ودالشمال10

‫‪EPIDEMIOLOGY‬‬ ‫النسخة العاشرة‬
‫ودالشمال‪10‬‬
‫مع تمنياتي بالتوفيق والنجاح للجميع‬

‫ودالشمال‪2017‬م‬
‫قروب طور ذاتك ‪ ..‬مناقشة امتحانات البرومتريك والبيرسون فيو للتمريض‬ ‫‪S - Page 1‬‬
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EPIDEMIOLOGY ‫النسخة العاشرة‬
10‫ودالشمال‬
Part 1:
1: The focus of epidemiologic studies is on:
B A: Individuals
B: Populations
C: Skin
2: The occurrence in a community or region of cases of

an illness, specific health-related behavior, or other
health-related events clearly in excess of normal
expectancy is a/an:
C A: Pandemic
B: Endemic
C: Epidemic
3: Any factor that brings about change in a health

condition or other defined characteristic is a/an:
A A: Determinant
B: Quantification
C: Outcome
‫ مناقشة امتحانات البرومتريك والبيرسون فيو للتمريض‬.. ‫قروب طور ذاتك‬ S - Page 2
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4: The level of prevention that takes place during the

early phases of pathogenesis and includes activities that
limit the progression of disease is:
B A: Primary Prevention
B: Secondary Prevention
C: Tertiary Prevention
5: The implementation of health education programs is

an example of :
A A: Primary Prevention
B: Secondary Prevention
C: Tertiary Prevention
6: Epidemiologic studies that are concerned with

characterizing the amount and distribution of health and
disease within a population are called:
B A: Analytic
B: Descriptive
C: Observational
7: The Black Death was thought to be an epidemic of:
A A: Bubonic Plague
B: Cholera
C: Smallpox
8: Sir Percival Pott made the astute observation that

chimney sweeps had a high incidence of:
C A: Lung Cancer
B: Stomach Cancer
C: Scrotal Cancer
9: The probability that an event will occur, e.g., that an

individual will become ill or die within a stated period of
time or by a certain age is:
B A: Epidmiologic Transition
B: Risk
C: Hypothesis
10: Prevalence refers to:
A A: The number of existing cases of a disease or

health condition, or deaths in a population at some
designated time
B: The occurrence of new disease or mortality
within a defined period of observation in a specific
population
C: A summary rate based on the actual number of
events in a population over a given time period
11: Count refers to:
B A: The occurrence of new disease or mortality

within a defined period of observation in a specific
population
B: The number of cases of a disease or other
health phenomenon being studied
C: Both A and B
12: The occurrence of new disease or mortality within a

defined period of observation in a specific population is:
A A: Incidence
B: Prevalence
C: Count
13: A rate is a type of ratio that:
C A: Has time as a component

B: Is used to measure risks associated with
exposure
C: Both A and B
14: A type of rate that has not been modified to take

account of any of the factors such as the demographic
makeup of the population that may affect the observed
rate is a/an:
A A: Crude Rate
B: Adjusted Rate
C: Cause-Specific Rate
15: A measure that refers to the mortality rate associated

with a specific cause of death divided by the population
size at the midpoint of a time period times a multiplier is
the:
C A: Crude Dealth Rate

B: Sex-specific Rate
C: Cause-Specific Mortality Rate
16: The term that refers to the number of deaths due to a

disease that occur among persons who are afflicted with
that disease is the:
B A: Crude Dealth Rate

B: Case-Fatality Rate
C: Proportional mortality ratio
17: The number of deaths within a population due to a

specific disease or cause divided by the total number of
deaths in the population times 100 is the:
C A: Crude Dealth Rate

B: Case-Fatality Rate
C: Proportional mortality ratio
18: The following term denotes the number of cases of a

disease diagnosed at any time during the person’s
lifetime:
B A: Period Prevalence
B: Lifetime Prevalence
C: Point Prevalence
19: Deaths, births, marriages, divorces and fetal deaths

are examples of:
B A: Life Events
B: Vital Events
C: Traumatic Events
20: Systematic and continuous gathering of information

about the occurrence of disease and other health
phenomena is:
B A: Data Analysis
B: Public health surveillance
C: Syndromic Surveillance
21: Using health-related data that precede diagnosis and

signal a sufficient probability of a case or an outbreak to
warrant further public health response is:
C A: Data Analysis
22: A centralized database for collection of information

about a disease is:
A A: Registry
23: The following refers to the number of years that a

person is expected to live, at any particular year:
B A: Maternal Mortality
B: Life Expectancy
C: Infant Mortality
24: The following refers to maternal deaths that result

from causes associated with pregnancy:
C A: Fetal Mortality
B: Infant Mortality
C: Maternal Mortality
25: The death of the fetus when it is in the uterus and

before it has been delivered:
A A: Fetal Mortality
B: Maternal Mortality
C: Infant Mortality
26: The number of live births reported in an area during

a given time interval divided by the number of women
aged 15-44 years in the area:
C A: Crude Birth Rate

B: Perinatal Mortality Rate
C: General fertility rate
27: The number of late fetal deaths after 28 weeks or

more gestation plus infant deaths within 7 days of birth
divided by the number of live births plus the number of
late fetal deaths during a year:
B A: Infant Fertility Rate

B: Perinatal Mortality Rate
C: Fetal Mortality Rate
28: Which of the following is not mentioned as an aim of

descriptive epidemiology?
C A: Permit evaluation of trends in health and

disease
B: Provide a basis for planning, provision, and
evaluation of health services
C: Promote studies of trends related to fetal
deaths in a specific area
29: This classifies the occurrence of disease according to

the variables of person, place, and time:
A A: Descriptive Epidemiology
B: Analytic Epidemiology
C: Environmental Epidemiology
30: Which of the following is an example of a type of

descriptive epidemiologic study?
B A: Case-Control Study
B: Case Reports
C: Cohort Study
31: Race and socioeconomic status are examples of:
A A: Person Variables
B: Secular Trends
C: Clustering
32: A term that refers to the place of origin of the

individual or his or her relatives:
C A: Habitat
B: Community
C: Nativity
33: A descriptive term for a person’s position in society:
A A: Socioeconomic Status
B: Nativity
C: Clustering
34: Point epidemics and clustering are examples of

disease occurrence according to:
B A: Place
B: Time
C: Person
35: Increases and decreases in the frequency of a disease

or other phenomenon over a period of several years or
within a year are:
C A: Secular Trends
B: Point Epidemics
C: Cyclic Trends
36: The Texas Sharpshooter Effect is related to:
C A: Point Epidemics
B: Secular Trends
C: Clustering
37: BRFSS stands for:
B A: Behavioral Records For Student Statistics

