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Epi 6410 > Midterm 1 > Flashcards

Midterm 1 Flashcards

1
Q

The agent/host/environment model is a common model in epidemiology used to illustrate the factors that are associated with disease transmission in populations. Host factors may include all of the following EXCEPT:

  1. Gender
  2. Race
  3. Rural Living
  4. Ethnicity
A
  1. Rural Living

Ch. 2/Q1

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2
Q

Characteristics of common-vehicle, single-exposure outbreaks are all of the following EXCEPT:

  1. Sudden increase increase in the number of cases in a population
  2. Cases have been exposed to the different sources of the infectious agent
  3. Only one peak is observed in the epidemic curve
  4. Few people get sick after being exposed to a primary case
A
  1. Cases have been exposed to the different sources of the infectious agent

Ch. 2/Q1

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3
Q

For herd immunity to exist, all of the following conditions must be met EXCEPT for:

  1. The disease must be caused by an infectious agent, or be an infectious disease (versus being a chronic disease such as coronary heart disease)
  2. Transmission from person to person (or host to host) must be direct
  3. Partial immunity must occur following exposure
  4. A population must have a critical percentage of people who are immune to the disease
A
  1. Partial immunity must occur following exposure

(complete immunity must occur following exposure)

Ch. 2/Q1

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4
Q

True or False: For all infectious diseases, 50% of individuals in a population need to be immune before the chain of transmission can be interrupted.

A

False

Ch.2/Q1

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5
Q

The “who” question when exploring the characteristics of a disease refer to which of the following?

  1. Person characteristics
  2. Place characteristics
  3. Time characteristics
  4. Clinical characteristics of the disease
A
  1. Person characteristics

Ch.2/Q1

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6
Q

What is in the numerator of an attack rate?

  1. The number of people at risk for the disease
  2. The number of people at risk for the disease who do not get the disease
  3. The number of people at risk for the disease who actually get the disease
  4. The number of people who get the disease, regardless of whether they are at risk
A
  1. The number of people at risk for the disease who actually get the disease

Ch.2/Q1

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7
Q

What is in the denominator of an attack rate?

  1. The number of people at risk for the disease
  2. The number of people who live in the population
  3. The number of people at risk for the disease who actually get the disease
  4. The number of people who do not get the disease
A
  1. The number of people at risk for the disease

Ch.2/Q1

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8
Q

Calculate the attack rate for the following scenario. At a CPH picnic, 120 people were in attendance and 32 people got sick with a gastrointestinal illness, which was later linked to food eaten at the picnic following an outbreak investigation by the local health department. What is the overall attack rate? Report the number as a percentage, without the “%” after it and report to one digit (e.g., if your answer is 32.1%, report 32.1) .

A

26.7

Ch.2/Q1

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9
Q

Now, suppose all 120 people filled out surveys and indicated what they did eat and what they did not eat, and whether they got sick. A total of 75 people ate ice cream and of these individuals, 23 got sick. What is the attack rate associated with eating ice cream? Report the number as a percentage, without the “%” after it and report to one digit (e.g., if your answer is 32.1%, report 32.1).

A

30.7

Ch.2/Q1

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10
Q

A “good” final written report of an outbreak investigation includes which of the following elements?

  1. Reviews the course of the outbreak in the form of a case study
  2. Compares the hypotheses with the established facts
  3. Utilizes tables, graphs, and charts
  4. All of the above are included in a “good” final report
A
  1. All of the above are included in a “good” final report

Ch.2/Q1

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11
Q

Which of the following is an example of a “fixed” population?

  1. The patient population of Riverside Hospital
  2. Dogs housed at the Capital Area Humane Society
  3. Mrs. Smith’s first glade class at Columbus Elementary School during the 2014/2015 year
  4. The hog population in North Carolina
A
  1. Mrs. Smith’s first grade class at Columbus Elementary School during the 2014/2015 year

Ch.3/Q2

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12
Q

During the summer 2014 Ebola outbreak, the number of new cases was 579 in Guinea and 972 in Liberia. Which country had a higher cumulative incidence of Ebola during the summer 2014 outbreak?

