g; exogenous insulin for dbts;mneu: PDR
(prevent; detect; reduce disability)
Q0568:Given the risk factor give the important prevention
services;dbts
eye; foot exams; urine test
services;drug use
hepatitis immunizations; HIV; TB tests
services;alcoholism
influenza; pneumococcal immunizations; TB test
services;overweight
blood sugar tests for dbts
services;homeless; recent immigrant inmate
TB test
services;High risk sexual behavior
HIV; hepatitis B; syphilis; gonorrhea; clamydia tests.
Q0574:Give the reportable dzs
Hep B;Hep
A;Salmonella;Shigella;Syphilis;Measles;Mumps;AIDS;Rubell
a;TB;Chickenpox;Gonorrhea;mneu: B.A. SSSMMART
CHICKEN or you're Gone
Q0575:leading causes of death in US of infants
congenital anomalies; short gestation/low birth weight; SIDS;
maternal complications of pregnancy; rspiratory distress
syndrome
Q0576:leading causes of death in US of children 1-14
injuries; Cancer; congenital anomalies; homocide; heart dz
Q0577:leading causes of death in US of people 15-24
injuries; homocide; suicide; cancer; heart dz
Q0578:leading causes of death in US of people 25-64
Cancer; heart dz; injuries; suicide; stroke
Q0579:leading causes of death in US of people 65+
heart dz; cancer; stroke; COPD; pneumonia; influenza
Q0580:Medicare and medicaid are federal programs that
originated from amendments to the social security
act;MedicarE is for ________;MedicaiD is for ________
Elderly;Destitute
Q0581:medicare part A pays for _____;medicare part B pays
for ____
A=hospital;B=doctor bills
Q0582:this describes the obligation to respect pts as
individuals and to honor their preferences in medical care
autonomy
Q0583:informed consent legally requires these 3 things
1) discussion of pertinant information;2) pts agreement to the
plan of cre;3) freedom from coertion
Q0584:in informed consent pts must understand these 3
things
risks; benefits; and alternatives (including no interventions)
Q0585:Give the 3 exceptions to informed consent
1) pt lacks decision-making capacity (not legally
competent);2) implied consent in an emergency;3) therapeutic
privilage (withholding info when disclosure would severely
harm the pt or undermine informed decision-making
capacity;4) waiver (pt waves rights)
Q0586:pts decision making capacity depends on these 5
things
1) pt makes and communicates a choice;2) pt is informed;3)
decision remains stable over time;4) decision is consistant w/
pts values and goals;5) decision is not a result of delusions or
hallucinations
Q0587:T or F. Pts family cannot require that a doctor
withhold info from the pt
T
Q0588:Describe what an oral advance directive is
when an incapacitated pts prior oral statements are used as a
guide. Problems arise form variance in interpretation. If pt
was informed; directive is specific; pt made a choice; and
decision was repeated over time; the oral directive is more
valid.
Q0589:this is when a pt directs physician to withold or
withdraw life-sustaining tx if the pt develops a terminal dz or
enters a persistant vegitative state
living will
Q0590:this is when a pt designates a surrogate to make
medical decisions in the event that the pt loses decision-
making capacity. Pt may also specify decisions in clinical
situations. Surrogate retains power unless revoked by pt.
More flexible than a living will; supersedes living wil if both
exist
durable power of atterney
Q0591:"do no harm". However; if benefits of intervention
outweigh the risks; a pt may make an informed decision to
procede
nonmaleficence
Q0592:Physicians have special ethical responsibility to act in
the pts best interest (physician is a fiduciary"). Pt autonomy
may conflict.
beneficence
Q0593:respect for the pts privacy and autonomy. Disclosing
info to family & friends should be guided by pts wishes. Pts
may wave rights
confidentiality
Q0594:Give the 2 exceptions to confidentiality
1) harm to others;2) harm self
Q0595:duty to break confidentiality because of potential to
harm others can take several forms. Give 3 examples
1) infectious dzs- duty to warm public officials and
identifiable people at risk;2) Child/Elder abuse;3) Impared
auto drivers
Q0596:what landmark decision involved a psychiatrist who
did not break confidentiality to warn apotential homocide
victem
Tarasoff decision
Q0597:Civil suit under negligence requires these 3 things
1) Dereliction- Physician breach of duty to patient;2)Damage-
-pt suffers harm;3) Direct- breach of duty causes harm;mneu:
3 Ds
Q0598:what is the most common factor leading to litigation
poor communication between physician and patient
Q0599:In a criminal suit the burdenof proof is "beyond a
reasonable doubt"; the burden of proof in a malpractice suit is
___________
"more likely than not"
Q0600:Given the situation; give the appropriate response;pt
is noncompliant
work to improve the physician-pt relationship
has difficulty taking medications
provide written instructions. Attempt to simplify tx regimens
Q0602:Given the situation; give the appropriate
response;family members ask for info about a pts prognosis
avoid discussing issues w/ relatives w/out the permission of
the pt
Q0603:Given the situation; give the appropriate response;17
y/o girl is pregnant and requests an abortion
many states require parental notification or consent for
minors for an abortion. Parental consent is NOT required for
emergency situations; tx of STDs; medical care during
pregnancy; prescriptions for contraceptives; and management
of drug addicition
Q0604:Given the situation; give the appropriate response;A
terminally ill pt requests physician assistance in ending his
life
in the overwhelming majority of states; refuse involvement in
any form of physician assisted suicide. Physician may;
however; prescribe medically appropriate analgesics that
coincidentally shorten the pts life.
states that he finds you attractive
ask direct; closed-ended questions and use a chaperone if
necessary. Romantic relationships with pts are NEVER
appropriate.
Q0606:Given the situation; give the appropriate response: Pt
refuses a necessary procedure or desires an unnecessary one.
attempt to understand why the pt wants/does not want the
procedure. Address the underlying concerns. Avoid
performing unnecessary procedures
is angry about the amount of time he spent in the waiting
room
apologize to the pt for any inconvenience. Stay away from
efforts to explain the delay
is upset with the way he was treated by another doctor
suggest that the pt speak directly to that physician regarding
his concerns. If the problem is with a member of the office
staff; tell the pt you will speak to that indiviedual.
Q0609:Given the situation; give the appropriate response: A
child wishes to know more about his illness
Ask waht the parents have told the child about his illness.
Parents of a child decide what info can be relayed about the
illness
continues to smoke; believing that cigarettes are good for him
Ask how the pt feels about his smoking. Offer advice on
cessation if the pt seems willing to make an effort to quit.
Q0611:How is APGAR scored and what does the APGAR
SCORE stand for
scored 0-2. 10 is a perfect score;Appearance (color) [blue;
trunk pink; all pink] ;Pulse [0;<100;100+];Grimace
[0;grimace; grimace+cough];Activity [no tone; some;
active];Respiration [0;irregular; regular]
Q0612:<2500g. Associated with greater incidence of physical
and emotional problems. Caused by prematurity or
intrauterine growth retardation. Complications include
infections; respiratiory distress syndrome; necrotizing
enterocolitis; intraventricular hemorrhage; and persistent fetal
circulation.
low birth weight
Q0613:long-term deprivation of affection results in these 7
things
1) decreased mm tone;2)poor language skills;3)poor
socialization skills;4)lack of basic trust;5) anaclitic
depression;6) weight loss;7) physical illness;severe
deprevation can result in infant dealth;mneu: The 4 Ws: Weak;
Wordless; Wanting (socially); Wary
Q0614:deprevation for greater than how long can lead to
irreversible changes
6 mo
Q0615:this describes depression in an infant owing to
continued separation from caregiver--can result in failure to
thrive. Infant becomes withdrawn and unresponsive.
anaclitic depression
Q0616:children often due this when they are under stress-
physical illness; punishment; birth of a new sibling; tiredness.
An example is bed-wetting in a previously toilet-trained child.
regression to younger behavior
Q0617:give some signs of physical abuse
healed fractures on x-ray; cigarette burns; subdural
hematomas; multiple bruises; retinal hemorrhage on
detachment
Q0618:what is the abuser profile of a physical abuser
usally female and the primary caregiver
Q0619:how many deaths occur each year in the US from
physical abuse
~3000
Q0620:give some signs of sexual abuse
genital/anal trauma; STDs; UTIs
Q0621:Give the profile of a sexual abuser
usaually male and known to the victem
Q0622:what is the peak age incidence of sexual abuse
9月12日
Q0623:3 mo motor milestones
holds head up; Moro reflex disapears
Q0624:3 mo cognitive/social milestone
social smile
Q0625:4-5 mo motor milestones
rolls front to back; sits when propped
Q0626:4-5 mo cognitive/social milestone
recognizes people
sits alone; crawls
Q0628:7-9 mo cognitive/social milestones
stranger anxiety; orients to voice
upgoing babinski disappears
Q0630:15 mo motor milestones
walks
Q0631:15 mo cognitive/social milestones
few words; separation anxiety
climbs stairs; stacks 3 blocks
object permanance
Q0634:18-24 motor milestones
stacks 6 blocks
Q0635:18-24 cognitive/social milestone
rapproachement
parallel play
Q0637:24-36 cognitive/social milestone
core gender identity
stacks 9 blocks
Q0639:30-36 mo cognitive/social milestones
toilet training
Q0640:3 yrs motor milestones
rides tricycle; copies line or circle drawing
Q0641:3 yrs cognitive/social milestone
group play
Q0642:4 yrs motor milestones
simple drawing (stick figure); hops on 1 foot
Q0643:4 yrs cognitive/social milestone
cooperative play; imaginary friends
Q0644:6-11 yrs motor milestones
reads; understands death
Q0645:6-11 yrs cognitive/social milestone
development of conscience (superego); same-sex friends;
identification with same- sex parent
Q0646:11 y/o girls ;13 y/o boys
abstract reasoning (formal operations); formation of
personality
Q0647:does sexual interest decrease with age
no
Q0648:describe sexual changes that occur in men in elderly
slower erection/ejaculation; longer refractory period
Q0649:describe sexual changes that occur in women in elderly
vaginal shortening; thinning; and dryness
Q0650:describe changes in sleep patterns in the elderly
decrease REM ;decrease slow wave sleep;increase sleep
latency;increase awakinings during the night
Q0651:common medical conditions occuring in the elderly
arthritis; hypertension; heart dz; osteoporosis
Q0652:In the elderly psychiatric problems (e.g; depression
become more prevalent. T or F
T
Q0653:suicide rate increases in elderly. T or F
T
Q0654:does intellegence decrease w/ age
no
Q0655:in the elderly mm mass ___; and fat ___
decreases;increases
Q0656:normal bereavement is is characterized by
shock; denial; guit; and somatic symptoms; sometimes may
experience illusions.
Q0657:how long does normal bereavmant usually last
6 mo to 1 yr
Q0658:Describe pathological grief
includes excessively intense or prolonged grief or grief that is
delayed; inhibited; or denied. May experience depressive
symptoms; delusions; and hallucinations
Q0659:Give the Kubler-Ross grief stages
Denial; Anger; Bargaining; Grieving; Acceptance;mneu: Death
Arrives Bringing Grave Adjustments;note: stages do not
necessarily occur in this order and >1 stage can be present at
once.
Q0660:Give 5 effects of stress
induces production of free fatty acids; 17-OH corticosteroids;
lipids; cholesterol; catecholamines; affects water absorption;
muscular tonicity; gastrocolic reflex; and mucosal circulation.
May exacerbate certain physical disorders (including CHF;
dbts; RA; IBS; gastric ulcer).
