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    New BehavioralScience FAE2016

    Uploaded by

    Selena Gajić
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    © All Rights Reserved
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    69 rnc 216 wnat enavons Sonce ont Behavioral Science AOR ee RR cs ented Using this table as a guide, read the Facts in First Aid for the USMLE Step 1 2016, watch the corresponding First Aid Express 2016 videos, and then answer the workbook questions. ony rr et ie 2016 321-381 Epidemiology'Biostatisties (5 videos) | 1-42 30.2-40.1 Ethics (1 video) 43-70 4BAAT Development and Aging (1 video) | 71-73 44288 4 Public Health 7481 page 2 First Aid Express 2016 workbook: BEHAVIORAL SCIENCE EPIDEMIOLOGY/BIOSTATISTICS 1. A case-control study is described as (experimentaobservational) and (prospectivelretrospective). (p32) 2A cohort study is described as (experimentafobservational) and (prospectiveiretrospectivey. (p22) 3. True or False: In a cohort study, subjects are chosen on the basis of the presence or absence of risk factors. © 32) - 4. True or False: A cohort study involves following subjects over a period of time to study the development of disease. (p32) - 5. True or False: A cross-sectional research study can show the correlation of a risk with a disease. (p 92) 6. Describe single-, double-, and tiple-blinded studies. (p 32) 7. What is the purpose of Phase Ill einical trials? (p 22) 8. How does a low prevalence of disease affect the positive predictive value of a test? (p 33) 9. Screening tests (eg, the ELISA in HIV testing) are (sensitivelspecific) and have a high false {negativespositwey rate, wath a (righviow) threshold. (p 33) 10. Confimnatory testing (eg, a Wester bt in HIV testing) is (sensitwerspectic) and has a high false— (negative/positive) rate, with a (highlow) threshold. (p 23) 11. How does a low prevalence of disease affect the negative predictive value of a test? (p 33) 12. Madiagnostic test has 100% sensitivity, what should the value of the false-negative rate equal? (0.33) 13. fadiagnostic test has 100% specificity, what should the value ofthe false-positive rate equal? 03) 14. What measure of disease frequency is calculated by dividing the total number of cases in the population at a given time by the total population at a oven time? (p 33) 18. 16. 17 8. 19. 21 2 First Aid Express 2016 workbook BEHAVIORAL SCIENCE page 3 What measure of disease frequency is calculated by dividing the number of new cases in the population during a period by the total population at risk during that time? (p 33) In chronic disease states such as diabetes is the prevalence of disease greater than, less than, or ‘equal to the ineidence? (p 33) In acute disease states such as a common cold is the prevalence of disease greater than, legs than, or equal to incidence? 033) True or False: When calculating the incidence of a disease, the total population at nsk during a certain time should include people. who have the disease. (p33). ‘The statement "Patients with COPD were more likely to have a history of smoking than those ‘without COPD" pertains to (odds ratio/retative risk). (0 34) The statement "Smokers were more likely to develop COPD than nonsmokers" pertains to (odds ratio/retative isk). (p 34) ‘True or False: The odds ratio for a disease based on exposure to a risk factor approximates the relative nsk f the prevalence of the disease is low. (p 34) How is the relative risk reduction calculated? (p 34). ‘What epidemiologic measurement is equal to the difference in disease incidence between an ‘exposed group and an unexposed group? (p 34) (Precision/accuracy) refers to the trueness of test measurements (validity), and (precision/accuracy) refers to the consistency and reproducibilly of a test or the ‘absence of fandom vaniation ina test. (p25) (Random/systematic) error reduces precision in a test, and (andomisystemie) error reduces accuracy in a test. (p 35) Name four ways to reduce bias in epidemiologic studies. (p 36) ‘What type of bias oceurs when there are two closely associated factors and therefore the effect of ‘one factor could change or confuse the effect of the other? (p 36) ‘What is the name of the phenomenon whereby a researcher's belief in the efficacy of a treatment changes the outcome of that treatment? (p 36) In a data set that has a distnbution with @ negative skew, what is the relationship between the mean, the median, ‘and the mode? © mm {In a data set that has a distribution with a positive skew, what is the relationship between the mean, the median, and the mode? (p 37) voaes ristaaEeress201swotesor aevavona. scence (EM) 31. Which characteristic is least affected by outliers: mean, median, or mode? (p 37) 32. What is the term for the hypothesis that there is no association between the variables being studied? © 37) 33. Ina data set that has a normal (Gaussian) distribution, what percentage of the data fas within two standard deviations af the mean? What percentage falls within 3 SDs of the mean? (p 27) 34. In statistical calculations, the P value is equal to the probability of making what type of error? (p 38) 35. Ina slatistical analysis, if P = 0.03, what is the probability that the data will show a difference by chance alone when none truly exists? (p 36) 36. In statistical analysis, if = 0.2, what is the probability that the null hypothesis has been falsely accepted? (p98) 37. The power of a statistical test depends on which three factors? (p 38) 38. What study parameter is calculated when the probability of making a type Il error is subtracted from 19 (p37) 39. If the 95% confidence interval for a mean difference between two variables includes 0, the null hypothesis (Gsiis not) rejected. (p 38) 49. What type of statistical test is used to check for a difference between the means of thtee or more ‘groups? (p 36), 41. What type of statistical test is used to check for a difference between the means of two groups? 