  1. Guinea
  2. Liberia
  3. Can’t be determined based on the information given
  4. The countries had the same cumulative incidence
A
  1. Can’t be determined based on the information given

Ch.3/Q2

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13
Q

Which type of morbidity measure best describes the following: the percent of children in a daycare who have impetigo (a skin disease) at entry into the daycare?

  1. Prevalence
  2. Person-time incidence rate
  3. Cumulative incidence
  4. None of the above
A
  1. Prevalence

Ch.3/Q2

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14
Q

Which measure of morbidity best describes the following: the number of at-risk nursing home residents who develop bed sores during summer 2014 per 1,000 residents?

  1. Prevalence
  2. Cumulative incidence
  3. Person-time incidence rate
  4. None of the above
A
  1. Cumulative Incidence

Ch.3/Q2

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15
Q

Which measure of morbidity best describes the following: the number of healthy, at risk men in the Physician’s Health Study who develop heart disease during 100,000 person-years of follow-up?

  1. Prevalence
  2. Cumulative incidence
  3. Person-time incidence rate
  4. None of the above
A
  1. Person-time incidence rate

Ch.3/Q2

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16
Q

Which of the following is an example of a person-time incidence rate?

  1. The number of newly diagnosed breast cancer cases per 1,000 person-years
  2. The number of men who were found to have high blood pressure at their yearly physical exam
  3. The percentage of infants who have spina bifida (a type of birth defect) at birth
  4. The number of drivers found to be using their cell phones at the time of the car accident among 1,000 car accidents
A
  1. The number of newly diagnosed breast cancer cases per 1,000 person-years

Ch.3/Q2

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17
Q

A population of 2,000 healthy, at risk people is monitored for one year starting on January 1st and the development of cases of chicken pox is noted. No one has chicken pox at the start of the investigation. Twenty-five people develop chicken pox on June 30th and fifty people develop chicken pox on September 30th. Assume complete follow-up. What is the cumulative incidence of chicken pox in this population during the one-year period from January 1st through December 31st?
(report per 1,000 individuals)

A

37.5/1000

Ch.3/Q2

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18
Q

Which of the following is true of the prevalence measure of morbidity?

  1. It is good for describing a health burden in a population
  2. It does not give an estimate of the risk of developing a disease
  3. It gives health departments and hospital administrators information for health planning
  4. All of the above are true
A
  1. All of the above are true

Ch.3/Q2

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19
Q

True or False: Cancer registries use passive surveillance systems to gather data.

A

True

Ch.3/Q2

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20
Q

True or False: Food-borne illness outbreak investigations use active surveillance systems to gather data.

A

True

Ch.3/Q2

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21
Q

In 2004, the U.S. population size was 293,235,580. During this same year, the number of deaths from diseases of the heart was 667,700. What was the mortality rate associated with heart disease? (express per 100,000)

A

228/100,000

Ch.4/Q3

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22
Q

In the U.S., the death rate from all causes was 830.7 per 100,000 for males for the combined years 2002-2006. The heart disease death rate was 256.2 per 100,000 for males. What is the proportionate mortality associated with heart disease? (express as percent)

A

31%

Ch.4/Q3

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23
Q

In general, how does the proportionate mortality vary with age?

  1. Unintentional injuries have the highest proportionate mortality among individuals under age 25
  2. “All other causes” make up, approximately, one-quarter to one-third of all deaths among all age groups
  3. The proportionate mortality estimates for heart disease increase with increasing age
  4. All of the above
A
  1. All of the above

Ch.4/Q3

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24
Q

Marburg hemorrhagic fever is a severe condition that affects humans and primates. The cause is a zoonotic, or animal-borne, virus that is from the same family as the Ebola virus. The virus was first recognized in Germany when 39 workers got sick after having been exposed to African green monkeys that were being were being used for research purposes. Of these 39 cases, 10 individuals died. What is the case fatality rate associated with this virus? (express as percent)

A

26%

Ch.4/Q3

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25
Q

True or False: Diseases that kill few people when they are young will result in a high years of potential life lost.

