You are on page 1of 96


Both hypnagogic (just

before sleep) and
Are hallucinations common in
hypnopompic (with
narcolepsy patients?
awakening) are both

Sudden collapse (falls asleep)

Define cataplexy.
while awake.

Person stops breathing for at

Define sleep apnea. least 10 seconds during

"In central sleep apnea, there

is no respiratory effort. In
Distinguish between central
Obstructive sleep apnea,
and obstructive sleep apnea.
there is respiratory effort
against airway obstruction."
Yes. Studies have shown a
Does narcolepsy have a
strong genetic component of
genetic component?

Does REM sleep increase or

decrease with age?

Extraocular movements Parapontine Reticular

during REM sleep are due to Formation/Conjugate Gaze
what portion of the brain? Center

Every 90 minutes (duration

How often does REM sleep
may increase during the
Name 1 neurotransmitter
change associated with Decreased Ach
Alzheimer's disease.

Name 1 neurotransmitter
change associated with Decreased Dopamine
Parkinson's disease.

Name 1 neurotransmitter
change associated with Increased Dopamine

"1. Induces production of

FFA, 17-OH corticosteroids,
Name 2 effects of stress on lipids, cholesterol, and
the body. catecholamines 2. Affects
water reabsorption, muscular
tonicity, gastrocolic reflex,
and mucosal circulation."
Name 2 neurotransmitter
Decreased NE and serotonin
changes associated with

Name 2 neurotransmitter
changes associated with Decreased GABA and Ach
Huntington's disease.

1. Reduced slow-wave sleep

Name 3 changes in sleep 2. Decreased REM latency 3.
stages often found in people Early morning awakening
with depression. (important screening

Name 3 possible findings in "Sleepwalking, night terrors,

non-REM sleep. and bedwetting"
"Increased/variable pulse,
rapid eye movements,
Name 4 physiological actions
increased/variable blood
found in REM sleep.
pressure, and penile/clitoral

"Dreaming, loss of motor

Name 5 possible findings in tone, possible memory
REM sleep. processing function, erection,
and increased brain 02 use"

"Alpha, Beta (highest

frequency, lowest amplitude),
Name 5 possible waveform
Theta, Delta (lowest
patterns seen in the various
frequency, highest
sleep/wake stages.
amplitude), Sleep spindles
with K-complexes"

"Concentration, Orientation,
Name 7 functions of the Language, Abstraction,
frontal lobe. Judgment, Motor regulation,
Name a possible chronic
Chronic fatigue
outcome of sleep apnea.

"Obesity, loud snoring,

Name five findings associated systemic/pulmonary HTN,
with sleep apnea. arrhythmias, and possibly
sudden death."

"1. Drugs (e.g. antiHTN,

neuroleptics, SSRIs, and
What 3 things does the
ethanol) 2. Diseases (e.g.
differential diagnosis for
depression and diabetes) 3.
sexual dysfunction include?
Psychological (e.g.
performance anxiety)"

What is a common treatment Stimulants (e.g.

for narcolepsy? amphetamines)
What is a helpful mnemonic
for the order of the
corresponding waveform "At night, BATS Drink Blood."
patterns in each stage of

What is considered the key to Serotonergic predominance of

initiating sleep? the raphe nucleus

What is narcolepsy? Person falls asleep suddenly

What is the most notable

change in function in a Lack of social judgment
frontal lobe lesion?
What is the principal
neurotransmitter involved in Ach
REM sleep?

What medication shortens

stage 4 sleep and can be Imipramine
used to treat enuresis?

What medication shortens

stage 4 sleep and is useful in
the treatment of night terrors
and sleepwalking?

What neurotransmitter can

reduce REM sleep?
What percentage of time is
spent in REM sleep?

What percentage of time is

spent in stage 1 sleep?

What percentage of time is

spent in stage 2 sleep?

What percentage of time is

spent in stage 3-4 sleep?
What phenomenon caused The EEG pattern during REM
REM sleep to be known as sleep is the same as the EEG
'paradoxical' or of a person that is awake and
'desynchronized' sleep? alert.

"What waveform pattern is

seen in a young adult who is
awake (eyes open), alert, and Beta waves
has active mental

What waveform pattern is

seen in a young adult who is
Alpha waves
awake but has his/her eyes

What waveform pattern is

Sleep spindles and K-
seen in a young adult who is
in deeper (stage 2) sleep?
What waveform pattern is
seen in a young adult who is Theta waves
in light (stage 1) sleep?

What waveform pattern is

seen in a young adult who is Beta waves
in REM sleep?

"What waveform pattern is

seen in a young adult who is
Delta waves
in the deepest, Non-REM
(stage 3-4) sleep? "

A person who is unable to

remember things that
Anterograde Amnesia
occurred after a CNS insult
Anterograde amnesia caused
Korsakoff's amnesia
by thiamine deficiency?