B: Behavioral Risk Factor Surveillance System
C: Behavioral Risk Factor Student Surveillance
38: A term that refers to any quantity that varies:
B A: Association
B: Variable
C: Mode
39: An association between two variables can be:
C A: Only Positive
B: Only Negative
C: Either Positive or Negative
40: Mortality, coronary heart disease, chronic obstructive

pulmonary disease, asthma, and lung cancer are most
likely to be consequences of exposure to:
A A: Air Pollution
B: Toxic Chemicals
C: Heavy Metals
41: Which type of curve is shown below?
A A: Dose-response curve
B: Multimodal Curve
C: Epidemic Curve
42: The following term denotes those diseases for which

two copies of an altered gene are required to increase risk
of the disease:
A A: Autosomal Recessive
B: Autosomal Dominant
C: Genetic Marker
43: A situation in which all of the factors in two or more

domains are the same except for a single factor is the:
C A: Method of Concomitant Variation

B: Hypothesis
C: Method of Difference
44: This criterion specifies that one must observe the

cause before the effect:
A A: Temporality
B: Biological Gradient
C: Plausibility
45: The association between exposure to tars and oils

and the development of scrotal cancer among chimney
sweeps is an example of:
C A: Temporality
B: Biological Gradient
C: Plausibility
46: The type of association in which an increase in the

value of one variable is linked with an increase in the
value of another variable:
A A: Positive
B: Negative
C: Continuous
47: A single value chosen to represent the population

parameter is a/an:
C A: Inference
B: Confidence Interval Estimate
C: Point Estimate
48: Which of the following terms refers to a study in

which the units of analysis are populations or groups of
people rather than individuals?
A A: Ecologic Study
B: Case-Control Study
C: Cohort Study
49: The Framingham Study is an example of a/an:
C A: Ecologic Study
B: Case-Control Study
C: Cohort Study
50: Obtaining information about exposures that occurred

in the past is considered a/an:
B A: Prospective Approach
B: Retrospective Approach
C: Ecological Fallacy
51: The measure of association used in a case-control

study is:
B A: Ecologic Correlation
B: Odds Ratio
C: Relative Risk
52: The measure of association used in a cohort study is:
C A: Ecologic Correlation
B: Odds Ratio
C: Relative Risk
53: A type of research in which the investigator

manipulates the study factor but does not assign
individual subjects randomly to the exposed and
nonexposed groups is a:
A A: Quasi-Experimental Study
B: Randomized Clinical Trial
C: Case-Control Study
54: This term refers to the observation that employed

populations tend to have a lower mortality experience
than the general population:
B A: Hawthorne Effect
B: Healthy Worker Effect
C: Ecological Fallacy
55: The smallest geographic entity for which the Census

Bureau tabulates decennial census data:
B A: Census Tract
B: Census Block
C: Metropolitan Area
56: A large population nucleus, together with adjacent

communities that have a high degree of economic and
social integration with that nucleus:
C A: Census Tract
B: Census Block
C: Metropolitan Area
57: The individuals who are involved in policy

formulation; these include members of the legislature,
citizens, lobbyists, and representatives of advocacy
groups:
B A: Stakeholders
B: Policy Actors
C: Interest Group
58: Individuals, organizations and members of

government who are affected by policy decisions:
A A: Stakeholders
B: Policy Actors
C: Interest Group
59: Which part of the policy cycle refers to setting

priorities, deciding at what time to deal with a public
health problem or issue, and determining who will deal
with the problem?
A A: Agenda Setting
B: Policy Establishment
C: Policy Implementation
60: Which part of the policy cycle focuses on achieving

the objectives set forth in the policy decision?
C A: Agenda Setting
B: Policy Establishment
C: Policy Implementation
61: Which of the following statements is true about

BPA?
C A: It is a chemical ingredient in the manufacture

of plastics and resins
B: It can cause changes in behavior and the brain,
prostate gland, and mammary gland of laboratory
animals
C: Both A and B
62: Which of the following terms relates to the adoption

of policies, laws, and programs that are supported by
empirical data?
B A: Cost-Effectiveness Analysis
B: Evidence-Based Public Health
C: Hazard Identification
63: Which term refers to the ability of a measuring

instrument to give consistent results on repeated trials?
A A: Reliability
B: Validity
C: Sensitivity
64: Which term refers to the ability of the test to identify

only nondiseased individuals who actually do not have
the disease?
C A: Validity
B: Sensitivity
C: Specificity
65: Which of the following terms refers to a process for

identifying adverse consequences and their associated
probability?
C A: Hazard Identification
B: Exposure Assessment
C: Risk Assessment
66: Which of the following terms is defined as the

domain in which disease-causing agents may exist,
survive, or originate?
C A: Host
B: Agent
C: Environment
67: Which of the following terms denotes the resistance

of an entire community to an infectious agent as a result
of the immunity of a large proportion of individuals in
that community to the agent?
B A: Active Immunity
B: Herd Immunity
C: Passive Immunity
68: According to a 2002 estimate, the number one cause

of death from chronic disease worldwide is:
A A: Infections and Parasitic Diseases

B: HIV/AIDS
C: Malaria
69: Which of the following terms denotes the time

interval between invasion by an infectious agent and the
appearance of the first sign or symptom of the disease?
B A: Generation Time
B: Incubation Period
C: Virulence
70: Clostridium botulinum is an example of an agent of:
B A: Sexually Transmitted Disease

B: Foodborne Illness
C: Vector-Borne Disease
71: Malaria is an example of a:
C A: Sexually Transmitted Disease

B: Foodborne Illness
72: Which of the following diseases is not at present

(2010) classified as vaccine-preventable?
A A: HIV/AIDS
B: Tetanus
C: Measles
73: Which of the following terms refers to disease that

can be transmitted from vertebrate animals to human
beings?
B A: Sexually Transmitted Disease