Q0661:give the DDX of sexual disfunction
1) Drugs (e.g; antihypertensives; neuroleptics; SSRIs; etoh);2)
Diseases (e.g; depression; dbts);3) psychological (e.g;
performance anxiety)
Q0662:this is the measure of weight adjusted for height
BMI
Q0663:BMI=
#NAME?
Q0664:BMI underweight
<18.5
Q0665:BMI normal
18.5-25
Q0666:BMI overweight
25-30
Q0667:BMI obese
>30
Q0668:give 2 famous IQ tests
Stanford-Binet & Wechsler
Q0669:this IQ test calculates IQ as mental age/chronological
age x 100
stanford-Binet
Q0670:this IQ test uses 11 subtestes (6 verbal; 5
performance)
Wechler Adult Intelligence Schale
Q0671:what is the mean IQ test and standard deviation
mean=100;SD=15
Q0672:mental retardation
IQ<70
Q0673:severe MR
IQ<40
Q0674:profound MR
IQ<20
Q0675:IQ scores are correlated w/ genetic factors and are
hightly correlated w/ school achievement. T or F
T
Q0676:IQ tests are objective (not projective) tests. T or F
T
Q0677:this describes learning in which a natural response (e.g.
salvation) is elicited by a conditioned; or learned; stimulus
(bell) that previously was presented in conjunction with an
unconditioned stimulus (food)
classical conditioning;note: Pavlov's classical experiments w/
dogs--ringing the bell provoked salivation
Q0678:This describes learning in which a particular action is
elicited because it produces a reward
operant conditioning
Q0679:in operant conditioning; this describes when a desired
reward produces action (e.g; mouse presses button to get
food)
positive reinforcement
Q0680:in operant conditioning; this describes when removal
of aversive stimulus increases behavior (mouse presses button
to avoid shock)
negative reinforcement;note: do not confused w/ punishment
Q0681:this determines how quickly a behavior is learned or
extinguished
Pattern of reinforcement
Q0682:this type of reinforcement schedule describes when a
reward is received after every response. It is rapidly
extinguished.
continuous;note: Think vending machine-- you stop using it if
it does not deliver.
Q0683:this type of reinforcement schedule describes when a
reward is received after random number of responses. It is
slowly extinguish
variable ratio;note: think slot machine--continue to play even
if it rarely rewards
Q0684:this occurs when pt projects feelings about formative
or other important persons onto physician (e.g;
psychiatrist=parent)
transference
Q0685:this describes when doctor projects feelings about
formative or other important persons onto patient
countertransference
Q0686:describe Id
primal urges; sex; and aggression (I want it.)
Q0687:describe Superego
Moral values; conscience. (YOu know you can't have it)
Q0688:describe Ego
Mediator between the unconscious mind and the external
world (Deals with the conflict)
Q0689:In the topographic theory of the mind this describes
what you are aware of
conscious
what you are able to make conscious with effort (e.g; your
phone number)
preconscious
what you are not aware of; the central goal of Freudian
psychoanylysis is to make the pt aware of what is hidden in
his/her unconscious.
unconscious
Q0692:this describes repressed sexual feelings of a child for
the opposite-sex parent; accompanied by rivalry with same-
sex parent. First described by Freud.
Oedipus complex
Q0693:these are automatic and unconscious reactions to
psychological stress
ego defences
Q0694:give the mature ego defenses
sublimation; altruism; suppression; humor;mneu: MATURE
women ware a SASH
Q0695:altruism
guilty feelings alleviated by unsolicited generosity towards
others;e.g; mafia boss makes large donation to charity
Q0696:humor
appreciating the amusing nature of an anziety-provoking or
adverse situation;e.g; nervous medical student jokes about the
boards
Q0697:sublimation
process whereby one replaces an unacceptable wish with a
course of action that is similar to the wish but does not
conflict with one's value system;e.g; aggressive impulses used
to succeed in business ventures
Q0698:suppression
voluntary (unlike other defenses) witholding of an idea or
feeling from conscious awareness;e.g; choosing not to think
about the USMLE until the week of teh exam
Q0699:acting out
unacceptable feelings and thoughts are expressed through
actions;e.g; tantrums
Q0700:dissociation
temporary; drastic change in personality; memory;
consciousness; or motor behavior to avoid emotional
stress;e.g;exteme forms can result in multiple personalities
(dissociative identity disorder)
Q0701:denial
avoidance of awareness of some painful reality;e.g; a common
reaction in newly diagnosed AIDS & CA pts
Q0702:displacement
process whereby avided ideas and feeligns are transferred to
some neutral person or object;e.g; mother yells at child
because she is angry at her husband
Q0703:fixation
partially remaining at a more childish level of development;e.g;
men fixating on sports games
Q0704:identifications
modeling behavior after another person who is more powerful
(although not necessarily admired);e.g; abused child becomes
an abuser
Q0705:isolation
separation of feelings from ideas and events;e.g; describing
murder in graphic detail with no emotional response
Q0706:projection
an unacceptable internal impulse is atttributed to an external
source;e.g; a man who wants another woman thinks his wife is
cheating on him
Q0707:rationalization
proclaiming logical reasons for actions actually performed for
other reasons; usually to avoid self blame;e.g; saying the job
was not important anyway; after getting fired.
Q0708:reaction formation
process whereby a warded-off idea or feeling is replaced by an
(unconsciously derived) emphasis on its opposite;e.g; a pt w/
libidinous thoughts enters a monastery
Q0709:regression
turning back the maturational clock and going back to earlier
modes of dealing with the world;e.g; seen in children under
stress (e.g; bed-wetting) and in pts on dialysis (e.g; crying)
Q0710:repression
involuntary witholding of an idea or feeling from conscious
awareness. The basic mechanism underlying all others.
Q0711:Splitting
belief that peoplea re either good or bad;e.g; a pt says that all
the nurses are cold and insensitive but that the doctors are
warm and friendly.
Q0712:How do delusions; illusions; and hallucinations differ?
Hallucinations are sensory impressions (without a stimulus);
illusions are misperceptions of real stimuli; and delusions are
false beliefs that are not shared by the culture.
Q0713:What syndrome is characterized by sweating;
insomnia; nausea; diarrhea; cramps; delirium; and general
restlessness secondary to MAOI and SSRI in combination?
Serotonin syndrome. It is also associated with high doses and
MAOI and synthetic narcotic combinations (Ecstasy).
Treatment consists of decreasing SSRI dosage; removing the
causative agent; and giving cyproheptadine.
Q0714:What is the legal age to be deemed competent to make
decisions?
18 years old (except if emancipated)
Q0715:With what stage of sleep is enuresis associated?
Stage 3 and 4 most commonly. It can occur at any stage in the
sleep cycle and is usually associated with a major stressor
being introduced into the home.
Q0716:When more than one explanation can account for the
end result; what form of bias occurs?
Confounding bias
Q0717:Increased levels of what neurotransmitter; in the
hippocampus; decrease the likelihood of learned helplessness?
Increased GABA levels decrease the likelihood of learned
helplessness.
Q0718:How does ceasation of barbiturate use affect sleep?
By causing rebound insomnia and decrease in REM sleep
Q0719:What type of correlation compares two ordinal
variables?
Spearman correlation
Q0720:What syndrome is characterized by bilateral medial
temporal lobe lesion; placidity; hyperorality; hypersexuality;
hyperreactivity to visual stimuli; and visual agnosia?
Klüver-Bucy syndrome
Q0721:What is the term for having fantasies or dressing in
female clothes for sexual arousal by heterosexual men?
Transvestite fetishism
Q0722:What disorder is described as having;? Unconscious
symptoms with unconscious motivation?
Somatoform disorder
Q0723:What disorder is described as having;? Conscious
symptoms with conscious motivation?
Malingering
Q0724:What disorder is described as having;? Conscious
symptoms with unconscious motivation?
Factitious disorder
Q0725:What is the term for the ability of a test to measure
something consistently?
Reliability (think of it as "nice grouping" or "precise")
Q0726:What cerebral vessel size is affected in patients with
vascular dementia?
Small to medium-sized cerebral vessels
Q0727:What is the name of the program that deals with
codependency and enabling behaviors for family members of
alcohol abusers?
Al-Anon
Q0728:What level of mental retardation is characterized by;?
Needing a highly structured environment with constant
supervision?
Profound (I.Q. range < 20)
Having the ability to communicate and learn basic habits but
training is usually not helpful?
Severe (range 20–34)
Being self-supportive with minimal guidance and able to be
gainfully employed (includes 85% of the mentally retarded)?
Mild (50–70)
Can work in sheltered workshops and learn simple tasks but
need supervision?
Moderate (35–49)
Q0732:Name these immature defense mechanisms;? Taking
others' beliefs; thoughts; and external stimuli and making them
part of the self. (Hint: if it's done consciously; it is called
imitation.)
Introjection (a sports fan is a good example)
Q0733:Name these immature defense mechanisms;? Returning
to an earlier stage of development (e.g; enuresis)
Regression
Q0734:Name these immature defense mechanisms;? Inability
to remember a known fact (aware of forgetting)
Blocking
Q0735:Name these immature defense mechanisms;? Psychic
feelings converted to physical symptoms
Somatization
Q0736:What is the term for ejaculation before or immediately
after vaginal penetration on a regular basis?
Premature ejaculation
Q0737:At what stage of cognitive development (according to
Piaget) do children;? See death as irreversible?
Concrete operations (6–12 years)
Piaget) do children;? Have abstract thinking?
Formal operations (> 12 years)
Piaget) do children;? Lack law of conservation and be
egocentric?
Preoperational (2–6 years)
Q0740:Is it acceptable to lie; even if it protects a colleague
from malpractice?
No; it is never acceptable to lie.
Q0741:What happens to prevalence as duration increases?
Prevalence increases. (Note: Incidence does not change.)
Q0742:With what stage of sleep are nightmares associated?
REM sleep. Nightmares are frightening dreams that we recall.
Q0743:What is the statistical term for the proportion of truly
nondiseased persons in the screened population who are
identified as nondiseased?
Specificity (it deals with the healthy)
Q0744:In the elderly; what happens to total sleep time;
percentage of REM sleep; and percentage of NREM sleep?
Total and NREM sleep decrease considerably as we age; but
REM sleep remains relatively constant (20%) up to age 80;
then begins to decline.
Q0745:What happens to dopamine levels when we awaken?
Dopamine levels rise with waking; dopamine is associated
with wakefulness.
Q0746:What is the primary risk factor for suicide?
Previous suicide attempt
Q0747:What is defined as a general estimate of the functional
capacities of a human?
IQ
Q0748:What dementia is associated with dilated ventricles
with diffuse cortical atrophy; decreased parietal lobe blood
flow; and a decrease in choline acetyl transferase activity?
These are the gross pathologic changes associated with
Alzheimer's disease.
Q0749:What is the term for a deficiency or absence of sexual
fantasies or desires?
Hypoactive sexual desire disorder
Q0750:What phobia is described as the fear of open spaces?
Agoraphobia. It also means having a sense of humiliation or
hopelessness.
Q0751:What antidepressant; which recently was approved
for general anxiety disorder; inhibits the reuptake of NE and
5-HT?
Venlafaxine. (It also has a mild dopaminergic effect.)
Q0752:What judgment states that the decision; by rights of
autonomy and privacy; belongs to the patient; but if the
patient is incompetent to decide; the medical decision is based
on subjective wishes?
Substituted judgment. It is made by the person who best
knows the patient; not the closest relative.
Q0753:What ethnic group has the highest adolescent suicide
rate?
Native Americans
Q0754:What are the three microscopic pathologic changes
seen in Alzheimer's disease?