Are DT's life threatening? Yes

Are the illness production and

motivation in somatoform No
disorders consicous drives?

Bipolar I describes? manic

Bipolar II describes? hypomanic

"Distinct period of abnormally

and persistently elevated,
Define a Manic episode.
expansive, or irritable mood
lasting at least 1 week"

Discrete period of intense

fear and discomfort peaking
Define a panic disorder.
in 10 minutes with 4/5

Define Anosognosia. being unaware that one is ill

Being unable to locate one's
Define Autotopagnosia.
own body parts

"symptoms suggest motor or

sensory neurologic or
Define Conversion disorder.
physical disorder, but tests
and PE are negative"

body seems unreal or

Define depersonalization.

"when patterns become

inflexible and maladaptive,
Define Personality disorder causing impairment in social
or occupational functioning
or subjective distress"
"an enduring pattern of
perceiving, relating to, and
thinking about the
Define Personality trait. environment and oneself that
is exhibited in a wide range
of important social and
personal contexts"

false beliefs not shared by

other memebers of culture/
Delusions are…. subculture that are firmly
maintained in spite of
obvious proof to the contrary

distrustful and suspicious;

Describe a Paranoid
projection is main defense

voluntary social withdrawl; no

Describe a Schizoid
psychosis; limited emotional
"interpersonal awkwardness,
Describe a Schizotypal
odd thought patterns and

Does the person who has the

"yes, they are exhibiting
phobia recognize their fear as

Does the phobic fear interfere

with normal routine?

perceptions in the absence of

Hallucinations are….
external stimuli
as odd or ecentric; cannot
How are Cluster A
develop meaningful social
personalities described?
relationships; Weird

How are Cluster B "Dramatic, emotional, or

personalities described? erratic; Wild"

How are Cluster C "Anxious and fearful,

personalities described? 'Worried'"

Recurrent-requires 2 or more
How is a major depressive depressive episodes with a
disorder characterized? symptom free interval of 2
"5 of the following for 2 weeks,
including (1) depressed mood or
(2) anhedonia: Sleep
How is a major depressive disturbances, Loss of Interest,
Guilt, Loss of Energy, Loss of
episode characterized?
Concentration, Change in
Appetite, Psychomotor
retardation, Suicidal ideation,
Depressed mood"

How is maladaptive pattern of 3 or more of the above signs

substance abuse defined? in 1 year

"periods of psychosis and

How is Schizophrenia
disturbed behavior lasting
>6months, "

> 1 month and causes

How long does the
distress or social/
disturbance due to PSSD last?
occupational impairment
"6 separate criteria exist for
bipolar disorders with
How many criteria sets exist
combinations of manic,
for bipolar disorder?
hypomanic, and depressed

"7; Visual, Auditory,

How many hallucination types
Olfactory, Gustatory, Tactile,
are there? Name them.
Hypnagogic, Hypnopompic"

How many heroin addicts are

there in the US?

"submissive and clinging,

How would you decribe a
excessive need to be taken
dependent personality?
care of, low self-confidence"
How would you decribe an "preoccupation with order,
obsessive-compulsive? perfectionism and control"

"unstable mood and behavior;

How would you describe a
impulsive, sense of
Borderline personality?

"excessive emotionally,
How would you describe a
somatization, attention
histrionic personality?
seeking, sexually provocative"

"as having a disregard for and

How would you describe an
violation of rights of others,
"sensitive to rejection,
How would you describe an
socially inhibited, timid,
avoidant personality?
feelings of inadequacy"

"grandiosity; sense of
How would you desribe a entitlement, many demand
Narcissistic personality? 'top' physician/best health

"If a patient consciously fakes

or claims to have a disorder
in order to attain a specific Malingering
gain, how is this behavior

"misinterpretation of actual
Illusions are…. external stimuli, ex.
Mistaking coat rack for man"
In what kind of disorder does
a person consciously create
symptoms in order to assume Factitious Disorder
a sick role and get medical

"NO, it is schedule I (ie. not

Is Heroin prescribable?

Is the motivation concious in

Munchausen's by proxy?

"Disorganized, Catatonic,
Name the 5 subtypes of
paranoid, Undifferentiated,
Name the types of Cluster B "Antisocial, Borederline,
personalities. Histrionic, Narcissistic"

"3 or more of the following:

Distractibility, Insomnia,
To be a manic episode what
Grandiosity, Flight of Ideas,
characteristic behaviors must
Inc in Activity/pyschomotor
be present?
agitation, Pressured Speech,

Whar are the signs of "Anxiety, seizures, delirium,

barbituate withdrawl? life-threatening CV collapse"

"Irritablility, headache,
Whar are the signs of nicotine
anxiety, weight gain, craving,
Whare are the 4 A's of
and lack of communication),
Affect(blunted), Associations

"development of mulitple
cognitive deficits: memory,
Whare are the characteristics apahasia, apraxia, agnosia,
of Dementia? loss of abstract thought,
changes, impaired

"Amnesia, ataxia,
Whare are the signs of
somnolence, minor resp
Benzodiazepine intox?

