PP [prefinal most Came From This File]

Question 1

What are the health effects of desertification? [minimum 2 examples]

Answer 1

Desertification means water and food shortage

Malnutrition [Vit A deficiency]
Famine [Famine related death, attributed to infectious diseases]
Mortality from measles in undernourished populations

Question 2

What are the six dimensions of quality according to Maxwell? [write at least 4]

Answer 2

Accessibility
Equity
Appropriateness
Effectiveness
Efficiency
Acceptability

Question 3

What are the proved health benefits of physical activity?

Lower rate of breast cancer
Lower rate of colon cancer
Lower rate of depression
Lower rate of osteoporosis

Answer 3

[pp says all 4]

Lower rate of depression
Lower rate of osteoporosis
Lower rate of breast cancer [saw it in lecture slide]

Question 4

How to use CAGE to screen for harmful alcohol drinking?

Answer 4

• Felt you should Cut down on your drinking?
• Annoyed by people criticising your drinking?
• Guilty about your drinking?
• Eye opening event aka drink first thing in the morning to calm nerves or rid of hangover?

Question 5

Which of the following statements are correct?

• According to the worst climate scenario, emission of CO2 is expected to increase by 200-300% by end of 21st century
• The emission of CFCs is expected to increase by 200-300% by the end of 21st century
• Childhood exposure to solar radiation is not a risk factor for non melanotic skin cancer
• The risk of non melanotic skin cancer correlates with the cumulative lifetime exposure to solar radiation

Answer 5

According to worst climate scenario, emission of CO2 is expected to increase by 200-300% by end of 21st century

The risk of non melanotic skin cancer correlates with cumulative lifetime exposure to solar radiation

Question 6

What factors determine the public health importance of mental disorders?

Answer 6

Under-diagnosed

Under-treated

RFs for Communicable/non-communicable diseases, Unintentional/Intentional injuries

Contributes to Stigmatisation, social exclusion, suffer from becoming victims of human rights abuse

Question 7

What is the definition of indicators in healthcare?

Answer 7

Indicators are QUANTIFIABLE characteristics of a population which researchers use as supporting evidence for describing the health of that population

Question 8

What is considered as a result from the Lalonde model?

Equal service provision
International resource generation
Emphasis of health determinants
Transparent financing of healthcare

Answer 8

Emphasis of health determinants

Question 9

What is Medicare [USA]

Answer 9

Federal social insurance program for elderly and non-elderly individuals with disabilities

[consists of Hospital/hospice insurance, Medical insurance, Medicare advantage plans, Prescription drug plans]

Question 10

What is the definition of quality in healthcare?

Answer 10

Degree to which health services increase the likelihood of desired health outcomes and are consistent with current professional knowledge

Question 11

Which of the following statements are true for medication adherence as a predictor of disease outcome in United States?

A third of all prescriptions are never filled

About half of prescriptions that are filled are associated with incorrect administration

It is estimated that non adherence to prescribed medications cause nearly 5000 deaths per year

1,52 percent of hospital admission are linked to non adherence

Answer 11

A third of all prescriptions are never filled

About half of the prescriptions that are filled are associated with incorrect administration

[about 125,000 deaths per year according to from non adherence to prescribed medications; 10 percent of hospital admission are linked to non adherence]

Question 12

Which of the following statements are true?

• Exposure to secondhand tobacco smoke is associated with increase risk of cancer and heart disease in adults
• Persons with mental illness are more likely to smoke
• Nicotine is the chemical that causes cancer in tobacco users
• 80% of tobacco users are in low and middle income countries

Answer 12

[pp says all 4]

Exposure to secondhand tobacco smoke is associated with increased risk of cancer and heart disease in adults [??]

Persons with mental illness are more likely to smoke

80% of tobacco users are in low and middle income countries

Question 13

What type of mortality is increase by BMI of 28?

Answer 13

Cardiovascular Diseases

Question 14

Decode ABCs of HIV/AIDS prevention

Answer 14

Abstinence from sexual activities and needle use [only 100% safe way to prevent HIV]

Best to have only one sexual partner

Condom use

Question 15

List at least 5 genes found to be associated with risk of malignancies by indicating the type of cancer

Answer 15

BRCA1/BRCA2 - Breast Cancer
APC - Colorectal Cancer
RET - Multiple Endocrine Neoplasia
RBI - Retinoblastoma in childhood
p53 - 50% of all cancers and Bone Cancer

Question 16

Which of the following statements are true?