Senile plaques; neurofibrillary tangles; and granulovascular
changes in neurons
Q0755:When does most REM sleep occur; in the first or
second half of sleep?
REM sleep occurs more often in the second half of sleep. The
amount of REM sleep increases as the night goes on.
Q0756:What is the name of the benzodiazepine antagonist
used in the treatment of an overdose?
Flumazenil
Q0757:What type of test asks a patient to draw a scene;
attempting to find out the individual's unconscious
perceptions in his or her life?
Projective drawing. The artistic form is irrelevant; but the
size; placement; erasures; and distortions are relevant.
Q0758:What is the biochemical trigger for REM sleep?
Increased ACh to decreased NE levels. (NE pathway begins in
the pons and regulates REM sleep.)
Q0759:What neuropsychologic test shows nine designs to the
patient; then asks for recall of as many as possible?
Bender Visual Motor Gestalt Test
Q0760:What are the three characteristics of ADHD?
1. Short attention span ;2. Impulsivity ;3. Hyperactivity
Q0761:Is suicidal ideation a component of normal grief?
It is rare with normal grief; however; it is relatively common
in depression
Q0762:In what stage of sleep is it easiest to arouse a sleeping
individual?
During REM sleep
Q0763:What scale separates things into groups without
defining the relationship between them?
Nominal scale (categorical; e.g; male or female)
Q0764:What specifies how accurately the sample values and
the true values of the population lie within a given range?
Confidence interval. It is a way of admitting estimation for the
population.
Q0765:If the family member of a patient asked you to
withhold information; would you?
For the USMLE Step 1 the answer is no; but if the
information would do more harm than good; withhold. This is
very rare but it does occur.
Q0766:What AD dementia has a defect in chromosome 4;
onset between the ages of 30 and 40; choreoathetosis; and
progressive deterioration to an infantile state?
Huntington's chorea. (Death in 15–20 years; often via
suicide.)
Q0767:What percentage of children born to HIV-positive
mothers will test positive for HIV at birth?
100%; with about 20% remaining positive after 1 year
Q0768:Name the reaction that appears in babies who are
temporarily deprived of their usual caretaker. (This reaction
usually begins around 6 months of age; peaks around 8
months; and decreases at 12 months.)
Separation anxiety
Q0769:Which drug is used to treat opioid withdrawal;
ADHD; and sometimes Tourette's syndrome?
Clonidine
Q0770:What chromosome is autism linked to?
Chromosome 15
Q0771:What type of correlation is defined as;? Two variables
that go together in the same direction?
Positive correlation
Q0772:What type of correlation is defined as;? Two variables
with no linear relation to one another?
Zero correlation
Q0773:What type of correlation is defined as;? One variable
that diminishes in the presence of the other?
Negative correlation
Q0774:When the results of a test are compared to findings for
a normative group; what form of reference does the objective
test use?
Norm reference (i.e; 75% of the students in the class will
pass)
Q0775:What hypothesis states that the findings of a test are a
result of chance?
Null hypothesis (what you hope to disprove)
Q0776:What is the term to describe the inability to feel any
pleasant emotions?
Anhedonia
Q0777:What is the term for involuntary constriction of the
outer third of the vagina to prevent penile penetration?
Vaginismus; it is the female counterpart of premature
ejaculation.
Q0778:What is the term for the same results achieved again on
testing a subject a second or third time?
Test–retest reliability
Q0779:At what age does a child develop;? Endogenous smile?
At birth (reflex)
Q0780:At what age does a child develop;? Exogenous smile?
8 weeks (response to a face)
Q0781:At what age does a child develop;? Preferential smile?
12 to 16 weeks (in response to mother's face)
Q0782:Per Freud; with what part of the unconscious are sex
and aggression (instincts) associated?
Id
Q0783:What enzyme is inhibited by disulfiram?
Acetaldehyde dehydrogenase. When this enzyme is blocked;
acetaldehyde builds up; and its presence in excess results in
nausea and hypotension.
Q0784:What type of questions should you begin with when a
patient seeks your medical opinion?
It is best to begin with open-ended questions; allowing
patients to describe in their own words what troubles them.
You can then move to closed-ended questions when narrowing
the diagnosis.
Q0785:What type of scheduled reinforcement states that after
a desired response; the reinforcement is given;? On a set time
schedule?
Fixed interval
a desired response; the reinforcement is given;? After a set
number of responses?
Fixed ratio (rewards set behaviors)
a desired response; the reinforcement is given;? Varying in
time?
Variable interval
a desired response; the reinforcement is given;? Varying in the
number of responses?
Variable ratio;If it is based on time; it is an interval; and if it is
based on the number of responses; it is a ratio.
Q0789:At what stage of psychosexual development
(according to Freud) do children fear castration?
Phallic stage (4–6 years)
Q0790:What is the label given to an individual whose IQ is;?
130
Very superior (<2.5% of the population)
110 to 119
High average
80 to 89
Low average
Q0793:What is the label given to an individual whose IQ is;70
to 79
Borderline
90 to 109
Average
Below 69
Mentally disabled
120 to 129
Superior
Q0797:At what stage of sleep is GH output elevated?
Stage 4
Q0798:Can incidence; prevalence; and cause and effect be
assessed in;? Case control studies?
Case control studies cannot assess incidence or prevalence;
but they can determine causal relationships.
assessed in;? Cross-sectional studies?
Cross-sectional studies determine prevalence; not incidence or
cause and effect.
assessed in;? Cohort studies?
Cohort studies determine incidence and causality; not
prevalence.
Q0801:Can a physician commit a patient?
NO!! Remember; only a judge can commit a patient. A
physician can detain a patient (maximum is for 48 hours).
Q0802:What are the five pieces of information considered
necessary for fully informed consent?
1. Benefits of the procedure ;2. Purpose of the procedure ;3.
Risks of the procedure ;4. The nature of the procedure (what
you are doing) ;5. The alternative to this procedure and its
availability ;(Don't forget the last one; this is where
physicians get in trouble.)
Q0803:What is the term for the number of individuals who
have an attribute or disease at a particular point in time?
Prevalence rate
Q0804:What is the term for the degree to which a test
measures what it is intended to measure?
Validity (remember; reliability is necessary but not the only
thing needed for validity)
Q0805:What Freudian psyche component is described as;?
The urges; sex aggression; and "primitive" processes?
Id (pleasure principle)
The conscience; morals; beliefs (middle of the road)?
Superego
Reality; rationality; language basis?
Ego
Q0808:What medication is used to help alcoholics avoid
relapse by decreasing glutamate receptor activity?
Acamprosate (the number of glutamate receptors increases
with chronic alcohol abuse)
Q0809:What is the term for new made-up words?
Neologisms. Thomas Jefferson noted; "Necessity obliges us
to neologize." (Abnormal use of neologisms is known as
neolalism.)
Q0810:What rate removes any difference between two
populations; based on a variable; to makes groups equal?
Standardized rate
Q0811:Can committed mentally ill patients refuse medical
treatment?
Yes. The only civil liberty they lose is the freedom to come
and go as they please.
Q0812:What is the term for any stimulus that increases the
probability of a response happening?
Reinforcement
Q0813:Does REM deprivation interfere with performance on
simple tasks?
No; but it does interfere with performing complex tasks and
decreases attention to detail. (Be careful post call!)
Q0814:Name the cluster C personality disorder;? Gets others
to assume responsibility; is subordinate; and is fearful of
being alone and caring for self
Dependent
Q0815:Name the cluster C personality disorder;? Orderly;
inflexible; perfectionist; makes rules; lists; order; doesn't like
change; has a poor sense of humor; and needs to keep a
routine
Obsessive-compulsive
Q0816:Name the cluster C personality disorder;? Sensitive to
criticism; shy; anxious; socially isolated but yearns to be in
the crowd
Avoidant
Q0817:What is the term for a complete aversion to all sexual
contact?
Sexual aversion disorder
Q0818:What type of symptoms in schizophrenia are
associated with;? Dopamine receptors?
Type I symptoms (positive); schizophrenics have them; but
otherwise healthy persons do not.
Q0819:What type of symptoms in schizophrenia are
associated with;? Muscarinic receptors (ACh)?
Type II symptoms (negative); otherwise healthy persons
have them; but schizophrenics do not.
Q0820:What general pattern of sleep is described by slowing
of EEG rhythms (high voltage and slower synchronization);
muscle contractions; and lack of eye movement or mental
activity?
NREM sleep. Remember awake body; sleeping brain
Q0821:Is spousal abuse a mandatory reportable offense?
No; it is not a mandatory reportable offense (if you can
believe it). Child and elderly abuse are mandatory reportable
offenses.
Q0822:What is the key issue surrounding teenagers'
maturation?
Formation of an identity through issues of independence and
rebellion; they define who they are.
Q0823:What is the relationship between chance of error and;?
Standard deviation?
As the standard deviation increases; the greater the chance of
error.
Q0824:What is the relationship between chance of error and;?
Sample size?
As sample size increases; the lower the chance of error.
Q0825:Name the cluster B personality disorder;? Colorful;
dramatic; extroverted; seductive; and unable to hold long-term
relationships
Histrionic
Q0826:Name the cluster B personality disorder;? In a
constant state of crisis; promiscuous; unable to tolerate
anxiety-causing situations; afraid of being alone; and having
intense but brief relationships
Borderline
Q0827:Name the cluster B personality disorder;? Criminal
behavior; lacking friends; reckless; and unable to conform to
social norms
Antisocial
Q0828:Name the cluster B personality disorder;? Grandiose
sense of self-importance; demands constant attention; fragile
self-esteem; can be charismatic
Narcissistic
Q0829:In what organ system would you attempt to localize a
sign for shaken baby syndrome"? What do you look for?
Look for broken blood vessels in the baby's eyes.
Q0830:What case is known as "let nature take its course"?
Infant Doe. Generally; parents cannot forego lifesaving
treatment; but this case states that there are exceptions to the
rule.
Q0831:If the P value is less than or equal to .05; what do you
do to the null hypothesis?
Reject it
Q0832:What disorder is characterized by an alternating
pattern of depressed mood with periods of hypomania for
more than 2 years?
Cyclothymia (nonpsychotic bipolar). Patients are ego
syntonic.
Q0833:What projective test asks the patient to tell a story
about what is going on in the pictures; evaluating the conflicts;
drives; and emotions of the individual?
TAT (Thematic apperception test)
Q0834:What has proved to be the best way to extinguish
enuresis?
Bell pad
Q0835:What scale assesses a rank order classification but
does not tell the difference between the two groups?
Ordinal scale (e.g; faster/slower; taller/shorter)
Q0836:What is associated with prolonged lithium use?
Hypothyroidism. (TSH levels must be monitored.)
Q0837:What scale has a true zero point; graded into equal
increments; and also orders them?
Ratio scale
Q0838:By what age should children be able to draw the
following figures?;? Triangle
6 years old
following figures?;? Cross
4 years old
following figures?;? Diamond
7 years old
following figures?;? Square
5 years old
following figures?;? Circle
3 years old
following figures?;? Rectangle
4.5 years old;(Alphabetic order except with a diamond last:
circle; cross; rectangle; square; triangle)
Q0844:What personality disorder affects 75% of the prison
population?
Antisocial personality
Q0845:What is the first formal IQ test used today for children
aged 2 to 18?
Stanford-Binet Scale; developed in 1905; is useful in the very
bright; the impaired; and children less than 6 years old.
Q0846:What type of foods should patients taking MAOIs
avoid? Why?
Foods rich in tyramine (e.g; cheese; dried fish; sauerkraut;
chocolate; avocados; and red wine) should be avoided.