A

False

Ch.4/Q3

26
Q

What can you say about the quality of death certificate data?

  1. There is perfect agreement between the underlying cause of death on death certificates and the underlying cause of death determined by autopsy
  2. In general, heart disease tends to be overreported on death certificates
  3. Almost 100% of death certificates are completed correctly
  4. Almost 100% of death certificates are completed without errors
A
  1. In general, heart disease tends to be overreported on death certificates

Ch.4/Q3

27
Q

When comparing mortality rates related to Chagas disease by region and over time in Brazil, public health officials calculated age-adjusted rates. Why is it important to report age-adjusted rates?

  1. The age distribution of the population within the regions of Brazil may change over time
  2. The age distribution may be different between the different regions in Brazil
  3. Mortality from Chagas disease may be related to age
  4. All of the above
A
  1. All of the above

Ch.4/Q3

28
Q

True or False: If there are 750 observed deaths and only 100 are expected based on the mortality experience in the standard population, the SMR is equal to 0.13 (assume that the SMR is NOT multiplied by 100).

A

False

Ch.4/Q3

29
Q

True or False: If the SMR is 2 then there are more deaths observed than what you would expect based on the mortality experience in the standard population (assume that the SMR is NOT multiplied by 100).

A

True

Ch.4/Q3

30
Q

The epidemiologic transition refers to the observation that…

  1. The rate of communicable or infectious diseases is increasing
  2. The rate of non-communicable or chronic diseases is decreasing
  3. The rate of communicable or infectious diseases is decreasing
  4. None of the above
A
  1. The rate of communicable or infectious diseases is decreasing

Ch.4/Q3

31
Q

Suppose a larger value on a screening test suggests an increased likelihood of disease. Now, assume that the cut-point at which the test is classified as positive is increased. Increasing the cut-point will increase the sensitivity, increase the specificity and increase the number of false positives.

A

False

Ch.5/Q4

32
Q

Diseases that are appropriate for screening have…

  1. Serious consequences
  2. Treatment that is more effective at an earlier stage
  3. A detectable pre-clinical phase that is understood so that screening can pick up cases in this stage
  4. All of the above
A
  1. All of the above

Ch.5/Q4

33
Q

The sensitivity of a test measures…

  1. The proportion of people with a positive test among those with disease
  2. The proportion of people with a negative test among those without disease
  3. The proportion of people with disease among those who have a positive test
  4. The proportion of people without disease among those who have a negative test
A
  1. The proportion of people with a positive test among those with disease

Ch.5/Q4

34
Q

The positive predictive value of a test measures…

  1. The proportion of people with a positive test among those with disease
  2. The proportion of people with a negative test among those without disease
  3. The proportion of people with disease among those who have a positive test
  4. The proportion of people without disease among those who have a negative test
A
  1. The proportion of people with disease among those who have a positive test

Ch.5/Q4

35
Q

The negative predictive value of a test measures…

  1. The proportion of people with a positive test among those with disease
  2. The proportion of people with a negative test among those without disease
  3. The proportion of people with disease among those who have a positive test
  4. The proportion of people without disease among those who have a negative test
A
  1. The proportion of people without disease among those who have a negative test

Ch.5/Q4

36
Q

The specificity of a test measures…

  1. The proportion of people with a positive test among those with disease
  2. The proportion of people with a negative test among those without disease
  3. The proportion of people with disease among those who have a positive test
  4. The proportion of people without disease among those who have a negative test
A
  1. The proportion of people with a negative test among those without disease

Ch.5/Q4

37
Q

T/F: Two-stage or sequential screening leads to a net gain in sensitivity and a net loss in specificity.

A

False

Ch.5/Q4

38
Q

T/F: Simultaneous or parallel screening leads to a net loss in sensitivity and a net gain in specificity.

A

False

Ch.5/Q4

39
Q

T/F: The positive predictive value of a test will be higher when screening a low-risk population compared to the value obtained when screening a high-risk population.

A

False

Ch.5/Q4

40
Q

Which of the following will affect the reliability of a screening test?

