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Behavior 2

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case control study
observational. choose ppl who have (cases) or don;t (controls) and collect info on risk factors
cohort study
choose ppl who do, and don't have a given risk factor. See what happens
how are results for cohort study presented
relative risk
results for case control study are presented
odd ratios
drawback for case control
recall bias
weakness in cohort
selection bias
late look bias
information gathered at inappropriate time
prevalence ? incidence for chronic dz
>
prevalence ? incidence for acute dz
=
formula for prevalence
prevalence=incidents x dz duration
formula for sensitivity
a/(a+c)
formula specificity
D/(B+D)
how are sensitivity/spec in relation to predictive value
sensit/spec looks at ppl w or w/o dz, predictive value looks at ppl w + or - test
in words formula for sensitivty
taking all ppl w dz, how many (%) have a positive test
in words formula for specif
taking all the ppl w/o dz, how many (%) had a negative test
positive predictive value-in words to the pt
if positive test, how likely is it the pt actually has the dz
PPV formula in words
number ppl w dz divided by number of ppl who tested +
NPV-in words to pt
if had neg test, how likely you don't have dz
NPV formula in words
number of ppl w/o dz divided by number ppl who tested -
NPV formula
d/(C+D)
PPV formula
A/(A+B)
how does prevalence effect PPV
higher prevalence, the higher the PPV
decline in prevalence, the higher the NPV
T/F Unlike sensitivity and specificity, predictive values depend on incidence
F PREVALENCE
odd ratio in words
number w dz / number w/o dz
divided by odds in other grp
or odds of having dz if you were in exposed grp vs. unexposed group
when does odds ratio ~ relative risk
if low prevalence
formula odds ratio
A/B / C/D

true pos/false pos / true neg/false neg
formula relative risk in words
number w dz/ all who tested positive
/
number w/o dz/all who tested -
formula relative risk
a/(a+b) / c/(c+d)
how does random error effect test
reduces precision
how does systematic error effect test
reduces accuracy
positive skew on curve
tail is on the up side, so most ppl were under what was reported as avg
(mean>median>mode)
negative skew on curve
tail is on the down side, the majority were higher than what was reported as avg
(mean<median<mode)
type I error
saying there is a diff when there is NONE
type II error
saying there's no difference when there's REALLY A DIFFERENCE
in fancy words type I error
to mistakenly accept the experimental hypothesis and reject the null hypothesis
beta
probability that you made a type II error (saying there's no difference when there's REALLY A DIFFERENCE)
p value
probability of making a type I error
(saying there's a diff, when there is NONE)
alpha
you saw a difference that didn't exist
power
probability of being right that there IS a difference
(saying there is a difference and there IS)
formula for power
=1-beta
t test
diff bw means of 2 grps
ANOVA
diff bw means 3 or greater tests
gamma squared
diff bw 2 or more percentages of categorical outcomes
how can you increase the power of your test
increase sample size
SEM
=std deviation/ (sq root of N)
SEM ? std deviation
<
how does SEM vary
decreases as n increases
what percentage are within 1 std dev? 2? 3?
68%, 95%, 99.7%
what is the formula for confidence interval
CI=mean +/- 1.96 SEM
three causes for malpractice suing
dereliction, damage, direct
(jury only needs to say more likely than not)
APGAR score, when
Appearance, Pulse, Grimace, Activity, Respiration


