1. What was the case-fatality rate from cholera in 2016? 2. Wha...

1. What was the case-fatality rate from cholera in 2016?

2. What would be the effect on age-specific incidence rates if women with hysterectomies were included in the denominator of calculations, assuming that there are some women in each age group who have had hysterectomies?
a. the rates would remain the same
b. the rates would tend to decrease
c. the rates would tend to increase
d. the rates would increase in older groups and decrease in younger groups
e. it cannot be determined whether the rates would increase or decrease

3. Age-adjusted death rates are used to:
a. Correct death rates for errors in the statement of age
b. Eliminate the effects of differences in the age distributions of populations in comparing death rates
c. Determine the actual number of deaths that occurred in specific age groups in a population
d. Correct death rates for missing age information
e. Compare deaths in persons of the same age group

Questions 4 and 5 use the information below:
Population of the city of Atlantis on March 30, 2016 = 152,000
No. of new active cases of TB occurring between January 1 and June 30, 2016 = 55
No. of active TB cases according to the city register on June 30, 2016 = 149

4. The incidence rate of active cases of TB for the 6-month period was
a. 7 per 100,000 population
b. 14 per 100,000 population
c. 36 per 100,000 population
d. 130 per 100,000 population

5. The prevalence of active TB as of June 30, 2016, was
a. 14 per 100,000 population
b. 144 per 100,000 population
c. 98 per 100,000 population
d. none of the above

6. A survey was conducted among the non-hospitalized adult population of the United States during 2014 through 2017. The results from this survey are shown below.
Age Group    Persons with Hypertension (%)
18–29 years 3
30–39 years 10
40–49 years 23
50–59 years 33
60–69 years 59
70 and older 79
The researchers stated that there was an age-related increase in the risk of hypertension in this population. You conclude that the researchers’ interpretation:
a. is correct
b. is incorrect because it was not based on rates
c. is incorrect because incidence rates do not describe risk
d. is incorrect because prevalence is used
e. is incorrect because the calculations are not age-adjusted

7. Which of the following is an advantage of active surveillance?
a. requires less project staff
b. is relatively inexpensive to employ
c. more accurate due to reduced reporting burden for health care providers

8. Which of the following is a disadvantage of active surveillance?
a. requires more project staff
b. is relatively inexpensive to employ
e. more accurate due to reduced reporting burden for health care providers

9. For a disease such as pancreatic cancer, which is highly fatal and of short duration:
a. Mortality rates will be much higher than incidence rates
b. Incidence rates will be much higher than mortality rates
c. Incidence rates and mortality rates will be similar
d. Incidence rates will be unrelated to mortality rates
e. None of the above

10. In 2016, there were 12,500 deaths due to lung diseases in miners aged 20 to 64 years. The expected number of deaths in this occupational group, based on age-specific death rates from lung diseases in all males aged 20 to 64 years, was 3,800 during 2016.
a. What was the standardized mortality ratio (SMR) for lung diseases in miners? Calculate the SMR and interpret the value of the SMR

Questions 11-14 are based on the information given below:
A physical examination was used to screen for breast cancer in 4,000 women with biopsy-proven adenocarcinoma of the breast and in 6,000 age- and race-matched control women. The results of the physical examination were positive (i.e., a mass was palpated) in 3,500 cases and in 300 control women, all of whom showed no evidence of cancer at biopsy.
11. What is the sensitivity of the physical examination? Interpret it.
12. What is the specificity of the physical examination? Interpret it.
13. What is the positive predictive value of the physical examination? Interpret it.
14. What is the negative predictive value of the physical examination? Interpret it

Question 15 is based on the following information:
A physical examination and an audiometric test were given to 800 persons with suspected hearing problems, of whom 400 were actually found to have them. The results of the examinations were as follows:
PHYSICAL EXAMINATION
HEARING PROBLEMS
Result Present Absent
Positive 320 100
Negative 80 300

AUDIOMETRIC TEST
HEARING PROBLEMS
Result Present Absent
Positive 390 20
Negative 10 380

15. Compared with the physical examination, the audiometric test is:
a. Equally sensitive and specific
b. Less sensitive and less specific
c. More sensitive and more specific
d.   Less sensitive and more specific
e. More sensitive and less specific

Questions 16a and 16b are based on the information given in the table below:
16. Calculate the age-adjusted death rate for disease Z in communities X and Y by the direct method, using the total of both communities as the standard population.
16a. The age-adjusted death rate from disease Z for community X is:
16b. The age-adjusted death rate from disease Z for community Y is:

COMMUNITY X
Age          No. of people    No. of Deaths from Disease Z
Young          9,500                     82
Old             19,500                   246

COMMUNITY Y
No. of people    No. of Deaths from disease Z
17,800                              49
6,500                               83

17. Which of the following is a good index of the severity of a short-term, acute disease?
a. Cause-specific death rate
b. Case-fatality rate
c. 5-year survival
d. Standardized mortality ratio
e. None of the above

18. 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:
a) Pandemic
b) Epidemic
c) Endemic

19. 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:
a) Epidemiologic Transition
b) Hypothesis
c) Risk

20. 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:
a) Cause-Specific Mortality Rate   
b) Sex-specific Rate
c) Crude Death Rate

21. Wearing a safety belt is an example of which level of prevention?
a) Primary prevention
b) Secondary prevention
c) Tertiary prevention
d) Community prevention

22. Providing education to a diabetic on how to use his/her insulin is an example of which level of prevention?
a) Primary prevention
b) Secondary prevention
c) Tertiary prevention
d) Community prevention

23. Encouraging individuals to take a daily dose of aspirin to reduce the chance of a heart attack is an example of which level of prevention?
a) Primary prevention
b) Secondary prevention
c) Tertiary prevention
d) Community prevention

24. Providing training or instructing patients on how to modify their diets and take their medications to prevent a second heart attack is an example of ________ prevention.
a) primary
b) secondary
c) tertiary
d) community

25. Which of the following is a measure of disease prognosis?
a) Prevalence
b) Age-adjusted mortality rates
c) Median survival time
d) Standardized mortality ratio

26. The level of prevention that takes place during the early phases of pathogenesis and includes activities that limit the progression of disease is:
a) Primary Prevention
b) Secondary Prevention
c) Tertiary Prevention

27. Sensitivity and specificity are important criteria for screening and diagnostic instruments. What is specificity?
a) Different method of measuring the same attributes yielding similar results
b) Ability to differentiate the construct being measured from other similar concepts
c) Instrument's ability to identify non-cases correctly.
d) Instrument's ability to identify a case correctly