B: Zoonotic Disease
C: Foodborne Illness
74: Which of the following diseases is transmitted by a

species of ticks?
A A: Lyme Disease
B: Dengue Fever
C: Malaria
75: Hepatitis C is an example of which of the following

types of infections:
B A: Airborne Infections
B: Vehicle-Borne Infections
76: Which of the following terms refers to the discipline

that examines the social distribution and social
determinants of states of health?
A A: Social epidemiology
B: Behavioral epidemiology
C: Psychiatric epidemiology
77: PTSD stands for:
B A: Physical trauma and sociological disorders

B: Post traumatic stress disorder
C: Psychological treatment for sociological
disorders
78: Graduation from school and marriage are examples

of:
B A: Negative Life Events

B: Positive Life Events
C: Chronic Strains
79: Which of the following terms refers to the

involuntary breathing of cigarette smoke by nonsmokers
in an environment where there are cigarette smokers
present?
C A: Second Hand Smoke Exposures

B: Passive Smoking
C: Both A and B
80: Which of the following illicit drugs is used most

commonly among all persons aged 12 or older?
B A: Ecstasy
B: Marijuana
C: Pain Relievers
81: Which of the following terms is defined as body

weight in kilograms divided by height?
A A: BMI
B: CDC
C: FDA
82: Which of the following is defined as the co-

occurrence of two or more mental disorders?
A A: Psychiatric Comorbidity
B: Autism
C: Dysthemia
83: This condition generally appears by 3 years of age

and is manifested by difficulties in cognitive functioning,
learning, and processing sensory information:
A A: Autism
B: Dysthemia
C: Bipolar Disorder
84: Binge drinking:
C A: For women, is more than three drinks during a

single occasion
B: Is associated with increased rates of sexually
transmitted disease, unintended pregnancy, and
violence
C: Both A and B
85: Which of the following terms is defined as the study

of the role of behavioral factors in health?
B A: Social epidemiology
B: Behavioral epidemiology
C: Psychiatric epidemiology
86: Which of the following conditions is described as a

bleeding disorder in which the blood does not clot
normally?
C A: Tay-Sachs Disease
B: Sickle Cell Disease
C: Hemophilia
87: Which of the following diseases is caused by a

genetic mutation that is inherited in an autosomal
recessive pattern?
A A: Tay-Sachs Disease
B: Down Syndrome
C: Hemophilia
88: This disease has the epidemiologic characteristic that

its frequency among newborns increases with increasing
age of mothers:
B A: Sickle Cell Disease

B: Down Syndrome
C: Hemophilia
89: Children come into contact with this heavy metal

from playground equipment or paint chips that are
peeling off the surfaces in older buildings:
B A: Mercury
B: Lead
C: Arsenic
90: Certain types of fish are believed to contain

unhealthful levels of which of the following heavy
metals:
A A: Mercury
B: Lead
C: Arsenic
91: Which of the following terms refers to the gradual

increase in the earth’s temperature over time?
A A: Global Warming
B: Environmental Epidemiology
C: Molecular Epidemiology
92: Which of the following conditions is characterized

by red blood cells that have an abnormal form of
hemoglobin, called hemoglobin S?
A A: Sickle Cell Disease

B: Tay-Sachs Disease
C: Down Syndrome
93: Mortality, coronary heart disease, chronic obstructive

pulmonary disease, asthma, and lung cancer are most
likely to be consequences of exposure to:
A A: Air Pollution
B: Toxic Chemicals
C: Heavy Metals
94: The following term denotes those diseases for which

two copies of an altered gene are required to increase risk
of the disease:
A A: Autosomal Recessive
B: Autosomal Dominant
C: Genetic Marker
Part2:
1. Epidemiologists are interested in learning about
____________________ .
a) the causes of diseases and how to cure or control them
b) the frequency and geographic distribution of diseases
c) the causal relationships between diseases
d) all of the above

D: CORRECT --> Epidemiology is the field of medical science that is
focused on learning about how, where, and why diseases develop and
how best to control their spread.
2. Diseases that are always present in a community, usually at a

low, more or less constant, frequency are classified as having
an ____________ pattern.
a) epidemic
b) endemic
c) pandemic
B: CORRECT --> Diseases that have an endemic pattern may or may

not be contagious, but they are always present in a community. Malaria,
arthritis, tooth decay, and high blood pressure are examples of endemic
diseases in some societies.
3. Which of the following statements is true concerning epidemic
diseases?
a) They are usually not very contagious.
b) At the end of an epidemic, a disease spreads at an

increasing rate and then abruptly disappears.
c) They usually appear and disappear seasonally

C: CORRECT --> The seasonality of epidemics is mostly a result of
changing human interaction patterns and changes in the environment.
For instance, we are more likely to get colds in winter because we are
more often indoors in close physical proximity to others.
4. An epidemic that becomes unusually widespread and even
global in its reach is referred to as a _________________ .
a) pandemic
b) hyperendemic
c) Spanish flu
A: CORRECT --> If conditions are optimal for the spread of contagion

and if few people have an immunity to a disease, there can be a
pandemic. This happened in 1918 when a new strain of the influenza
virus (the Spanish flu), infected 1/5 of all people in the world.
5. A disease vector is a(n) ____________________ .
a) organism that transmits a disease
b) symptom of a disease
c) environmental condition associated with a disease

A: CORRECT --> Disease vectors are intermediate hosts or organisms
that spread a disease. Mosquitoes, fleas, lice, ticks, flies, and snails are
vectors for specific diseases that infect humans. They carry the
microorganisms that cause diseases such as the plague.
6. Which of the following things cause malaria?
a) mosquitoes
b) plasmodia (singular plasmodium)
c) red blood cells
B: CORRECT --> Plasmodia are single celled organisms that are

parasites on red blood cells. They ultimately cause the severe anemia
and very high fever that are malaria symptoms. They are transmitted
from host to host unintentionally via blood sucking mosquitoes.
7. About what fraction of the people in the world have chronic
diseases that are vector-borne?
a) 1/4
b) 1/2
c) 3/4
B: CORRECT --> Close to half of the people in the world today have
serious vector-borne diseases. Tropical and subtropical regions are the
most effected. In third world nations, vector-borne diseases cause high
levels of physical disability and low life expectancies.
8. Most of the major health problems in the poorer nations are
due to ____________________ .
a) parasitic worms and microorganisms
b) psychological tension resulting from work
c) air pollution
A: CORRECT --> Along with malnutrition, parasitic diseases are still

