question

Clinical outcomes of severe WNV neurologic disease was substantially worse for elderly patients. Advanced age is best described as..?

answer

prognostic factor

question

a study conducted in which rates of subsequent malarial infections are compared in communities w/ and w/o mosquito abatement programs. This is best described as...?

answer

cohort study

question

WNV had occurred for the 1st time in the US the preceding year. This unusual pattern of occurrence is best described as...?

answer

epidemic

question

Among Staten Island residents, 2.5 per 100,000 persons developed severe WNV neurologic disease during an epidemic. This measure is best described as...?

answer

incidence rate

question

A study of antiviral agents is conducted for the treatment of severe WNV neurologic disease in which treatment assignments to individual patients are made by chance. This study is a...?

answer

randomized controlled clinical trial

question

Epidemiology is broadly defined as the study of factors that influence the health of populations. The application of epidemiologic findings to decisions in the care of individual patients is:

answer

clinical epidemiology

question

Epidemiology is broadly defined as the study of factors that influence the health of a population. The application of epidemiologic findings in populations for the prevention of non-infectious disease in communities is:

answer

classical epidemiology

question

the BEINGS model is a useful paradigm for:

answer

evaluating etiological factors in disease

question

the BEINGS model provides a list of factors in disease causality. Which of the following factors are explicitly included in the list?

answer

behavioral, environmental, immunologic, nutritional, genetic and social factors

question

for an infectious disease to occur there must be an interaction between

answer

the host and the agent

question

Herd immunity refers to:

answer

the prevention of disease transmission to susceptible individuals through acquired immunity in others

question

A study involves tracking a recurring disease (migraines) in individuals over a 3 year period. Which of the following measures would allow the authors of the study to make full use of their collected data?

answer

incidence density???

question

During a given year, 12 cases of disease X are detected in a population of 70,000 college students. Many more students have mild symptoms of the disease, such as persistent daydreams about selling coconuts on a Caribbean beach. Of the 12 detected cases, 7 result in death. The ratio of 7/12 represents:

answer

case fatality ratio

question

During a given year, 12 cases of disease X are detected in a population of 70,000 college students. Many more students have mild symptoms of the disease, such as persistent daydreams about selling coconuts on a Caribbean beach. To report the incidence rate of disease X, it would be necessary to know:

answer

the midyear population at risk

question

During a given year, 12 cases of disease X are detected in a population of 70,000 college students. Many more students have mild symptoms of the disease, such as persistent daydreams about selling coconuts on a Caribbean beach. To report the prevalence of disease X, it would be necessary to know

answer

the number of cases at a given time

question

What percentage of death certificate diagnoses are thought to be potentially inaccurate?

answer

15-20%

question

What percentage of death certificate diagnoses are thought to be accurate?

answer

80-85%

question

An outbreak of disease should be reported to the local or state health department:

answer

under all circumstances

question

AZ, CO, and NM report cases of a spike in respiratory tract illness with a high case fatality ratio. What is most reliably true regarding this event?

answer

it is appropriately investigated by the FDA

question

Cases of 'flesh‐eating' group A streptococcal disease are reported in a defined population. Which of the following types of information would be most helpful for determining whether these cases represent a disease outbreak?

answer

the usual disease patterns and reporting practices

question

An official from the state department of public health visits outpatient clinics and emergency departments to determine the number of cases of post exposure prophylaxis for rabies. The official's action is an example of:

answer

active surveillance

question

An article highlighting the long‐term consequences of inadequately treated Lyme's disease is published in a medical journal. After a summary of the article appears in popular newspapers and magazine, patients with joint pains begin insisting that their physicians test them for Lyme's disease. Cases in which the test results are positive are reported as cases of Lyme borreliosis. This represents:

answer

a change in surveillance that would have an unknown effect

question

Among elderly subjects who are physically fit, vigorous exercise reduces the risk of heart disease. Among elderly subject who are physically unfit, the initiation of vigorous exercise might precipitate a myocardial infarction. Fitness may be considered:

answer

an effect modifier

question

Among elderly subjects who are physically fit, vigorous exercise reduces the risk of heart disease. Among elderly subject who are physically unfit, the initiation of vigorous exercise might precipitate a myocardial infarction. Exercise may be considered:

answer

effect modifier

question

In the relationship between obesity and cardiovascular disease, what are hyperlipidemia and hyperglycemia?

