define:

reliability

validity

kappa

reliability is the reproducibility of data

validity is a measure of accuracy

kappa is a measure of inter-rater reliability

= Pr(o) - Pr(e) / 1 - Pr(e)

when do you use fleiss's kappa?

Cohen's kappa?

for multi-rater data

for bi-rater data

add a rater's positives and divide by total

(this is their probability for positives) 

multiply by the other rater's probability for positives

this is a calculation of both rater's likelihood of finding a positive

add this number to a calculation of both rater's likelihood of finding a negative

SNOUT'S RULE:

A highly sensitive test... 

=> few false negatives

=> Very sensitive test with negative result rules out the disease  

SPIN RULE:

 A highly specific test

      => few false positives

        => Very specific test with positive result rules in the disease

disease prevalence

    - good PPV in sub-Saharan Africa,

    - extremely low PPV in the US

      because the prevalence of malaria is vanishingly low in US

FractureàTear of blood vesselsàBlood collectionàBlood clot

it would be positive for anti-SS-A and SS-B

in addition, it would be RF positive and have a speckled FANA appearance

salivary gland destruction is seen in this disease and lymphoid destruction at the lip

acute RA has to be caused by viruses and have a course that is about 5 weeks long and self-limiting.

if it has lasted 6-8 weeks, it is not acute, and this is important because treatments are different.

Type 1:  Reagin (allergy) mediated (IgE)

Type 2:  Cytotoxic (IgM and IgG)

Type 3:  Ab-Ag complex (IgM and IgG)

Type 4:  Delayed hypersensitivity (cell mediated immunity)

Which test would most likely be normal or near normal in a patient with Dermat/Poly?

Serum Creatine kinase

Electromyography

Muscle biopsy

Autoantibodies

T3T4 thyroid test

During an isotonic contraction of skeletal muscle, the maximum velocity of shortening is a function of:

Number of motor units recruited

Rate of cross-bridge cycling

Number of cross-bridges that are in a position to interact with actin filaments

Frequency of action potentials across the sarcolemma

Rate of calcium influx across the sarcolemma

In immune complex vasculitis, which of the following is the predominant effector cell?

B-cell

Giant cell

Macrophage

Polymorphonuclear leukocyte

T-cell

Polymorphonuclear leukocyte

A patient complains of vague pain over the anterior medial portion of the shoulder girdle just under the

clavicle. You palpate the area and find they are tender to palpation over the corocoid process of the

scapula. Injury to what tendon may cause this finding?

Supraspinatus tendon

Teres minor tendon

Long head of biceps tendon

Short head of biceps tendon

Deltoid tendon

both are members of the synovial intima

A and B.

A is phagocytic, of macrophage origin, and is responsible for the removal of undesirable elements from synovial fluid

B is fibroblastic (mesyncimal) in origin and produces hyaluronan which makes the synovial fluid ropy 

in petrosis, clastic activity is inhibited and leads to loss of the medullary cavity (which leads to loss of marrow).  obviously this will lead to anemia.

-there is carbonin anhydrase deficiency and limited RANKL (which is needed to activate the clasts)

clast activity and demineralization

infections around bone, may have come from a direct inoculation (usually staph or salmonella in sickle cell)

this is where you see the sequestrum and involucrum

de quevarvain's tenosynovitis

extensor pollicis brevis and abductor pollicis longus

stretch, NOT contraction, and passive stretch at that.  if the biceps muscle is being actively contracted, the triceps muscle's Ia activity is increasing.

The actual LENGTH is being measured by Ib, not Ia. A measures RATE.

major inflammation, RA, AS, Gouty Arthritis

not simple fevers and pain (there's a high rate of intolerance)

in is a form of diclofenac and it induces uterine contractions.

monitor hepatic enzymes for all diclofenacs