| Terms |
Definitions |
|
TN/(FP+TN)
|
Specificity
|
|
Urophilia
|
sex and urination
|
|
Personality disorder:preoccupation with order, perfectionism, and control
|
Obsessive-Compulsive personality
|
|
blocking
|
Transient inability to remember
|
|
Incidence x Disease Duration
|
Prevalence
|
|
What is 1-sensitivity?
|
False negative ratio.
|
|
repression
|
Forgetting so it is nonretrievable
|
|
What neurotransmitter is associated with sedation and weight gain?
|
Histamine
|
|
Name these mature defense mechanisms:
• Preparing for an upcoming event
|
Anticipation
|
|
Personatliy disorder:
submissive and clinging, excessive need to be taken care of, low self confidence
|
Dependent personality
|
|
Most common work-related disability anywhere
|
musculoskeletal
|
|
What neurotransmitter reduces REM sleep?
|
NE
|
|
Define the Superego.
|
Moral values and conscience
|
|
suppression
|
Forgetting but it is retrievable. Forget and remember.
|
|
Amphetamines and cocaine treatment
|
Antipsychotics and/or benzodiazepines
|
|
What paraphilia is defined as
• Having a recurrent desire to expose the genitals to strangers?
|
Exhibitionism
|
|
Shuffling gait, cogwheel rigidity, masklike facies, pill-rolling tremor, and bradykinesia describe what form of dementia?
|
Parkinson's disease
|
|
Name the cluster B personality disorder:
• Criminal behavior; lacking friends, reckless, and unable to conform to social norms
|
Antisocial
|
|
What disorder is described as having
• Conscious symptoms with conscious motivation?
|
Malingering
|
|
What paraphilia is defined as
• Combining sex with urination?
|
Urophilia
|
|
What are the pharmacologic effects seen sexually with
• β-Blockers?
|
Impotence
|
|
Reinforcement type:
reward received after every response;
rapidly extinguished
|
Continuous reinforcement schedule
|
|
What neurotransmitter change are associated with Alzheimers dementia?
|
decreases ACh
|
|
Dx:
tachycardia, tremors, and anxiety followed by hallucinations, delusions, and confusion in an alcoholic
|
Delirium Tremens
|
|
Who does MedicarE provide for?
|
The Elderly
|
|
Dx:
patient conciously fakes or claims to have a disorder in order to attain a specific gain.
|
Malingering
|
|
True or False: A patients family cannot require that a doctor withhold information from the patient.
|
True
|
|
the probability of rejecting the null hypothesis when it is in fact false.
|
Power
|
|
When information gathered on subjects is done so at an inappropriate time, what bias is likely?
|
Late-look bias.
|
|
Dx:X-linked disorder seen only in girls. Characterized by loss of development and mental retardation appearing at about 4 years.
|
Rett disorder
|
|
Conditioned response
|
Response to an associated conditioned stimulus
|
|
Opiate intoxication and Rx
|
Pupillary constriction (pinpoint), constipation, drowsiness, respiratory depression, coma. Rx.: naloxone
|
|
Based on operant conditioning, what type of reinforcement is described when
• Removing a stimulus reinforces a behavior?
|
Negative reinforcement
|
|
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
|
|
What are treatment options for specific phobias?
(2)
|
Systematic desensitization;
Flooding
|
|
Difference b/t Transsexual and Transvestite
|
Transsexual:
Cross-dresses and uncomfortable w/ gender
Transvestite:
Cross-dresses but comfortable w/ gender
|
|
Define Countertransference.
|
When the doctor projects feelings stemming from their personal life onto the pt.
|
|
The trueness of the test measurements is the ...
|
Accuracy
|
|
Dx:
patient reports Sx to acheive and easily recognizable gain (like drugs)
|
Malingering
|
|
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.
|
|
The physicians ethical responsibility to act in the patients best interest. Can conflict with autonomy.
|
Beneficence[Best interest = Beneficence]
|
|
What is specificity equation?
