Garantie de satisfaction à 100% Disponible immédiatement après paiement En ligne et en PDF Tu n'es attaché à rien
logo-home
Test Bank For Harrison s principles of internal medicine self assessment and board review 19 Edition €17,02   Ajouter au panier

Examen

Test Bank For Harrison s principles of internal medicine self assessment and board review 19 Edition

 16 vues  0 fois vendu
  • Cours
  • Harrison\'s principles of internal medicine, 19e
  • Établissement
  • Harrison\'s Principles Of Internal Medicine, 19e
  • Book

Test Bank For Harrison s principles of internal medicine self assessment and board review 19 Edition

Aperçu 4 sur 755  pages

  • 25 septembre 2024
  • 755
  • 2024/2025
  • Examen
  • Questions et réponses
  • Harrison's principles of internal medicine, 19e
  • Harrison's principles of internal medicine, 19e
avatar-seller
, SECTION I q




General Considerations in Clinical Medicine q q q q




qqqqqqqqqqqqqqqqqqqqqqqqqqqqqq

qqqq QUESTIONS


DIRECTIONS: Choose the one best response to each question.
q q q q q q q q




I-1. All of the following statements regarding practice guidelines set forth by governing agencies and professional
q q q q q q q q q q q q q q q


qorganizations are true EXCEPT: q q q



A. Clinical practice guidelines protect caregivers against inappropriate charges of malpractice, yetdo not
q q q q q q q q q q q


provide protection for patients from receiving substandard care.
q q q q q q q q


B. Practice guidelines have largely reached a stage of nuance allowing them to address every uniqueillness and
q q q q q q q q q q q q q q q


patient presented to the modern physician.
q q q q q q


C. Practice guidelines provide a legal constraint to physicians, and deviation from guideline-basedcare
q q q q q q q q q q q


invariably leaves physicians vulnerable to legal action.
q q q q q q q


D. Where different organizations disagree regarding practice guidelines, a third-party agency has been
q q q q q q q q q q q


appointed to mitigate these disagreements such that now all major organizations’ guidelines are consistent.
q q q q q q q q q q q q q q


E. All of the above statements are not true.
q q q q q q q




I-2. Regarding molecular medicine, which of the following statements represents an INACCURATE example of the
q q q q q q q q q q q q q q


qlisted area of study:
q q q



A. Exposomics: An endocrinologist studies sunlight exposure and population risk of hip fracture.
q q q q q q q q q q q


B. Metabolomics: A biochemist studies the rate of flux through the creatine kinase pathway during the cardiac
q q q q q q q q q q q q q q q


cycle.
q


C. Metagenomics: A biologist studies the genomic alterations in molds commonly found in humandwellings.
q q q q q q q q q q q q


D. Microbiomics: A microbiologist studies the genomic variation in thermophiles, bacteria that cansurvive
q q q q q q q q q q q


extreme heat near deep ocean vents.
q q q q q q


E. Proteomics: A cardiologist studies desmosomal proteins and their posttranslational modifications in
q q q q q q q q q q


studying arrhythmogenic right ventricular dysplasia.
q q q q q




I-3. Which of the following is the best definition of evidence-based medicine?
q q q q q q q q q q q



A. A summary of existing data from existing clinical trials with a critical methodologic review andstatistical
q q q q q q q q q q q q q q


analysis of summative data
q q q q


B. A type of research that compares the results of one approach to treating disease with anotherapproach to
q q q q q q q q q q q q q q q q


treating the same disease
q q q q


C. Clinical decision-making support tools developed by professional organizations that includeexpert opinions
q q q q q q q q q q


and data from clinical trials
q q q q q


D. Clinical decision making supported by data, preferably randomized controlled clinical trials
q q q q q q q q q q


E. One physician’s clinical experience in caring for multiple patients with a specific disorder over many years
q q q q q q q q q q q q q q q


I-4. Which of the following is the standard measure for determining the impact of a health condition on a
q q q q q q q q q q q q q q q q q q


qpopulation?
A. Disability-adjusted life-years q


B. Infant mortality q


C. Life expectancy
q


D. Standardized mortality ratio q q


E. Years of life lost q q q

,I-5. Which of the following statements regarding disease patterns worldwide is true?
q q q q q q q q q q q



A. Childhood undernutrition is the leading risk factor for global disease burden.
q q q q q q q q q q


B. In a 2006 publication, the World Health Organization (WHO) estimated that 10% of the totalglobal burden
q q q q q q q q q q q q q q q


qof disease was due to modifiable environmental risk factors.
q q q q q q q q


C. In 2010, ischemic heart disease was the leading cause of death among adults.
q q q q q q q q q q q q


D. In the last two decades, mortality attributed to communicable diseases, maternal and perinatalconditions,
q q q q q q q q q q q q


qand nutritional deficiencies has remained fairly stable, with the majority (76%) of mortality from these
q q q q q q q q q q q q q q


qcauses occurring in sub-Saharan Africa and southern Asia.
q q q q q q q


E. While poverty status has been shown to be linked to health status on the individual level, thesame
q q q q q q q q q q q q q q q q


qrelationship does not hold true when studying the link between national health indicators and gross
q q q q q q q q q q q q q q


qdomestic product per capita among nations. q q q q q




I-6. You are appointed to a governmental healthcare advisory subcommittee concerned with addressing problems
q q q q q q q q q q q q q


q facing the global health community. Your task is to draw general conclusions from the global fight against
q q q q q q q q q q q q q q q q


q tuberculosis (TB) and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) that
q q q q q q q q q q


q may be applied in combatting other diseases, including noncommunicable diseases. Which of the following
q q q q q q q q q q q q q


q conclusions is reasonable when considering HIV/AIDS and TB as chronic diseases?
q q q q q q q q q q