Hypertensive crisis occurs when tyramine and MAOIs are
mixed.
Q0847:What form of anxiety; appearing at 6 months; peaking
at 8 months; and disappearing by 1 year of age; is seen in the
presence of unfamiliar people?
Stranger anxiety
Q0848:What are the three stages that children aged 7 months
to 5 years go through when they are separated from a primary
caregiver for a long time?
1. Protest ;2. Despair ;3. Detachment
Q0849:What five things are checked in the APGAR test?
1. Skin color ;2. Heart rate ;3. Reflexes ;4. Muscle tone ;5.
Respiratory rate ;;APGAR; Appearance; Pulse; Grimace;
Activity; Respiration
Q0850:What are the top three causes of infant mortality?
Birth defects; low birth weight (< 1500 g) with neonatal
respiratory distress syndrome (NRDS); and SIDS
Q0851:Do newborns have a preference for still or moving
objects?
Moving objects; along with large bright objects with curves
and complex designs.
Q0852:What is the name of the 12-step program believed to
be the most successful for the treatment of alcohol abuse?
Alcoholics Anonymous
Q0853:How can you differentiate between a medial temporal
lobe and a hippocampal lesion based on memory impairment?
Long-term memory is impaired in hippocampal lesions; it is
spared in medial temporal lobe lesions.
Q0854:What serotonin reuptake inhibitor's major sexual side
effect is priapism?
Trazodone
Q0855:What is the central issue regarding the Roe vs. Wade
decision (legalization of abortion)?
The patient decides about the health care she does or does not
get even if it harms the fetus. This also means she can refuse
blood transfusions even if it harms the fetus.
Q0856:What part of the ANS is affected in the biofeedback
model of operant conditioning?
The biofeedback model is based on the parasympathetic
nervous system.
Q0857:The proportion of truly diseased persons in the
screened population who are identified as diseased refers to?
Sensitivity (it deals with the sick)
Q0858:How far below ideal body weight are patients with
anorexia nervosa?
At least 15%
Q0859:True or false? According to social learning theory;
people who believe that luck; chance; or the actions of others
control their fate have an internal locus of control.
False. These beliefs are characteristic of people with an
external locus of control.
Q0860:What is the term for an inhibited female orgasm?
Anorgasmia. (The overall prevalence is 30%.)
Q0861:What are the four exceptions to requirements for
informed consent?
1. Incompetent patient (determined by the courts) ;2.
Therapeutic privilege (in the best interest of the patient when
he or she is unable to answer) ;3. Waiver signed by the patient
;4. Emergency
Q0862:What is the term for recurrent and persistent pain
before; after; or during sexual intercourse?
Dyspareunia. It is a common complaint in women who have
been raped or sexually abused.
Q0863:What type of bias is it when the sample population is
not a true representative of the population?
Selection bias
Q0864:In what stage of sleep is it hardest to arouse a sleeping
individual?
During stage 3 and 4 (remember; it is called deep sleep.)
Q0865:What is the period between falling asleep and REM
sleep called?
REM latency; normally it is about 90 minutes.
Q0866:What case is best known for use of the "best interest
standard"?
Brother Fox (Eichner vs. Dillon). The substituted standard
could not apply because the patient had never been
competent; so no one knew what the patient would have
wanted. Therefore; the decision was based on what a
"reasonable" person would have wanted.
Q0867:What drug is used to prevent alcohol consumption by
blocking aldehyde dehydrogenase?
Disulfiram
Q0868:According to Freud; what facet of the psyche
represents the internalized ideals and values of one's parents?
Superego
Q0869:What pineal hormone's release is inhibited by daylight
and increased dramatically during sleep?
Melatonin. It is a light-sensitive hormone that is associated
with sleepiness.
Q0870:What somatoform disorder is described as;? Having a
F:M ratio of 20:1; onset before age 30; and having 4 pains (2
gastrointestinal; 1 sexual; 1 neurologic)?
Somatization disorder
Q0871:What somatoform disorder is described as;? La belle
indifférence; suggestive of true physical ailment because of
alteration of function?
Conversion disorder
Q0872:What somatoform disorder is described as;?
Unrealistic negative opinion of personal appearance; seeing
self as ugly?
Body dysmorphic disorder
Q0873:What somatoform disorder is described as;?
Preoccupied with illness or death; persisting despite
reassurance; lasting longer than 6 months?
Hypochondriasis (they will begin with "I think I have;")
Q0874:What somatoform disorder is described as;? Severe;
prolonged pain that persists with no cause being found;
disrupts activities of daily living?
Somatoform pain disorder
Q0875:What statistical test compares the means of many
groups (>2) of a single nominal variable by using an interval
variable?
One-way ANOVA
Q0876:What disease is described by the following
characteristics: multiple motor and vocal tics; average age of
onset 7; a M:F ratio of 3:1; and association with increased
levels of dopamine?
Tourette's syndrome; it is usually first reported by teachers
as ADHD with symptoms of obsessive-compulsive disorder
and learning disabilities.
Q0877:In Parkinson's disease; what area of the basal ganglia
has a decreased amount of dopamine?
Substantia nigra
Q0878:What naturally occurring substances mimic the effects
of opioids?
Enkephalins
Q0879:What disorder; experienced more than half of the time
for a 6-month period; is described as being fearful; worrisome;
or impatient and having sleep disturbances; poor
concentration; hyperactivity; and an overall sense of
autonomic hyperactivity?
Generalized anxiety disorder
Q0880:What percent of sexual abuse cases are committed by
family members?
50%. The uncles and older siblings are the most likely
perpetrators; although stepfathers also have a high rate.
Q0881:Kaiser-Fleischer rings; abnormal copper metabolism;
and ceruloplasmin deficiency characterize what disease; which
may include symptoms of dementia when severe?
Wilson's disease (Remember chromosome 13 and
hepatolenticular degeneration)
Q0882:To what does failure to resolve separation anxiety
lead?
School phobia
Q0883:What is the term to describe the average?
Mean
Q0884:How does L-tryptophan affect sleep?
It increases REM and total sleep time.
Q0885:Should information flow from the patient to the family
or vice versa?
Your duty is to tell the patient; not the family. The patient
decides who gets to know and who doesn't; not you.
Q0886:Can parents withhold treatment from their children?
Yes; as long the illness does not threaten limb or life. If illness
is critical or an emergency; treat the child.
Q0887:What is the name of the hypothesis you are trying to
prove?
Alternative hypothesis (what is left after the null has been
defined)
Q0888:What percent of unwed mothers are teenagers?
50%; with 50% of them having the child
Q0889:What happens to REM; REM latency; and stage 4
sleep during major depression?
Increased REM sleep; decreased REM latency; and decreased
stage 4 sleep; leading to early morning awakening
Q0890:What 11–amino acid peptide is the neurotransmitter of
sensory neurons that conveys pain from the periphery to the
spinal cord?
Substance P. (Opioids relieve pain in part by blocking
substance P.)
Q0891:True or false? In a positively skewed curve the mean
is greater than the mode.
True. In positively skewed distributions the mode is less than
the median is less than the mean.(Remember to name a
skewed distribution: the tail points in the direction of its
name. positive skew tails point to the positive end of a scale.)
Q0892:What is the term to describe jumping from one topic
to the next without any connection?
Loose association
Q0893:What is the leading cause of school dropout?
Pregnancy
Q0894:Name the four components of the narcoleptic tetrad.
1. Sleep paralysis ;2. Hypnagogic hallucinations (while falling
asleep) ;3. Sleep attacks with excessive daytime sleepiness ;4.
Cataplexy (pathognomonic) ;;Narcolepsy is a disorder of
REM sleep; with REM occurring within 10 minutes of sleep.
Q0895:What happens to cortisol levels in sleep-deprived
individuals?
Cortisol levels increase. Lymphocyte levels decrease in sleep-
deprived individuals.
Q0896:What is the period between going to bed and falling
asleep called?
Sleep latency
Q0897:What disorder is characterized by a depressed mood
and a loss of interest or pleasure for more than 2 years?
Dysthymia; which is also known as nonpsychotic depression.
(Think of it as the car running but not well.)
Q0898:What form of conditioning is defined as a new
response to an old stimulus resulting in a consequence?
Operant conditioning (reinforcement is after a response)
Q0899:What pituitary hormone is inhibited during sleep?
TSH. 5-HT and prolactin increase during sleep; and dopamine
levels decrease during sleep.
Q0900:Based on operant conditioning; what type of
reinforcement is described when;? Adding a stimulus stops a
behavior?
Punishment
reinforcement is described when;? Removing a stimulus stops
a behavior?
Extinction
reinforcement is described when;? Adding a stimulus
reinforces a behavior?
Positive reinforcement
reinforcement is described when;? Removing a stimulus
reinforces a behavior?
Negative reinforcement
Q0904:What is the formula to calculate IQ?
(MA/CA) x 100 = IQ score; where MA = mental age and CA
= chronological age
Q0905:What happens to NE levels in ;? Major depression?
Decrease (5-HT and dopamine levels do the same)
Q0906:What happens to NE levels in ;? Bipolar disorder?
Increase (5-HT and dopamine levels do the same)
Q0907:What law was adopted to shield physicians from
liability when helping at the scene of an accident?
Good Samaritan Law. (Physicians are not required to stop and
help.)
Q0908:What is the term for the number of new events
occurring in a population divided by the population at risk?
Incidence rate
Q0909:What is the term to describe inability to recall the past
and possible assumption of a completely new identity?
Dissociative fugue. (Patients are unaware of memory loss.)
Q0910:What classical conditioning therapy or modification is
described as;? Pairing noxious stimuli to an inappropriate
behavior?
Aversive conditioning
described as;? Forcing patients to confront their fears by being
exposed to them until they are extinguished?
Exposure
described as;? Triage of a hierarchy of fears (from least to
most); then teaching muscle relaxation techniques in the
presence of those fears until the subject is not afraid
anymore?
Systematic desensitization
Q0913:Failure to accurately recall the past leads to what form
of bias?
Recall bias. These problems arise in retrospective studies.
Q0914:Regarding neuroleptics; what is the relationship
between potency and anticholinergic side effects?
Inversely proportional: the higher the potency; the lower the
anticholinergic side effects.
Q0915:What potentially lethal side effect of clozapine should
be monitored with frequent blood drawing?
Agranulocytosis; approximately 2% develop this side effect.
Q0916:True or false? Being college educated increases a man's
risk of having premature ejaculation.
True; also; stressful marriage; early sexual experiences in the
back of a car; and sex with a prostitute all increase the risk of
premature ejaculation.
Q0917:What is the term for the rate measured for a subgroup
of a population?
Specific rate (e.g; men aged 55–60)
Q0918:In what stage of psychosexual development; according
to Freud; do children resolve the Oedipus complex?
Latency stage (6–12 years)
Q0919:Where is lithium metabolized and excreted?
95% in the kidneys; that's why adequate Na+ and fluid intake
is essential.
Q0920:At what age do children begin to understand the
irreversibility of death?
At 8 to 9 years of age. Prior to this age they view death as a
form of punishment.
Q0921:What are the three benzodiazepines that do not
undergo microsomal oxidation?
Oxazepam; temazepam; and lorazepam (OTL) (mnemonic:
Outside The Liver). They undergo glucuronide conjugation;
not via the cytochrome p450 system.
Q0922:What neuropsychologic test has five basic scales
testing for the presence and localization of brain dysfunction?
The Halsted-Reitan battery. It consists of finger oscillation;
speech sound perception; rhythm; tactual; and category
testing.