answer

intervening variables

question

When questioned years after an illness, individuals who served as cases reported more severe subjective symptoms than did those who served as controls. This probably an example of:

answer

recall bias

question

What is the relationship of asbestos to asbestosis?

answer

necessary cause

question

The basic goal of epidemiologic research is to: (Ch. 5)

answer

compare 2 groups that differ in terms of exposure or outcome

question

Studies may be conducted to generate or test hypotheses. The "Gold Standard" for testing a hypothesis is a:

answer

randomized controlled trial

question

The members of a public health team have a continuing interest in controlling measles infection through vaccination. To estimate the level of immunity in a particular population in a quick and efficient manner, what type of study should they conduct?

answer

cross-sectional survey of vaccination status

question

A case‐control study may have a particular advantage over a cohort study when the disease in question is:

answer

Rare

question

A cohort study may have a particular advantage over a case‐control study when the disease in question is:

answer

not sure, but the answer is NOT rare

question

A clinical research team recommends symptomatic treatment for a clinical toxidrome which has been shown to be effective in animal models. Now the team will test multiple dose levels of the FDA approved drug in a very small group of volunteers. Which of the designs would yield the most information and why?

answer

A latin square study because it efficiently limits the number of..??? something?

question

A team of researchers hypothesize that watching "Barney" might lead to epilepsy in childhood. Children with and without epilepsy are compared on the basis of hours spent watching "Barney." Which of the following statements best characterize the assessment of data in a study such as this?

answer

the risk ratio cannot be calculated directly

question

The researchers in the previous question do not find statistically significant evidence that "Barney" produces epilepsy in childhood. Unwilling, however, to relinquish their line of reasoning, they hypothesize that the parents of children who watch "Barney" are more likely to develop migraine headaches. They assemble two groups of parents: one with children who watch "Barney" and one with children who destroy furniture instead of watching "Barney." Which of the following is a characteristic of a study such as this?

answer

additional risk factors cannot be assessed as the study progresses. The risk ratio cannot be calculated directly

question

The risk of acquiring infection beta is 312 per 1000 among the unvaccinated and 7.2 per 1000 among the vaccinated. Approximately 80% of the population is exposed to the pathogen every year. Which of the following actions taken to develop policy would be incompatible with this information?

answer

reporting that the PAR% is 27

question

The likelihood ratio associated with the use of CK levels for the diagnosis of myocardial infarction varies with the:

answer

cutoff point

question

As the sensitivity of a test increases, which of the following generally occurs?

answer

the false-positive error rate increases

question

Two radiologists interpret 100 mammograms. They agree that the results are normal in 70 mammograms and abnormal in 12 mammograms. In the remaining 18 cases, the first radiologist thinks that results are normal in 6 mammograms and abnormal in 12 mammograms, whereas the second radiologist thinks just the opposite. The value of an appropriate measurement of their agreement is:

answer

46%

question

Which of the following characteristics is most important in a screening test that is used to rule out a diagnosis?

answer

a high degree of sensitivity

question

Visceral protein malnutrition that tends to occur in developing nations during the weaning of children from breast milk is known as:

answer

Kwashiorkor

question

Of the following environmental hazards, the only one categorized as a nonthreshold hazard is:

answer

ionizing radiation

question

A modified influenza vaccine must be produced every year because of the antigenic drift of the influenza virus. of the following is appropriate for determining the efficacy of the vaccine for a particular year?

answer

routine surveillance

question

What characteristic must a disease have for its eradication to be feasible?

answer

the disease must lack an animal reservoir

question

An example of secondary prevention is:

answer

During the latent stage, when the disease process has already begun but is still asymptomatic, screening for the disease and providing appropriate treat- ment may prevent progression to symptomatic disease

question

What is an example of tertiary prevention?

answer

During the symptomatic stage, when disease manifestations are evident, intervention that slow, arrest, or reverse the progression of disease

question

What is the relationship of smoking to lung cancer?

answer

A Risk factor (not a necessary cause or sufficient cause)

question

Which one of the following quality measures for diagnostic tests is most important in a confirmatory test that is used to rule in a diagnosis?

answer

specificity is needed to rule in for confirmatory testing purposes

question

Clinical outcome of severe cryptospiridium disease was substantially worse for immunocompromised patients. Immunocompromised status is best described as?