• There is a strong negative correlation between life satisfaction and life expectancy
• Development can be assessed based upon the level of happiness
• As countries become richer, fertility rates fall and life expectancy rises
• Countries where more people live in poverty tend to have particularly bad health outcomes

Answer 16

Development can be assessed based upon the level of happiness

As countries become richer, fertility rates fall and life expectancy rises

Countries where more people live in poverty tend to have particularly bad health outcomes

[first option, POSITIVE correlation instead of negative]

Question 17

Characterise the GLOBOCAN database

Answer 17

It is an interactive web-based platform presenting global cancer statistics to inform cancer control and research

Provides data visualisation to current incidence, mortality rates, predicts future cancer incidence and mortality rates, tools to visualise changing nature of caners, find underlying causes of cancers, comprehensive survival estimates for cancers and interactive stories of cancer facts

Question 18

Anthrax vaccine is recommended for? [list at least 3]

Answer 18

• Certain laboratory workers who work on B.anthracis
• People who handle potentially infected animals or their carcasses
• Some emergency and other responders whose response activities might lead to exposure

Question 19

What are major categories of health care interventions that area available for TB prevention?

Answer 19

TB preventive treatments

Prevention of transmission of M. Tuberculosis through infection prevention and control

Vaccination of children with BCG vaccine

Question 20

Describe the targets regarding DASH diet

Answer 20

Dietary Approaches to Stop Hypertension [DASH]. Lifelong approach to healthy eating that’s designed to help treat or prevent HTN. For non-medicated treatment and prevent development of HTN

Question 21

What are the objectives of chronic respiratory disease prevention?

Answer 21

Reducing tobacco smoking in the whole population

Encouraging smoking cessation for patients

Control of ambient air pollutants

Prevention of occupational exposures

Question 22

Index case?

Answer 22

The first recognised case in a definite outbreak is called an index case

Question 23

An example of primary prevention is

• Fluoridation of water supply to prevent dental carries
• Measles immunisation
• Smoking cessation after heart attack
• Cervical cytology screening

Answer 23

Fluoridation of water supply to prevent dental carries

Measles immunisation

Question 24

In double blind randomised control clinical trial

• there must be always placebo treatment
• established drugs need to be monitored for side effects
• nobody knows who is getting the active treatment
• patients should be blinded to the fact that they are in trial

Answer 24

There must be always placebo treatment

[option 2 - long term clinical monitoring of drug]
[option 3 - this is a triple blind study]
[option 4 - this is breaks code of ethics]

Question 25

Which of the following are the components of a well specified research question?

Answer 25

PICO

Population, Intervention/Exposure, Comparison group(s), Outcome(s)

Question 26

In any given screening test

• The high sensitivity means few false negatives
• The specificity is the truly positive subjects correctly classified by the test
• The low sensitivity means a spuriously high measure prevalence rate
• The higher the sensitivity the higher the specificity

Answer 26

The high sensitivity means few false negatives

Sensitivity = TP/(TP + FN)
Specificity = TN/(TN + FP)
PPV = TP/(TP + FP)
NPV = TN/(TN + FN)

Question 27

What are the advantageous properties of the cohort studies?

• Can produce results with highest validity among observational studies
• Can investigate many disorders
• Recall bias for outcome assessment is the most important determinant for its validity
• Can investigate many exposures

Answer 27

Can investigate many disorders

Question 28

If the Case Fatality Ratio [CFR] for a disease is 70% in a country, then the risk of death in the population

• Lower than in the global reference
• Higher than in the global reference
• Same as in the global reference
• Can be lower or higher than in the global reference

Answer 28

Can be lower or higher than in the global reference

[Need total mortality rates to know]

Question 29

Which of the following statements is true for the statistical evaluation of an observational epidemiological investigation?

• multivariate statistical analyses are the only method by which the confounding effects can be controlled
• it is compulsory part of the epidemiological investigation
• it can evaluate the relationship between the studied model and the observations
• drawing practical conclusion from the observed results of an investigation

Answer 29

It is compulsory part of the epidemiological investigation

Drawing practical conclusions from the observed results of an investigation

Question 30

Which of the following improvements of the epidemiological methodology were elaborated by John Graunt?

Answer 30

First known life tables
Urban-rural differences
Proposed national statistics and their comparison
Seasonal mortality variations
Higher infant morality rate among boys
Excess male births
Chronic diseases kill more people than acute [apart from plague]

Question 31

Which factors make the observational epidemiological studies inevitable for well operating public health services?

• precise exposure assessment
• direct human relevance of the observational epidemiological findings
• high level precision achieved by statistical methods
• precise control for the confounding effects

Answer 31

[dont know]

Precise exposure assessment

Direct human relevance of the observational epidemiological findings

Question 32

List the characteristic chemical pollutants of untreated municipal wastewater

Answer 32

Cl-, Sulphate ion, Phosphate ion
Pathogenic microorganisms
Endocrine disrupting agents
Natural and synthetic hormones
Metabolites of medications

Question 33

List occupations where exposure to Cadmium can occur

Answer 33

Manufacture of paints, glass, ceramics, plastics

Manufacture of nickel-cadmium batteries, semiconductors, computer chips

Question 34

Which of the following statements are correct?