39) 42. What statistical term's absolute value indicates the strenath of the correlation between two variables? © 39) ETHICS 43. What are the four core ethical principles of medicine? (p 29) 44. True or False: Patient autonomy may contfict with beneficence. (p 29) 45. Which right is being exercised when a patient makes an informed decision to proceed with a ‘medical treatment when the benefits ofthe intervention outweigh its risks? (p 39) 48. What must be explained by a doctor to obtain informed consent? (p 40). a7 51 60 First Aid Express 2016 workbook: BEHAVIORAL SCIENCE page 5 What are the four exceptions to informed consent? (p 40) Name four conditions in which 2 minor may be considered emancipated. (p 40) What five requirements must be met in order to determine that a patient has full decision-making capacity? (p 40) \What term refers to an incapacitated patient's previous oral statements, which are commonly used to guide medical deesions? (p 417) What four factors give greater valicty toa patient's oral advance directive? (p 41) What is the term for the legal document that describes treatments the patient wishes to receive or not receive if he/she becomes incapacitated and cannot communicate about treatment decisions? 41) \What legal tem refers to.a patient's authorization ofa surrogate to may make medical decisions in the evert that the patent loses decision-making capacity? (p 41) True oF False: When authorizing a medical power af attomey, the patient may specify decisions that are tobe = made_=in.— certain clinical’—stuations. § (p41) True or False: A patient's agent authorized with medical power of attorney retains that power unless it is revoked by the patient © 41) Which type of advance directive provides greater flexibilty, a living will or a medical power of attorney? (p41) What standard should be used to determine the amount of medical information to disclose toa patient's family or friends? (p 41) In the case of serious infectious diseases, a physician may have a duty to break patient confidentialty to wam certain groups ‘of people. Name the two groups. (p 41) What legal precedent requires physicians to directly inform and protect @ potential victim from harm, even iit involves a breach of confidentiality? (p 41) A child presents to the emergency department with multiple fractures and bruises of different ages. ‘The patient's mother requests that authonties not be involved. Must the physician respect her request for confidentiality? Why or why not? (p 41) page 6 Furst Aid Express 2016 workbook: BEHAVIORAL SCIENCE 61 ‘A young woman confides to her physician that she has considered ending her life by ingesting a boltle's worth of her prescription pills, and that she does not want anyone else to know of her plan. ‘Must the physician respect her request for nondisclosure? Why or whiy not? (p 41) ‘A patient discloses that he frequently drives after consuming four or fwe drinks at the bar. In the office, the patient clearly has been drinking alcohol and has arrived on his own. Is the physician obligated to uphold confidentiality? Why or why nol? (p 41), — First Aid Express 2016 workbook: BEHAVIORAL SCIENCE page 7 63. True or False: A patient's family can require that a doctor withhold information from the patient. (41) 64. What is an appropriate response to a patient who is upset about how he or she was treated by another doctor? (p 42) 65. What is an appropriate response to a child who wishes to know more about his or her'lness? 42) 86. What is an appropriate response to a patient who is nancampliant? (p 42) 67. What is an appropriate response to a 17-year-old gi who is pregnant and requests an abortion? (p 42) 68. What is an appropriate response to a terminally ill patient who requests physician assistance with tending his or her ite? (p 42) 69. What is an appropriate response to a patient who refuses a necessary procedure or desires an unnecessary one? (p 42) 70. What is an appropriate response to a patient who states that he or she finds you attractive? (p 42) DEVELOPMENT AND AGING 71. What is the approximate age of a child who is anxious when separated from his or her mother? 43) 72. What is the approximate age range of a child who plays alongside, but not with, another child? 43) 73. What sexual changes normally occur in elderly men? (p 44) page 8 First Aid Express 2016 workbook: BEHAVIORAL SCIENCE PUBLIC HEALTH 78. 79. at Give an example of primary, secondary, and tertiary disease prevention strategies. (p 44) Primary: Secondary Tertiary ‘What two federally funded healthcare programs originated from amendments to the Social Security ‘Act? Who is eligible for each of these these programs? (p 44). ‘What is the most common cause of death in young adults? (p 45). What is the most frequent cause of readmissions for patients with Medicaid? (p 45) ‘What are the four components of the process improvement model? (p 45) P. . se A__ Match the examples with the corresponding quality measurement. (p 46) A. Outcome 1. Average HbA,. of patients with diabetes B. Process: 2. Incidence of hypoglycemia among patients with ©. Balancing measured HDA. 3. Ratio of patents whose HbA. was measured in the past 6 months Patient misidentifiation is an example of. {activellatent) errar. (p46) Root cause analysis is a, (prospectivefretrospective) approach to analyzing medical error. (p 45) First Aid Express 2016 workbook: BEHAVIORAL SCIENCE page 9 EPIDEMIOLOGY/BIOSTATISTICS retrospective. prospective (more common) or retrospective. a Tne, 4. True for prospective cohort studies. 5 True. (However, it cannot show causality.) 