Q0923:What subtype of schizophrenia is characterized by;?
Childlike behaviors; unorganized speech and behaviors; poor
grooming; incongruous smiling and laughter; and the worst
prognosis?
Disorganized schizophrenia
Stuporous mute echopraxia and automatic obedience; waxy
flexibility with rigidity of posture?
Catatonic schizophrenia
Delusions of persecution and/or grandeur; auditory
hallucinations; late onset; and the best prognosis?
Paranoid schizophrenia
Q0926:If a patient cannot pay; can you refuse services?
No; you never refuse to treat a patient simply because he or
she can't pay. You are a patient advocate.
Q0927:Does alcoholism increase the rate of suicide?
Yes. It increases the rate of suicide to nearly 50 times that of
the general population.
Q0928:What is the term for the dementia characterized by
decremental or patchy deterioration in cognitive function due
to a cerebrovascular accident?
Vascular dementia. It is characterized as a stepwise
deterioration in cognitive function.
Q0929:What is the term for the difference between the highest
and the lowest score in a population?
Range
Q0930:How is sleep affected in a person with alcohol
intoxication?
Decreased REM sleep and REM rebound during withdrawal
Q0931:How many attacks are needed over how much time
before panic disorder is diagnosed?
Need 3 panic attacks over 3 weeks (remember; they come out
of the blue.)
Q0932:What axis I disorder is characterized by pronoun
reversal; preference for inanimate objects; obliviousness to the
external environment; lack of separation anxiety; and
abnormalities in language development?
Autism. Head-banging; rocking; and self-injurious behaviors
are also common in autism.
Q0933:What major side effect of neuroleptics is characterized
by pill rolling; shuffling gait; and tremors that abate during
sleep?
Tardive dyskinesia. It persists even after treatment is
discontinued and has no treatment. Focus is on monitoring for
side effects and prevention.
Q0934:If you report a suspected case of child abuse and are
wrong; are you protected from legal liability?
Yes. This is done to help prevent underreporting out of fear
of lawsuit. Remember that it is your duty to protect the child
first; not worry about legal responsibility.
Q0935:Can advance directives be oral?
Yes
Q0936:Increased self-esteem; flight of ideas; decreased sleep;
increased libido; weight loss; and erratic behavior are all
symptoms of what disorder?
Bipolar disorder (manic-depressive disorder)
Q0937:Is marital satisfaction higher for couples with or
without children?
Without children (but don't think about this one for too long)
Q0938:At what age does IQ stabilize?
From age 5 onward IQ stabilizes.
Q0939:Name the aphasia based on these characteristics;?
Nonfluent speech; telegraphic and ungrammatical; lesion in
Brodmann's area 44; unimpaired comprehension
Broca's aphasia
Lesion in the prefrontal cortex; inability to speak
spontaneously; unimpaired ability to repeat
Transcortical aphasia
Lesion is in the parietal lobe or arcuate fibers because the
connection between Broca's and Wernicke's area is severed;
word comprehension preserved; inability to write or speak
the statement (can't tell you what you said)
Conduction aphasia
Both Broca's and Wernicke's areas damaged by lesion in the
presylvian speech area; trouble repeating statements; poor
comprehension with telegraphic speech
Global aphasia
Lesion in Brodmann area 22; impaired comprehension;
incoherent rapid; fluent speech; verbal paraphrasias; trouble
repeating statements
Wernicke's aphasia
Q0944:What rare form of dementia is associated with
personality changes and affects the frontal and temporal
lobes?
Pick's disease
Q0945:Which drug is used to treat respiratory depression
associated with an overdose of opioids?
Naloxone or naltrexone
Q0946:What rate is indicated by 1-specificity?
False-positive rate
Q0947:When does most of the NREM sleep (stage 3 and 4)
occur; in the first or second half of sleep?
The deepest sleep levels (stage 3 and 4) occur mostly in the
first half of sleep.
Q0948:Name the stages of sleep with these EEG patterns;?
Disappearance of alpha waves; appearance of theta waves
Stage 1
Delta waves
Stage 3 and 4
Sawtooth waves; random low voltage pattern
REM
Alpha waves
Being awake
Sleep spindles; K-complexes
Stage 2
Q0953:What is the drug of choice for treating ADHD?
Methylphenidate (Ritalin)
Q0954:True or false? Prolactin levels can serve as a rough
indicator of overall dopamine activity.
True. PIF is dopamine in the tuberoinfundibular system.
Q0955:What is the term for failure to give up infantile
patterns of behavior for mature ones?
Fixation (arrested development)
Q0956:Is masturbation considered an abnormal sexual
practice?
No. It is abnormal only if it interferes with normal sexual or
occupational function.
Q0957:Which benzodiazepine has the longest half-life?
Flurazepam
Q0958:In the classical conditioning model; when a behavior is
learned; what must occur to break the probability that a
response will happen?
Stimulus generalization must stop. (Pairing of the
unconditioned stimulus and the conditioned stimulus must
cease.)
Q0959:What is the most abundant neuron in the cerebellum?
The granule cell. Its neurotransmitter is glutamic acid; which is
also the principal neurotransmitter of the visual pathways.
Q0960:Name these anxiety defense mechanisms;? Separating
oneself from the experience. The facts are accepted but the
form is changed for protection.
Dissociation
Q0961:Name these anxiety defense mechanisms;? Use of
explanations to justify unacceptable behaviors.
Rationalization
Q0962:Outburst to cover up true feelings (emotion is covered;
not redirected).
Acting out
Q0963:Use of an outlet for emotions (stuff flows downhill).
Displacement
Q0964:Fact without feeling (la belle indifférence)
Isolation of affect
Q0965:Replacing normal affect with "brain power"
Intellectualization
Q0966:Unconsciously forgetting(forgetting that you forgot
something!)
Repression
Q0967:Fixing impulses by acting out the opposite of an
unacceptable behavior
Undoing
Q0968:Setting up to be let down (it is unconscious; if
conscious; you're just rude)
Passive-aggressive
Q0969:A complete opposite expression of your inward
feeling (e.g; arguing all the time with someone you are
attracted to when your feelings are not known)
Reaction formation
Q0970:Name these cluster A personality disorders;? Odd;
strange; has magical thinking; socially isolated; paranoid; lacks
close friends; has incongruous affect
Schizotypal
Q0971:Name these cluster A personality disorders;? Socially
withdrawn; seen as eccentric but happy to be alone
Schizoid
Q0972:Name these cluster A personality disorders;? Baseline
mistrust; carries grudges; afraid to open up; uses projection as
defense mechanism; lacks hallucinations or delusions
Paranoid
Q0973:What statistical method do you use when analyzing;?
Cross-sectional studies?
Chi-square.
Cohort studies?
Relative risk and/or attributable risk. (Cohort studies deal
with incidence.)
Case control studies?
Odds ratio. (Case control studies deal with prevalence.)
Q0976:If a patient asks you a question and you do not know
the answer; do you tell a white lie or simply not respond?
Absolutely not! Answer any question you are asked.
Q0977:True or false? There is a strong positive correlation
between IQ and academic achievement.
True. IQ correlates well with education and academic
achievement but is not a predictor of success.
Q0978:What is the term for headaches; inability to
concentrate; sleep disturbances; avoidance of associated
stimuli; reliving events as dreams or flashbacks following a
psychologically stressful event beyond the normal range of
expectation?
Posttraumatic stress disorder. (Important: symptoms must be
exhibited for longer than 1 month.)
Q0979:What is the term for a schizophrenic episode lasting
longer than 30 days with full return to former functioning
capacity?
Brief psychotic disorder. (In schizophreniform disorder the
symptoms last longer than 6 months.)
Q0980:What is the primary method of nonverbal
communication of emotional states?
Facial expression (the second is vocal intonation)
Q0981:What type of mortality rate is defined as the number
of deaths;? In the population?
Crude mortality rate
of deaths;? From a specific cause per population?
Cause-specific mortality rate
of deaths;? From a specific cause per all deaths?
Proportionate mortality rate
of deaths;? From a specific cause per number of persons with
the disease?
Case fatality rate
Q0985:Does being a female physician increase or decrease the
risk of suicide?
Being a female physician increases the risk of suicide nearly
four times the general population.
Q0986:Are sexually abused females more likely to have
learning disabilities than the general population?
Yes; by three to four times. Having multiple sexual partners;
being overweight; and pelvic pain and/or inflammatory
disorders are also likely to be seen in sexually abused females.
Q0987:What form of bias is due to false estimates of survival
rates?
Lead-time bias (remember; patients don't live longer with the
disease; they are diagnosed sooner.)
Q0988:The probability that a person with a positive test
result is truly positive refers to what value?
Positive predictive value
Q0989:Objective tests that base the result of the examination
on a preset standard use what form of reference?
Criterion-referenced tests. You need a certain number correct
to pass (e.g; the USMLE).
Q0990:True or false? A patient can refuse a feeding tube.
True. It is considered medical treatment; so it can be
withdrawn or refused. (Remember the Cruzan case.)
Q0991:What are the CAGE questions?
Cut down (ever tried and failed?);Annoyed (criticism makes
angry?);Guilty (about drinking behavior?);Eye opener
(drinking to shake out the cobwebs?)
Q0992:What type of scale is graded into equal increments;
showing not only any difference but how much?
Interval scale (a ruler; for example)
Q0993:With what stage of sleep are bruxisms associated?
Teeth grinding is associated with stage 2 sleep.
Q0994:What rate is indicated by 1- sensitivity?
False-negative rate
Q0995:What drug is being given to HIV-positive mothers
during labor and to the children after birth to decrease the risk
of mother-to-child HIV transmission?
Nevirapine; it cuts the rate from 20% to 10%. AZT is also
used; cutting the rate from 20% to 10%.
Q0996:What is the name of depression and mania alternating
within a 48-to 72-hour period?
Rapid cycling bipolar disorder
Q0997:Aroused EEG pattern (fast low voltage and
desynchronization); saccadic eye movements; ability to
dream; and sexual arousal are all associated with what general
pattern of sleep?
REM sleep. Remember; awake brain in a sleeping body.
Q0998:What is the teratogenic effect associated with lithium?
Epstein-cardiac anomaly of the tricuspid valve
Q0999:What is the triad of NPH?
Dementia;Urinary incontinence;Gait apraxia;(NPH wet;
wacky; wobbly)
Q1000:True or false? Only men have refractory sexual
periods.
Sad but true. Some women can have multiple successive
orgasms.
Q1001:In which syndrome does a person present with
intentionally produced physical ailments with the intent to
assume the sick role?
Münchhausen's syndrome (factitious disorder)
Q1002:Name these mature defense mechanisms;? Preparing
for an upcoming event
Anticipation
Q1003:Name these mature defense mechanisms;? Helping
others without expecting any return
Altruism
Q1004:Name these mature defense mechanisms;? Converting
an unacceptable impulse to a socially acceptable form (Hint: it
is the most mature of all defense mechanisms)
Sublimation
Q1005:Name these mature defense mechanisms;? Forgetting
on purpose (so you can actually remember it)
Suppression
Q1006:Name these mature defense mechanisms;? Easing
anxiety with laughter
Humor
Q1007:Name the area of the cerebral cortex with the function
described;? Speech; critical for personality; concentration;
initiating and stopping tasks (do one thing and begin a new
without completion of the first); abstract thought; and
memory and higher-order mental functions
Frontal lobe
described;? Language; memory; and emotion (Hint:
herpesvirus infects here commonly)
Temporal lobe
described;? Intellectual processing of sensory information;
with the left (dominant) processing verbal information; the
right processing visual-spatial orientation
Parietal lobe
described;? Initiation and control of movements
Basal ganglia
described;? Skill-based memory; verbal recall; balance; refined
voluntary movements
Cerebellum
described;? Important for REM sleep; origin of NE pathway
Pons
described;? Motivation; memory; emotions; violent behaviors;
sociosexual behaviors; conditioned responses
Limbic system
described;? Recall of objects; distances; and scenes; visual
input processed here
Occipital lobe
Q1015:What is the degree to which two measures are related?