  1. Variability within individuals that affects the test result
  2. Variability due to the screening test itself
  3. Variability due to the individuals who are reading the screening test results and classifying individuals as “positive” or “negative”
  4. All of the above affect the reliability of a screening test
A
  1. All of the above affect the reliability of a screening test

Ch.5/Q4

41
Q

Town A and Town B have approximately 10,000 children each, and their own water supply. Within each city, half of the children are given fluoride supplements to take. The goal is to determine whether fluoridation prevents dental decay. The decision about who received the supplements was made using a computerized program. Children in both towns are monitored and compared with regards to the occurrence of new cases of dental caries (cavities) over a 5 year period. What type of study is this?

  1. Individual Preventive Randomized Controlled Trial
  2. Community Preventive Randomized Controlled Trial
  3. Individual Therapeutic Randomized Controlled Trial
  4. Community Therapeutic Randomized Controlled Trial
A
  1. Individual Preventive Randomized Controlled Trial

Ch.7/Q5

42
Q

Five-hundred (500) patients with hypertension are enrolled in a trial: 250 are given an anti-hypertensive drug, while 250 are given the same drug plus a water-pill. The decision to give one treatment versus the other to each person was made using a computerized program. Both groups are followed for 2 years and are compared to see which group had the greatest reduction in blood pressure level. What type of study is this?

  1. Individual Preventive Randomized Controlled Trial
  2. Community Preventive Randomized Controlled Trial
  3. Individual Therapeutic Randomized Controlled Trial
  4. Community Therapeutic Randomized Controlled Trial
A
  1. Individual Therapeutic Randomized Control Trial

Ch.7/Q5

43
Q

A process that is used to balance groups with respect to factors that may be related to the treatment or outcome is known as……

  1. Non-compliance
  2. Equipoise
  3. Randomization
  4. Blinding
A
  1. Randomization

Ch.7/Q5

44
Q

An analysis that includes all subjects who were randomized to the treatment and comparison groups, regardless of whether they received or completed their assigned study protocol, is using the following…

  1. Run-in period
  2. Efficacy Analysis
  3. Comparability
  4. Intention-to-treat analysis
A
  1. Intention-to-treat analysis

Ch.7/Q5

45
Q

Which of the following best defines a placebo effect?

  1. An inactive substance or treatment (i.e. containing no pharmacological activity)
  2. A method used to blind patients
  3. The effect on patient outcomes that may result from the patient’s expectation that a particular intervention will have an effect
  4. All of the above
A
  1. The effect on patient outcomes that may result from the patient’s expectation that a particular intervention will have an effect

Ch.7/Q5

46
Q

In a study to determine the effect of a new cardiac surgical technique on sternal wound healing, researchers reported the results from 25 patients who received this new procedure. This is an example of which type of design…

  1. A randomized clinical trial
  2. A case series
  3. A clinical trial with a historical control group
  4. A clinical trial with a nonrandomized control group
A
  1. A case series

Ch.7/Q5

47
Q

In a study to determine how quickly patients recover from knee replacement surgery following a new physical therapy regimen, researchers examined recovery time in 35 patients who completed the new regimen following knee replacement surgery. They compared the recovery time in these patients to patients who received the old regimen last year. Their results were reported in a medical journal. This is an example of which time of design…

  1. A randomized clinical trial
  2. A case series
  3. A clinical trial with a historical control group
  4. A clinical trial with a nonrandomized control group
A
  1. A clinical trial with a historical control group

Ch.7/Q5

48
Q

John Buckeye Middle School decided to implement a new type of physical education program that had a goal of decreasing weight gain among 7th graders. Local university researchers decided to collect data from the students before and after the 7th grade to determine how weight changed during the year. They compared to the results from Suzy Buckeye Middle School, which is another local school but one that did not adopt this new physical education program. This is an example of which time of design…

  1. A randomized clinical trial
  2. A case series
  3. A clinical trial with a historical control group
  4. A clinical trial with a nonrandomized control group
A
  1. A clinical trial with a nonrandomized control group

Ch.7/Q5

49
Q

Researchers performed a study and randomly assigned 1/4 of participants to exercise, 1/4 to a low-fat diet, 1/4 to exercise and a low-fat diet, and 1/4 to neither exercise nor a low-fat diet. This represents which type of design?

