EPI

Question 1

1. Questions answered by DESCRIPTIVE
   EPIDEMIOLOGY include the following EXCEPT.
   A. What specific age groups are affected by the
   disease?
   B. Is there a specific region in the country where the
   disease predominantly occurs?
   C. How was the disease transmitted?
   D. Has there been an increase in the prevalence of
   the illness in the last five years?

Answer 1

C. How was the disease transmitted?
(Remember: when talking about descriptive
epidemiology, we talk of time, place and person)

Question 2

2. The MOST important HOST characteristic affecting
   disease occurrence is:
   A. gender C. occupation
   B. age D. civil status

Answer 2

B. Age

Question 3

3. Which of the following factors would LEAST likely
   account for differences in pattern of occurrence of
   disease based on GENDER?
   A. biologic differences
   B. differences in lifestyles and habits
   C. differences in health seeking behavior
   D. differential exposure to environmental factors

Answer 3

C. differences in health seeking behavior

Question 4

4. Which pattern of disease distribution according to TIME
   would be most appropriate to monitor for chronic NONCOMMUNICABLE
   DISEASES like malignant
   neoplasms?
   A. short-term fluctuation C. seasonal pattern
   B. secular trend D. all of the above

Answer 4

B. secular trend

Remember: Secular trend (long-term)

Question 5

5. Which pattern of disease distribution according to TIME
   would be most appropriate to monitor for
   COMMUNICABLE DISEASES like leptospirosis?
   A. short-term fluctuation
   B. secular trend
   C. seasonal pattern
   D. epidemic curve

Answer 5

A. short-term fluctuation- also an epidemic
B. secular trend
C. seasonal pattern- cyclic
D. epidemic curve
(Remember: Short-term is also an epidemic, seasonal
pattern (cyclic))

C is the answer

Question 6

A rapidly emerging disease outbreak that affects a wide
range of geographically distributed populations is
referred to as a/an:
A. endemic disease C. pandemic disease
B. epidemic disease D. none of the above

Answer 6

C. pandemic disease

Question 7

For numbers 7 to 10, refer to the case scenario below ( from
Neurology Asia, Vol. 14:pages 73-76, 2009).
In late September 1998, an outbreak of acute febrile
encephalitis (i.e. fever, drowsiness, seizure, comatose,
respiratory distress) associated with high mortality was
reported in Kinta, a district in Perak, Malaysia, among pigfarming
community. This was subsequently followed by
another outbreak in three districts in Negeri Sembilan
namely (1) Sikamat, (2) Sungai Nipah and (3) Hukit
Pelanduk, from December 1998 through February 1999.
The later outbreak was associated with the movement of
pigs from Kinta district and between farms. Experts initially
believed the outbreak was caused by a mammalian virus,
with pigs being one of its hosts.
Subsequent epidemiologic investigations led to the eventual
discovery of the NIPAH VIRUS in March 1999, a highly
virulent virus of the Paramyxoviridae family, as the
etiological agent of this fatal outbreak— NIPAH
ENCEPHALITIS. The Nipah virus is a single stranded RNA
virus, belonging to the family Paramyxoviridae in the
subfamily Paramyxovirinae in the genus Henipavirus that it
shares with HENDRA VIRUS. There is an apparent high
mutation rate with this virus and the Nipah virus has the
inherent ability to infect across many mammalian species
(i.e. DOGS, CATS, FERRETS, PIGS, HORSES). This
prompted the search for the virus among FRUIT BATS, the
natural host and vector of the Hendra virus ( which is closely
and genetically related to the Nipah virus). Surveillance of
wildlife species during the outbreak using a novel collection
method isolated the Nipah virus from the urine and saliva of
fruit bats of the PTEROPUS family, namely Pteropus
hypamelanus.
Further academic research studies have shown that the
Nipah virus could be transmitted from bat-to- human and
from human-to-human. Wildlife studies have also shown that
the virus was widely distributed in at least 10 genera and 23
species of bats in a large part of Asia-Pacific and Africa— a
region that stretches from Australia and Southern China and
from Indonesia to as far as Ghana, a region with a total
population of more than 1.4 billion people. As bats are long
distant flying, gregarious animals living in large colonies,
which could exchange novel viruses from one species to
another, it is not unexpected that the seroprevalence of
Henipavirus among bat colonies is relatively high. The
widespread distribution of both the Henipavirus and its hosts
also means that the virus will remain an important cause of
zoonotic disease.