Does it imply causation?
Correlation. No; correlation does not imply causation.
Q1016:What is the most common form of dementia?
Alzheimer's (dementia of Alzheimer's type; DAT).
(Remember; Alzheimer's constitutes 65% of dementias seen in
patients 65 years old.)
Q1017:What is the only drug that does not have an
intoxication?
Nicotine (but it sure has a nasty withdrawal!)
Q1018:What is the term to describe homosexuals who;? Are
comfortable with their own person and agree with their sense
of self?
Ego syntonic
Q1019:What is the term to describe homosexuals who;? Are
uncomfortable with their own person and disagree with their
sense of self?
Ego dystonic
Q1020:Which benzodiazepine has the shortest half-life?
Triazolam
Q1021:What statistical test compares the means of groups
generated by two nominal variables by using an interval
variable?
Two-way ANOVA. It allows the test to check several
variables at the same time.
Q1022:What are the two ways to leave the prevalence pot?
Recovery and death
Q1023:What aspects of sleep are affected during
benzodiazepine use?
REM and stage 4 sleep; they decrease.
Q1024:What is the term to describe a man who has;? Never
been able to achieve an erection?
Primary erectile disorder
Q1025:What is the term to describe a man who has;? The
ability to have an erection sometimes and other times not?
Selective erectile disorder
Q1026:What is the term to describe a man who has;? Used to
be able to achieve an erection but now cannot?
Secondary erectile disorder (Male erectile disorder is the same
as impotence.)
Q1027:What stage of sleep is associated with somnambulism?
Sleepwalking is associated with stage 4 and occurs most often
in the first third of sleep.
Q1028:What are the three surrogate criteria?
1. What did the patient want? ;2. What would the patient
say? ;3. What is in the patient's best interests?
Q1029:True or false? Four-fifths of those who attempt
suicide first give a warning.
True; 80% have visited a doctor in the previous 6 months.
And 50% within the last month!
Q1030:Can a patient refuse life-saving treatment for religious
reasons?
Yes. (Remember; Jehovah's witnesses refuse blood
transfusions.)
Q1031:What form of bias occurs when the experimenter's
expectation inadvertently is expressed to the subjects;
producing the desired effects? How can it be eliminated?
Pygmalion effect (experimenter expectancy). This can be
eliminated with double-blind studies.
Q1032:What type of hallucination occurs during awakening?
Hypnopompic hallucinations occur during awakening;
whereas hypnagogic hallucinations occur while one is falling
asleep.
Q1033:When attempting to make up sleep; what stage of
sleep is recovered?
About 80% of stage 4 sleep is recovered; approximately half
of REM is recovered; and only one-third of total sleep is ever
made up.
Q1034:What is backward masking; and is there a positive
correlation with schizophrenic patients?
When showing two pictures in rapid succession; you split the
pictures half a second apart; resulting in the second picture
masking the first (indicating poor short-term memory). This is
seen in nearly 33% of schizophrenic patients.
Q1035:True or false? Being single increases your risk of
suicide.
False. Separation; divorce; being widowed; and
unemployment increase your risk; but being single does not.
Q1036:True or false? Serious psychiatric illness is more
common after abortion than childbirth.
False. Childbirth carries five times as much risk of serious
psychiatric illness as abortion.
Q1037:What type of error is made if you accept the null
hypothesis when it is false?
Type II error (beta error). (Remember it as saying something
doesn't work when it does.)
Q1038:Most sleep time is spent in what stage of sleep?
Stage 2; which accounts for approximately 45% of total sleep
time; with REM occupying 20%.
Q1039:In a negatively skewed curve is the mean greater than
the mode?
Yes. In a negatively skewed distribution the mean is greater
than the median is greater than the mode.
Q1040:What axis I disorder is characterized by a clinically
significant syndrome that affects social; occupational; and/or
academic achievement; occurs less than 3 months after a
stressor; and abates less than 6 months after the stressor is
removed?
Adjustment disorder. It is a diagnosis of exclusion (used if no
other choice).
Q1041:What type of personality test is the Rorschach inkblot
test; objective or projective?
Projective test. Most tests with a wide range of possibilities
for the answers are projective.
Q1042:What statistical test checks to see whether the groups
are different by comparing the means of two groups from a
single nominal variable?
The T-test (used when comparing two groups)
Q1043:What antipsychotic movement disorder can occur at
any time and is characterized by a subjective sense of
discomfort that brings on restlessness; pacing; sitting down;
and getting up?
Akathisia
Q1044:What form of depression is due to abnormal
metabolism of melatonin?
Seasonal affective disorder (treat with bright light therapy)
Q1045:What three circumstances allow a child to be
committed to institutional care?
1. The child poses an imminent danger to self or others;2. The
child is unable to self-care daily at the appropriate
developmental level;3. The parents or guardians have no
control over the child or will not promise to ensure the child's
safety even though they refuse hospitalization.
Q1046:What operant conditioning therapy or modification is
described as;? Reinforcing successive attempts that lead to the
desired goal (gradual improvement)?
Shaping (successive approximation)
described as;? Having a stimulus take over the control of the
behavior (unintentionally)?
Stimulus control
described as;? Providing the person with information regarding
his or her internal responses to stimuli with methods of
controlling them?
Biofeedback
described as;? Removing a reinforcement (without the patient
knowing) gradually over time to stop a condition?
Fading
described as;? Stopping the reinforcement that is leading to an
undesired behavior?
Extinction
Q1051:The DSM-IV-TR is scored on the basis of five axes of
diagnosis. In what axis would you place;? Psychosocial and
environmental problems (stressors)?
Axis IV
diagnosis. In what axis would you place;? Medical or physical
ailments?
Axis III
diagnosis. In what axis would you place;? Personality and
mental disorders?
Axis II
diagnosis. In what axis would you place;? Global assessment
of function?
Axis V
diagnosis. In what axis would you place;? Clinical disorders
(e.g; schizophrenia)?
Axis I
Q1056:Should you refer a patient to a form of folk medicine
even if you don't believe in it?
Actually; yes. You should encourage your patient to try other
forms of medicine as long as they are not contraindicated with
the patient's preexisting illness. You must be able to accept
the health beliefs of your patients; even if you don't agree.
Q1057:In regard to motor development during infancy; choose
the motor response that happens first;? Release or grasp
Grasp proceeds release
the motor response that happens first;? Proximal or distal
progression
Proximal to distal progression
the motor response that happens first;? Radial or ulnar
progression
Ulnar to radial progression
the motor response that happens first;? Palms up or down
Palms-up before palms-down maneuvers
Q1061:What are the strongest determinants of gender
identity?
Parental assignment and culture (not biology)
Q1062:With what stage of sleep are night terrors associated?
NREM sleep. Night terrors are dreams that we are unable to
recall.
Q1063:What type of bias is it when the information is
distorted because of the way it is gathered?
Measurement bias
Q1064:What term describes senseless repetition of words or
phrases?
Verbigeration
Q1065:Who decides competency and sanity?
The courts. These are legal; not medical terms.
Q1066:Name these narcissistic defense mechanisms;?
Everything in the world is perceived as either good or bad .
No middle ground; it is all extremes.
Splitting
Q1067:Name these narcissistic defense mechanisms;? Not
allowing reality to penetrate because afraid of becoming aware
of painful aspect of reality.
Denial
Q1068:Name these narcissistic defense mechanisms;? Person
takes his or her own feelings; beliefs; wishes; and so on and
thinks they are someone else's. (e.g; a cheating man thinks his
wife is unfaithful)
Projection
Q1069:Which is the conditioned response; the conditioned
stimulus; the unconditioned response; the unconditioned
stimulus in this case? A patient has blood withdrawn and
faints. The next time she goes to have blood taken; she faints
at the sight of the needle.
The blood withdrawn is the unconditioned stimulus; inducing
the unconditioned response (fainting). The needle is part of
the blood-drawing procedure and is the conditioned stimulus
(unconditioned and conditioned stimuli are paired) resulting in
the conditioned response (fainting at the sight of the needle).
Q1070:What three actions should take place when one person
threatens the life of another? (Hint: think of the Tarasoff
decision.)
1. Notify police;2. Try to detain the person making the
threat;3. Notify the threatened victim.
Q1071:Name the area of the cerebral cortex affected by the
description of the effects; symptoms; and results of the
lesion;? Apathy; aggression; inability to learn new material;
and memory problems
Limbic system
lesion;? Apathy; poor grooming; poor ability to think
abstractly; decreased drive; poor attention span (Hint: if the
lesion is in the dominant hemisphere; the patient will develop
Broca's aphasia)
Dorsal prefrontal cortex
lesion;? Euphoria; delusions; thought disorders; Wernicke's
aphasia; auditory hallucinations (Hint: the lesion is in the left
hemisphere)
Dominant temporal lobe
lesion;? Agraphia; acalculia; finger agnosia; right–left
disorientation
Dominant parietal lobe (Gerstmann's syndrome)
lesion;? Withdrawn; fearful; explosive moods; violent
outbursts; and loss of inhibitions
Orbitomedial frontal lobe
lesion;? Denial of illness; hemineglect; construction apraxia
(can't arrange matchsticks)
Nondominant parietal lobe
lesion;? Denies being blind; cortical blindness
Occipital lobe (Anton's syndrome if it is due to bilateral
posterior cerebral artery occlusions)
lesion;? Dysphoria; irritability; musical and visual abilities
decreased
Nondominant temporal lobe
Q1079:What hormone's release is strongly associated with
stage 4 sleep?
GH. The largest output of GH in a 24-hour period is during
stage 4 sleep.
Q1080:What is the male-to-female ratio for committing
suicide?
M:F 4:1 committing; but M:F ratio of attempts is 1:3 (males
commit more but females try it more)
Q1081:What is the term for the total percentage of correct
answers selected on a screening test?
Accuracy (think of it as all the trues; because they are the
ones correctly identified)
Q1082:What type of error is made if you reject the null
hypothesis when it is true?
Type I error (alpha error). (Remember it as saying something
works when it doesn't.) The chance of a type I error occurring
is the P value.
Q1083:If one event precludes another event; their
probabilities are combined by what method?
Addition (They are mutually exclusive.)
Q1084:True or false? Marriage emancipates a child less than
17 years old.
True; military service and independent self-care by a child
over 13 years old also emancipate.
Q1085:What term describes the inability to recall personal
information; commonly associated with trauma?
Amnesia. (The person is aware of the memory loss.)
Q1086:What is the most stressful event as determined by the
Holmes and Rahe scale?
The death of a spouse. The higher the score; the greater the
risk of developing an illness in the next 6 months.
Q1087:What renal side effect is commonly seen in patients
taking lithium?
Nearly 25% of patients taking lithium develop polyuria and
polydipsia.
Q1088:What statistical test; using nominal data only; checks
whether two variables are independent events?
Chi-square (when you are in doubt and have nominal data; use
chi-square)
Q1089:What is the term for repetitive actions blocking
recurring bad thoughts?
Compulsions. They are actions done to fix the bad thoughts.
Obsessions are the thoughts.
Q1090:True or false? A patient has to prove his or her
competency.