|
TN/(TN+FP) x 100 = specificity
|
|
At what age range are organized sports first possible?
|
6-12 years
|
|
At this age, children can handle hypotheticals, being systematic problem solving and deal with the past, present, and future.
|
adolescence (12+)
|
|
What is schizoaffective disorder?
|
combination of Schizophrenia and Depression
|
|
Define the Ego.
|
Mediator between unconcious mind and external world.
|
|
Positive reinforcement
|
A stimulus that when triggered after an operant response strengthens the probability of that response occurring
|
|
What rate is indicated by 1- sensitivity?
|
False-negative rate
|
|
What phase of Food and Drug Administration approval tests
• The safety in healthy volunteers?
|
Phase I
|
|
In Parkinson's disease, what area of the basal ganglia has a decreased amount of dopamine?
|
Substantia nigra
|
|
Name the aphasia based on these characteristics:
• Lesion in Brodmann area 22; impaired comprehension; incoherent rapid, fluent speech; verbal paraphrasias; trouble repeating statements
|
Wernicke's aphasia
|
|
What is the leading cause of school dropout?
|
Pregnancy
|
|
a mafia boss making a large donation to charity is an example of what ego defense?
|
altruism.
|
|
Dx:
prolonged pain that is not explained completely by illness.
|
Somatoform pain disorder
|
|
Dx:
Depression in an infant owing to continued separation from caregiver - it can result in failure to thrive
|
Anaclitic depression
|
|
Age range of Parrallel Play?
|
2 - 4 years
|
|
What is Korsakoff's anmesia?
|
classic anterograde anmesia caused by a thymine deficiency.
|
|
Define: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.
|
Durable power of attorney
|
|
At 5 years of age, what percentage of the adult brain mass does the child have?
|
75%
|
|
A todler is using two word sentences and has a vocabulary of about 250 words, how old is he?
|
1 year
|
|
A baby is crawling, how old is she?
|
9 months
|
|
A 15 year old girl of normal height and weight for her age has enlarged parotid glands but no other complaints; The mother confides that she found laxitives in the daughter's closet. What is the diagnosis?
|
Bulimia
|
|
The DSM-IV-TR is scored on the basis of five axes of diagnosis. In what axis would you place
• Global assessment of function?
|
Axis V
|
|
Name the stages of sleep with these EEG patterns:
• Sleep spindles, K-complexes
|
Stage 2
|
|
At what stage of psychosexual development (according to Freud) do children fear castration?
|
Phallic stage (4–6 years)
|
|
What is the name of the program that deals with codependency and enabling behaviors for family members of alcohol abusers?
|
Al-Anon
|
|
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
|
|
What is the most common factor leading to litigation between the physician and pt?
|
poor communication.
|
|
The rate of new cases in a population in a given time.
|
Incidence.
|
|
A todler is using two word sentences and has a vocabulary of about 250 words, how old is he?
|
1 year
|
|
Pts with personality disorders that leave them anxious or fearful and have a genetic association with anxiety disorders are classified as what Cluster type?
|
Cluster C personality disorders
|
|
A child has an imaginary friend and this is entirely normal for this age group, how old is she?
|
4 years
|
|
At what age range are organized sports first possible?
|
6-12 years
|
|
Define: Pre-concious
|
What you are able to make consious with effort
|
|
A child puts everything in their mouth. How old are they?
|
1st year of life.
|
|
A baby kicks and throws a ball, how old is he?
|
1 year
|
|
How far below ideal body weight are patients with anorexia nervosa?
|
At least 15%
|
|
Name the area of the cerebral cortex affected by the description of the effects, symptoms, and results of the lesion.
• Euphoria, delusions, thought disorders, Wernicke's aphasia, auditory hallucinations (Hint: the lesion is in the left hemisphere)
|
Dominant temporal lobe
|
|
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.
|
|
What is the term for the same results achieved again on testing a subject a second or third time?
|
Test–retest reliability
|
|
The probability that a person with a negative test result is truly disease free refers to what value?
|
Negative predictive value
|
|
In regard to motor development during infancy, choose the motor response that happens first.