the major source of illness in third world nations. They were also the
major cause of disease in developed nations before the 20th century.
9. The prime cause of illness resulting in death in the poor
countries of the tropical and subtropical regions today is
__________________ .
a) lyme disease
b) plague
c) malaria
C: CORRECT --> There are close to 100,000,000 new cases of malaria
reported annually around the world. It causes approximately 1,500,000
deaths every year and most of them are children. The majority of fatal
malarial cases are in poor tropical and subtropical regions.
10. Diseases that are due mostly to environmental changes,
increased population densities, and pollution that result from
modernization in third world nations are referred to as:
a) diseases of poverty
b) diseases of development
c) schistosomiasis
B: CORRECT --> Poor sanitation in burgeoning urban centers,
industrial pollution, and river damming have resulted in an increase in
the frequency of some diseases (e.g., cholera, dysentery, lung cancer,
and schistosomiasis). These are diseases of development.
11. Which of the following statements is true?
a) Modern medicine has at times been responsible for

causing health problems.
b) Malnutrition has been essentially eliminated in the

United States.
c) Persistent undernourishment among children rarely

results in serious health problems.
A: CORRECT --> Medications sometimes have unexpected side effects.
For instance, the drug thalidomide given to many pregnant women in the
1950`s caused serious birth defects in their children, especially
extremely small appendages that were essentially non-functional.
12. Which of the following statements is true concerning culture
specific diseases?
a) They sometimes become world-wide epidemics.
b) They are found only in small-scale societies.
c) They cause only relatively minor illnesses.
d) none of the above

D: CORRECT --> All of the above statements are false. Look at the
feedback for each of them to see why.
13. Which of the following statements is true concerning kuru?
a) It has been found mostly among the South Foré people

of the eastern New Guinea Highlands.
b) It is caused by eating pig meat that has not been

thoroughly cooked.
c) Its victims die within a few days of the onset of the

first symptoms.
d) none of the above

A: CORRECT --> Kuru seems to have been concentrated among the
South Foré and their immediate neighbors due to their shared practice of
cannibalism. Kreutzfeld-Jacob (or mad cow) disease found in Western
Europe is very similar in symptoms and is also caused by prions.
14. Which of the following was a consequence of kuru among the

South Foré?
a) There was a reduction in the number of adult men

relative to women.
b) People carefully cleaned up their house sites to make

sure that witches could not obtain any of their hair,
fingernail clippings, feces, or personal belongings.
c) The Australian government rounded up South Foré

men and had them sterilized in order to prevent the
inheritance of kuru.
B: CORRECT --> The South Foré had a personalistic explanation of
illness which led them to believe that kuru was caused by witches
practicing contagious magic with personal possessions of others to cause
them to become sick.
15. Which of the following statements is true concerning mental
illness?
a) It is not present in all societies.
b) All societies define people who regularly carry on

animated conversations with dead relatives or other
supernatural beings as being mentally ill.
c) What a culture defines as abnormal behavior is a

consequence of what it defines as a modal personality.
C: CORRECT --> Behavior that is beyond the range of what a society
defines as normal is usually labeled as being eccentric, mentally ill, or
even dangerous and criminal. However, what is thought to be normal
can vary widely from society to society.
16. Among the Saora tribe of India, young men and women
sometimes exhibit abnormal behavior patterns that Western
trained doctors would likely define as a mental disorder.
These young people cry and laugh at inappropriate times,
have memory loss, pass out, and claim to experience the
sensation of being repeatedly bitten by ants. The Saora
explain this odd behavior as being due to
___________________ ?
the actions of supernatural beings who want to

a)
marry them
b) malaria
witchcraft practiced by strangers from neighboring

c)
tribes
A: CORRECT --> To cure this problem the Saora have a marriage
ceremony in which the mentally disturbed person is married to the spirit.
Once this marriage has occurred, the abnormal symptoms end and the
young person becomes a shaman responsible for curing people.
17. Which of the societies listed below traditionally would most
likely have little respect for and avoid a person who is violent
and aggressive towards other people within their community?
a) Yanomamo of Venezuela and Brazil
b) Pueblo Indians of the Southwestern United States
c) none of the above

B: CORRECT --> Among the Pueblo Indians, this kind of behavior was
considered abnormal and dangerous for society. People who exhibited
these traits were intentionally avoided and even ostracized.
18. The culture-bound syndrome known as
______________________ occurred among the Chippewa ,
Ojibwa , and Cree Indians of Canada and the United States.
a) koro
b) windigo psychosis
c) amok
B: CORRECT --> People with this culture specific mental disorder have
a delusion of being transformed into a Windigo monster. These
supernatural beings eat human flesh. People who have Windigo
psychosis increasingly see others around them as being edible.
19. An irrational perception that one's prominent sexual body
parts (penis and testes or vulva and nipples) are withdrawing
into the body and subsequently being lost is a characteristic of
which of the following culture-bound mental syndromes?
a) koro
b) gajdusek
c) kuru
A: CORRECT --> Koro is a fear of the loss of masculinity or femininity
followed by premature death. This culture-bound syndrome is
traditionally believed to be caused by masturbation or sex with
prostitutes. It also thought to be caused by tainted foods.
20. Which of the following statements is true concerning culture-

bound syndromes?
They are rare--only two or three have been

a)
discovered around the world.
b) Any of them is likely to appear in other cultures.
c) none of the above

C: CORRECT --> All of the above statements are false. Look at the
feedback for each of them to see why.
Part3:
1. An outbreak of gastritis occurred on a cruise ship. The data in the
following table were obtained shortly after the outbreak, from a
questionnaire completed by everyone on board the ship.
What is the relative risk of developing gastritis from herring

consumption?
0.5
2.0
2.3
8.0
1.0
ANSWER: B
Feedback
Relative risk (RR) = Risk in exposed/Risk in unexposed
And, Risk = Number of cases (d)/ Total number of people at risk (N)
Therefore, RR for developing gastritis from herring consumption = Risk
in ‘Ate’/ Risk in ‘Did not eat’ = (200/1000)/(100/1000)= 2.0