6. _In-single-blind studies, subjects are not aware of their study-group assignment. In double-blind studies, neither doctors nor subjects are aware of study-group assignment. Intriple-blind studies, the researchers analyzing the data are also unaware of study-group assignment 7. Tocompare the efficacy of the new treatment with the current standard of care. 8. The positive predictive value of the test is lower for a disease that has a lower prevalence. Sensitive, positive, low. 10. Specific; negative; high 11. The negative predictive value of the testis higher for a disease that has a lower prevalence, 12. It should equal 0. (All cases of the disease are detected by the test.) 13. It should equal 0. (All patients without the disease are identified correct.) 14. Point prevalence. 15. Incidence. (Incidence refers to new incidents). 16. Much greater than the annual incidence (because of the long duration ofthe disease). 17. Approximately equal (for diseases of short duration). 18. False. (The total population at risk during a certain period should not include people who have the disease because incidence is a measure of new cases of a disease, those who have the disease are not at risk of getting the disease.) 19. Odds ratio. 20. Relative nsk. 21 Tre, page 10 First Aid Express 2016 workbook: BEHAVIORAL SCIENCE 22. 1—Relative risk = 1 —[ailarb)yfel(e+d)] 23. Alibutable risk; itis the percentage of cases of a disease caused by a risk factor. 24. Accuracy, precision, 25. Random; systematic. 28. Use blinded studies (preferably double blind), assess placebo responses, perform a crossover study, and use randomization, 27. Confounding bias, in which the causal relationship is better explained by a variable other that the one being studied. 28. Observer-expectancy effect 23, Mean < median < mode 80. Mean > median > mode. 31. Mode, 82. Null hypothesis, 83, 95% fall within 2SDs of the mean, and 99.7% fall within 3SDs of the mean. 34, Type | etror (a). (This type of error occurs when itis incorrectly concluded that an association is present) 35. 3%. 38. 20%. (This is generally considered an acceptable level for 8 in a study design). 37. The sample size, precision of measurement, and the size of the expected effect. 38. Power. 39. If the 95% Cl includes 0, the null hypothesis is not rejected because there is no significant difference between the two variables. 40. Analysis of variance (ANOVA). At Hest 42. Correlation evefficient (9. ETHICS 43. Autonomy, beneficence, nonmaleficence, and justice. 44 True 45. Autonomy. rt ines 201 vo ORAL CENCE vet 46. 41. Bees AsRre- sg or ‘The risks and benefits of the proposed intervention, and the risks and benefits of the alternatives (including doing nothing). If the patient lacks decision-making capacity; ifthe situation is emergent; if disclosure of information would harm the patient, and i the patient waives the right of informed consent. Ifthe minoris married, self-supporting, has children, or isin the ritary ‘The patient must make and communicate a choice; the patient must be informed; the decision must remain stable aver time; the decision must be consistent with the patient's values and goals; and the decision cannot be a result of delusions or hallucinations. Oral advance directive. ‘The patient was informed, the directive is specific, the patient made a choice, and the decision was repeated overtime. Living will e, written advance directive) Durable power of attorney. Tne. Tne. ‘A durable power of attomey, The disclosure of information to family or fiends should be guided by what the patient would want Public officials and identifiable people who may be at isk. “The Tarasoff Decision. No, a physician may break confidentially to report the abuse (or suspected abuse) of a child or an elderty person No; a physician may break confidentiality ta report a suicidal or homicidal patient. No; a physician can break confidentiality to report an impaired driver. False. (A patient's family cannot require the physician to withhold information from the patient ) ‘Suggest that the patient speak directly to that physician about the concerns. Ifthe problem is with a ‘member of the office staff, inform the patent that you will speak to that person. ‘Ask the parents what they have told the child about his or her illness. (The parents decide what information should be relayed to the child about the illness.) ‘Attempt to identify the patient's reason for nonadherence and whether he or she is willing to change the behaviar Do not force the patient ta comply ar refer the patient to ancther physician, Many states require parental noification or consent for minors to have an abortion. However, parental consent is not required for emergency situations, the treatment of sexually transmitted diseases, medical care during pregnancy, prescriptions for contraceptives, or the management of ‘drug addiction. pone 2 Fic At Eres 2016 woook senavonaa science (EE 6 70. In most states, physicians should refuse to be involved in any form of assisted suicide; however, the physician may prescribe medically appropriate analgesics that coincidentally shorten the patients life ‘Attempt to understand why the patient wants or does not want the procedure; address the underlying concems, and avoid performing unnecessary procedures. Ask direct closed ended questions and use a chaperone if necessary. (Romantic relationships with patients are never appropriate.) DEVELOPMENT AND AGING n rp. 1B ‘9 months. 124 to 48 months (parallel play). ‘Slower erection/ejaculation and a longer refractory period PUBLIC HEALTH 74 %. 7. n 7 7 at Vaccination is @ primary disease prevention strategy, because the vaccinated person is not considered susceptible to the disease. A Pap smear is secondary disease prevention, since it can

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