"restlessness, insomina,
Whare are the signs of increased diuresis, muscle
caffeine intox? twitching, cardiac
"Euphoria, anxiety, paranoid
delusions, perception of
Whare are the signs of slowed time, impaired
Marijuana intox? jugdment, social withdrawl,
increased appetite, dry mouth
and hallucinations"

"Belligerence, impulsiveness,
fever, psychomotor agitation,
Whare are the signs of PCP vertical and horizontal
intoxication? nystagmus, tachycardia,
ataxia, homicidality,
psychosis and delirium"

What are 2 opioid

Naloxane and Naltrexone
comptetitive inhibitors?

What are some common substance use/abuse or

causes of delirium? medical illness
"Hepatitis, abscesses, OD,
What are some related hemorrhoids(reason enough
diagnoses of Heroin addicts? to shy away), AIDS, and right-
sided endocarditis"

"Palipitations, Abdominal
What are the 5 characteristics distress, Nausea, Increased
of panic? perspiration, Chest pains,
chills and choking"

"conversion, somatoform pain

disorder, hypochondriasis,
What are the 6 somatoform
somatization disorder, body
dysmorphic disorder,

"Decreased attention span

and level of arousal,
What are the characteristics disorganized thinking,
of Delirium? hallucinations, illusions,
misperceptions, disturbance
of sleep-wake cycle, cognitive
What are the etiologic factors "genetics and environment,
for schizophrenia? genetics outweigh env"

"Tolerance, Withdrawl, Substance

taken in larger amounts than
intended, Persistent desire or
What are the maladaptive attempst to cut down, lots of
energy spent trying to obtain
signs of substance use?
substance, withdrawl from
responsibility, used continued in
spite of knowing the problems
that it cause"

"flat affect, social withdrawl,

What are the negative
thought blocking, lack of
symptoms of schizophrenia?

"Hallucinations, delusions,
What are the Positive
strange behavior and loose
symptoms of Schizophrenia?
"Disinhibition, emotional
What are the signs of alcohol
lability, slurred speech,
ataxia, coma, blackouts"

"Tremor, Tachycardia, HTN,

malaise, nausea, seizures,
What are the signs of alcohole
delirium tremens,
tremulousness, agitation,

"Psychomotor agitation,
impaired judgement,
pupillary dilation, HTN,
What are the signs of tachycardia, euphoria,
Amphetamine intoxication? prolonged wakefulness and
attention, cardiac
arrhythmias, delusions,
hallucinations, fever"

"Post-use crash, including

anxiety, lethargy, headache,
What are the signs of stomach cramps, hunger,
Amphetamine withdrawl? severe depression, dysphoric
mood, fatigue, insomnia/
What are the signs of
respiratory depression
Barbiutate intox?

What are the signs of benzo "Rebound anxiety, seizures,

withdrawl? tremor, insomnia"

What are the signs of caffeine "Headache, lethargy,

withdrawl? depression, weight gain"

"Euphoria, psychomotor
agitation, impaired judgment,
tachycardia, pupillary
What are the signs of cocaine dilation, HTN, hallucinations
intoxication? (including tactile:bugs on
skin), paranoid ideations,
angina, and sudden cardiac
"Hypersomnolence, fatigue,
What are the signs of cocaine
depression, malaise, severe
craving, suicidality"

"Marked anxiety and

What are the signs of LSD depression, delusions, visual
intoxication? hallucinations and

"dilated pupils, lacrimation,

What are the signs of narcotic rhinorrhea, sweating,
abstinence syndrome? yawning, irritability, and
muscle aches"

"CNS depression, nausea and

What are the signs of opioid vomiting, constipation,
intoxication? pupillary constriction,
"Anxiety, insomnia, anorexia,
What are the signs of opioid turkey), fever, rhinorrhea,
withdrawl? nausea, stomach cramps,
diarrhea, flu-like symptoms,

"Recurrence of intoxication
symptoms due to
What are the signs of PCP
reabsorption in GI tract,
sudden onset of severe,
random, homicidal violence"

"ANS Hyperactivity
(tachycardia, tremors, and
What are the symptoms of
anxiety), Psychotic symptoms
DT's(in order of appearance)?
(hallucinations, delusions),

What are the symptoms of "Restlessness, insomnia,

nicotine intoxication? anxiety, arrhythmias"
What are the types of Cluster "Paranoid, Schizoid,
A personalities? Schizotypal"

What are the types of Cluster "Avoidant, Obsessive-

C personalities? Compulsive, Dependent"

What are treatment options of

systematic desensitization

What can be confused with

dementia in elderly?
complications associated with
What complication result from
anesthesia and retrograde

What does exposure to object

an anxiety response
of phobia evoke?