EPIDEMIOLOGY variables/factor:
A. PERSON factor
B. TIME factor
C. PLACE factor
D. B and C
E. A, B and C
7. In March 1999, a similar illness was reported among
eleven abattoir ( slaughter- home) workers in
Singapore, with one fatality. The pigs were imported
from the 1998 outbreak region in Malaysia.

Answer 7

E. (PERSON- slaughter house workers, TIME- March

1999, PLACE-slaughter house in Singapore)

Question 8

EPIDEMIOLOGY variables/factor:
A. PERSON factor 
B. TIME factor
C. PLACE factor
D. B and C
 E. A, B and C

Refer to the case:
8. Since the initial outbreak in Malaysia, small outbreaks
of Nipah encephalitis have been reported almost
annually in Bangladesh.

Answer 8

D

Question 9

EPIDEMIOLOGY variables/factor:
A. PERSON factor 
B. TIME factor
C. PLACE factor
D. B and C
 E. A, B and C

9. In India, individuals who consume raw date palm sap
   contaminated with infectious bat excretions are believed
   to be at higher risk of developing Nipah encephalitis.

Answer 9

A

Question 10

EPIDEMIOLOGY variables/factor:
A. PERSON factor 
B. TIME factor
C. PLACE factor
D. B and C
 E. A, B and C

Experts have theorized that there is higher incidence of
Nipah encephalitis during the migration and breeding/
reproductive cycles of the fruit bats.

Answer 10

D

Question 11

For numbers 11 to 15, refer to the actual vital statistics from
Bacoor, Cavite in 2013:
HEALTH INDICES:
DATA
Estimated Population Census (as of 07-01-13) 588,256
Total Death 1,237
Death Under Five Years Old 26
Stillbirth 3
Deaths Under One Year Old 18
Maternal Deaths 5
Live Births 3,284

11. The OVER-ALL INDEX OF THE HEALTH status of
    Bacoor City in the year 2013 is measured as:
    A. 18 / 3,284 C. 5 / 3, 284
    B. 18 / 588, 256 D. 1,237 / 588, 256

Answer 11

A. 18 / 3,284

Question 12

For numbers 11 to 15, refer to the actual vital statistics from
Bacoor, Cavite in 2013:
HEALTH INDICES:
DATA
Estimated Population Census (as of 07-01-13) 588,256
Total Death 1,237
Death Under Five Years Old 26
Stillbirth 3
Deaths Under One Year Old 18
Maternal Deaths 5
Live Births 3,284

12. The measure of ADEQUACY AND ACCESSIBILITY OF
    HEALTH SERVICES in Bacoor City is:
    A. 18 / 3,284 C. 5 / 3,284
    B. 18 / 588,256 D. 1,237 / 588,256

Answer 12

A (looking for Maternal Mortality Rate which is the number
of maternal deaths or pregnancy related deaths divided
by no. of livebirths)

Question 13

For numbers 11 to 15, refer to the actual vital statistics from
Bacoor, Cavite in 2013:
HEALTH INDICES:
DATA
Estimated Population Census (as of 07-01-13) 588,256
Total Death 1,237
Death Under Five Years Old 26
Stillbirth 3
Deaths Under One Year Old 18
Maternal Deaths 5
Live Births 3,284

13. What is the RISK OF DYING BEFORE BIRTH?
    A. 3 / 3,284 C. 5/ 1,237
    B. 3/ 1,237 D. 3 / 588,256

Answer 13

A. 3 / 3,284

Question 14

For numbers 11 to 15, refer to the actual vital statistics from
Bacoor, Cavite in 2013:
HEALTH INDICES:
DATA
Estimated Population Census (as of 07-01-13) 588,256
Total Death 1,237
Death Under Five Years Old 26
Stillbirth 3
Deaths Under One Year Old 18
Maternal Deaths 5
Live Births 3,284

