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CHLH 274 Final Exam Study Set

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John Snow, Author of Snow on Cholera:
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Was an early epidemiologist who used natural experiments.
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Which of the following activities characterizes a clinical approach?
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Description of specific signs and symptoms in a patient
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Lung Cancer is the leading cause of cancer deaths among both males and females in the United States.
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True
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The Framingham Heart Study, begun in 1948, pioneered research into coronary heart disease risk factors.
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True
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Cyclic Variations in the occurrence of pneumonia and influenza mortality may reflect:
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Seasonal variations in cases of influenza.
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Marriage is hypothesized to act as either a selective or a protective factor in health.
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True
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In less developed regions, triangular population distributions are linked to high mortality among younger age groups.
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True
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Indicate the level of prevention for: Immunization against rubella
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Primary Prevention Active
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Indicate the level of prevention for: Pasteurization of milk
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Primary Prevention Passive
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Indicate the level of prevention for: Screening for breast cancer
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Secondary Prevention
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Indicate the level of prevention for: Half-Way houses for persons recovering from addiction
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Tertiary Prevention
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Indicate the level of prevention for: Nutritional counseling for pregnant women
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Primary Prevention Active
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In 1900, the death rate per 100,000 members of the population for influenza and pneumonia (I & P) was 202.2; it was 22.4 in 2003. How much did the death rate due to I & P decline?
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90%
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There has been an increase in the number of epidemiologic studies reported in medical journals because:
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They interest the public and physicians concerned with preventative medicine.
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Beach City has a rising population of 500,000 robust, fertile males and 450,000 robust, fertile females. If there were 4,000 live births, 3 fetal deaths, and 40 maternal deaths, what is the crude birth rate?
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4,000/950,000 × 1,000
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The difference between primary and secondary prevention of disease is:
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Primary prevention means control of causal factors, while secondary prevention means early detection and treatment of disease.
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Which of the following terms is expressed as a proportion (as distinguished from a ratio)?
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Female Births/ Male + Female Births
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An epidemiologic survey of roller-skating injuries in Metroville, a city with a population of 100,000 (during the midpoint of the year), produced the following data for a particular year: Number of skaters in Metroville during any given month 12,000 Roller-skating injuries in Metroville 600 Total number of residents injured from roller-skating 1,800 Total number of deaths from roller-skating 90 Total number of deaths from all causes 900
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90/900 × 100
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An epidemiologic survey of roller-skating injuries in Metroville, a city with a population of 100,000 (during the midpoint of the year), produced the following data for a particular year: Number of skaters in Metroville during any given month 12,000 Roller-skating injuries in Metroville 600 Total number of residents injured from roller-skating 1,800 Total number of deaths from roller-skating 90 Total number of deaths from all causes 900
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900/100,000 × 100,000
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An epidemiologic survey of roller-skating injuries in Metroville, a city with a population of 100,000 (during the midpoint of the year), produced the following data for a particular year: Number of skaters in Metroville during any given month 12,000 Roller-skating injuries in Metroville 600 Total number of residents injured from roller-skating 1,800 Total number of deaths from roller-skating 90 Total number of deaths from all causes 900
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90/100,000 × 100,000
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Incidence and prevalence data have different applications in public health. For the list of uses for data in this question, indicate by choosing the appropriate option whether the use is for incidence or prevalence data. The fundamental tool for etiologic studies of both acute and chronic diseases
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This is a use primarily for incidence data.
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Incidence and prevalence data have different applications in public health. For the list of uses for data in this question, indicate by choosing the appropriate option whether the use is for incidence or prevalence data. Determining workload and planning the scope of facilities and manpower needs, particularly for chronic disease.
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This is a use primarily for prevalence data.
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An investigator wanted to know whether chronic lymphocytic leukemia (CLL) had a genetic or environmental etiology. He knew that rates in country X were higher than those in the United States. He decided to study the rates in the country of origin, in migrants, and in U. S. whites. He observed the following: Population Rate Country X 50/100,000 Migrants from Country X to U. S. 10/100,000 U. S. whites 10/100,000 What are the reasons for this relationship?
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The cause may be environmental.
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Successful treatment programs that would shorten the duration of a disease primarily affect:
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The prevalence of the disease.