What drug is used for long

term maintenance of heroin Methadone

What else is classically "Confabulations, ie. Making it

associated with Korsakoff's? up as you go along"
What is a hallmark sign of
track marks
heroin addiction?

it is like a manic episode

except mood disturbance is
not severe enough to cause
What is a Hypomanic Episode? marked impairment in social
and/or occupational
functioning or to necessitate
hospitalization; no psychotic

What is a pain somatoform pain that is not explained

disorder? completely by illness

"fear that is excessive or

unreasonable, cued by the
What is a phobia?
presence or anticipation of a
specific object or entity"
What is a schizoaffective a combo of schizophrenia
disorder? and a mood disorder

What is a somatization Varitey of complaints in

disorder? multiple organ systems

milder form of bipolar lasting

What is Cyclothymic disorder?
at least 2 years

What is dementia commonly irreversible

characterized by? memory loss
What is destroyed in
Mamillary bodies(bilaterally)
Korsakoff's Amnesia?

What is drug of choice for


milder form of depression

What is Dysthymia?
lasting at least 2 years

a tx option for major

depressive disorder refractory
What is Electroconvulsive to other tx. It is painless and
Therapy(ECT)? produces a seizure with
transient memory loss and
"misinterpretation of normal
physical findins, leading to
preoccupation with and fear
What is Hypochondriasis?
of having a serious medical
illness in spite of medical

What is it called when a

parent causes their child to
Munchausen's by proxy
become ill in order to receive

when a person experienced or

witnessed an event that involoved
actual or threatened death or
What is post-traumatic stress serious injury. The traumatic
event is reexperienced; person
persistently avoids stimuli
associated with the trauma and
experiences persistent symptoms
of increas

what the symptom does for

What is primary gain? the patient's internal psychic
What is retrograde amnesia a ECT-electroconvulsive
complication of? therapy(shock)

What the symptoms gets the

What is secondary gain? patient(sympathy or

What is tertiary gain? what the caretaker gets

"One or more of the following

in 1 year: Recurrent use
resulting in failure to complete
What is the criterion for dx of responsiblities, recurrent use in
substance abuse? physically hazardous situations,
recurrent legal problems,
continued use in spite of
persistent problems of use"
"maladaptive pattern of use
leading to clinically
What is the definition of
significant impairment or
substance abuse?
distress, symptoms have not
met criteria for dependence"

delusion is a disorder in the

content of thought(the actual
What is the difference
idea) where a loose
between delusions and loos
association is a disorder in
the form of thought(the way
the idea is tied together)

what is the fear of heights? acrophobia

what is the fear of marriage? gamophobia

what is the fear of open

what is the fear of pain? algophobia

What is the Fifth A? Auditory hallucinations

What is the inability to

remember things that Retrograde Amnesia
happened before CNS insult?
Waxing and waning level of
What is the key to delirium
conciousness that develops

"rule out delirium-patient is

What is the key to dementia alert, no change in level of
diagnosis? conciousness. More often
gradual onset. "

What is the lifetime

prevalence for Major "13% for males, and 21% for
Depressive Disorder in Males females"
and Females:

What is the lifetime
blacks/whites) presents
prevalence for schizophrenia?
earlier in men"
What is the most common
psych illness on medical and "Delirium, often reversible"
surgical floors?

What is the order of loss or

"Time, place, and Person"

What is the response to the "intense fear, helplessness or

traumatic event? horror"

What is the trigger for DT's? alcohols withdrawl

What patient population will
you see Korsakoff's?

What questions do you have Is the patient aware of him/

to answer when assessing an herself as a person? Does the
patient's orientation? patient know his/her name?

What syndrome is manifested

by a chronic history of
multiple hospital admissions Munchausen's
and willingness to receive
invasive procedures?

patient is convinced that part

Whate is body dysmorpic
of one's own anatomy is
false belief of being pregnant
Whate is pseudocyesis? associated with objective
signs of pregnancy

"Visual(acute organic brain

syndrom), Auditory
(Schizophrenia), Olfactory(aura of
When are the halluinations psychomotor epilepsy), Gustatory
common? (rare), Tactile(DT's and Cocaine
abusers), Hypnagogic(while going
to sleep), Hypnopmpic(while
waking from sleep)"

When do DT's peak? 2-5 days after last drink

When must a painc disorder in the context of the

be dx? occurrence
"Who are more likely to be
antisocial, male or female?"

"Who are more likely to be

borderline, male or female?"