NOTE: The risk can be calculated here because the total number of
people who were at risk for falling ill is known. If the total number of
people at risk of falling ill – say in a situation where a certain food chain
is contaminated – then one cannot calculate risk but the odds of
exposure is calculated instead (which should approximate the risk).
2. In a study of 500 cases of a disease and 500 controls, the suspected

etiological factor is found in 400 cases and 100 controls. What is the
absolute risk of disease in people with the factor?
80%
40%
16%
20%
Cannot be computed from the data given
ANSWER: E
Feedback
Only odds can be calculated as a measure of incidence from case-control
studies. In a case control study one is not sure about all the persons who
had the particular exposure at the time in question and therefore the total
number of persons at risk is unknown. Likewise, the duration of
exposure to the risk factor in most instances and therefore rates cannot
be calculated. The odds however gives a value that is numerically close
to the risk.
3. Regionville is a community of 100,000 persons. During 1985 there

were 1,000 deaths from all causes. All cases of tuberculosis have
been found and they total 300 – 200 males and 100 females. During
1985, there were 60 deaths from tuberculosis, 50 of them males. What
is the crude mortality rate for Regionville?
300 per 100,000
60 per 1,000
10 per 1,000
100 per 1,000
200 per 1,000
ANSWER: C
Feedback
The crude mortality rate it the death rate that is calculated using all
deaths as the numerator and the total population as the denominator.
Therefore
Crude mortality rate = total deaths/total population = 1000/100,000 = 10
per 1,000
NOTE: Age-adjusted mortality rates are reported when population
mortality statistics are calculated. This means that the mortality rate has
been standardized against a ‘standard’ population to account for any
differences in age-group distribution in the population from year to year.
4. In 1945, there were 1,000 women who worked in a factory painting

radium dials on watches. The incidence of bone cancer in these
women up to 1975 was compared to that of 1,000 women who
worked as telephone operators in 1945. Twenty of the radium dial
painters and four of the telephone operators developed bone cancer
between 1945 and 1975. What study design is this?
Cohort study
Experimental study
Clinical trial
Cross-sectional study
Case-control study
ANSWER: A
Feedback
The two groups where selected on the basis of the exposure (radium)
and ‘followed’ over time (1945 to 1975) to see what the outcome
experience (bone cancer) was. In fact because the investigators when
back in time to establish the groups this study could also be called a
retrospective cohort study (as compared to the usual prospective cohort
study in which the groups are established in real time and followed up
into the future.
5. Researchers set out to demonstrate that a new drug is more effective

in lowering systolic blood pressure than beta-blockers. They select
two groups from among a number of previously uncontrolled
hypertensive patients to receive either the new drug or a beta-blocker
using a computer programme to make the allocation purely by
chance. What is this method of assignment called?
Random selection
Randomization
Blinding
Cross-over
Factorial
ANSWER: B
Feedback
Randomization (or random allocation) is the method by which chance is
used to allocate study participants to study groups. Random selection it
the method by which chance (e.g. rolling dice or using a table of random
numbers) is used to select participants for inclusion in a study. Blinding
is where the participants are not aware whether they are receiving the
intervention under investigation, current treatment or placebo. Cross-
over is where one group in a cohort receives the intervention under study
while the other receives current best treatment or placebo and then
(following a wash out period) the groups switch around so that the group
which was receiving placebo or current treatment now receives the
intervention under evaluation. Factorial design is where a cohort study is
set up to test more than one hypothesis at the same time so that the study
group is randomized first to test one hypothesis and then those groups
are randomized another time to create groups to test a second
hypothesis.
6. A screening test for breast cancer was administered to 400 women

with biopsy-proven breast cancer and to 400 women without breast
cancer. The test results were positive for 100 of the proven cases and
50 of the normal women. What is the sensitivity of this screening
test?
88%
67%
25%
33%
12%
ANSWER: C
Feedback
Sensitivity = (# correctly positive on screening test / # positive on gold
standard)x 100 = (100/400) x 100 = 25%

NOTE: Validity (sensitivity, specificity etc.) questions are best answered
by first setting up a 2x2 table before attempting to answer the question
even if the answer seems to be obvious (so as to avoid simple errors).
Make sure that your totals in the table are correct before you proceed
with the calculation.
7. A 25 year old male patient presents to you with a purulent urethral

discharge for one day. He admits to having had unprotected sex 3
nights ago and has had no other sexual contact in the past year. In
order to initiate empirical treatment while awaiting laboratory tests
for this sexually transmitted illness in this patient what other period
do you need to know?
Period of exposure
Incubation period
Infectious period
Latent period
Serial interval
ANSWER: B
Feedback
You need to know which is the most likely pathogen and therefore you
need to know what are the incubation periods for organisms which cause
urethritis. The latent and infectious periods would be useful to know
when trying to establish whether any other individuals may have been
infected by this patient.
8. Researchers investigated the relationship between the use of statins

and prostate cancer mortality by examining the records of patients
who died from prostate cancer as well as records of matched controls.
They report an unadjusted odds ratio of 0.49 (95% confidence
interval, 0.34-0.70), which decreased to 0.37 (P<0.0001), after
adjusting for education, waist size, body mass index, comorbidities
and anti-hypertensive medication. What can you conclude from these
results?
Statins significantly lower the risk of death from prostate cancer
Statins have no effect on cancer mortality
Comorbidities have no effect on prostate cancer mortality
This was an ecological study
The sample size was too inadequate
ANSWER: A
Feedback
The unadjusted odds ratio has a 95% confidence interval that does not
include 1 and the adjusted odds ratio is associated with a P-value of
Comorbidities are a confounder along with education, waist size, body
mass index and anti-hypertensive medication hence the calculation of
the adjusted odds ratio to account for their effect on the mortality rate.
The participants were individuals who were selected on the basis of
outcome (prostate cancer mortality). This is therefore a case-control
study. If data from groups of patients were being examined then it would
be an ecological study.
The 95% confidence interval is not that wide and so the sample size is
adequate
Part4:
1. You may remember that three years ago there was a multistate
outbreak of illnesses caused by a specific and unusual strain of
Listeria monocytogenes. As part of the investigation of this
outbreak, CDC workers checked the food histories of 20 patients
infected with the outbreak strain and compared them with the food
histories of 20 patients infected with other Listeria strains. This
study design is best described as which one of the following:
a. Analytical, experimental
b. Analytical, observational, case-control
c. Analytical, observational, cohort
d. Descriptive
Answer: b
2. A published study follows a large group of women with untreated

dysplasia of the uterine cervix, documenting the number who
improve, stay unchanged, or progress into cervical cancer. This
study design is best described as which one of the following:
a. Analytic, experimental
b. Analytic, observational, cohort
c. Analytic, observational, case/control
d. Descriptive, observational
Answer: d
3. A community assesses a random sample of its residents by