False. You need clear evidence the patient is not competent; if
you are unsure; assume the patient is competent.
Q1091:True or false? Panic attacks can be induced by
hyperventilation or carbon dioxide.
True. Yohimbine; sodium lactate; and epinephrine can also
induce panic attacks; they are considered panicogens.
Q1092:In what study; for ethical reasons; is no group left out
of intervention?
Crossover study
Q1093:Shuffling gait; cogwheel rigidity; masklike facies; pill-
rolling tremor; and bradykinesia describe what form of
dementia?
Parkinson's disease
Q1094:Anhedonia; lack of motivation; feelings of
worthlessness; decreased sex drive; insomnia; and recurrent
thoughts for at least 2 weeks; representing a change from
previous level of function; describes what disorder?
Unipolar disorder (major depression)
Q1095:What form of dementia is characterized by onset at age
40 to 50; rapid progression; infection by a prion; and death
within 2 years?
Creutzfeldt-Jakob's disease. Patients first develop vague
somatic complaints and anxiety; rapidly followed by
dysarthria; myoclonus; ataxia; and choreoathetosis.
Q1096:The most frequent number occurring in a population is
what?
Mode
Q1097:Movement disorders are associated with what
dopamine pathway (what part of the brain)?
Nigrostriatal pathways (basal ganglia)
Q1098:What neurotransmitter is associated with sedation and
weight gain?
Histamine
Q1099:The probability that a person with a negative test
result is truly disease free refers to what value?
Negative predictive value
Q1100:What are the five Kübler-Ross stages of death and
dying? Must they be completed in order?
Denial;Anger;Bargaining;Depression;Acceptance;No; they can
be skipped; repeated; and completed out of sequence.
Q1101:What P value defines whether the hull hypothesis
should or should not be rejected?
P = .05; P < .05 rejects the null hypothesis
Q1102:What hormone level increases in the first 3 hours of
sleep?
Prolactin
Q1103:What is the most widely used class of
antidepressants?
SSRIs
Q1104:What happens to prevalence as the number of long-
term survivors increases?
Prevalence increases. (Remember; prevalence can decrease in
only two ways; recovery and death.)
Q1105:What is the primary predisposing factor for vascular
dementia?
Hypertension
Q1106:What paraphilia is defined as;? Sexual urges toward
children?
Pedophilia
Q1107:What paraphilia is defined as;? Deriving sexual
pleasure from watching others having sex; grooming; or
undressing?
Voyeurism
Q1108:What paraphilia is defined as;? Having a recurrent
desire to expose the genitals to strangers?
Exhibitionism
pleasure from other peoples' pain?
Sadism
pleasure from being abused or in pain?
Masochism
Q1111:What paraphilia is defined as;? Having sex with
cadavers?
Necrophilia
Q1112:What paraphilia is defined as;? Sexual fantasies or
practices with animals?
Zoophilia
Q1113:What paraphilia is defined as;? Combining sex with
defecation?
Coprophilia
Q1114:What paraphilia is defined as;? Combining sex with
urination?
Urophilia
Q1115:What paraphilia is defined as;? A male rubbing his
genitals on a fully clothed female to achieve orgasm?
Frotteurism
Q1116:Name the neurotransmitter at the neuromuscular
junctions for all of the voluntary muscles in the body.
ACh; think about the ANS.
Q1117:What are the pharmacologic effects seen sexually
with;? (alpha)1-Blockers?
Impaired ejaculation
with;? Serotonin?
Inhibited orgasm
with;? (beta)-Blockers?
Impotence
with;? Trazodone?
Priapism
with;? Dopamine agonists?
Increased erection and libido
with;? Neuroleptics?
Erectile dysfunction
Q1123:What is the term for the point on a scale that divides
the population into two equal parts?
Median (think of it as the halfway point)
Q1124:True or false? Pregnancy ensures emancipation.
False
Q1125:True or false? Paranoid and catatonic schizophrenia
are good prognostic predictors.
True. Being female; having positive symptoms; quick onset;
and family history of mood disorders are all good prognostic
predictors of schizophrenia.
Q1126:What happens to prevalence as incidence increases?
Prevalence increases.
Q1127:What type of correlation compares two interval
variables?
Pearson correlation
Q1128:What term is defined as a patient unconsciously
placing his or her thoughts and feelings on the physician in a
caregiver or parent role?
Transference. When it is from the physician to the patient it
is called countertransference.
Q1129:What phase of Food and Drug Administration
approval tests;? The efficacy and occurrence of side effects in
large group of patient volunteers?
Phase III. It is considered the definitive test.
approval tests;? The safety in healthy volunteers?
Phase I
approval tests;? The protocol and dose levels in a small group
of patient volunteers?
Phase II
Q1132:In biostatistics; what are the three criteria required to
increase power?
1. Large sample size ;2. Large effect size ;3. Type I error is
greater
Q1133:If the occurrence of one event had nothing to do with
the occurrence of another event; how do you combine their
probabilities?
Since they are independent events; their probabilities would
be multiplied.
Q1134:What type of random controlled test is least subjective
to bias?
Double-blind study. It is the most scientifically rigorous
study known.
Q1135:Why isn't the incidence of a disease decreased when a
new treatment is initiated?
Because incidence is defined as new events; treatment does
not decrease the number of new events. It does decrease the
number of individuals with the event (prevalence would
decrease).
Q1136:Formula for prevalence?
Prevalence = (total cases in population at a given time)/(total
population)
Q1137:Formula for Incidence?
Incidence = ;(NEW cases in population over a given time
period)/(total population at risk during that time);*Note:
when calculating incidence; don't forget that people peviously
positive for a disease are no longer considered at risk.
Q1138:Prevalence is approximately equal to (formula)?
Prevalence is approx. to incidence * disease duration
Q1139:When is prevalence > incidence?
chronic diseases (e.g; diabetes)
Q1140:When is prevalence = incidence?
acute diseases (e.g; common cold)
Q1141:Sensitivity is the number of […] divided by the
number of all people with the disease.
Sensitivity is the number of TRUE POSITIVES divided by
the number of all people with the disease.
Q1142:Sensitivity is the probability of a […] given that a
person has the disease.
Sensitivity is the probability of a POSITIVE TEST given that
a person has the disease.
Q1143:Specificity is the number of […] divided by the
number of all people without the disease.
Specificity is the number of TRUE NEGATIVES divided by
the number of all people without the disease.
Q1144:Specificity is the probability of a […] given that a
person is free of the disease.
Specificity is the probability of a NEGATIVE TEST given
that a person is free of the disease.
Q1145:The false […] rate is equal to 1-sensitivity.
The false NEGATIVE rate is equal to 1-sensitivity.
Q1146:The false […] rate is equal to 1-specificity.
The false POSITIVE rate is equal to 1-specificity.
Q1147:Formula for PPV?
PPV = a/(a+b)
Q1148:Formula for NPV?
NPV = d/(c+d)
Q1149:Formula for sensitivity?
sensitivity = a/(a+c)
Q1150:Formula for specificity?
specificity = d/(b+d)
Q1151:Number of true positives divided by the number of
people who tested positive for the disease?
Positive Predictive Value (PPV)
Q1152:The probability of having a condition given a positive
test?
Positive Predictive Value (PPV)
Q1153:The number of true negatives divided by the number
of people who tested negative for the disease?
Negative Predictive Value (NPV)
Q1154:The probability of not having the condition given a
negative test?
Negative Predictive Value (NPV)
Q1155:Unlike sensitivity and specificity; predictive values
are dependent on the […] of the disease.
Unlike sensitivity and specificity; predictive values are
dependent on the PREVALENCE of the disease.
Q1156:Odds Ratio (OR)?
Odds of having disease in exposed group divided by odds of
having disease in unexposed group.
Q1157:For Odds Ratio; odds are calculated […] as the
number with disease divided by the number without disease.
For Odds Ratio; odds are calculated WITHIN A GROUP as
the number with disease divided by the number without
disease.
Q1158:In what situation does Odds Ratio (OR) approximate
Relative Risk?
if prevalence of disease is not too high.
Q1159:Odds Ratio is used for […] studies.
Odds Ratio is used for CASE-CONTROL studies.
Q1160:Formula for Odds Ratio?
OR = (a*d)/(b*c)
Q1161:Formula for Relative Risk?
RR = a/(a+b) divided by c/(c+d)
Q1162:Formula for Attributable Risk?
AR = a/(a+b) minus c/(c+d)
Q1163:Relative Risk (RR)?
Disease risk in exposed group divided by disease risk in
unexposed group.
Q1164:Risk is calculated […] as the number with disease
divided by the total number of people in the group.
Risk is calculated WITHIN A GROUP as the number with
disease divided by the total number of people in the group.
Q1165:Relative Risk (RR) is used for […] studies.
Relative Risk (RR) is used for COHORT studies.
Q1166:To commit a Type I error (alpha) is to state what?
There IS an effect or difference when none exists (to
mistakenly accept the experimental hypothesis and reject the
null hypothesis).
Q1167:p is judged against […]; a preset level of significance
(usually < 0.05).
p is judged against alpha; a preset level of significance (usually
< 0.05).
Q1168:p = ?
p = probability of making a type I error.
Q1169:If p < 0.05; then there is less than a 5% chance that
[…].
If p < 0.05; then there is less than a 5% chance that THE
DATA WILL SHOW SOMETHING THAT IS NOT
REALLY THERE.
Q1170:Layman's way of describing alpha?
alpha = you "saw" a difference that did NOT exist--for
example; convicting an innocent man.
Q1171:In a four quadrant box; power lies in what region?
Power is at the intersection of column H1 (reality) and row
H1 (study results)
Q1172:In a four quadrant box; alpha lies in what region?
Alpha is at the intersection of column H0 (reality) and row
H1 (study results)
Q1173:In a four quadrant box; beta lies in what region?
Beta is at the intersection of column H1 (reality) and row H0
(study results)
Q1174:To commit a Type II error (beta) is to state what?
There is NOT an effect or difference when one exists (to fail
to reject the null hypothesis; when; infact H0 is false).
Q1175:Beta is the probability of making a type […] error.
Beta is the probability of making a type II error.
Q1176:Layman's way of describing beta?
Beta = you did not "see" a difference that does exist--for
example; setting a guilty man free.
Q1177:Qualitative definition of Power?
Power is the probability of rejecting the null hypothesis when
it is; in fact; false.
Q1178:Power depends upon what (3 items)?
1. Total number of end points experienced by population;2.
Difference in COMPLIANCE b/w treatment groups
(differences in the mean values b/w groups);3. Size of
expected effect.
Q1179:If you […] sample size; you increase Power.
If you INCREASE sample size; you increase Power. There is
Power in numbers.
Q1180:Formula for SEM?
SEM = SD/(square root of sample size)
Q1181:SEM […] SD?
SEM < SD?
Q1182:SEM […] as sample size increases?
SEM DECREASES as sample size increases?
Q1183:For a Normal (Gaussian) distributional curve; SD of 1
= x%?
SD 1 = 68%
= x%?
SD 2 = 95%
= x%?
SD 3 = 99.7%
Q1186:CI = range from […] to […]?
CI = range from [mean - Z(SEM)] to [mean + Z(SEM)]
Q1187:The 95% CI corresponds to what p value?
p = 0.05
Q1188:For the 95% CI; Z = […].
For the 95% CI; Z = 1.96.
Q1189:If the 95% CI for a […] between 2 variables includes
0; then there is no significant difference and H0 is NOT
rejected.
If the 95% CI for a MEAN DIFFERENCE between 2
variables includes 0; then there is no significant difference and
H0 is NOT rejected.
