Mixed Deck — All DO Topics Flashcards

Which type of error occurs when a study fails to detect a true difference between groups because of insufficient sample size?

Answer: Type II error (beta error)

A Type II (beta) error is a false negative — failing to detect a real difference due to inadequate statistical power, often caused by too small a sample size.

In a clinical study, internal validity refers to:

Answer: Whether the study results accurately reflect the true effect in the study population

Internal validity reflects how well the study design eliminates bias and confounding to establish that the observed association is real within the study population.

In craniosacral therapy, the practitioner monitors the 'primary respiratory mechanism,' which has a normal rate of approximately how many cycles per minute?

Answer: 6–12 cycles per minute

The craniosacral rhythm, reflecting the primary respiratory mechanism, normally oscillates at 6–12 cycles per minute.

The positive predictive value (PPV) of a test increases as:

Answer: Disease prevalence in the tested population increases

PPV (probability a positive test is truly positive) rises when the disease is more prevalent in the population being tested, because there are more true positives relative to false positives.

The lymphatic pump technique is primarily used to enhance what physiological function?

Answer: Lymphatic and immune circulation

Lymphatic pump techniques rhythmically increase intrathoracic pressure to propel lymph through the lymphatic vessels and boost immune function.

A physician discovers that a colleague is impaired by substance use and posing a risk to patients. The physician's ethical obligation is to:

Answer: Report the colleague to the appropriate authority or licensing board

Physicians have a professional duty to protect patients from harm, which requires reporting an impaired colleague to hospital administration or the state medical board.

A patient on an SSRI develops agitation, tremor, diaphoresis, hyperreflexia, and clonus within hours of adding tramadol. How does serotonin syndrome differ from Neuroleptic Malignant Syndrome?

Answer: Serotonin syndrome has rapid onset with clonus; NMS has slower onset with lead-pipe rigidity

Serotonin syndrome has rapid onset (within hours), features clonus and hyperreflexia, and is caused by serotonergic drugs; NMS has slower onset over days, lead-pipe rigidity, and is caused by antipsychotics.

Which beta-blocker is cardioselective (β1-selective) and preferred in patients with mild asthma requiring heart rate control?

Answer: Metoprolol

Metoprolol is β1-selective and less likely to cause bronchospasm than nonselective agents like propranolol, though caution is still advised in asthma.

The anterior cruciate ligament arises from the ____ and runs backward, upward, and ____ to insert on to the lateral femoral condyle.

Answer: Tibia; Lateral

The anterior cruciate ligament (ACL) originates from the anterior intercondylar area of the tibia. From there, it runs backward, upward, and laterally to insert onto the medial surface of the lateral femoral condyle. This specific orientation is critical for preventing anterior translation of the tibia relative to the femur and limiting hyperextension of the knee.

The Still technique in OMM is best described as which type of combined approach?

Answer: Indirect followed by direct with a dynamic thrust

The Still technique first moves toward ease (indirect), then through the barrier with a dynamic corrective force.

A patient prescribed an SSRI for depression develops agitation, hyperthermia, and clonus after adding tramadol. What syndrome is occurring?

Answer: Serotonin syndrome

Tramadol inhibits serotonin reuptake, and when combined with an SSRI, excessive serotonergic activity causes serotonin syndrome.

Soft tissue technique in OMM achieves its effect primarily through which mechanism?

Answer: Stretching and kneading muscles and fascia to reduce tension

Soft tissue technique uses sustained pressure, stretching, and kneading to lengthen hypertonic muscles and improve local circulation.

Which of the four elements of malpractice must include proof that the physician's breach directly caused patient harm?

Answer: Causation

Causation (both actual and proximate) requires proving that the physician's breach of the standard of care directly resulted in the patient's injury.

The Zink patterns in fascial compensation describe alternating regions of fascial preference. Which pattern is considered the 'common compensatory pattern'?

Answer: OA right, CT left, TL right, LS left

The common compensatory Zink pattern shows alternating fascial rotatory preferences: OA right, CT left, TL right, LS left.

A patient taking haloperidol develops hyperthermia (40.5°C), severe lead-pipe muscle rigidity, altered consciousness, and autonomic instability. CPK is markedly elevated. What is this condition?

Answer: Neuroleptic Malignant Syndrome

Neuroleptic Malignant Syndrome is a life-threatening antipsychotic reaction presenting with hyperthermia, lead-pipe rigidity, altered consciousness, and autonomic instability with elevated CPK.

A 95% confidence interval (CI) for a relative risk that does NOT cross 1.0 indicates:

Answer: The result is statistically significant at the p < 0.05 level

When a 95% CI for RR excludes 1.0 (no effect), the finding is statistically significant at the corresponding p < 0.05 threshold.

A patient on lithium develops nausea, tremor, and confusion. Which medication should be reviewed as a potential cause of lithium toxicity?

Answer: Ibuprofen (NSAID)

NSAIDs reduce renal prostaglandin synthesis, decreasing GFR and lithium clearance, which can rapidly elevate lithium levels to toxic concentrations.

A systematic review that mathematically pools data from multiple RCTs to increase statistical power is called a:

Answer: Meta-analysis

Meta-analysis combines quantitative data from multiple studies using statistical methods to derive more precise pooled estimates of treatment effects.

A 40-year-old woman with depression is started on fluoxetine. What is the primary mechanism of action of SSRIs?

Answer: Inhibition of serotonin reuptake at the presynaptic terminal

SSRIs block the serotonin transporter (SERT), preventing reuptake of serotonin into the presynaptic neuron and increasing serotonin availability in the synaptic cleft.

Which drug class is used to treat opioid-induced constipation by acting as a peripherally restricted mu-opioid receptor antagonist?

Answer: Methylnaltrexone (PAMORA)

PAMORAs like methylnaltrexone block peripheral gut opioid receptors without crossing the blood-brain barrier, relieving constipation without reversing analgesia.