Who do you need to see to

witness caffeine withdrawl Blake Williams
approx every six weeks?

Obligation to respect pts as

Define Autonomy. individuals and to honor their
preferences in medical care
"- discussion of pertinent
information- obtaining the
"Legally, what does informed
patient's agreement to the
consent require?"
plan of care- freedom from

Pt autonomy vs. beneficence: "If pt makes an informed

when does autonomy win decision, ultimately, the pt.
out? has the right to decide."

"- Dr. breach of duty to

patient- pt. suffers harm-
What 3 proofs are required
breach of duty causes harm
for a sucessful malpractice
Note--beyond reasonable
civil suit for neglegence?
doubt not needed, just more
likely than not"

"- potential harm to others is

serious- likelihood of harm is
What are the 4 exceptions to great- no alternative means
confidentiality? exist to warn or to protect
those at risk- Drs. Can take
steps to prevent harm"
"- pt. lacks decision-making
capacity (not letally competent)-
implied consent in an emergency-
What are the 4 exceptions to therapeutic privelege--
withholding information when
informed consent?
disclosure would severly harm the
pt or undermine informed
decision-making capacity-
waver--pt. waves "

"- pt. makes and

communicates a choice- pt. is
informed- decision remains
What are the 5 signs of a pt's stable over time- decision
decision-making capacity? consistent w/ pt's values and
goals- decision not a result
of delusions or
"- LIVING WILLS--pt. directs Dr.
to withhold/withdraw life-
sustaining tx if the pt develops
What are the types of written terminal disease or enters a
persisitent vegative state-
advance directives?
pt designates a surrohate to
make medical decisions in an
event pt. loses deci"

Dr. have special ethical

responsibility to act in the
What is beneficence? pt's best interest. Pt.
autonomy may conflict with
Confidentiality respects pt.
privacy and autonomy.
Disclosure to family and
What is confidentiality? friends should be guided by
what pt. would want. Pt can
waive right to confidentiality
(i.e. to insurance co.)

"Do no harm. But, if benefits

of intervention outweigh
What is nonmaleficence? risks, pt may make an
informed decision to

What must patients "- risks- benefits-

understand in informed alternatives, which includes
consent? no intervention"

"Incapacitated patient's prior oral

statements commonly used as
guide, but problems arise from
When is an oral directive variance in interpretation. if pt
was INFORMED, directive is
and decision is REPEATED over
time, the oral directive is more
At what ages does sexual
9 to 12 years of age
abuse in children peak?

At what time (minutes after "after 1 min. and 5 min.,

birth) do you run an APGAR score 0-2 in 5 categories (10
score? is perfect score)"

Define low birth weight less than 2500g

Irreversible changes of long

term deprivation of affection 6 months
occurs after how long?
Physical abuse in children
leads to how many deaths in ~3000 deaths/yr.
the U.S.?

"- healed fractures on x-ray-

cigarette burns- subdural
What are evidence of physical
hematomas- multiple
abuse in children?
bruises- retinal hemorrhage
or detachment"

What are evidence of sexual "genital/anal trauma, STDs,

abuse in children? UTIs"

"1. sexual changes: sexual

interest does NOT decrease (men:
slower erection/ejaculation,
What are the 5 changes in the longer refractory period; women:
vaginal shortening, thinning,
dryness) 2. sleep patterns:
decreased REM, decreased slow-
wave sleep, increased sleep
latency, increase"
"- A= Apperance (color)- P=
Pulse- G= Grimace (reflex
What are the 5 components of
irritability)- A= Activity
the APGAR score at birth?
(muscle tone)- R=

"1. Weak 2. Wordless 3.

Wanting (socially) 4. Wary
What are the 7 effects of
(lack trust) 5. Weight loss 6.
long-term deprivation of
anaclitic depression 7.
physical illness [Hint: 5 W's
and 2 more]"

What are the development

"- group play- rides tricycle-
milestones at about 3 years
copies line or circle drawing"
old in preschool?

What are the development "- cooperative play- simple

milestones at about 4 years drawings (stick figure)- hops
old in preschool? on 1 foot"
What are the developmental
milestones at about 12-14 #NAME?
months old in infancy?

What are the developmental

"- walking- few words-
milestones at about 15
separation anxiety"
months old in infancy?

What are the developmental "- holds head up- social

milestones at about 3 months smile- Moro reflex
old in an infant? disappears"

What are the developmental

"- rolls on back- sits when
milestones at about 4-5
months old in an infant?
What are the developmental
"- stranger anxiety- sits
milestones at about 7-9
alone- orients to voice"
months old in infancy?

