Test Questions on Exam 1 – Flashcards with Answers

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T/F: The prolonged training of physicians erodes their professionalism
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False
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T/F: There are far more medical schools in the US today than there used to be in the 1800s
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False
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T/F: The Flexner Report of 1910 found that nearly all medical schools were up to a very good standard
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False
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T/F: When hospitals served as centers of religious practice they primarily catered to the wealthy
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False
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T/F: The epidemiology transition is a period marked by a transition from chronic to infectious diseases
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False
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T/F: A life course perspective focuses solely on a specific point in the life course
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False
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T/F: Demographers and epidemiologists have never diverged in their academic objectives
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False
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T/F: Social epidemiologists have found a common research agenda with demographers
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True
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T/F: Epidemiologists only study infectious diseases
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False
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T/F: In founding modern epidemiology, Dr. John Snow identified yeast from bread makers as the source of cholera outbreaks in London, England
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False
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T/F: Current epidemiologists have proposed that we are entering a fourth era of epidemiology, defined by multidisciplinary causes of disease including reemerging infectious diseases
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True
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T/F: The Framingham Study helped unravel the major causes of heart disease
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True
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T/F: Curranderos and curranderas tend to view suffering as a part of God’s play, much like Spanish Catholic tradition, which believes that Christ suffering on the cross was beneficial
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True
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T/F: Racial/ethnic minorities or people with lower socioeconomic backgrounds tend to use folk and faith healers the most
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True
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T/F: The american Medical Association (AMA) conspired to destroy the field of osteopathy
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False
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T/F: Patients are typically referred to chiropractors by their biomedical physicians
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False
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T/F: Doctors of osteopathy undergo training through an internship and residency
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True
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T/F: The majority of patients who use complementary and alternative medicine do not see a general practitioner first
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False
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Patients report the following reason(s) for using complementary and alternative medicine: A. more time with the doctor B. a more holistic approach C. care providers rely more on patients knowledge of their own symptoms D. concern with side effects of biomedicine E. enjoy the experience F. Believe it will help their health G. all of the above
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G. All of the above
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What is sociology?
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Scientific study of society, including patters of social relationships, social interaction, and culture
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Key points of the history of medical sociology
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1. Historical overlap between medicine, medical sociology, and public health 2. Schift between social and biological causes of medicine 3. Parallel rise in disciplines of medicine and medical sociology in 20th century
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What did the Chadwick report of 1842 do?
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Connected social conditions to health and illness
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What did Rudolph Virchow (1848) say? What did he study?
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“Medicine is a social science” Typhus fever
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What is the moral concept of illness?
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Moral people stayed healthy while the immoral became sick
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Turning point of the concept of health and illness in the US was…
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The Civil War
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When was the beginning of social medicine?
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20th century
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When was an organization of public health structure prompted?
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20th century
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Bacteriology studied:
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Germ theory
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What is path dependence, as it related to the US health care system
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A timeline of the history of medicine in the US that led to the system we have today
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What was the end result of the path the US health care system took?
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Categorical health care system and employer-based
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What in the timeline changed the support of the AMA for National Health Insurance?
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1927 Committee on the Costs of Medical Care
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Describe the health care experience in the 19th century in relation to hospital vs home
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Hospital: Payment was direct, no privacy, people went to just die Home: by lay people, the fam (women)
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Describe the health care experience in the 20th century in relation to hospital vs home
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Hospital: more protective wear, new technology, new reasons to provide care, national institution, decentralized, more acceptable, trained physicians and nurses due to the Flexner report Homes: secondary role for families
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Medical knowledge in the 19th century
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Not segregated by profession
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2 key facts in the medical knowledge in the 20th century
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Germ theory and technology
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The germ theory and technology changed what in the 20th century?
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Image of medicine, visibility of the physician, elevated prestige of the physician
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Medical authority in the 19th century
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Individual character, lay attitudes, and patient-provider relationships
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Medical authority in the 20th century
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Credentials, institutional affiliations
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Explain how the economic power became a business
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Strengthened authority led to limited supply in licensing led to standardized “product” led to Higher $ returns
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Demography 101
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Epidemiology transition
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What is the epidemiology transition?
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Period where chronic diseases replace infectious diseases as the major causes of mortality
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The 4 epidemiology transitions as types of mortality transitions
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1. Age of infectious epidemics and famine 2. Age of receding pandemics 3. Age of noncommunicable diseases 4. Age of delayed mortality
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Why do we live longer today?
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Better sanitation
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Life course perspective
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???
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Risk-factor vs social epidemiology
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Risk-factor: focus on individual environmental, lifestyle, biological or genetic causes of disease or illness Social: Population based
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Epidemiology
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Study of epidemics by “disease detectives” (epidemiologists).
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What do epidemiologists primarily focus on?
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Health of populations, rather than the individual
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Incidence vs Prevalence
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Incidence: number of new cases Prevalence: number of total cases
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Odds ratio
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odds that an exposed person develops disease ____________________________________ odds that a non-exposed person develops disease
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Disease outbreak ratios
Disease outbreak ratios
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Causal Agents
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1. Biological 2. Nutritional 3. Chemical 4. physical 5. Social
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Major eras of Epi
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1. Sanitary (early 19th) 2. Infectious (late 19t-mid-20th) 3. Chronic (second half of 20th) 4. Eco-epidemiology (21st)
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Example of sanitary era
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Cholera
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Example of infectious era
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Polio
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Example of chronic era
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Smoking
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Example of Eco-epi
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Ebola outbreak
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Do physicians criticize their colleagues?
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No
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Do professionals have protection by the state?
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Yes
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When was the Golden Era of doctoring?
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Middle of the 20th century (1950s)
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What three components made up the golden era?
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1. Professionalization 2. Medical knowledge 3. Economic power
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Were escalated prices and overcharging part of the golden era?
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Yes
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Was fee-for-service payment structure part of the golden era?
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Yes
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When was the end of the golden era?
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Late 20th century
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What caused the end of the golden era?
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1. Corporatization 2. Competition 3. Globalization 4. Technology reliance 5. Changing doctor-patient relationships 6. Fragmentation of the physicians’ union (AMA) 7. Rising health care costs- managed care
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How did doctoring become corporatized?
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Physicians provide care in increments, restricted by time and required quota, creates assembly-line medicine
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What is meant by globalization?
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Over or under-supply of doctors internet lay knowledge
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What did reliance of technology cause?
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Body seen as a machine Demystification of the body
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How did health care cost change from the golden era?
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Fee-for-service to Third-party payer (health insurance)
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How do we define alternative or complementary medicine? (Alternative to…?)
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Alternative to biomedicine
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Osteopaths/Chiropractors: Views the neuromuscular system as vital
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osteopaths
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Osteopaths/Chiropractors: Manipulation of bones in spinal column
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chiropractors
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Osteopaths/Chiropractors: Has training similar to MDs
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osteopaths
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Osteopaths/Chiropractors: not recognized by the AMA
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chiropractors
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Osteopaths/Chiropractors: Reimbursed by Medicare
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chiropractors
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Who uses CAM?
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Middle- or working-class social backgrounds (women>men) Racial/ethnic minorities or lower social groups
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Describe Lia Lee’s story
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4 year old had epilepsy; family believed these seizures were a gift of “seeing,” did not allow medicine, had a fatal seizure that caused her to be in a vegetative state until twenty something… when she died.

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