telephone questionnaire. Obesity is strongly associated with
diagnosed diabetes. This study design is best described as which
one of the following:
a. Case-control
b. Cohort
c. Cross-sectional
d. Experimental
Answer: c
4. Based on a list of residents from election rolls, 2/3 of men in a

large city are invited (including repeated educational urgings) and
1/3 of men are not invited to be screened by PSA blood test for
prostate cancer. Over the next 10 years the two groups are
compared as to the rate of death from prostate cancer. This study
design is best described as which one of the following:
a.Case-control
b. Cohort
c. Cross-sectional
d. Experimental
Answer: d
5. The initial studies establishing maternal diethylstilbesterol (DES)

intake as a cause of vaginal adenocarcinoma in female offspring
were case-control studies. This was probably largely because:
a. A couple of decades ago cohort studies hadn't been invented.
b. A woman taking DES was always rare.
c. The disease outcome is rare.
d. The investigators had probably just happened to have a number
of cases in their practices.
Answer: c
6. In a case-control study of alcohol intake and bladder cancer, cases

and matched controls are each interviewed by interviewers who are
not blinded as to whether the subject is a case or a control. Many
of the interviewers are in fact convinced that drinking alcohol is a
cause of bladder cancer. Is this likely to represent a bias?
a. No, because the interviewers can't affect whether the subjects
are considered cases or controls; that's already decided
b. Yes, but it's hard to predict the direction of the bias.
c. Yes, and would predispose to a rejection of the null hypothesis.
d. Yes, and would predispose to an acceptance of the null
hypothesis
Answer: c
7. Savannah plans to conduct a study that involves cosmetics. She
wanted to know the preference of cosmetic use among adolescents,
young adult, middle adult and the late adult women. The research
design of her study would be:
Descriptive
Correlational
Qualitative
Cohort
Answer: A
This is definitely descriptive by design since Savannah would most
likely be conducting a survey where results upon which would require
statistics such as frequency and percentages. This type of research
design would want to gain more information pertinent to the
phenomenon understudy. The information is presented via quantitative
means
8. Freya wanted to know the relationship between the level of anxiety

experienced during examinations and the exam performance
among the level 2 student nurses of Colegio San Agustin Bacolod.
The type of research design utilized is:
Experimental
Quasi-Experimental
Correlational
Causal-Comparative
Answer: C
When trying to realize whether a relationship or association exists
between two or more variables expressed quantitatively, the research
design most suited is correlational. In the example there are two
variables that are expressed quantitatively, specifically, level of anxiety
and performance in examination.
9. Alfred randomly grouped the participants into two and tested the
effects of his new product towards their endurance. His study uses
this type of research design:
Correlational
Survey
Experimental
Causal-comparative
Answer: C
Researches which aim to realize a cause and effect relationship and are
prospective in nature would usually be experimental by design.
Moreover, an experimental research design can be deemed as true

experimental if it possess elements such as randomization, control
group, manipulated group and validity. If not, it is known to be quasi -
experimental.
10. In an event that the researcher wanted to know more about

the cause and effect relationship however the cause already exists
and cannot be manipulated, the type of research design appropriate
for this is:
Experimental
Clinical Study
Correlational
Casual-comparative
Answer: D
Researches dedicated in knowing the cause and effect relationship
between variables, however, deals with variables measured / have
occurred in the past bears a causal - comparative design. Simply said, a
causal - comparative design is retrospective.
11. This is another type of quantitative research design wherein

the researcher wanted to know about the cause and effect
relationship between variables, where the cause is being
manipulated and respondents are chosen by choice not by chance.
Descriptive
Quasi-experimental
Correlational
True Experimental
Answer: D
As explained in one of the rationale for a question earlier, researches
which aim to realize a cause and effect relationship, prospective by
nature but lacks one of the four elements required for a true
experimental design are categorized as quasi - experimental.
12. Tiara wanted to conduct a research that will delve into

knowing the effects of post traumatic stress disorder towards the
academic performance of teenagers during the first grading of
academic year 2012-2013. The type of research design most suited
towards her study would be:

Causal-comparative
Experimental
Quasi-experimental
Correlational
Answer: A
Retrospective researches, trying to see the cause and effect relationship
between two or more variables, usually have a causal - comparative
research design. Moreover, it can also be noted that variables in this
research design can not be manipulated
13. Vincent conducts a study that will further get to know the
frequency of scrub cases between the north and south affiliated
hospitals of their school. What's the type of research design to be
used in his study?
Descriptive
Correlational
Causal-Comparative
Experimental
Answer: A
Drawing out more meaning from collected data via quantitative means
would usually have a descriptive research design
14. Members of the health team introduce a new admission

system and wishes to study the efficiency of its implementation as
compared to the previous admission system which is still being
practiced in other departments. In this study, it is not feasible to
conduct randomization. What type of research design is used?
Experimental
Causal-comparative
Quasi-experimental
Correlational
Answer: C
Prospective researches exploring cause and effect relationships that do
not meet the four elements of a true experimental research design are
known as quasi – experimental
15. Which of the following researches would be considered as

prospective?
The effects of preschool attendance towards the maturity of the
first grade students
The effects of being a working mother towards the child’s

absenteeism
The effect of stress towards the co-curricular activities
participation of 3rd year students
The effects of memory enhancers towards the academic

performance of students
Answer: D
Prospective research designs work on variables that are to be measured
in the near future
16. A quantitative research paper is entitled as "Nursing Model

of Care Utilized by Selected Hospitals and its Association with the
Performance of Nurses in their Area of Assignment". What is the

research design of this study?
Survey
Correlational
Causal – Comparative
Experimental
Answer: B
Research studies that aim to realize whether a relationship exists
between two variables measure quantitatively are known to have
correlational research designs
Part5:
1. What is the cost per confirmed HIV infection of testing for HIV in
a population of one million persons if the sensitivity of the Elisa
test is 99.8% and the specificity is 99.9%, and the sensitivity of the
Western blot test is 99.8%? The unit cost of counseling plus the
Elisa test is $60, and the unit cost of the Western blot is $120. The
total cost of the Elisa test and counseling for the one million
persons is $60,000,000, and for the Western blot test of the Elisa
test positives is $1,317,600. Nine hundred and eighty eight (988)
persons were confirmed to be HIV-infected:
a. 60,000,000 + 1,317,000  988 = $62,062
b. 60,000,000 - 1,317,000  988 = $59,396
c. 60,000,00 x .998 + 1,317,000 x .999  988 = $61,939
d. 60,000,000 + 1,317,000  1,000,000 = $61
e. Predictive value positive - predictive value negative x $60 x
$120
2. Individuals who test positive at home using the rapid test for HIV
should first:
a. Immediately start HAART treatment