• Increase in sperm counts is one of the supposed adverse effects of endocrine disrupting agents
• Endocrine disrupting agents show a weak androgenic activity
• Endocrine disrupting agents show a weak estrogenic activity
• There is no evidence for any adverse effect of endocrine disrupting agents in humans

Answer 34

Endocrine disrupting agents show a weak estrogenic activity

There is no evidence for any adverse effect of endocrine disrupting agents in humans

Question 35

Why can occupational diseases be considered as ‘Iceberg’?

Answer 35

Occupational diseases are already diseases recognised to be related to work exposures in addition to other environmental exposures.

Many people can get affected but show no symptoms. Many symptoms that do show up don’t receive medical attention. People who do receive medical attention don’t end up diagnosed with occupational disease as no relationship gets established

Question 36

What kind of frequency measure is mentioned in the sentence: In 5 years, 1354 [38%] patients with confirmed diagnosis of malignant melanoma will die

Answer 36

Period Prevalence

Question 37

What are the characteristics of deterministic and stochastic dose-response relationships?

Answer 37

Deterministic:
- Threshold exists
- severity of health effect increases with dose

Stochastic:
- No threshold
- likelihood of health effect increases with dose

Question 38

List the pre-narcotic effects of organic solvents

Answer 38

Headache
Nausea
Dizziness
Tachycardia
Parenthesis
Incoordination
Euphoria

Question 39

Which of the following substances lead to pneumoconiosis by inhalation

Iron
Hardwood dust
Crystalline silica
Cotton

Answer 39

Crystalline silica

Hardwood dust [??]

Question 40

What is asbestos lung disease?

Answer 40

Progressive fibrosis of lungs caused by inhalation of asbestos fibres [aka magnesium silicate mineral fibres]

Disease includes Lung fibrosis/Asbestosis, Benign pleural Fibrosis, Pleural plaques, Lung cancer, Mesothelioma

Question 41

Which of the following pesticides cause the accumulation of acetylcholine at synaptic sites?

• Organophosphate pesticides
• Nmethylcarbamates
• Organochorine pesticides
• Phenoxyalkanes

Answer 41

Organophosphate Pesticides

N-methyl-carbamates

Question 42

What is the main strategy to control Iodine deficiency diseases?

Dietary diversification
All of the above
Fortification
Supplementation

Answer 42

All of the above

Question 43

Which of the following air pollutants plays a role in the development of lung cancer?

Nitrogen dioxide
Ozone
Sulphate particles
Fine particles

Answer 43

Fine particles [PM2,5]

Question 44

List categories of workplace hazards

Answer 44

Physical [noise, vibration, radiation, light]
Chemical [metals, solvents, gases, plastics, particles]
Biological [bacteria, viruses, fungi, insects]
Mechanical [ergonomics and safety]
Psychological [stress, morale, motivation]

Question 45

What are the dietary recommendations for the prevention of CVD?

• Consume less food with high cholesterol content
• Consume more wholegrains, nuts, legumes, fruits and vegetables
• Consume low fat diet [total fat intake less than 20 E%]
• Replace foods high in saturated fat with foods rich in unsaturated fat

Answer 45

Consume more wholegrains, nuts, legumes, fruits and vegetables

Replace food rich in saturated fat with foods rich in unsaturated fat

[cholesterol is not a nutrient on concern for overconsumption]
[Total fat intake recommendation has to be >20%]

Question 46

Which of the following diseases can become more frequent due to deforestation and loss of biodiversity?

Answer 46

Malaria
West Nile fever
Measles

Question 47

What were the most important achievements of the public health in the 20th century?

Answer 47

Vaccination

Motor-vehicle safety

Safer workplaces

Control of infectious diseases

Decline in deaths from coronary heart disease and stroke

Safer and healthier foods

Healthier mothers and babies

Family planning

Fluoridation of drinking water

Recognition of tobacco use as a health hazard

Question 48

Which of the following risk factors of CVD did not become controlled in the last 50 years in the United States?

• Adults aged 20 to 74 years with HTN
• Percentage of calories in the diet from saturated fat
• Percentage of calories in the diet from fat
• Smoking

Answer 48

Percentage of calories in the diet from saturated fat

Percentage of calories in the diet from fat

Question 49

Diarrhoea diseases are responsible for most food borne diseases in Europe. What are the main pathogens?

E.coli
Campylobacter
Noroviruses
Salmonella [non-typhoid]

Answer 49

PP says all of the above but actual test only has 3 correct answers

Pick Noroviruses, Campylobacter

Question 50

What dietary or diet-related factors are associated with risk of breast cancer?

Answer 50

High consumption of alcohol

Diet high in salted and barbecued food

Diet high in animal fat [red meat]

High energy intake, low physical activity [obesity]

Question 51

What dietary or diet-related factors are associated with risk of breast cancer?

Answer 51

High consumption of alcohol

Diet high in salted and barbecued food

Diet high in animal fat [red meat]

High energy intake, low physical activity [obesity]