Paper 4

Question 1

“Health care for all from non-profit insurance system financed jointly by employers and employees by payroll deduction”. Those mentioned above are the characteristics of which health care model?

a) Bismarck
b) Beveridge
c) Out of Pocket
d) Affordable Care Act
e) None of them

Answer 1

A

Question 2

The goal of secondary prevention is

a) To protect healthy people from developing a disease or experience an injury in the first place
b) To avert the onset of new cases of diseases
c) To halt/slow the progress of disease in its earliest stages
d) To reduce the incidence rate
e) To help people manage complicated long-term health problems

Answer 2

C

Question 3

Confounding is when another factor than exposure influences the outcome and confuses the results. Which statement(s) is/are true about confounding?

a) A confounder is associated to the exposure
b) A confounder is associated to the outcome
c) A confounder is an intermediate link between exposure and outcome
d) Confounding can be handled by increasing the study sample
e) Confounding can be unknown

Answer 3

ABE

Question 4

For which reason a bonus has been introduced in a health care delivery system?

a) To increase equity
b) To increase solidarity
c) To encourage responsibility
d) To reward appropriateness
e) None of them

Answer 4

C

Question 5

Which are the actions of the basic cycle for continuous quality improvement?

a) Plan
b) Do
c) Check
d) Act
e) Study

Answer 5

ABCD

Question 6

The methodology of primary prevention includes

a) Physical rehabilitation
b) Selective screening
c) Environmental interventions
d) Eugenics
e) Immunization

Answer 6

CDE

Question 7

The per capita health expenditure in Italy

a) Amounts roughly to 1000 euros
b) Is roughly over 5000 euros
c) Is over than the OECD mean
d) Is less than the OECD mean
e) None of them

Answer 7

D

Question 8

Which of the following are kind of error in the risk management theory?

a) Error of commission
b) Error of omission
c) Error of execution
d) Little mistaken
e) Very little mistaken

Answer 8

ABC

Question 9

Which of the following are International Patient Safety goals?

a) Identify patients correctly
b) Improve effective communication
c) Improve the safety of high-alert medications
d) Reduce the risk of health care-associated infections
e) Reduce the risk of patient harm resulting from falls

Answer 9

ABCDE

Question 10

____________ is defined as any effort, whether in personal health care, public health services, or through intersectoral initiatives, whose primary purpose is to improve health. Choose the missing among the following:

a) Health action
b) Health care
c) Health improvement
d) Health system
e) None of them

Answer 10

A

Question 11

The concept of macromonotoxicity can be applied to a) Infectious diseases

b) Environmental diseases
c) Foodborne diseases
d) Chronic diseases
e) Sexually transmitted diseases

Answer 11

AC

Question 12

An animal when an infectious agent lives an multiplies is defined as

a) Reservoir of infection
b) Source of infection
c) Pathogen
d) Host susceptible
e) Vehicle

Answer 12

A

Question 13

In a cohort study of negative stress among middle school students and the risk of high blood pressure, all students in grade 7 from 5 different schools underwent a physical examination. The level of stress (exposure) was evaluated with a questionnaire. The blood pressure (outcome) was measured by a trained nurse one year later. However, in one of the schools, the blood pressure cuff was not calibrated and it always measured the blood pressure as 10 mmHg too high. What kind(s) of systematic error was/were introduced in the study?

a) Confounding
b) Selection bias
c) Information bias
d) Healthy worker effect
e) Differential loss to follow up

Answer 13

C

Question 14

Surgical instruments that enter in contact with sterile tissue
a) Are associated with high risk of infection if contaminated with any microorganism
b) Need a high level disinfection
c) Need a low level disinfection
d) Need to be sterilized by steam sterilization or by ethylene oxide (ETO) or hydrogen peroxide
gas plasma or with liquid chemical sterilants
e) Must be disposable

Answer 14

AD

Question 15

A researcher collects 300 adults with myocardial infarction in a registry. He then uses 600 orthopedic patients of the same age and sex as comparison group. All these persons are questioned about their sports habits in childhood.
What study design is this?

a) Cross-sectional study
b) Randomized control study
c) Intervention study
d) Case-control study
e) Cohort study

Answer 15

D

Question 16

Which of the following(s) is/are a measure of relative risk?

a) Odds ratio
b) Incidence rate ratio
c) Cumulative incidence
d) Absolute risk
e) Risk ratio

Answer 16

ABE

Question 17

A fungal meningitis outbreak occurred in 2012 in the USA

a) ≤ 100 cases occurred
b) An endogenous source was suspected
c) Pathogen was transmitted via contaminated medications
d) No death occurred
e) Pathogen was transmitted via healthcare worker hands

Answer 17

C

Question 18

The variable of the model of the Reasoned Action (Fishbein and Ajzen) implied when a young adolescent discover that smoking is disgusting is

a) Attitude
b) Social norm
c) Self-efficacy
d) Prohibition
e) Cognitive perception

Answer 18

A

Question 19

Which of the following sentences best defines public health surveillance?
a) Public health surveillance is the ongoing systematic collection and analysis of health data
b) Public health surveillance is the ongoing systematic collection, analysis, interpretation, and
dissemination of health data to stimulate public health actions
c) Public health surveillance is the close observation of persons who had been exposed to a
communicable disease in order to detect early symptoms and to set prompt isolation and
control measures
d) Public health surveillance is the systematic ongoing collection and dissemination of information
to those who need to know so that the action can be taken
e) Public health surveillance allows to learn the ongoing pattern of disease occurrence and the
potential for disease in population