• Radial or ulnar progression
|
Ulnar to radial progression
|
|
Equation that answers:
"how much more likely"
|
Relative Risk = PPV / (FN/[FN+TN])
|
|
describe identification as an ego defense.
|
modeling behavior after another person.
|
|
When is high specificity desirable?
|
In a confirmatory test
Specificity = # of people who DON'T have the Dz
|
|
what is key to initiating sleep
|
serotonergic dominance in the raphe nucleus
|
|
When is suicide most likely?What is the best Tx?
|
coming out of a depressionTx:Hospitalization(giving meds leads to malpractice)
|
|
Error type:Stating there IS an effect or difference where none really exists.
|
Type 1 error (alpha probability)
|
|
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.
|
|
What level of mental retardation is characterized by
• Needing a highly structured environment with constant supervision?
|
Profound (I.Q. range < 20)
|
|
What are the two ways to leave the prevalence pot?
|
Recovery and death
|
|
What is the term for failure to give up infantile patterns of behavior for mature ones?
|
Fixation (arrested development)
|
|
What is the name of depression and mania alternating within a 48-to 72-hour period?
|
Rapid cycling bipolar disorder
|
|
By what age should children be able to draw the following figures?
• Circle
|
3 years old
|
|
A major depressive episode MUST include one of two symptoms, these are ...
|
1. Depressed mood
or
2. Anhedonia
|
|
What does a Correlation coefficient indicate?
|
the strength of the correlation between two consecutive variables. The sign indicates a positive or negative.
(no nominals...intervals only)
|
|
When does prevalence = incidence?
|
For acute disease (ie the common cold)
|
|
What drugs can lead to sexual dysfunction?
(4)*
|
End in Having No Sex:
EtOH;
HTN meds;
Neuroleptics;
SSRI
|
|
What drugs can lead to sexual dysfunction?
(4)*
|
End in Having No Sex
|
|
List 3 types of Cluster C personality disorders
|
C's:
1. Avoidant (Coward)
2. Obsessive-Compulsive
3. Dependent (Clingy)
|
|
BNZ decrease what stage of sleep
|
stage 4 (can decrease night terrors and sleep walking)
|
|
How is Tardive Dyskinesia managed?(2)what is the adverse affect of the drug?
|
1. Do not stop taking the meds abruptly, instead switch to an atypical...2. ClozapineAE:Agranulocytosis
|
|
How long must a patient experience symptoms of schizophrenia for a diagnosis?
|
Periods of psychosis or disturbed behavior lasting > 6 months.
|
|
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).
|
|
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.
|
|
What happens to dopamine levels when we awaken?
|
Dopamine levels rise with waking; dopamine is associated with wakefulness.
|
|
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.
|
|
What central tendency (mean, median or mode) is best measured in a skewed distribution?
|
Median
(it is always in the middle)
|
|
Describe denial as an ego defense.
|
avoidance of awareness of some painful reality.
|
|
describe supression as an ego defense.
|
VOLUNTARY withholding of an idea or feeling from concious awareness.
|
|
What are the top (3) leading causes of death for people 15-24 years of age in the US?
|
1. Injuries 2. Homicide 3. Suicide
|
|
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.
|
|
What is the primary method of nonverbal communication of emotional states?
|
Facial expression (the second is vocal intonation)
|
|
True or false? Prolactin levels can serve as a rough indicator of overall dopamine activity.
|
True. PIF is dopamine in the tuberoinfundibular system.
|
|
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.
|
|
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).
|
|
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.
|
|
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.)
|
|
Why aren't boys seen with Rett syndrome?
|
With this X-linked disorder, boys die in utero.
|
|
What are the leading (5)causes of death for adults over the age of 65 in the US?
|
1. Heart disease
2. Cancer
3. Stroke
4. COPD
5. Pneumonia
|
|
When do the reflexes present at birth typically disappear?
|
Within the 1st year of life.
|
|
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.