answer

prognostic factor

question

An unusually large number of incident cases of swine flu occurred for the first time in the U.S. the preceding year. This pattern of occurrence is best described as...

answer

epidemic

question

During a given year, 13 cases of disease X are detected in a population of 90,000 college students. Many more students have mild symptoms of the disease, such as persistent daydreams about being a rock star and traveling the world. Of the 13 detected cases, 7 result in death. The ratio of 7/13 represents:

answer

case fatality ratio

question

During a given year, 13 cases of disease X are detected in a population of 90,000 college students. Many more students have mild symptoms of the disease, such as persistent daydreams about being a rock star and traveling the world. To report the incidence rate of disease X, it would be necessary to know:

answer

mid-year population at risk

question

A team of researchers hypothesize that watching "Barney" might lead to epilepsy in childhood. Children with and without epilepsy are compared on the basis of hours spent watching "Barney." Which of the following statements best characterize the assessment of data in a case‐control study such as this?

answer

the risk ratio cannot be calculated directly

question

Cross‐sectional surveys are subject to Neyman bias, or 'late look' bias. This may be explained as the tendency to:

answer

detect the more indolent cases of a disease preferentially

question

A screening program analogue to the 'late look' (Neyman bias) is:

answer

length bias, because cases lasting longer are more apt to be detected

question

Widely publicized fatalities associated with an "emerging" disease (e.g., hantavirus pulmonary syndrome) may be an example of:

answer

iceberg phenomenon

question

Which one of the following activities is beyond the scope of activities undertaken by epidemiologists?

answer

rationing healthcare resources

question

Epidemiology is best defined as the study of:

answer

factors that influence the occurrence and distribution of disease in human populations

question

The mosquito involved in the transmission of malaria assumes the role of:

answer

vector

question

Which one of the following types of data does epidemiology derive directly from the US census?

answer

denominator data for population based studies

question

he adequacy of a health care system in a country is best measured by the:

answer

the infant mortality rate

question

During a 3‐month period, hantavirus pulmonary syndrome is reported in nine individuals, and three of these individuals die. Which of the following calculations would be 33%?

answer

case fatality ratio

question

Studies may be conducted to generate or test hypotheses. The best design for testing a hypothesis is a

answer

RCT

question

Cross‐sectional surveys are subject to the Neyman bias, or late look bias. This may be explained as the tendency to

answer

detect the more indolent cases of a disease preferentially

question

A screening program analogue to the late look bias is:

answer

length bias because cases lasting longer are more apt to be detected

question

Which of the following is a measure of the risk of having a risk factor?

answer

odds ratio

question

In a case‐control study that is being planned to study possible causes of myocardial infarction, patients with myocardial infarction serve as the cases. Which of the following would be a poor choice to serve as the controls?

answer

subjects whose cardiac risk factors are similar to those of the cases

question

You wish to determine the proportion of myocardial infarctions that are fatal within 24 hr of their occurrence. You decide to examine the records of all local emergency departments and physicians' offices. You will then calculate the proportion of the reported myocardial infarctions that resulted in death 24 hr or less after the patient was initially seen. You briefly discuss your plan with a friendly neighborhood biostatistician, who immediately points out that your study is particularly subject to which one of the following forms of bias?

answer

late look bias

question

The national Health and Nutrition Examination Surveys (NHANES) are conducted at intervals by the US government to establish trends in health related behaviors and dietary practices. NHANES III Phase 1, conducted from 1988 to 1991, showed a decline in the population's mean fat intake from 37% of total calories to 34% of total calories. This type of research is an example of:

answer

repeated cross-sectional study

question

The Physicians' Health Study was a randomized double‐blind, placebo‐controlled trial that was designed to test the effects of aspirin and beta carotene on cardiovascular disease and cancer. The participants in the trial consisted of approximately 22,000 male physicians who lived in the US and were 40 to 75 yr old. The randomization of participants in the study was performed to help achieve which of the following

answer

prevention of confounding by known and unknown factors

question

The likelihood ratio associated with the use of CK levels for the diagnosis of myocardial infarction varies with the?

answer

cutoff point

question

As the sensitivity of a test increases, which of the following generally occurs?