b. Initiate treatment first with nevirapine
c. Get a confirmatory test
d. Notify their sexual partners
e. Write a will
3. If all persons in the United States were tested for HIV using an
Elisa test with a sensitivity of 99.8% and a specificity of 99.9%,
there would be:
a. More false positives than true positives
b. More true positives than false positives
c. More false negatives than true negatives
d. More false negatives than false positives
4. AIDS fatigue refers to:

a. The exhaustion that accompanies having a diagnosis of AIDS
b. Gay men are tired of talking about the AIDS epidemic
and AIDS
c. The upsurge of risky behavior among men under 20 who are
gay
d. The heterosexual population is becoming tired of talking
about HIV in the gay community
e. None of the above
5. What is the proportion of HIV Ag+ positive donors who are HIV
Ab-?
a. 1 per 100,000
b. 1 per 500,000
c. 1 per million
d. 1 per 4 million
e. 1 per 9 million
6. The three guiding principles of ethical research involving humans

are:
a. Empathy, caution and truthfulness
b. Respect for persons, beneficence and justice
c. Respect for human dignity, compensation and integrity

d. Beneficence, legal recourse and reimbursement
e. Legal recourse, justice and compensation
7. The most important component of human subjects protection is:
a. Compensation
b. Informed consent
c. Taking only 10ccs of blood
d. Not asking personally embarrassing questions
e. Providing the telephone number of the principal investigator
8. The primary goal of public health is to:

a. Protect infected individuals
b. Protect uninfected individuals
c. Inform the spouses of infected individuals
d. Determine the mortality rate of all infectious diseases
9. Informed consent includes which of the following?

a. Purpose of study
b. Description of study
c. Description of foreseeable risks and discomforts
d. Reasonably expected benefits

e. All of the above
10. Which of the following is NOT considered to be a risk of human

research?
a. Physical harm
b. Social harm
c. Psychological harm
d. Inadequate compensation
e. Economic harm
11. As part of ethical research, a potential human subject must:

a. Be provided alternative sources of medical care, which is part
of the research project
b. Be informed of alternative sources of medical care, which
is part of the research project
c. Be denied alternative sources of care
12. Guaranteeing anonymity means that the researcher will:

a. Keep identifying information safeguarded and disclose it to
no one without the permission of the research participant

b. Will not collect identifying information
c. Will not inform the participant that s/he is collecting
identifying information
d. Will only release identifying information if required to by a
judge
13. The success of individual level interventions depends on:

a. Reaching the riskiest individuals
b. Reaching enough of the riskiest individuals
c. Having an intervention that is sufficiently intensive
d. All of the above
e. a. and c. above
14. The most effective health education/behavioral intervention
strategies use:
a. The empty vessel strategy
b. As many different strategies as possible
c. Provide only the important information on HIV
d. Target only high-risk individuals
e. A combination of effective strategies
15. The diffusion of innovation strategy suggests targeting first the:

a. Early innovators
b. Middle innovators
c. Late adopters
d. The laggards
e. All of the above
16. Which is NOT one of the stages of behavior change?

a. Precontemplation
b. Preparation
c. Maintenance
d. Reconsideration
e. Contemplation
17. With the use of highly active antiretroviral therapy given to the
mother beginning in the second trimester of pregnancy and to the
infant for one week after birth, the risk of transmission from
mother to child can be reduced to:
a. Less than 20%
b. Less than 10%
c. Less than 5%
d. Less than 2%
18. The highest risk of transmission from mother to infant occurs:

a. In-utero
b. During the birth process
c. Through breast feeding
d. The risk is equal during all stages of pregnancy and delivery
19. Factors which increase the risk of transmission from mother to

infant include:
a. The phenotype of the virus
b. The stage of HIV disease in the mother
c. The level of HIV in the mother
d. All of the above
20. The rate of HIV disease progression is highest in babies who were
infected:
a. In-utereo
b. During the birth process
c. During breast feeding
d. The rate of progression is the same in all three of the above
21. A slower rate of progression of HIV disease in the baby is

associated with:
a. The presence of high levels of neutralizing antibody in the
mother
b. The presence of high levels of neutralizing antibody in the
baby
c. Early appearance of HIV diversity in the baby
d. All of the above
22. The most important step in effective national control of HIV/AIDS

is:
a. Mobilization of political will and commitment
b. Focused interventions to marginalized groups

c. Reduction of stigmatization
d. Identification of risk groups
23. The objectives of an HIV vaccine program may include:

a. Prevention of infection
b. Prevention of disease
c. Prevention of transmission
d. All of the above
24. The major barrier to the development of an HIV vaccine has been:
a. The cost of developing the drug
b. The lack of demonstrated natural immunity following
HIV infection
c. The presence of two types of HIV: CD4-tropic and
macrophage-tropic
d. The lack of political commitment for the development of a
vaccine
25. The following are requirements for an effective HIV vaccine

EXCEPT:
a. Must be safe
b. Must elicit a protective response
c. Must stimulate a cytotoxic lymphocyte response
d. Must stimulate IgM antibodies
e. Must be practical to produce, transport and administer
26. Current risk of getting infected with HIV through blood

transfusion in the United States is:
a. 1 per 1, 800,000
b. 1 per 1, 600,000
c. 1 per 9,000,000
d. 1 per 63,000
27. Which one of these is NOT a layer of safety implement in blood

safety in the United States?
a,Self exclusion in response to written material
b. Health history interview
c. Laboratory testing
d. Viral inactivation
e. Partner notification
28. Partner Counseling and Referral Services in LA County provide a

range of services but do NOT provide follow-up service to:
a. HIV+ clients
b. HIV- clients
c. Sexual partners of HIV+ clients
d. Needle-sharing partners of HIV+ clients
29. Increasing knowledge about HIV/AIDS is:

a. Sufficient but not necessary
b. Necessary but not sufficient
c. Sufficient and necessary
30. One of several factors that may be attributed to the resurgence of

the HIV epidemic among men who have sex with men in the
United States is:
a. Discrimination against men who have sex with men