|
|
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.
|
|
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.
|
|
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.
|
|
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%.
|
|
how often does REM sleep occur while sleeping?
|
every 90 minutes. duration of REM sleep increases throughout the night.
|
|
Where is the "tail" on a positive skew distribution?
relation b/t mean, median and mode?
|
is asymmetry with the tail to the right, hump on the left
(Mean > Median > Mode)
[alphabetical]
|
|
Confidence interval equationWhat is Z for 95%?99%?When is Null Accepted w/ respect to CI?
|
CI = mean +/- Z (SD/sqroot of N)95% = 299% = 2.5If the CI includes zero, Null is accepted.
|
|
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.
|
|
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.
|
|
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.
|
|
What is the only drug that does not have an intoxication?
|
Nicotine (but it sure has a nasty withdrawal!)
|
|
Describe the 3 levels of muscle tone on the apgar scale.
|
0 = limp
1 = some
2 = active
|
|
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.
|
|
TP/(TP+FP)
|
PPV
|
|
Withdrawl:
Anxiety, delirium, seziures. Can lead to life-threatening CV collapse
|
Barbiturates
|
|
Personality disorder:excessive emotionality, somatization, attention seeking, sexually provacative
|
Histrionic personality
|
|
Personality disorder:
interpersonal awkwardness, odd thought patterns and appearance; eccentric behaviors (thinks they are magical)
|
Schizotypal personality
|
|
Personality disorder:
gradiosity, sense of entitlement, may demand "top" physician, or best health care
|
Narcissistic personality
|
|
Learning:Removing a stimulus increases behavior
|
Negative Reinforcement
|
|
Impotence treatment
|
sildenafil (viagra). Phosphodiesterase 5 inhibitor
|
|
Fetichism
|
Sexual focus on objects. Transvestites
|
|
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
|
|
What naturally occurring substances mimic the effects of opioids?
|
Enkephalins
|
|
Name these narcissistic defense mechanisms:
• Everything in the world is perceived as either good or bad . No middle ground; it is all extremes.
|
Splitting
|
|
Personality Disorder:
distrust and suspiciousness, projection is main defense mechanism
|
Paranoid personality
|
|
May a physician break confidentiality if they suspect child or elder abuse?
|
Yes.
|
|
Schizotypal personality
|
Eccentric behavior, thought and speech. Magical thinking.
|
|
Narcissistic personality
|
Grandiose, over-concerned with issues of self-esteem
|
|
True or false? Pregnancy ensures emancipation.
|
False
|
|
What is agoraphobia?
|
fear of open places.
|
|
A patient complains of sexual dysfunction, what 3* things are on your differential?
|
3-D:
Drugs,
Disease,
Depression / psychological
|
|
A patient complains of sexual dysfunction, what 3* things are on your differential?
|
3-D
|
|
a pt presents with agitation, pupillary dilation, HTN, tachycrdia, euphoria, fever, hallucinations and they have been awake for 36 hours ... what drug do you suspect?
|
Amphetamines
|
|
Define depersonalization
|
body seems unreal or dissociated
|
|
MC female sexual disorder
|
Hypoactive Sex desire
|
|
Define the Id.
|
Primal urges, sex and aggression.
|
|
Personality disorders that lead pts to be erratic, emotional, or dramatic and have a genetic association with mood disorders are classified as what Cluster type?
|
Cluster B
|
|
What is the treatment for ADHD?
|
methylphenidate (Ritalin)
|
|
Unconditioned response
|
The response to the unconditioned stimulus
|
|
What type of scheduled reinforcement states that after a desired response, the reinforcement is given
• On a set time schedule?
|
Fixed interval
|
|
What rate is indicated by 1-specificity?
|
False-positive rate
|
|
The most frequent number occurring in a population is what?
|
Mode
|
|
Dx:
variety of complaints in multiple organ systems
|
Somatization disorder
|
|
What is sensitivity?