answer

false positive error rate increases

question

Two radiologists interpret 100 mammograms. They agree that the results are normal in 70 mammograms and abnormal in 12 mammograms. In the remaining 18 cases, the first radiologist thinks that results are normal in 6 mammograms and abnormal in 12 mammograms, whereas the second radiologist thinks just the opposite. The value of an appropriate measurement of their agreement is:

answer

46%

question

When a 2x2 table is used, the probability of disease in a patient with a negative test result is expressed as:

answer

c/(c + d)

question

Which of the following characteristics is most important in a screening test that is used to rule out a diagnosis?

answer

a high degree of sensitivity

question

A study is conducted to determine the effects of drinking Mountain Dew on a teenager's willingness to bungee jump from frightful heights. A total of 500 teenagers are assembled on the basis of bungee jumping status: 250 are jumpers, and 250 are not. Of the 250 jumpers, 150 report drinking Mountain Dew. Of the 250 nonjumpers, 50 report drinking Mountain Dew. Most of the nonjumpers report a preference for warm milk. Which of the following statement is true?

answer

this study can be used to calculate an odds ratio

question

A study is conducted to determine the effects of drinking Mountain Dew on a teenager's willingness to bungee jump from frightful heights. A total of 500 teenagers are assembled on the basis of bungee jumping status: 250 are jumpers, and 250 are not. Of the 250 jumpers, 150 report drinking Mountain Dew. Of the 250 nonjumpers, 50 report drinking Mountain Dew. Most of the nonjumpers report a preference for warm milk. What is the absolute difference in the risk of jumping?

answer

it cannot be calculated because this is a case-control study

question

A study is conducted to determine the effects of drinking Mountain Dew on a teenager's willingness to bungee jump from frightful heights. A total of 500 teenagers are assembled on the basis of bungee jumping status: 250 are jumpers, and 250 are not. Of the 250 jumpers, 150 report drinking Mountain Dew. Of the 250 nonjumpers, 50 report drinking Mountain Dew. Most of the nonjumpers report a preference for warm milk. The odds ratio calculated from this study would give the odds of:

answer

drinking among jumpers to drinking among non-jumpers

question

A study is conducted to determine the effects of drinking Mountain Dew on a teenager's willingness to bungee jump from frightful heights. A total of 500 teenagers are assembled on the basis of bungee jumping status: 250 are jumpers, and 250 are not. Of the 250 jumpers, 150 report drinking Mountain Dew. Of the 250 nonjumpers, 50 report drinking Mountain Dew. Most of the nonjumpers report a preference for warm milk. The odds ratio in this study is:

answer

6

question

A study is conducted to determine the effects of drinking Mountain Dew on a teenager's willingness to bungee jump from frightful heights. A total of 500 teenagers are assembled on the basis of bungee jumping status: 250 are jumpers, and 250 are not. Of the 250 jumpers, 150 report drinking Mountain Dew. Of the 250 nonjumpers, 50 report drinking Mountain Dew. Most of the nonjumpers report a preference for warm milk. The results of this study indicate that

answer

bungee jumping and beverage choice are associated

question

Having obtained your master's degree in public health, not to mention a lifetime supply of Mountain Dew and you own initialized bungee cord, from conducting the study described in questions 4‐8, you decided to pursue a PhD, with further investigation if this proactive subject. Your study again involves time, however, you assemble the groups on the basis of their history of Mountain Dew consumption, and you prospectively determine the incidence rate of bungee jumping. You exclude subjects with a prior history of jumping. Over a 5‐year period, 135 of the exposed group and 38 of the unexposed group engage in jumping. The relative risk of bungee jumping among the exposed is:

answer

3.6

question

Having obtained your master's degree in public health, not to mention a lifetime supply of Mountain Dew and you own initialized bungee cord, from conducting the study described in questions 4‐8, you decided to pursue a PhD, with further investigation if this proactive subject. Your study again involves time, however, you assemble the groups on the basis of their history of Mountain Dew consumption, and you prospectively determine the incidence rate of bungee jumping. You exclude subjects with a prior history of jumping. Over a 5‐year period, 135 of the exposed group and 38 of the unexposed group engage in jumping. Among bungee jumpers, what % of the total risk for jumping is due to consumption of Mountain Dew?