  1. Crossover
  2. Factorial
  3. Case series
  4. Cohort study
A
  1. Factorial

Ch.7/Q5

50
Q

A study was performed where investigators recruited people and randomly assigned them to consume either soy powder or soy bread over a two week period. After a week of not consuming any soy products, subjects were then asked to consume the other soy product for two weeks (e.g., those who ate bread first were asked to use the powder second). This represents which type of design?

  1. Crossover
  2. Factorial
  3. Case series
  4. Cohort study
A
  1. Crossover

Ch.7/Q5

51
Q

The Health Professionals Cohort Study began in 2005 in order to evaluate a series of hypotheses about men’s health relating nutritional factors to the incidence of serious illnesses such as cancer, heart disease, and other vascular diseases. Every two years, members of the study will receive surveys with questions about diseases and health-related topics like smoking, physical activity, and medications taken. The surveys that ask detailed dietary information will be administered in four-year intervals. What kind of cohort study is this?

  1. Retrospective
  2. Prospective
  3. Experimental
  4. None of the above
A
  1. Prospective

Ch.9/Q6

52
Q

Investigators conducted a study in 1995 to evaluate the association between infertility treatment and ovarian cancer occurrence among 3,000 Rhode Island women treated for infertility between 1984 and 1994. Cancer incidence was determined by matching the women to information in the Rhode Island Cancer Registry. The cancer rates in this sample were compared with cancer rates among the population of Rhode Island women. What kind of cohort study is this?

  1. Retrospective
  2. Prospective
  3. Experimental
  4. None of the above
A
  1. Retrospective

Ch.9/Q6

53
Q

Prospective cohort studies are not good for studying . . .

  1. Diseases that develop over a long period of time (long latency)
  2. Diseases that are common
  3. Exposures that are common
  4. None of the above
A
  1. Diseases that develop over a long period of time (long latency)

Ch.9/Q6

54
Q

Retrospective cohort studies are better than prospective cohort studies for studying . . .

  1. Diseases that develop over a long period of time (long latency)
  2. Diseases that are rare
  3. Both of the above
  4. None of the above
A
  1. Diseases that develop over a long period of time (long latency)

Ch.9/Q6

55
Q

A good comparison group in a cohort study….

  1. Is as similar as possible to the exposed group with respect to other factors that could influence the development of disease.
  2. Would, if possible, consist of exactly the same individuals in the exposed group had they not been exposed.
  3. Both of the above are good comparison cohorts
  4. None of the above
A
  1. Both of the above are good comparison cohorts

Ch.9/Q6

56
Q

Loss to follow-up bias is an important concern in which type of epidemiologic study?

  1. Cohort studies only
  2. Experimental studies only
  3. Both cohort and experimental studies
  4. Neither cohort nor experimental studies
A
  1. Both cohort and experimental studies

Ch.9/Q6

57
Q

A difference between experimental and observational studies is…

  1. The investigator may use placebos in an experimental study, but not in an observational study
  2. The investigator controls the subject’s exposure in an experimental study, but not in an observational study
  3. Both of the above
  4. None of the above
A
  1. Both of the above

Ch.9/Q6

58
Q

True or false: A retrospective cohort study is generally more expensive to perform than a prospective cohort study.

A

False

Ch.9/Q6

59
Q

True or false: Non-differential misclassification occurs when the exposed and unexposed groups are unequally likely to have their disease status misclassified.

A

False

Ch.9/Q6

60
Q

Which of the following scenarios results in differential misclassification?

  1. The exposed group is more likely to have their disease status misclassified than the non-exposed group
  2. The exposed group is less likely to have their disease status misclassified than the non-exposed group
  3. Both of the above could result in differential misclassification
  4. Neither of the above could result in differential misclassification
A
  1. Both of the above could result in differential misclassification

Ch.9/Q6

Epi 6410 (1 decks)

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