What are the developmental "- abstract reasoning (formal

milestones during operations)- formation of
adolescence? personality"

"- development of conscience

What are the developmental
(superego)- same-sex
milestones during the
friends- identification with
schoolage years (6-11y/o)?
same-sex parent"

Grieving-Acceptance, don't
What are the Kubler-Ross
occur necessarily in this order
dying stages?
[Hint: Death Arrives Brining
Grave Adjustments]"
"assoc. w/ gtr. Incidence of
physical and emotional
problems. Complications
What are the risks of low birth include:- infections-
weight? respiratory distress
syndrome- necrotizing
entercolitis- persistent fetal

"Stress:- physical illness-

What can cause regression to
punishment- birth of new
younger behavior in children?
sibling- tiredness"

prematurity or intrauterine
What causes low birth weight?
growth retardation

depression in an infant owing

to continued separation from
caregiver--can result in
What is anaclitic depression?
failure to thrive. Infant
becomes withdrawn and
"normal bereavement
characterized by shock,
What is grief? denial, guilt, and somatic
symptoms, Typically lasts
6mo. to 1yr."

"includes excessively intense

or prolonged grief or grief
What is pathologic grief?
that's delayed, inhibited, or

What is the result of severe

long-term deprivation of death

When can a child parallel

"Toddler, 24-48 months old"
When does a child achieve
"Toddler, 24-36 months old"
core gender identity?

When does a child achieve

"Toddler, 12-24 months old"
object permanence?

When does a child achieve

"Toddler, 18-24 months old"

When does a child become "Preschool, 30-36 months

toilet trained? old"
When is adolescence for boys "Boys: 13 years old Girls: 11
and for girls? years old"

Who is usually the abuser in

female primary caregiver
physical abuse in children?

Who is usually the abuser in "known to victim, usually

sexual abuse in children? male"

Case-control studies are

Retrospective (case control)
Characteristics of a normal Gaussian = Bell Shaped
statistical distribution? ( mean=median=mode )

Country with highest divorce


Peaks on either side of the

Define a bimodal distribution

Pooling data from several

Define a Meta-analysis studies to achieve greater
statistical power
Asymmetry with the tail on
Define a negative skew the left

Asymmetry with the tail on

Define a positive skew the right

The trueness of test

Define Accuracy

Hypothesis that there is some

Define Alternate Hypothesis
Define Coefficient of r^2 (Correlation coefficient
Determination squared)

Always between -1 and 1.

Define Correlation coefficient
Absolute value indicates the
(r )
strength of correlation.

Number of true negatives /

Define Negative Predictive
number that tested neg. for

"Number of true positives /

number that tested pos. for
Define Positive Predictive
disease or the prob. Of
having a condition, given a
pos. test"
"The consistency of a test
Define Precision (reliability), absence of
random error"

Define Primary Disease "Prevent occurrence, e.g.,

Prevention vaccination"

Disease risk in exposed

group / disease risk in
Define Relative Risk
unexposed group; a/a+b / c/

Reproducibility of a test;
Define Reliability repeat measurements are the
Define Secondary Disease "Early detection of disease,
Prevention e.g., Pap smear"

Standard Error of the Mean;

Define SEM standard deviation / square
root of n (sample size)

Number of true positives / all

Define sensitivity
people with disease

Number of true negatives /

Define specificity number of all people w/o the
"Reduce disability form
Define Tertiary Disease
disease, e.g. insulin for

Probability of rejecting a null

Define the Power of a study
hypothesis when it is false

Whether a test truly measures

Define Validity what it purports to measure;
the appropriateness of a test

Do divorcees remarry
How do disease prevalence
Higher prevalence = Higher
and positive predictive value
Positive Predictive Value

How do prevalence and

P>I for chronic diseases; P=I
incidence relate to disease
for acute diseases

How do SEM and Standard "SD > SEM; as n increases,

Deviation relate? SEM decreases"

How do you measure the

'power' of a study or the
probability that the study will
see a difference if one exists?
"It is the probability of
How does alpha relate to the
making a Type I error, is
Type I error?
equal to p (p is usually <.05)"

How does beta relate to the Beta is the probability of

Type II error? making a Type II error

How many people >65 "35,000,000 (approx. 13%)"

"If the 95% confidence interval

for OR of RR includes 1, what That the study is inconclusive
does this mean?"
In what age group will the
greatest population increase Those >85
be seen in?

Increasing sample size will

affect the Power of a study By increasing the Power

Is divorce related to

Is HIV positivity a reportable

"Teenage marriages, Mixed
Marriages at high risk religions, Low socio-
economic status"

Memory aid for Medicare/ MedicarE=Elderly;

Medicaid MedicaiD=Destitute

Preventive services needed "Influenza, pneumococcal

for Alcoholism immunizations; TB test"

Preventive services needed

"Eye, foot exams; Urine test"
for Diabetes
Preventive services needed "HIV, TB tests; hepatitis
for Drug Abuse immunization"

Preventive services needed "HIV, Hep B, syphilis,

for High-risk sexual behavior gonorrhea, chlamydia tests"

"Preventive services needed

for Homeless, Refugee, or TB test

Preventive services needed

Blood glucose test
for Obesity
Random error yields poor? Precision

Relative Risk is used for what

kind of study?