Answer 19

B

Question 20

Which are the main objectives of the global influenza surveillance network?
a) To eradicate disease
b) To provide information to public health authorities for planning appropriate control and
intervention measures and health resource allocation
c) To provide timely global alert for emerging virus with pandemic potential
d) To assess only the epidemiological trend of influenza
e) To identify circulating types/subtypes and provide candidate viruses for vaccine production

Answer 20

BCE

Question 21

Referring to the proportion of cancer cases attributable to infection, which of the following sentences are correct?
a) The Population Attributable Fraction (PaF) is the proportion of new cancer cases in a specific
population that would be prevented by a hypothetical intervention on a specific infective
exposure
b) HBV, HCV, HPV, and H. pylori are together responsible for about 2 million cancer cases
worldwide
c) The number of new cancer cases attributable to infection is higher in less developed countries
than in more developed countries
d) The total number of cancer cases attributable to infection is higher in women than in men
e) PAF = 70% for cervical cancer

Answer 21

ABC

Question 22

Which of the following factors are risk factor for getting HPV infection?

a) Having first sexual relations at an early age
b) Having an immunosuppressive status
c) Having sex with many partners
d) Having sex with one partner who has had many partners
e) Having other STDs

Answer 22

ACD

Question 23

What is profit?

a) Part of he balance sheet
b) An expenditure
c) A loan
d) A cash inflow
e) The difference between revenues and costs

Answer 23

E

Question 24

What are vision, mission, and values statements?

a) A marketing strategy
b) Public objectives set by founders
c) Legal mandatory documents
d) A summary of the financial activity
e) None of the others

Answer 24

B

Question 25

What the difference between stakeholders and shareholders?

a) None
b) Stakeholders are more important than shareholders
c) Shareholders are more important than stakeholders
d) Shareholders invested in the company’s equity
e) Shareholders didn’t invest in the company equity

Answer 25

D

Question 26

Exposure to noise

a) Varies with individual susceptibility to the harmful effects
b) Can be best measured or assessed by an occupational physician
c) At levels below the legal occupational exposure limit
d) Might cause hearing loss and possibly hypertension
e) Might cause digestive disorders

Answer 26

D

Question 27

Which occupational disease is unlikely to occur in crop handling

a) Contact dermatitis
b) Allergic alveolitis
c) Bladder cancer
d) Repetitive strain injury
e) Lip cancer

Answer 27

C

Question 28

What is epigenetics?
a) The study of metabolic changes induced by a disease
b) The changes in gene expression not associated with alterations in the DNA sequence
c) The study of the hereditary characteristics of organisms and their transmission
d) The variability in drug response due to genetic factors, in individuals or populations
e) The analysis of the genome (DNA) and its products (RNA and proteins) in order to correlate
these information with the cellular state

Answer 28

B

Question 29

People exposed to asbestos fibers have an increased risk for four types of cancer. Choose the correct set of cancer types among the following:

a) Breast, lung, malignant mesothelioma, larynx
b) Lung, bladder, ovary, bone
c) Malignant mesothelioma, pharynx, pancreas, stomach
d) Lung, malignant mesothelioma, larynx, ovary
e) Larynx, leukemia, ovary, lung

Answer 29

D

Question 30

In investigating a case of possible work related illness
a) It is always essential to remove the patient from the workplace under suspicion before
commencing investigation
b) Exposure to an agent at a level below is legal occupational exposure limits excludes it as a
cause of ill-health
c) Laboratory tests of function of a target organ are the most specific way of reaching a diagnosis
d) An occupational history further back than 30 years may be needed
e) An occupational history further back of no less than one year is necessary

Answer 30

D

Question 31

Which of the following is not included among the 9 criteria for “causality association” proposed by A. Bradford Hill in 1964 and still applied today?

a) Plausibility
b) Biologic-gradient
c) Originality
d) Specificity
e) Temporality

Answer 31

C

Question 32

The Strain Index of Moore and Garg (1995) is a
a) Semi quantitative job analysis tool for upper limbs, based on measurement or estimation of 5
tasks variables(?)
b) Semi quantitative job analysis tool for distal upper extremities based on measurements or
estimation of 6 tasks variables
c) A quantitative job analysis tool for upper limbs, based on measurements or estimation of 5
tasks variables
d) A qualitatively job analysis tool for distal UE based on measurements or estimation of 5 tasks
variables

Answer 32

B

Question 33

The international agency for research on cancer (IARC) classifies different agents as carcinogenic to humans. If an agent is in group 2A is

a) Possibly carcinogenic to humans
b) Not classifiable as to its carcinogenicity to humans
c) Probably carcinogenic to humans
d) Carcinogenic to humans
e) Probably not carcinogenic to humans

Answer 33

C

Question 34

Which classification of pesticides does not exist?

a) Target based
b) Functional
c) Toxicological
d) Chemical
e) Environmental

Answer 34

E

Question 35

Decrease in DNA methylation content (global hypomethylation)

a) Commonly occurs in young subjects tissues
b) Is a common feature of non-neoplastic tissues
c) Is a frequent feature of neoplastic tissues or healthy tissues during aging
d) Is only determined by genetic characteristics, not by environmental exposures
e) Has never been demonstrated in human tissues

Answer 35

C

Question 36

Which of the following lists represents ergonomic variables?
a) Workspace, postures, seating, displays, controls, manual material handling, workforce
variables, work organization
b) Workspace, postures, seating, displays, controls, manual material handling, manipulation,
hand tools, environmental factors, work organization, economic variables
c) Workspace, postures, seating, displays, controls, manual material handling, manipulation,
hand tools, environmental factors, work organization
d) Workspace, postures, seating, displays, controls, manual material handling, environmental
factors, work organization
e) Workspace, postures, seating, displays, controls, manual material handling, manipulation,
hand tools, environmental factors, work organization, economic variables, psychosocial
variables, workforce variables

Answer 36

C