A. Barriers to adequate healthcare and patient adherence imposed by extreme poverty must beconcomitantly
q q q q q q q q q q q q


addressed to adequately treat and prevent chronic disease in developing nations.
q q q q q q q q q q q


B. Charging small fees for health services (e.g., AIDS prevention and care) supplies the patient witha sense of
q q q q q q q q q q q q q q q q


the treatment’s value and increases compliance and overall public health.
q q q q q q q q q q


C. Despite adequate available tools to practice their trade locally in developing nations, manyphysicians and
q q q q q q q q q q q q q


nurses emigrate to developed nations to practice their respective trades, a phenomenon called “brain
q q q q q q q q q q q q q q


drain.”
q


D. In developed nations where physicians are abundant, community health worker supervision ofthe care of
q q q q q q q q q q q q q


chronically ill patients is not effective.
q q q q q q


E. In the case of chronic infectious diseases, switching from one drug to another through aprolonged course of
q q q q q q q q q q q q q q q q


treatment provides the highest cure rate by obviating the infectious agent’s ability to develop resistance to
q q q q q q q q q q q q q q q q


any single drug.
q q q




I-7. Mrs. Jones, a 22-year-old African American woman, presents to Dr. Smith, an internal medicine specialist, with
q q q q q q q q q q q q q q q q


q a facial rash. Mrs. Jones states that the rash began after spending a day at the beach with her family. She also
q q q q q q q q q q q q q q q q q q q q q


q notes that her metacarpophalangeal and proximal interphalangeal joints have been painful and swollen for the
q q q q q q q q q q q q q q


q preceding 2 weeks. On examination, the joints are swollen and tender. Laboratory analysis discloses reduced
q q q q q q q q q q q q q q


q creatinine clearance, proteinuria, and hemolytic anemia. Antinuclear antibodies (a test with a high negative
q q q q q q q q q q q q q


q predictive value for systemic lupus erythematosus) are detected at significant titer, and ultimately, the
q q q q q q q q q q q q q


q diagnosis of systemic lupus erythematosus is made.
q q q q q q


Two weeks later, Mrs. Johnson, a 24-year-old African American woman, presents with a facial rash and elbow
q q q q q q q q q q q q q q q q


q pain to Dr. Smith. After a cursory interview and brief physical exam, Dr. Smith sends blood work only testing for
q q q q q q q q q q q q q q q q q q q


q antinuclear antibodies. When the test returns negative (no antibodies detected), Dr. Smith presumes this to be
q q q q q q q q q q q q q q q


q a false-negative result and starts Mrs. Johnson on hydroxychloroquine and prednisone for treatment of
q q q q q q q q q q q q q


q systemic lupus erythematosus. Which heuristic(s) did Dr. Smith likely employ in diagnosing Mrs. Johnson with
q q q q q q q q q q q q q q


q systemic lupus erythematosus? q q


A. Availability heuristic q


B. Anchoring heuristic q


C. Bayes’ rule q


D. Confirmation bias q




E. A and B q q




I-8. You have invented a blood test, which you name “veritangin,” to determine if patients are having a myocardial
q q q q q q q q q q q q q q q q q q


q infarction. You devise an experiment to determine the performance of your veritangin assay by testing it versus
q q q q q q q q q q q q q q q q


q the troponin assay, the currently accepted gold standard for determining myocardial infarction, in 100 random
q q q q q q q q q q q q q q


q emergency department patients with chest pain. You choose a veritangin result >1 ng/dL as positive for
q q q q q q q q q q q q q q q


q myocardial infarction. Your results are listed in the table below.
q q q q q q q q q

, Which of the following statements regarding the characteristics of the veritangin assay in this trial is true?
q q q q q q q q q q q q q q q q



A. The posttest probability of the veritangin test does not depend on the population studied.
q q q q q q q q q q q q q


B. The sensitivity of the veritangin assay depends on the population studied and the diseaseprevalence in that
q q q q q q q q q q q q q q q


population.
q


C. The sensitivity of the veritangin assay will decrease by 50% if you reduce the threshold for apositive result
q q q q q q q q q q q q q q q q q


to >0.5 ng/dL.
q q q


D. The sensitivity of the veritangin test cannot be calculated based on the above data.
q q q q q q q q q q q q q


E. The specificity of the veritangin assay is 0.93 (70/75).
q q q q q q q q




I-9. You are designing a clinical trial to test the use of a novel anticoagulant, clotbegone, in the treatment of deep
q q q q q q q q q q q q q q q q q q q q


q vein thrombosis. Which of the following statements regarding the design of the trial is true?
q q q q q q q q q q q q q q