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The incidence of a disease is five times greater in men than in women, but the prevalence shows no sex difference. The most likely explanation is that:
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The duration of the disease is greater in women.
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According to classic studies, age-standardized morbidity rates in the United States for acute conditions, chronic conditions, and disability due to acute conditions show the following sex differences:
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Rates for females are higher than rates for males.
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Blood pressure measurements on adult males 30-39 years of age were obtained in a survey of a representative sample of Twin Cities households. To compare the frequency of hypertension in the white and non-white population surveyed, the most appropriate measure is the:
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Race-specific prevalence
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Age-specific and age-adjusted mortality rates by sex in the United States generally show the following sex differences:
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Rates for males are higher than rates for females from birth to age 85 and older.
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Which of the following reasons might account for place variation in disease? a. Concentration of racial or ethnic groups within an area b. Genetic and environment interactions c. Influence of climate d. Presence of environmental carcinogens e. All of the above
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All of the above
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Descriptive epidemiology characterizes the amount and distribution of disease within a population and enables the researcher to:
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Generate testable hypotheses regarding etiology and Evaluate trends in health and disease within a population.
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The major disadvantage of crude rates is that:
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They do not permit comparison of populations that vary in composition.
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At the initial examination in the Framingham study, coronary heart disease was found in 5 per 1000 men ages 30-44, and in 5 per 1000 women ages 30-44. The inference that in this age group men and women have an equal risk of getting coronary heart disease is incorrect because the data are prevalence data and not incidence data.
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True
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Health insurance statistics provide a generally representative picture of the health status of the United States population.
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False
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Cohort studies preserve the temporality of cause (exposure) happening before the effect (disease).
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True
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Controls are needed in a case-control study to evaluate whether the frequency of a factor or past exposure among the cases is different from that among comparable persons who do not have the disease under investigation.
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True
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Identify which of the following six types of study designs most appropriately characterizes the situation described below. To test the efficacy of vitamin C in preventing colds, army recruits are randomly assigned to one of two groups: one in which 500 mg of vitamin C is administered daily, and one in which 500 mg of a placebo is administered daily. Both groups are followed to determine the number and severity of subsequent colds.
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Clinical Trial
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Repeated cross-sectional surveys may underestimate past smoking behavior of older age cohorts.
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True
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Relative risk is the ratio of the risk of disease among the exposed to the risk among the unexposed.
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True
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Identify which of the following six types of study designs most appropriately characterizes the situation described below. The physical examination records of the incoming freshmen class of 1935 at the University of Minnesota are examined in 1980 to see whether their recorded height and weight at the time of admission to the university are related to their chance of developing coronary heart disease by 1981.
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Historical Prospective Cohort Study
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In contrast to observational studies, intervention studies are employed to:
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Test the efficacy of prevention measures
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Subjects for an exposure-based cohort study would be selected most appropriately from:
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Certain occupational groups such as battery workers
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Controlled clinical trials enable researchers to: a. derive knowledge about the origins of a disease b. exercise control over who will receive an exposure c. more accurately identify cause and effect associations d. all of the above
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All of the Above
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Indicate the level of prevention (A, B, or C) that is represented in: Nutritional counseling for pregnant women.
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Primary Prevention
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Indicate the level of prevention (A, B, or C) that is represented in: Half-way houses for persons recovering from addiction.
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Tertiary Prevention
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Indicate the level of prevention (A, B, or C) that is represented in Pasteurization of milk.
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Primary Prevention
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Indicate the level of prevention (A, B, or C) that is represented in: Immunization against rubella.
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Primary Prevention
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Indicate the level of prevention (A, B, or C) that is represented in: Screening for breast cancer.
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Secondary Prevention
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Nested case-control studies: a. use subjects drawn from a cohort study b. provide a degree of control over confounding c. reduce the cost of collecting exposure information d. all of the above
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All of the Above
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Examples of descriptive epidemiologic studies do not usually include:
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Cohort Studies
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A major advantage of community trials is that they are:
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Able to estimate directly the realistic impact of behavior change
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A major advantage of cohort studies over case-control studies with respect to the role of a suspected factor in the etiology of a disease is that:
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They permit direct estimation of risk of disease in those exposed to the suspected factor.
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Which number best approximates risk associated with alcohol Drinking in Men?