Systematic error yields poor? Accuracy

U.S. population in 2000 "300,000,000"

"Unlike specificity and
sensitivity, what are Prevalence of disease in the
predictive values dependent population

"White, male, alone, prior

attempts, presence and
What are risk factors for lethality of plan, medical
suicide? illness, alcohol or drug use,
on 3 or more prescription

"Injuries, cancer, congenital

What are the leading causes
anomalies, homicide, heart
of death in AGE 1-14?

What are the leading causes "Injuries, homicide, suicide,

of death in AGE 15-24? cancer, heart disease"
What are the leading causes "Cancer, heart disease,
of death in AGE 25-64? injuries, stroke, suicide"

What are the leading causes "Heart disease, cancer,

of death in AGE 65+? stroke, COPD, pneumonia"

"Congenital anomalies, SIDS,

short gestation, respiratory
What are the leading causes
distress syndrome, maternal
of death in INFANTS?
complications during

"Dilation and curettage,

hysterectomy, tonsillectomy,
What are the most common
sterilization, hernia repair,
oophorectomy, cesarean
section, cholecystectomy"
"AIDS, chickenpox,
gonorrhea, hepatitis A and B,
What are the reportable
measles, mumps, rubella,
salmonella, shigella, syphilis,
and tuberculosis"

The difference between two

What does a t-test check?
means (Mr. T is mean)

Variance of 3 or more
What does an ANOVA
variables (Analysis of

"Sex (male), Age, Depression,

Previous attempt, Ethanol,
Rational thought, Sickness,
Organized plan, No spouse,
Social support lacking"
1)The total # of endpoints
What factors influence the experienced by a population;
Power of a study? 2) Difference in compliance
between treatment groups

Observational study. Sample

chosen based on presence or
What is a case-control study?
absence of disease. Info
collected about risk factors.

Experimental study.
What is a Clinical trial? Compares benefit of 2 or
more treatments.

Observational study. Sample

chosen based on presence or
absence of Risk Factors.
What is a Cohort study?
Subjects followed over time
for disease development.
(Framingham study)
What is a memory key for
suicide risk factors?

"Hypothesis of no difference,
What is a Null Hypothesis? e.g., no assoc. between
disease and risk factor"

Cannot overcome limitations

What is a pitfall of Meta-
of individual studies or bias
in study selection

Stating that an effect of

What is a Type I error (alpha)? difference exists when one
really does not
Stating that there is not an
What is a Type II error (beta) effect or difference when
actually there is

Approximates relative risk

What is an Odds Ratio used
when prevalence is not too
high; OR = ad/bc

To check differences between

What is Chi-Square test used 2 or more percentages or
for? proportions of categorical

What is desirable for

High specificity
confirmatory tests?
What is desirable for High sensitivity is desirable
screening tests? for a screening test

Number of new cases in a

What is incidence?
population per unit time

Fed. And State assistance for

What is Medicaid? those on welfare or who are

What is Medicare Part A? Hospital related

What is Medicare Part B? Supplemental

What is Medicare? Fed. Program for the Elderly

Total number of cases in a

What is prevalence? population at a given time
(incidence x disease duration)

What is the False Negative

What is the False Positive

What is the highest quality

Clinical Trial

The probability of making a

What is the p value?
Type I error.

What percent of medical costs

will those >35 incur?
What type of studies are Odds
Retrospective (case control)
Ratios used for?

When do divorces peak? During the 2nd to 3rd year.

Which sex has the most


Are intelligence tests

objective or projective tests?
Unacceptable feelings and
Define acting out. thoughts are expressed
through actions

Guilty feelings alleviated by

Define altruism. unsolicited generosity toward

Learning in which a natural

response is elicited by a
conditioned stimulus that
Define classical conditioning.
previously was presented in
conjunction with an
unconditioned stimulus

Avoidance of awareness of
Define denial.
some painful reality
Process whereby avoided
ideas and feelings are
Define displacement.
transferred to some neutral
person or object

"Temporary, drastic change in

personality, memory,
Define dissociation. consciousness, or motor
behavior to avoid emotional

automatic and unconscious

Define ego defenses. reactions to phychological

Partially remaining at a more

Define fixation.
childish level of development
Appreciating the amusing
nature of an anxiety-
Define humor.
provoking or adverse

Modeling behavior after

Define identification.
another person

Separation of feelings from

Define isolation.
ideas and events

Learning in which a particular

Define operant conditioning. action is elicited because it
produces a reward
An unacceptable internal
Define projection. impulse that is attributed to
an external source

"Proclaiming logical reasons

for actions actually performed
Define rationalization.
for other reasons, usually to
avoid self-blame"

Process whereby a warded-

off idea or feeling is replaced
Define reaction formation.
by an (unconsciously derived)
emphasis on its opposite

Turning back the

maturational clock and going
Define regression.
back to earlier modes of
dealing with the world
Involuntary withholding of an
Define repression. idea or feeling from
conscious awareness.