answer

72%

question

Assume that the risk of death in patients with untreated pneumonia is 15%, whereas the risk of death in patients with antibiotic‐treated pneumonia is 2%. Assume also that the risk of anaphylaxis with antibiotic treatment is 1%, whereas the risk without treatment is essentially 0%. What is the NNT in this scenario?

answer

7.7

question

Assume that the risk of death in patients with untreated pneumonia is 15%, whereas the risk of death in patients with antibiotic‐treated pneumonia is 2%. Assume also that the risk of anaphylaxis with antibiotic treatment is 1%, whereas the risk without treatment is essentially 0%. What is the NNH (net result of intervention) in this scenario?

answer

100

question

Assume that the risk of death in patients with untreated pneumonia is 15%, whereas the risk of death in patients with antibiotic‐treated pneumonia is 2%. Assume also that the risk of anaphylaxis with antibiotic treatment is 1%, whereas the risk without treatment is essentially 0%. What would be the net result of intervention in this scenario?

answer

13 patients saved for each patient harmed

question

You randomly assign subjects to 4 years of pharmacy school (intervention) or 4 years as understudies on an MTV reality series (control), and you test for evidence of metal health problems (outcome). After 4 years, of 100 subjects assigned to each condition, you find evidence of mental health problems in each condition, you find evidence of mental health problems in 12 in the pharmacy school group and 92 in the reality series group. An appropriate ratio to compare the "protective effect" of pharmacy school without exaggeration is

answer

risk ratio

question

You randomly assign subjects to 4 years of pharmacy school (intervention) or 4 years as understudies on an MTV reality series (control), and you test for evidence of metal health problems (outcome). After 4 years, of 100 subjects assigned to each condition, you find evidence of mental health problems in each condition, you find evidence of mental health problems in 12 in the pharmacy school group and 92 in the reality series group.The value of the ratio to compare the "protective effect" of pharmacy school without exaggeration is

answer

0.13

question

From Epidemiology 24(2):179-183, 2013, John Gaunt's evaluation of London's Bills of Mortality indicated (best answer only

answer

A. The striking regularity of mortality from causes other than the plague. B. Deaths from plague were suspected to be environmental. C. Many physicians used leather beak-like cones to filter air in homes with plague patients. D. None are true E. ***All are true (except D)***

question

(T/F) According to the Epidemiology article, unlike physicians' or pharmacists' professions which cannot be pinpointed in history, John Graunt's work represents the birth of epidemiology 350 years ago

answer

TRUE

question

10. The 1st person with severe WNV neurologic disease became ill the week of July 15th. This individual is best described as...

answer

sentinel case

question

A study involves tracking a condition that can recur in individuals over time. Which of the following measures would allow the authors of the study to make full use of their collected data?

answer

incidence density

question

When generating hypotheses regarding causality, as demonstrated in the Siberian encephalomyelitis, evaluating alternative hypotheses would NOT include which one of the following

answer

Pick 1 possible cause (e.g. infectious, genetic, environmental, ecological, immunological, & social factors)

question

So in analyzing the data, could you calculate Attributable Risk, Relative Risk, and Odds Ratio. Which might Daniel want to emphasize if there really was a positive likelihood of a good outcome from his perspective?

answer

Odds Ratio is most likely to exaggerate the positive effect... this will become a Likelihood Ratio.

question

1. The clinicians in a primary care clinic do not know the prevalence of Chlamydia trachomatis infection in their community. In screening patients for this infection, they plan to use a test that performed with a sensitivity of 75% and a specificity of 75% in clinical trials. When the clinicians use the test to screen patients for C. trachomatis in their own community, which of the following could they use to help them interpret a positive test result?

answer

LR+

question

2. The clinicians in a primary care clinic do not know the prevalence of Chlamydia trachomatis infection in their community. In screening patients for this infection, they plan to use a test that performed with a sensitivity of 75% and a specificity of 75% in clinical trials. What is the value of the LR+ from the previous question?

answer

3

question

Attempts to eradicate a disease through wide-spread immunization programs may be associated with potential adverse effects. Which of the following adverse effects is correlated with the efficacy of the vaccine?

answer

loss of the natural booster effect

question

Which of the following phenomena resulted from attempts to solve a public health problem?

answer

desertification in sub-saharan africa

question

Evaluation of which of the following potentially preventable causes of disease is mostly likely to raise ethical concerns?

answer

Genetic susceptibility

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