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1.37
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A five-year prospective cohort study has just been completed. The study was designed to assess the association between supplemental vitamin A exposure and mortality and morbidity for measles. The RR for incidence of measles was 0.75 and the RR for measles mortality was 0.5. Which statement is correct?
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Exposure to vitamin A appears to protect against morbidity and mortality for measles.
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What is one of the widely used sources of statistical data on cancer?
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Disease Registries
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Descriptive epidemiology characterizes the amount and distribution of disease within a population and enables the researcher to:
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Generate testable hypotheses regarding etiology and Evaluate trends in health and disease within a population
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What data source has the advantage of being almost nearly complete in the U.S.?
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Mortality and Birth Statistics
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Information about the cause of death listed on a death certificate may be unreliable because: a. the cause of death may be unclear b. certain diseases carry a stigma c. diagnostic criteria may lack standardization d. assignment of the cause of death may be arbitrary e. all of the above
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All of the Above
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In case-control studies, the odds ratio is used as an estimate of the relative risk. In order for this approximation to be reasonable, some conditions must be met. Which of the following conditions is not necessary in order to use the odds ratio to estimate the relative risk?
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With respect to exposure, controls are representative of the population to which you want to generalize your results.
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Examples of exposure data in ecologic studies include: a. Per capita income b. Mean ambient temperatures c. Smoking prevalence d. Per capita calorie intake e. All of the above
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All of the Above
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As an epidemiologist you are going to investigate the effect of a drug suspected of causing malformations in newborn infants when the drug in question is taken by pregnant women during the course of their pregnancies. As your sample you will use the next 200 single births occurring in a given hospital. For each birth a medication history will be taken from the new mother and from her doctor; in addition, you will review medical records to verify use of the drug. [N.B.: These mothers are considered to have been followed prospectively during the entire course of their pregnancies, because a complete and accurate record of drug use was maintained during pregnancy.] The resultant data are: Forty mothers have taken the suspected drug during their pregnancies. Of these mothers, 35 have delivered malformed infants. In addition, 10 other infants are born with malformations. Suppose that a relative risk of 0.5 (users of the drug compared to non-users) has been found. Which interpretation might follow?
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The risk of congenital malformations is half as high among users of the drug as among non-users.
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As an epidemiologist you are going to investigate the effect of a drug suspected of causing malformations in newborn infants when the drug in question is taken by pregnant women during the course of their pregnancies. As your sample you will use the next 200 single births occurring in a given hospital. For each birth a medication history will be taken from the new mother and from her doctor; in addition, you will review medical records to verify use of the drug. [N.B.: These mothers are considered to have been followed prospectively during the entire course of their pregnancies, because a complete and accurate record of drug use was maintained during pregnancy.] The resultant data are: Forty mothers have taken the suspected drug during their pregnancies. Of these mothers, 35 have delivered malformed infants. In addition, 10 other infants are born with malformations. What type of study design is this?
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Prospective cohort study
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As an epidemiologist you are going to investigate the effect of a drug suspected of causing malformations in newborn infants when the drug in question is taken by pregnant women during the course of their pregnancies. As your sample you will use the next 200 single births occurring in a given hospital. For each birth a medication history will be taken from the new mother and from her doctor; in addition, you will review medical records to verify use of the drug. [N.B.: These mothers are considered to have been followed prospectively during the entire course of their pregnancies, because a complete and accurate record of drug use was maintained during pregnancy.] The resultant data are: Forty mothers have taken the suspected drug during their pregnancies. Of these mothers, 35 have delivered malformed infants. In addition, 10 other infants are born with malformations. The number of individuals who both did not take the drug and did not give birth to infants who were malformed was:
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150
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As an epidemiologist you are going to investigate the effect of a drug suspected of causing malformations in newborn infants when the drug in question is taken by pregnant women during the course of their pregnancies. As your sample you will use the next 200 single births occurring in a given hospital. For each birth a medication history will be taken from the new mother and from her doctor; in addition, you will review medical records to verify use of the drug. [N.B.: These mothers are considered to have been followed prospectively during the entire course of their pregnancies, because a complete and accurate record of drug use was maintained during pregnancy.] The resultant data are: Forty mothers have taken the suspected drug during their pregnancies. Of these mothers, 35 have delivered malformed infants. In addition, 10 other infants are born with malformations. The relative risk between exposure to the drug and malformations is:
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14