|
TP/(TP+FN) x 100 = Sensitivity
|
|
Best data analysis for:
1. Case-control
2. Cross-sectional
3. Cohort
Which deals w/ Prevalence? Incidence?
|
Case-control: Odds Ratio
Cross-Sectional: Chai squared
(Prevalence)
Cohort: Relative Risk
(Incidence)
|
|
Two children are caught "playing doctor", at what age does this curiosity manifest?
|
4 years
|
|
Define retrograde amnesia
|
inability to remember things that occured before a CNS insult
|
|
Reasons for decreased libido
|
low testosterone, CNS depressants, depression, oral contraceptives
|
|
According to Freud, what facet of the psyche represents the internalized ideals and values of one's parents?
|
Superego
|
|
What type of correlation compares two interval variables?
|
Pearson correlation
|
|
Which drug is used to treat opioid withdrawal, ADHD, and sometimes Tourette's syndrome?
|
Clonidine
|
|
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
|
|
At what age does communication become the focus of friendships?
|
adolescence (12+)
|
|
At this age, children can handle hypotheticals, being systematic problem solving and deal with the past, present, and future.
|
adolescence (12+)
|
|
What neurotransmitter changes are associated with Huntington's Disease?
(2)
|
decrease GABA and ACh
|
|
Dx:
patient that reports Sx to enter the "sick role"
|
Facticious Disorder
|
|
Define: PPV
|
The probability of having a condition given a positive test
TP/(TP+FP) = PPV
|
|
What is specificity equation?
|
TN/(TN+FP) x 100 = specificity
|
|
Define: Pre-concious
|
What you are able to make consious with effort
|
|
A child has just learned to climb (crawl up) the stairs alone, how old is he?
|
18 months
|
|
Gaussian distribution is ...
|
a normal distribution (bell curve) (mean=median=mode)
|
|
The rate of new cases in a population in a given time.
|
Incidence.
|
|
Name the area of the cerebral cortex with the function described:
• Language, memory, and emotion (Hint: herpesvirus infects here commonly)
|
Temporal lobe
|
|
What is the period between going to bed and falling asleep called?
|
Sleep latency
|
|
What is the term to describe jumping from one topic to the next without any connection?
|
Loose association
|
|
At 5 years of age, what percentage of the adult brain mass does the child have?
|
75%
|
|
A child shows a shift from egocentric to social speech and incomplete sentences decline, how old is he?
|
6-12 years
|
|
An infant sits with support, how old is she?
|
4 months
|
|
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.
|
|
What is the Moro reflex?
|
extension of limbs when startled
|
|
What is involved in orienting the patient?(3)
|
person, place, and time
|
|
What is the teratogenic effect associated with lithium?
|
Epstein-cardiac anomaly of the tricuspid valve
|
|
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.)
|
|
At what age does a child develop
• Endogenous smile?
|
At birth (reflex)
|
|
Two types of studies that are without procedures on patients or drug tests
|
Case-control study
Cohort study
|
|
Most difficult sexual dysfunction to treat?
|
Primary Ejaculatory Incompetence in Men
(never ejaculated during intercourse)
|
|
In addition to anxiety, seizures, and delirium, what are you concerned about in a patient who is withdrawing from barbituates?
|
life threatening cardiovascular collapse.
|
|
What two drugs are used to treat heroin addicts?
|
Naloxone and Methadone.
|
|
Dx:
Cannot get an erection only with certain people
|
Erectile Dysfunction that is
Psychogenic
|
|
What are the major adverse effects of ECT?
|
disorientation, and amnesia.
|
|
A child is able to aim and throw a ball and stack 6 cubes, how old is he?
|
2 years
|
|
When does prevalence = incidence?
|
For acute disease (ie the common cold)
|
|
Is marital satisfaction higher for couples with or without children?
|
Without children (but don't think about this one for too long)
|
|
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)
|
|
When is high sensitivity desirable?
|
In a screening test
Sensitivity = the number of people who HAVE the Dz
|
|
Describe displacement as an ego defense.
|
process whereby avoided ideas and feelings are transferred to some neutral person or object.
|
|
What is the current treatment for autism?
|
increase communication and social skills
|
|
When is suicide most likely?