Q1190:If the 95% CI for […] or […] includes 1; then H0 is
NOT rejected.
If the 95% CI for ODDS RATIO or RELATIVE RISK
includes 1; then H0 is NOT rejected.
Q1191:Chi squared checks what?
difference b/w 2 or more percentages or proportions of
categorical outcomes (NOT mean values).
Q1192:Chi squared =
compare percentages (%) or proportions
Q1193:r squared =
Coefficient of determination
Q1194:Mnemonic for reportable diseases IN ALL STATES?
"B.A. S.S.S.M.M.A.R.T. Chicken or you're Gone:" ;Hep
B;Hep
A;Salmonella;Shigella;Syphilis;Measles;Mumps;AIDS;Rubell
a;TB;Chickenpox;Gonorrhea
Q1195:Which disease can vary by state for reporting?
HIV
Q1196:Medicare Part A =
hospital
Q1197:Medicare Part B =
doctor bills
Q1198:when both a living will and power of attorney exist;
which supersedes the other?
power of attorney
Q1199:stages of grief
denial; anger; bargaining; grieving; acceptance
Q1200:how do you treat DTs?
benzodiazapenes
Q1201:what are the characteristics of DTs?
autonomic system hyperactivity (tachycardia; tremors;
axiety); psychotic sx (hallucinations; delustions); confusion
Q1202:sleep patterns of depressed patients?
decreased slow-wave sleep; decreased REM latency; early
morning awakening
Q1203:what is malingering?
patient conciously fakes or claims to have a disorder in order
to attain a specific gain
Q1204:what is a facticious disorder?
conciously creates sx in order to assume 'sick role' and get
medical attention - motivation is unconscious
Q1205:what is gamophobia?
fear of marriage
Q1206:what is algophobia?
fear of pain
Q1207:what is acrophobia?
fear of height
Q1208:what are the characteristics of an adjustment disorder?
emotional symptoms (anxiety; depression) causing
impairment following an identifiale psychosocial stressor (e.g.
divorce; moving); and lasting <6 months
Q1209:what do you call a false blief not shared with other
members of culture/subculture that is firmly maintained in
spite of obvious proof to the contrary?
delusion
Q1210:what the difference between a hallucination and an
illusion?
hallucination - perception in the absence of external stimuli;
illusion - misinterpretations of actual stimuli
Q1211:when does hypnagogic hallucination occur?
when GOing to sleep
Q1212:tactile hallucinations are common when?
Dts; cocaine abusers
Q1213:when do hypnopompic hallucinations occur?
while waking from sleep
Q1214:how do you treat narcolepsy?
stimulants; e.g. amphetamines
Q1215:what is a schizoaffective disorder?
a combination of schizophrenia and a mood disorder
Q1216:paranoid; schizoid; schizotypal personality disorders
fall into what cluster?
cluster A - weird
Q1217:antisocial; borderline; histrionic; narcissistic
personality disorders fall into what cluster?
cluster B - wild
Q1218:avoidant; obsessive-compulsive; dependent
personality disorders fall into what cluster?
cluster C - worried
Q1219:cluster A personality disorders are characterized by
what?
odd or eccentric; can't develop meaningful social relationships'
no psychosis; but genetic association with schizophrenia
Q1220:personality disorder characterized by distrust and
suspiciousness; projection is main defense mechanism
paranoid
Q1221:personality disorder characterized by voluntary social
withdrawal; limited emotional expression
schiziod
Q1222:personality disorder characterized by interpersonal
awkwardness; odd beliefs or magical thinking; eccentric
appearance
schizotypal
Q1223:characteristics of cluster B personality disorders?
dramatic; emotional; or erratic; genetic association with mood
disorders and substance abuse
Q1224:personality disorder characterized by disregard for and
violation of rights or others; criminality
antisocial
Q1225:personality disorder characterized by unstable mood
and interpersonal relationships; impulsiveness; sense of
emptiness
borderline
Q1226:personality disorder characterized by excessive
emotionality; attention seeking; sexually provocative
histrionic
Q1227:personality disorder characterized by grandiosity;
sense of entitlement; may react to criticism with rage; may
demand 'top' physician/best health care
narcissistic
Q1228:personality disorder characterized by sensitivity to
rejection; social inhibition; timid; feelings of inadequacy
avoidant
Q1229:what are the characteristics of cluster C personality
disorders?
anxious or fearfull; genetic association with anxiety disorders
Q1230:personality disorder characterized by submissive and
clinging; excessive need to be taken care or; low self-
confidence
dependent
Q1231:personality disorder characterized by preoccupation
with order; perfectionism; and control
obsessive-compulsive
Q1232:moro reflex
can be elicited by any startling event; extension and abduction
of the arms; followed by adduction of arms - normally
disappears between 3-6 months
Q1233:palmar grasp reflex
infant's hand closing over an object that is placed in palm of
hand - normally disappears at 2 months
Q1234:tonic neck reflex
extension of ipsilateral leg and flexion of the contralateral arm
when the head is turned - normally disappears between 7-8
months
Q1235:what is prosopagnosisa and what causes it?
inability to recognize faces - usually caused by a bilateral
lesion of the visual association cortex
Q1236:what is anosagnosia and what causes it?
deficit in cognition about one's illnes; or the lack of awareness
that one is suffering from a certain condition - related to large
lesions of hte nondominant parietal lobe; which causes the
pateint to be confused and unaware of motor and sensory
deficits
Q1237:what is confabulation?
fabrication of stories and events that never happened in order
to fill in memory gaps; seen mostly in dementias
Q1238:what is conversion disorder?
characterized by one or more neurologic symptoms (motor;
sensory; or changes in consciousness such as pseudoseizures)
associated with unresolved psychological conflicts - sx are
unconscious and develop as a result of repressed anxiety
about the unacceptable impulses
Q1239:what is Ganser syndrome?
dissociative disorder NOS - giving approximate answers
instead of exact ones - associated with other sx like amnesia;
disorientation; and perceptual disturbances. seen most
commonly in prison inmates
Q1240:dissociative disorder defined by combination of
amnesia plus travel
psychogenic fugue - patient typically regains awareness after
traveling to a different locale but retains no memory of the
trip of the decision to go on it
Q1241:what is somnambulism?
sleep walking - disorder of stage 4 sleep
Q1242:what is mobius syndrome?
congenital facial diplegia - face is expressionless; and ocular
palsy may be present. frequently accompanied by clubfoot
and syndactyly and MR
Q1243:what is pseudodementia?
major depression in an elderly person - all of the symptoms
of a depressive disorder without hallmarks of an organic
condition
Q1244:what is the Tarasoff I decision?
requires that physicians warn a potential victim if they truly
believe the patient will cause harm to that person
Q1245:what is the Tarasoff II decision?
states that even though physicians must warn a potential
victim; they must also protect the patient from harm from
that person
Q1246:the irresistible impulse rule and the McNaughten rule
are involved in what?
insanity defenses
Q1247:the combination of an MAOI with what drug
produces a severe reaction; including delerium; hyperpyrexia;
convulsions; and hypertension
meperidine
Q1248:intelligence scale best for younger children since it
doesn't rely exclusively on language
stanford-binet
Q1249:scale used to assess the attainment of developmental
milestones in children younger than 2 years
denver developmental scale
Q1250:age group for which WAIS-R is used
17 and older (think rated R)
Q1251:age group for which WISC III is used
16-Jun
Q1252:age group for which WPPSI is used
6-Apr
Q1253:person acts out dreams in what sleep disorder?
REM sleep disorder - normal paralysis of muscles during
REM sleep is absent; content of dreams often violent or
aggressive
Q1254:what sleep disorder encompasses both night terrors
and sleepwalking?
non-REM sleep disorder - people do not act out dreams in
either condition
Q1255:child's awareness of the conservation of volume occurs
between what ages and is what stage?
7-11 years - concrete operations
Q1256:between what ages is the preoperational stage?
2-7 years
Q1257:the sensorimotor stage corresponds to what ages?
0-2
Q1258:learning by reinforcement is what type of
conditioning?
operant
Q1259:toilet training is not possible before what age?
18 months
Q1260:stranger anxiety; orientation to voice occurs at
approximately what age?
7-9 months
Q1261:when does separation anxiety occur?
between 10-12 months
Q1262:when does the social smile appear?
2-3 months
Q1263:what is the infant mortality rate equal to?
the number of deaths occuring until the first birthday divided
by the total number of live births
Q1264:this is a projective test htat uses pictures depicting
ambiguous interpersonal situations that the examinee is asked
to interpret
the thematic apperception test
Q1265:this is the most popular objective personality test; it
uses true and false items
minnesota multiphasic personality inventory
Q1266:a relationship between what neurotransmitter and
aggression has been found?
serotonin
Q1267:a study that is chosen based on presence or absence of
disease and then information collected about risk factors
case-control study
Q1268:a cohort study is what kind of study?
observational
Q1269:in this type of study; the sample is chosen about
presence or absence of risk factors and subjects are followed
over time for development of disease
cohort study
Q1270:define prevalence
total cases in population at a given time/ total population
Q1271:define incidence
new cases in population over a given time period/total
population at risk during that time
Q1272:for what type of diseases is prevalence greater than
incidence?
chronic diseases
Q1273:for what type of diseases does prevalence equal
incidence?
acute diseases
Q1274:for what type of test is high sensitivity desirable?
screening
Q1275:define sensitivity and give formula
number of true positives divided by number of all people with
the disease: a/a+c
Q1276:how do you calculate the false negative rate?
1-sensitivity
Q1277:for what type of test is high specificity desirable for?
confirmatory test
Q1278:define specificity and give formula
number of true negatives divided by number of all people
without the disease: d/b+d
Q1279:1-specificity is equal to what?
false positive rate
Q1280:what is positive predictive value and how do you
calculate it?
probability of havinig a condition given a positive test -
number of true positives divided by number of people who
tested positive for the disease: a/a+b
Q1281:what is negative predictive value and how do you
calculate it?
probability of having a condition given a negative test -
number of true negatives divided by number of people who
tested negative for a disease: d/c+d
Q1282:which are dependent on the prevalence of disease:
sensitivity/specificity or predictive values?
predictive values
Q1283:when prevalence is higher; what increases?
positive predictive value
Q1284:when prevalence is lower what increases?
negative predictive value
Q1285:what is an odds ratio?
odds of having disease in exposed group divided by odds of
having disease in unexposed group (odds calculated within
group as number with disease divided by number without
disease)
Q1286:what is the formula for odds ratio?
(a/b)/(c/d) = ad/bc
Q1287:what is relative risk?
disease risk in exposed group dividd by disease risk in
unexposed group - risk is calculated within a group as number
with disease divided by total number of people in group
Q1288:what is the formula for relative risk?
a/(a+b)/c/(c+d)
Q1289:what is a type I error?
stating that there is an effect when none exists; equal to p
Q1290:what is a type II error?
stating that there is not an effect of difference when one exists
(power= 1-type II)
Q1291:what does Z equal for the 95% confidence interval?
1.96
Q1292:what is the formula for confidence interval?
CI=range from (mean-Z(SEM) to (mean+Z(SEM)
Q1293:what does standard error of the mean equal?
standard deviation/square root of n
Q1294:a t-test checks the difference between what?
the means of 2 groups
Q1295:what does ANOVA check?
the difference between the means of 3 or more groups
Q1296:what does chi square check?
difference between 2 or more percentages or proportions of
categorical outcomes (not means)
Q1297:mean > median > mode is what kind of skew?
positive - tail on right
Q1298:mean < median < mode is what kind of skew?
negative - tail on left

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