14. The RISK OF DYING FROM DENGUE is computed as?
A. 178/ 588,256
B. 178/ 1,237
C. 178/ 1,755
D. 178/3,284

Answer 14

A. 178/ 588,256

Question 15

For numbers 11 to 15, refer to the actual vital statistics from
Bacoor, Cavite in 2013:
HEALTH INDICES:
DATA
Estimated Population Census (as of 07-01-13) 588,256
Total Death 1,237
Death Under Five Years Old 26
Stillbirth 3
Deaths Under One Year Old 18
Maternal Deaths 5
Live Births 3,284

15. The MAGNITUDE OF DEATH FROM DENGUE is
composed as:
A. 178/ 588, 256
B. 178/1,237
C. 178/1,785
D. 178/3,284

Answer 15

B. 178/1,237

Question 16

Based on the figure above, how will you compute for
the HEALTHY LIVE YEARS LOST?
A. (0.40 x 40) – (1.0X 10)
B. (0.6 X 40) – (1.0X 10)
C. (1.0X10) – (0.6X40)
D. (0.6X10) – (0.4X40)

Answer 16

A. (0.40 x 40) – (1.0X 10)

Question 17

17. In hospital statistics, this usually indicates a breach of
    aeseptic technique, isolation and proper patient
    handling:
    A. high net morbidity rate
    B. high anesthesia death rate
    C. low post operative infection rate
    D. high net death rate

Answer 17

A. high net morbidity rate

Question 18

18. This might indicate the hospital staff or doctors are
    doing clandestine or illicit procedures for finanficl gain:
    A. high dilation and cuerrage (D&C) rate
    B. high enesthesia death rate
    C. low post-operative infections rate
    D. high net death rate

Answer 18

A. high dilation and cuerrage (D&C) rate

Question 19

19. The following is/are TRUE regarding DIRECT
    STANDARDIZATION of rates?
    a. It is used when stramm- specific rates are
    stable.
    b. It uses a standard age specific death rates as
    a basis for the standardization
    c. It entails the use of a standardized mortality
    ration
    d. All of the above

Answer 19

A It is used when stramm- specific rates are

stable.

Question 20

20. A low SWAROOP-EUMURA index means:
    a. A high infant mortality rate (IMR)
    b. Longer life expectancy
    c. Success in the control of communicable
    diseases
    d. All of the above

Answer 20

A A high infant mortality rate (IMR)

Question 21

For numbers 21 to 25, refer to the scenario below:
A newly appointed public health doctor (rural health officer)
needs to know the health state of the ocmmunity he is
assigned to. He is pressed for time as he is expected to
develop a health plan within a month.

21. He reviews records of his new office. What favors using
    such information at this point?
    a. Information on patients’ health state is
    complete
    b. Clinical data are encoded by health
    professional
    c. Easy and quick means of obtaining general
    information
    d. Informatuon obtained by this doctor is primary
    data

Answer 21

C Easy and quick means of obtaining general

information

Question 22

22. The doctor also needs information on the frequency and
    causes of death experienced in this community over the
    last five (5) years. His best source for such date will be:
    a. Hospital records of deaths
    b. Civil registries of vital events
    c. Medical practitioner’s patient records
    d. Local notifiable diesase reports

Answer 22

b. Civil registries of vital events

Question 23

23. What are some of the statistical publications that he can
    likewise review to schieve his purpise?
    a. Field health service inforamtions systems
    (FHSIS) and the department of health (DOH)
    b. Rural health unit’s logbooks
    c. Company and school clinic records
    d. All of the above

Answer 23

a. Field health service inforamtions systems

FHSIS) and the department of health (DOH

Question 24

24. The public health doctor opts to obtain complete and
    current information on the health state of the population
    in his new community after his initial, quick assessment.
    Which of the following can be obtained if he conducats
    a HEALTH SURVEY?
    a. Amount of illness and deahts, as well as their
    causes in the population
    b. Specific health-related characteristics of the
    population
    c. Both A and B
    d. Neather A nor B