What is the best Tx?
|
coming out of a depression
Tx:
Hospitalization
(giving meds leads to malpractice)
|
|
The parent is the central figure and issues of trust are key, how old is the child?
|
1st year of life.
|
|
What are the functions of the frontal lobe?
|
concentration orientation language abstraction judgement motor regulation mood
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A man who has lost his wife appears to be in shock, and expresses denial, guilt and somatic symptoms for the past 4 months. What is the diagnosis?
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Normal bereavement.
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what are the 4 D's of malpractice
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duty, dereliction of duty, damage, direct breach of duty cause damage
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What should guide the physicans decision to disclose information to family and friends?
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What the patient wants, or would want.
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What are 3 types of Cluster A personality disorders?
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A's:1. Paranoid (Afraid)2. Schizoid (Alone)3. Schizotypal (Amazing powers)
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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?
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Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive-compulsive disorder and learning disabilities.
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True or false? Marriage emancipates a child less than 17 years old.
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True; military service and independent self-care by a child over 13 years old also emancipate.
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For chronic diseases, which is larger - prevalence or incidence?
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Prevalence > Incidence for Chronic Disease
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A patient with depression will typically show these three changes in their sleep stages:
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1. decrease slow wave sleep
2. decrease REM latency
3. early morning awakening
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Describe fixation as an ego defense.
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partially remaining at a more childish level of development.
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What are the leading (4) causes of death for children age 1-14 in the US?
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1. Injuries2. Cancer 3. Congenital anomalies 4. Homicide
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When a child is found to be physically abused, who is typically the abuser?
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usually female and the primary caregiver.
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True or false? Panic attacks can be induced by hyperventilation or carbon dioxide.
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True. Yohimbine, sodium lactate, and epinephrine can also induce panic attacks; they are considered panicogens.
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Are sexually abused females more likely to have learning disabilities than the general population?
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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.
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Failure to accurately recall the past leads to what form of bias?
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Recall bias. These problems arise in retrospective studies.
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What happens to REM, REM latency, and stage 4 sleep during major depression?
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Increased REM sleep, decreased REM latency, and decreased stage 4 sleep, leading to early morning awakening
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In what circumstances can a physician break confidentiality?
(3)
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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
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What do you do if a patient states that he finds you attractive?
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ask direct, closed ended questions and use a chaperone if necessary.
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What three circumstances allow a child to be committed to institutional care?
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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.
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In biostatistics, what are the three criteria required to increase power?
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1. Large sample size
2. Large effect size
3. Type I error is greater
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What are the three surrogate criteria?
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1. What did the patient want?
2. What would the patient say?
3. What is in the patient's best interests?
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What is Munchausen's syndrome by proxy?
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when the illness in a child is caused by a parent;
the motivation is unconcious
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Ethically, what do you do if your patient is non-compliant?
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Work to improve the physician patient relationship.
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What is the IQ cuttoff for diagnosis of mental retardation?(2)
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IQ < 70 or 2 SD below mean.
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What is the order of orientation loss in a disoriented patient?
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time goes first, then place, and last person
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When attempting to make up sleep, what stage of sleep is recovered?
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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.
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In what organ system would you attempt to localize a sign for shaken baby syndrome"? What do you look for?
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Look for broken blood vessels in the baby's eyes.
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36-year old woman with a strong family history of breast cancer refuses mammogram because she heard it hurts. What do you do?
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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.
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What part of the ANS is affected in the biofeedback model of operant conditioning?
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The biofeedback model is based on the parasympathetic nervous system.
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What do you do if a patient refuses a necessary procedure or desires and unnecessary one?
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attempt to understand why the patient wants/does not want the procedure. address underlying concerns. avoid performing unnecessary procedures.
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What do you do if a child wishes to know more about his illness?
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Ask what the parents have told the child about his illness. Parents of a child decide what information can be relayed about the illness.
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