1 and 5 minutes
17 yr old asks for abortion
in most states requires parent consent. not for emergency, care of STDs, or care during preg
stage awake
awake
beta (highest frequency, lowest amplitude)
awake eyes closed
eyes closed
alpha
stage 1 sleep
light sleep
theta
stage 2 sleep
deeper sleep
sleep spindles and K complexes
stage 3-4 sleep
deepest non-REM sleep
sleepwalking,
night terrors
bed-wetting
slow wave sleep
Delta (lowest frew highest amplitude)
REM sleep
Dreaming, loss of motor tone, pocc a memory processing, erection, INCREASED brain O2 use
Beta
pneumonic for sleep stages
BATS Drink Blood
what key to initiate sleep
5HT
what key NT during REM
Ach
what inhibits REM
NE
what Rx for night terrors and sleep-walking
benzos (shorten st 4 sleep)
what use for enuresis?
imipramine, decr st 4 sleep
how autonomics change during REM
increase and variable pulse and BP, penile/clitoral tumescence
when REM occur
every 90 min, increases as going thru the night
decr in elderly
how does sleep change in depression
decr slow wave sleep
decr REM latency
early am awakening
social smile
3mo
recognize ppl
4-5mo
stranger anxiety
7-9 mo
orients to voice
7-9 mos
sits alone
7-9mos
rolls front to back
4-5 mos
sits when propped
4-5 mos
holds head up
3 mos
moro reflex disappears
3 mo
4 reflexes present at birth
-moro (extend arms when startled)
-rooting
-palmar (grasps things in hand)
-babisnki (large toe dorsiflexes)
babinski disappers
12-14mos
walks
15 mo
climbs stairs
12-24m
stacks 3 blocks
12-24m
object permanence
12-24 mo
stacks 6 blocks
18-24
rapprochement
18-24m
parallel play
24-48
core gender identity
24-36mo
toilet training
30-36m
stacks 9 blocks
30-36 mo
rides tricycle
3 yrs
copies line or circle drawing
3 yrs
grp play
3y
stick figure
4y
hop on one foot
4y
cooperative play
4y
what happening during school age
development of conscience (superego), same sex friends, identifies w same sex parent
abstract reasoning (formal operations)
puberty 11y girls, 13y boys
formation of personality
puberty 11y girls, 13y boys
how do NT change in anxiety
incr NE, decr GABA, decr 5HT
how NT change in depression
decr NE, decr 5HT
stages of grief
denial, anger, bargaining, grieving, acceptance
(Death arrives bringing grave adjustments)
anosognosia
unaware one is ill
autopagnosis
unable to locate one's body parts
normal BMI
18.5-24.9
opioid intox
CNS depression, N/V, constipation, pupillary constriction, sz
EtOH w/draw
tremor, tachy cardia, HTN, malaise, N, sz, agitation, hallucinations
opioid w/draw
anxiety, insomnia, anorexia, sweating, dilated pupil, piloerection
amphetamines
pyschomotor agitation, impaired judgement, pupillary dilation, HTN, tachycardia, euphoria, prolonged wakefulness and attn, arrhythm, delusions, hallucinations, F
w/draw amphetamines
post-use "crash" w depression, lethargy, HA, stomache cramps,hunger, hypersomnolence
cocaine intox
euphoria, psychomotor agitation, impaired judgement, tachycardia, pupillary dilation, HTN, hallucinations (incl tactile), paranoid ideations, angina, SCD
cocaine w/draw
post use "crash" w severe depression, suicidiality, hypersomnolence, fatigue, malaise, severe psychological craving
PCP intox
belligerence, impulsiveness, horiz and vert nystagmus, tachcardia, ataxia, homicidiality, psychosis, delirium
PCP wdraw
recurrence of intox sx due to reabsorb GI tract, sudden onset of severe, random, homicidal violence
LSD intox
marked anxiety or depression, delusions, visual hallucinations, flashbacks, pupil dilation
Marijuana
euphoria, anxiety, paranoid ideations, perception of slowed time, impaired judgement, social w/drw, incr appetite, dry mouth, hallucinations
nicotine use, and wdraw
restlessness, insomnia, anxiety, arrhyth
irritability, HA, anxiety, wgt gain, craving
chracteristics major depressive
SIG E CAPS
Sleep disturb
Interest gone
Guilt
Energy gone
Concentration gone
Appetite changed
Psychomotor retard
Suicidal ideations
depressed mood
(need >5 for wks incl depression, anhedronia
heroin addiction related dx
hep, abscesses, OD, hemorrhoid, AIDs, right-sided endocarditis
manic dx
last>1wk
DIG FAST
Distract.
Insomnia
Grandiosity
Flight of ideas
Activity/Agitation increase
Speech pressured
Thoughtlessness (doesn't think of consequences)
cluster B disorders
antisocial, borderline, histrionic, narcissitic
Tourettes syn
motor/vocal tics and involuntary profanity onset <18, tx haloperidol
Rett disorder
X linked only seen in girls (boys die in utero), loss of develop MR, hand wringing appears~4y.
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