Answer 24

c. Both A and B

Question 25

25. Which of the following methods of data collection
    should the docto utilize in the conduct of this halth
    survey?
    a. Interview
    b. Observation or measurement
    c. Review of records
    d. A and B only

Answer 25

d. A and B only

Question 26

26. In view of their public health importance, the following
    diseases are MAINTAINED IN REGISTRIES, EXCEPT:
    a. Schistosomiasis
    b. Tubercolosis
    c. Malaria
    d. Leptospirosis

Answer 26

d. Leptospirosis

Question 27

27. The certificate of deat of an individual, whose death
    was NOT attended by a licensed physician, is usually
    accomplished by:
    a. Patient’s original attending personaly physicial
    / family doctor
    b. Any liscense physicial working in a nearby
    government hospital whose death occurred
    c. Local civil registrar office
    d. Municipal/ city healh officer

Answer 27

d. Municipal/ city healh officer

Question 28

28. Births that occurred at home need to be certified and
    registered. Who is responsible for certifying the facts of
    birth?
    A. Person who attended the delivery (e.g.
    Tradition birth attendant/hilot)
    B. Parents of the newborn baby
    C. Local civil registrar
    D. All of the above

Answer 28

A. Person who attended the delivery (e.g.

Tradition birth attendant/hilot)

Question 29

29. Which of the following information in a Certificate of
    Death is usually selected for PRIMARY TABULATION
    as cause of death?
    A. Immediate cause
    B. Antecedent cause
    C. Underlying cause
    D. Other significant conditions contributing to
    death

Answer 29

C. Underlying cause

Question 30

30. Deaths are usually registered in:
A. The place of occurrence of death
B. The place of residence of the deceased
C. The place of burial
D. The birth place of the deceased

Answer 30

A. The place of occurrence of death

Question 31

31. A Singaporean died on an airplane (i.e. Cebu Pacific)
    en route to the Phils. (Specifically bound to Cebu City),
    but the exact place of death could not be ascertained.
    The foreigner had visited the Philippines several times
    already since 2010, and he usually stayed with his
    friends in QC whenever he visited the country. The
    Singaporean is not a permanent resident of the
    Philippines. Where will the Certificate of Death be
    registered?
    A. Local Civil registry in Cebu City
    B. Local Civil registry in QC
    C. Local Civil Registry in Manila
    D. None of the above, death must be registered
    in Singapore

Answer 31

C. Local Civil Registry in Manila

Question 32

32. Based on the Administrative Order of the department of
    health on “Disposal of Dead persons”, the requirement
    for a Certificate of Death BEFORE BURIAL may be
    WAIVED in the case of special circumstances when the
    death certificate cannot be issued in time. This/These
    include/s the following:
    A. The deceased died from a dangerous
    communicable disease and must be buried
    within 12 hours.
    B. The family members of the deceased have
    requested immediate cremation without
    embalming or viewing.
    C. Religious beliefs or traditions (e.g. Islam or the
    Jewish faith) call for burial witin 12 hours after
    death.
    D. All of the above

Answer 32

D. All of the above

Question 33

33. As per directive of the DOH, which of the following
    disease was included in the LIST OF NOTIFIABLE
    DISEASE in the Philippines last July 2012?
    A. AIDS
    B. Ebola infection
    C. Chikungunya fever
    D. Influenza A H1N1 infection

Answer 33

B. Ebola infection

Question 34

34. Based on the Philippine Integrated disease Surveillance
    and Response (PIDSR) system, the following illnesses
    are target for ELIMINATION AND ERADICATION,
    EXCEPT:
    A. Acute flaccid paralysis
    B. Neonatal tetanus
    C. Measles
    D. PTB

Answer 34

D. PTB

Question 35

35. The following diseases are considered DANGEROUS
COMMUNICALBLE DISEASE EXCEPT:
A. Japanese encephalitis
B. Rabies
C. Creutzfeldt-Jakob disease
D. Yellow fever

Answer 35

A. Japanese encephalitis

Question 36

For numbers 36 to 43, under which part of the COMMUNITY
DIAGNOSIS should be the following statements belong:
A. Definition of the problem
B. Appraisal of existing facts
C. Hypothesis formulation
D. Practical application

36. The number of firecracker related injuries in the 2013
    New Year celebration has decreased significantly over
    the last decade, but the problem of indiscriminate firing
    of guns during New Year has not changed.