A. An optimal study design would assign many patients to clotbegone and compare their outcomesto the
q q q q q q q q q q q q q q


outcomes of prior (historical) patients not taking clotbegone. This would allow faster trial completion.
q q q q q q q q q q q q q q


B. If the trial returns a positive result (clotbegone is superior to placebo), that means that anypatient with a
q q q q q q q q q q q q q q q q q


clot would benefit from clotbegone therapy.
q q q q q q


C. Observing the outcomes of patients already taking clotbegone versus patients who are not ispreferable to
q q q q q q q q q q q q q q


assigning patients to clotbegone or placebo in a blinded fashion. The observational strategy is more “real
q q q q q q q q q q q q q q q q


world,” applicable to the general population, and free of bias.
q q q q q q q q q q


D. Population selection for the trial enrollment is not important as long as careful attention torandomization
q q q q q q q q q q q q q q


and blinding is observed.
q q q q


E. The advantage of performing a randomized clinical trial of clotbegone over a prospectiveobservational
q q q q q q q q q q q q


study of clotbegone is the avoidance of treatment selection bias.
q q q q q q q q q q




I-10. A receiver operating characteristic (ROC) curve is constructed for a new test developed to diagnose disease X.
q q q q q q q q q q q q q q q q q


qAll of the following statements regarding the ROC curve are true EXCEPT:
q q q q q q q q q q q



A. One criticism of the ROC curve is that it is developed for testing only one test or clinicalparameter with
q q q q q q q q q q q q q q q q q q


exclusion of other potentially relevant data.
q q q q q q


B. ROC curve allows the selection of a threshold value for a test that yields the best sensitivity withthe fewest
q q q q q q q q q q q q q q q q q q


false-positive tests.
q q


C. The axes of the ROC curve are sensitivity versus 1 – specificity.
q q q q q q q q q q q


D. The ideal ROC curve will have a value of 0.5.
q q q q q q q q q


E. The value of the ROC curve is calculated as the area under the curve generated from the true-positive rate
q q q q q q q q q q q q q q q q q q


versus the false-positive rate.
q q q q




I-11. When considering a potential screening test, what end points should be considered to assess the potential
q q q q q q q q q q q q q q q q


qgain from a proposed intervention?
q q q q



A. Absolute and relative impact of screening on the disease outcome
q q q q q q q q q


B. Cost per life-year saved q q q


C. Increase in the average life expectancy for the entire population
q q q q q q q q q


D. Number of subjects screened to alter the outcome in one individual
q q q q q q q q q q


E. All of the aboveq q q




I-12. You are appointed to an advisory committee in the WHO tasked with making recommendations regarding
q q q q q q q q q q q q q q q


qbreast cancer screening and prevention. In regard to screening and preventing breast cancer in women, which
q q q q q q q q q q q q q q q


qof the following potential recommendations from your committee would be valid?
q q q q q q q q q q

Les avantages d'acheter des résumés chez Stuvia:

Qualité garantie par les avis des clients

Qualité garantie par les avis des clients

Les clients de Stuvia ont évalués plus de 700 000 résumés. C'est comme ça que vous savez que vous achetez les meilleurs documents.

L’achat facile et rapide

L’achat facile et rapide

Vous pouvez payer rapidement avec iDeal, carte de crédit ou Stuvia-crédit pour les résumés. Il n'y a pas d'adhésion nécessaire.

Focus sur l’essentiel

Focus sur l’essentiel

Vos camarades écrivent eux-mêmes les notes d’étude, c’est pourquoi les documents sont toujours fiables et à jour. Cela garantit que vous arrivez rapidement au coeur du matériel.

Foire aux questions

Qu'est-ce que j'obtiens en achetant ce document ?

Vous obtenez un PDF, disponible immédiatement après votre achat. Le document acheté est accessible à tout moment, n'importe où et indéfiniment via votre profil.

Garantie de remboursement : comment ça marche ?

Notre garantie de satisfaction garantit que vous trouverez toujours un document d'étude qui vous convient. Vous remplissez un formulaire et notre équipe du service client s'occupe du reste.

Auprès de qui est-ce que j'achète ce résumé ?

Stuvia est une place de marché. Alors, vous n'achetez donc pas ce document chez nous, mais auprès du vendeur Ascorers. Stuvia facilite les paiements au vendeur.

Est-ce que j'aurai un abonnement?

Non, vous n'achetez ce résumé que pour €17,02. Vous n'êtes lié à rien après votre achat.

Peut-on faire confiance à Stuvia ?

4.6 étoiles sur Google & Trustpilot (+1000 avis)

85443 résumés ont été vendus ces 30 derniers jours

Fondée en 2010, la référence pour acheter des résumés depuis déjà 14 ans

Commencez à vendre!
€17,02
  • (0)
  Ajouter