b. Changes in beliefs regarding the severity of HIV disease
c. There are few intervention programs for men who have sex
with men
31. The inability of mature T cells and B cells to pathologically

respond to self is known as:
a. Tolerance
b. Central tolerance
c. Peripheral tolerance
d. Autoimmune
32. The two known types of HIV (HIV-1 and HIV-2) belong to a
family of:
a. Lentiviruses
b. Oncoviruses
c. Spumaviruses
33. The type of first antiretroviral drug to show an effect in humans
was:
a. Reverse transcriptase inhibitors
b. Protease inhibitors
c. Integrase inhibitors
d. gp120 blockers
e. A combination of the three above
34. The major AIDS-defining illness in most developing countries is:

a. Pneumocystis carinii
b. Kaposis sarcoma
c. Lymphoma
d. Tuberculosis
35. The rate of new HIV infections is probably declining in which one
of the following Asian countries:
a. China
b. India
c. Vietnam
d. Myamar
e. Cambodia
36. The major mode of spread of HIV in the world is through:

a. Homosexual activities
b. Needle sharing among injecting drug users
c. Heterosexual activities
d. Unscreened blood
e. Infected mother to infant
37. The set point refers to:

a. The level of CD4 cells after the initial stage of HIV infection
b. The level of CD8 cells after the initial stage of HIV infection
c. The level of viral load after the initial stage of HIV
infection
d. The level of viral load at the late stage of HIV infection
38. HIV infection alone can cause all of the following EXCEPT:
a. AIDS dementia
b. Direct killing of neurons
c. Vacuolar myelopathy
d. Peripheral neuropathy
e. Meningitis
39. In 2002, worldwide, the number of adults and children NEWLY

infected with HIV is:
a. 2 million
b. 3 million
c. 4 million
d. 5 million
40. In 2002, worldwide, what percentage of new HIV infections

occured in developing countries?
a. Almost 50%
b. More than 95%
c. Less than 50%
d. About 75%
41. During 2002, the highest number of HIV/AIDS cases occurred in

which area?
a. Sub-Saharan Africa
b. Southeast Asia
c. China
d. Russia and the former Soviet Union

e. United States
42. The highest proportion of HIV-infected persons in the United

States were in which risk group?
a. Men-who-have-sex-with-men
b. Heterosexuals
c. Injection drug users
d. Plasma donors
e. Hemophiliacs
43. The risk group with the greatest rate of decline in the proportion of
AIDS cases in the United States has been:
a. Men-who-have-sex-with-men
b. Heterosexuals
c. Injection drug users
d. Plasma donors
e. Hemophiliacs
EPIDEMIOLOGY ‫العاشرة‬
10‫ودالشمال‬ ‫النسخة‬
44. The advantages of using the saliva test include all of the
following EXCEPT:
a. It is non-invasive
b. It is more acceptable to most people than giving a blood
specimen
c. As many as five specimens can be pooled for testing
d. It is not necessary to keep the specimens cold during
transport
e. It does not require sterile needles and syringes
45. Which component of the HIV virion first attaches to the CD4
cell?
a. P24
b. GP41
c. GP120
d. The lipid envelope
e. Pol proteins
46. The major characteristics of adaptive immunity are all of the

following EXCEPT:
a. Antigen specificity
b. Diversity
c. Memory
d. Self/non-self recognition
EPIDEMIOLOGY ‫العاشرة‬
10‫ودالشمال‬ ‫النسخة‬
e. Immediate protection
47. The most effective cell of the immune system response to
HIV is which of the following?
a. CD4 cells
b. CD8 cells
c. B cells
d. NK cells
e. Plasma cells
48. The key characteristic of an effective HAART regimen is to

include:
a. One drug from each of the three classes of drugs
b. Three drugs, with one drug from at least two of the
three classes of drugs
c. One protease inhibitor
d. Zidovudine
e. Four drugs, with at least one drug from all three classes
of drugs
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‫‪EPIDEMIOLOGY‬‬ ‫النسخة العاشرة‬

‫مع تمنياتي بالتوفيق والنجاح للجميع‬

2: The occurrence in a community or region of cases of

3: Any factor that brings about change in a health

4: The level of prevention that takes place during the

5: The implementation of health education programs is

6: Epidemiologic studies that are concerned with

7: The Black Death was thought to be an epidemic of:

8: Sir Percival Pott made the astute observation that

9: The probability that an event will occur, e.g., that an

10: Prevalence refers to:

A A: The number of existing cases of a disease or

11: Count refers to:

B A: The occurrence of new disease or mortality

12: The occurrence of new disease or mortality within a

13: A rate is a type of ratio that:

C A: Has time as a component

14: A type of rate that has not been modified to take

15: A measure that refers to the mortality rate associated

C A: Crude Dealth Rate

16: The term that refers to the number of deaths due to a

B A: Crude Dealth Rate

17: The number of deaths within a population due to a

C A: Crude Dealth Rate

18: The following term denotes the number of cases of a

19: Deaths, births, marriages, divorces and fetal deaths

20: Systematic and continuous gathering of information

21: Using health-related data that precede diagnosis and

22: A centralized database for collection of information

23: The following refers to the number of years that a

24: The following refers to maternal deaths that result

25: The death of the fetus when it is in the uterus and

26: The number of live births reported in an area during

C A: Crude Birth Rate

27: The number of late fetal deaths after 28 weeks or

B A: Infant Fertility Rate

28: Which of the following is not mentioned as an aim of

C A: Permit evaluation of trends in health and

29: This classifies the occurrence of disease according to

30: Which of the following is an example of a type of

31: Race and socioeconomic status are examples of:

32: A term that refers to the place of origin of the

33: A descriptive term for a person’s position in society:

34: Point epidemics and clustering are examples of

35: Increases and decreases in the frequency of a disease

36: The Texas Sharpshooter Effect is related to:

37: BRFSS stands for:

B A: Behavioral Records For Student Statistics

38: A term that refers to any quantity that varies:

39: An association between two variables can be:

40: Mortality, coronary heart disease, chronic obstructive

41: Which type of curve is shown below?

42: The following term denotes those diseases for which

43: A situation in which all of the factors in two or more

C A: Method of Concomitant Variation

44: This criterion specifies that one must observe the

45: The association between exposure to tars and oils

46: The type of association in which an increase in the

47: A single value chosen to represent the population