Answer 36

B

Question 37

For numbers 36 to 43, under which part of the COMMUNITY
DIAGNOSIS should be the following statements belong:
A. Definition of the problem
B. Appraisal of existing facts
C. Hypothesis formulation
D. Practical application

37. Since 2009, the Philippines has been experiencing
    extreme weather events (i.e. Storm surges, flash floods,
    turbulemt sea water with strong fast moving winds and
    monsoon rains), which has resulted in an increase in
    incidence of flood-borne disease, such as leptospirosis
    and fungal skin infections

Answer 37

B

Question 38

For numbers 36 to 43, under which part of the COMMUNITY
DIAGNOSIS should be the following statements belong:
A. Definition of the problem
B. Appraisal of existing facts
C. Hypothesis formulation
D. Practical application

The DOH is alarmed with the increasing number of new
cases of HIV infection which has been described to be
“fast and furious” as compared to its previous status of
“low and slow”.

Answer 38

A

Question 39

For numbers 36 to 43, under which part of the COMMUNITY
DIAGNOSIS should be the following statements belong:
A. Definition of the problem
B. Appraisal of existing facts
C. Hypothesis formulation
D. Practical application

39. Various conditions originating in the perinatal period
    have significantly contributed to and impacted on the
    infant mortality rate (IMR) in the Philippines.

Answer 39

A

Question 40

For numbers 36 to 43, under which part of the COMMUNITY
DIAGNOSIS should be the following statements belong:
A. Definition of the problem
B. Appraisal of existing facts
C. Hypothesis formulation
D. Practical application

40. Rapid urbanization has been associated with the
    altered epidemiology of dengue and vector biology of
    Aedes mosquitoes

Answer 40

C

Question 41

For numbers 36 to 43, under which part of the COMMUNITY
DIAGNOSIS should be the following statements belong:
A. Definition of the problem
B. Appraisal of existing facts
C. Hypothesis formulation
D. Practical application

41. In geographically isolated and disadvantaged areas
    (GIDAs) where access of basic diagnosis procedures
    (e.g. CT scan) remains problematic, the NIH in UP
    Manila has proposed the use of “tele-medicine” (ig.
    Remote transmission of electrical medical data from
    GIDAs to central health offices based/situated in Metro
    Manila, Metro Cebu, and Metro Davao) to remedy this
    dilemma.

Answer 41

D

Question 42

For numbers 36 to 43, under which part of the COMMUNITY
DIAGNOSIS should be the following statements belong:
A. Definition of the problem
B. Appraisal of existing facts
C. Hypothesis formulation
D. Practical application

42. The DOST has recommended several preventive
    measures in terms of integrated vector control for
    dengue prevention such as the use of the ovicidallavicidal
    (OL) traps and insecticide-treated curtains in
    selected public elementary school with high dengue
    incidence

Answer 42

D

Question 43

For numbers 36 to 43, under which part of the COMMUNITY
DIAGNOSIS should be the following statements belong:
A. Definition of the problem
B. Appraisal of existing facts
C. Hypothesis formulation
D. Practical application

43. This increasing incidence in pregnancies among
    adolescent Filipinas has been linked to several
    biopsychosocial factors, such as family dysfunctionality,
    low educational attainment of parents of teen-age
    mothers, and domestic violence within the family of
    origin of the teen-age girl.

Answer 43

C

Question 44

For numbers 44 and 45, choose from the following ECONOMIC
COSTS of a disease/health-related problem:
A. Cost of early death
B. Potential income lost due to death
C. Cost of disability
D. Total economic cost

44. This is the product of the number of deaths due to a
    specific cause, expected annual wage, and the years
    lost due to death

Answer 44

A

Question 45

For numbers 44 and 45, choose from the following ECONOMIC
COSTS of a disease/health-related problem:
A. Cost of early death
B. Potential income lost due to death
C. Cost of disability
D. Total economic cost

45. This is the product of the average annual income,
    number of cause-specific deaths, and the difference
    between 65 years and median age at time of death.