Process whereby one replaces

an unacceptable wish with a
course of action that is
Define sublimation.
similar to the wish but does
not conflict with one's value

Voluntary (unlike other

defenses) withholding of an
Define suppression.
idea of feeling from
conscious awareness

Pavlov's dogs (ringing of a

Give an example of classical
bell provoked salivation in
Give an example of A person gets upset when a
continuous reinforcement vending machine doesn't
schedule. work

Give an example of negative a mouse presses a button to

reinforcement of opperative avoid shock (do not confuse
conditioining. with punishment)

Give an example of positive

a mouse presses a button to
reinforcement of opperative
get food

Give an example of remembering your phone

preconscious topography. number
Give an example of variable
A person continuing to play a
ratio reinforcement
slot machine at a casino

Is IQ testing more highly

correlated with genetics or School achievement
school achievement?

Name 4 characteristics of
places great demands on the

What are Freud's three

structures of the mind
"-Sense of Impotence
(powerlessness)-Sense of
What are the four factors in Guilt-Sense of Anger-Sense
hopelessness? of loss/Deprivation leading to
depression (Mnemonic

"Acting out, Disassociation,

Denial, Displacement,
What are the immature ego Fixation, Identification,
defenses? (12) Isolation, Projection,
Rationalization, Reaction
formation, Regression,

What are the MATURE ego Suppression-Humor
defenses? (4) (Mneumonic: Mature women
wear a SASH)"

What are the two most

famous forms of intelligence Stanford-Binet and Wechsler
What are two factors with
Genetics and school
which IQ scores are

What is an example of acting

Temper tantrums

What is an example of Mafia boss makes large

altruism? donation to charity

A common reaction in newly

What is an example of denial. diagnosed AIDS and cancer
What is an example of Mother yells at child because
displacement? she is angry at her husband

Extreme forms can result in

What is an example of multiple personalities
dissociation? (dissociative identity

What is an example of
Men fixating on sports games

What is an example of Nervous medical student

humor? jokes about the boards
What is an example of Abused child becomes an
identification? abuser

Describing murder in graphic

What is an example of
detail with no emotional

A man who wants another

What is an example of
woman thinks his wife is
cheating on him

"Saying the job was not

What is an example of
important anyway, after
getting fired"
What is an example of A patient with libidinous
reaction formation? thoughts enters a monastery

"Seen in children under stress

What is an example of (eg., bedwetting) and in
regression? patients on dialysis (eg.,

What is an example of Aggressive impulses used to

sublimation? succeed in business ventures

Choosing not to think about

What is an example of
the USMLE until the week of
the exam
the removal of an aversive
What is negative
stimulus so as to increase

What is positive the desired reward which

reinforcement? produces an action

What is the basic mechanism

underlying all ego defenses?

To make the patient aware of

What is the central goal of
what is hidden in his/her
Freudian psychoanalysis?
What is the IQ criteria for IQ lower than 70 (or 2
diagnosis of mental standard deviations below the
retardation? mean)

What is the topographical

term used in psychoanalysis
to describe what you are not
aware of?

What is the topographical

term used in psychoanalysis
used to describe what you are Preconscious
able to make conscious with

What is the topographical

term used in psychoanalysis
used to describe what you are
aware of?
What number is defined as
100 (with a standard
the mean for standard IQ
deviation of 15)

"What term fist described by

Freud is used to refer to
repressed sexual feelings of a
child for the opposite-sex Oedipus complex
parent, accompanied by
rivalry with same-sex

What term is used to describe

the form of insight therapy
developed by Freud which is Psychoanalysis
often used for changing
chronic personality problems?

Bridge and mediator between

What thought structures is the unconscious mind and
the Ego responsible for? the world (Think-Deals with
What thought structures is
" - Primal urges-sex-
the Id responsible for? (3
agression (Think-'I want it')"

What thought structures is " - Moral values-conscience

the Superego responsible for? (Think-'You know you cant
(2 things) have it')"

What type of behavior behavior which shows the

requires a continuous most rapid extinction when
reinforcement schedule? not rewarded

What type of behavior behavior which shows the

requires a variable ratio slowest extinction when not
reinforcement schedule? rewarded
Which is the conditioned
(learned) stimulus in Pavlov's ringing bell

Which is the natural response

in Pavlov's experiment?

Which is the unconditioned

stimulus in Pavlov's food