Answer 45

B

Question 46

46. Which of the following statements are TRUE?
    A. Intra-observer variation is seen when the same
    nurse takes successive measurements of the
    blood pressure of the same patient.
    B. Two different radiologists interpreting the same
    chest x-ray is an example of inter-observer
    variation.
    C. The use of an automated instrument, such as
    the digital Sphygmomanometer may prevent
    errors of measurement
    D. All of the above

Answer 46

D. All of the above

Question 47

47. Which of the following statements is/are TRUE?
    A. Accuracy refers to the ability of measurement
    to be correct on the average.
    B. Precision is the ability of a measurement to
    give the same or a very similar result with
    repeated measurements of the same thing.
    C. Precision is sometimes known as
    reproducibility.
    D. All of the above.

Answer 47

D. All of the above.

Question 48

48. The ability of a test to detect a disease when the
disease is present is referred to as:
A. Sensitivity
B. Specificity
C. Positive predictive value
D. Negative predictive value

Answer 48

A. Sensitivity

Question 49

49. The ability of a test to label as negative those who do
not have the disease is referred to as:
A. Sensitivity
B. Specificity
C. Positive predictive value
D. Negative predictive value

Answer 49

B. Specificity

Question 50

50. A patient consulted at the clinic due to a nodular cystic
    mass on the anterior neck area. A fine needle aspiration
    biopsy (FNAB) was done which revealed normal
    results. However, the patient still opted to undergo
    thyroidectomy, and histopathology report revealed
    thyroid malignancy. This is an example of which type of
    error?
    A. Alpha error
    B. Beta error
    C. Delta error
    D. Kappa error

Answer 50

B. Beta error

Question 51

51. A SCREENING test must ideally have;
    A. A high degree of sensitivity and a low false
    positive error
    B. A high degree of specificity and a low false
    negative error
    C. A high degree of sensitivity and low false
    negative error
    D. A high degree of specificity and a low false
    positive error

Answer 51

51. A SCREENING test must ideally have;
    A. A high degree of sensitivity and a low false
    positive error
    B. A high degree of specificity and a low false
    negative error
    C. A high degree of sensitivity and low false
    negative error
    D. A high degree of specificity and a low false
    positive error

Question 52

52. A CONFIRMATORY test ideally must have;
    A. A high degree of specificity and a low false
    positive error
    B. A high degree of sensitivity and a low false
    negative error
    C. A high degree of specificity and low false
    negative error
    D. A high degree of

Answer 52

A. A high degree of specificity and a low false

positive error

Question 53

A group of Year Level IV medical students currently rotating in
the Department of Clinical Neuroscience at the UERM memorial
Hospital wanted to determine the accuracy of SIRIRAJ STROKE
SCORING SYSTEM (validated at the UP Manila – PGH) in the
diagnosis of hemorrhagic versus ischemic stroke (i.e.
Cerebrovascular accident/brain attack). They compared the
results of the scoring system done at the emergency room with
the actual findings of the Vaseline cranial tomography (CT) scan.
The table below summarize the results of the tests:
(insert pic)

53. The SENSITIVITY of the Siriraj stroke score is:
A. (210 + 80) / (210 +80 +100 +90)
B. 210 / (210 + 100 +80 +90)
C. 210 / (210 +80)
D. 210 / (210+100)

Answer 53

C. 210 / (210 +80)

Question 54

54. The SPECIFICITY of the Siriraj stroke score is:
A. 90 / (100+90)
B. 90 / (80+90)
C. (90 +100) / (210 +80 +100 +90)
D. 90 / (210 +80 +100 +90)

Answer 54

A. 90 / (100+90)

Question 55

55. The POSTITIVE PREDICTIVE VALUE of the Siriraj
stroke score is:
A. 210 / (210+80)
B. 210 / (210 +100 +80 +90)
C. 210 / (210+100)
D. (210+80) / (210 +80+100+90)

Answer 55

C. 210 / (210+100)