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Heaven ૮ ˶ᵔ ᵕ ᵔ˶ ა > Public Health > Flashcards

Public Health Flashcards

1
Q

What is the benefit of case controls?

Good for rare exposures
Good for rare outcomes
Can prove causation

A

Good for rare outcomes

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2
Q

89/100,000 got flu over winter. What is this measuring?

A

Incidence ‘over winter’ so over time.

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3
Q

People in a study were given atorvastatin. cos 13.4% had cardiovascular events in the control group and 9.4% in the treatment group. What does 13.4 - 9.4 give us?

Relative risk
Odds ratio
Absolute risk reduction
Number to treat

A

Absolute risk reduction

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4
Q

PPIs given as RCT for functional dyspepsia. Showed a stat sig difference for crude RR. BUT then adjusted for age and shit, RR no longer stat sig. What was the problem with crude RR?

A

Confounding factors

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5
Q

Study looking at hospital and census data for rheumatic fever, seeing what decile they were and calculating ARF incidence rates

A

Retrospective cohort as it was over time (even tho it compared neighbouring populations)

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6
Q

Best method to reduce information bias in this study:
- Measure a 95% confidence interval
- Measure the p value
- Double-blinded study
- Multi-centre study
- Placebo-controlled
- Randomisation
- Having exclusion criteria
- Using a logistic regression analysis

A

Double-blinded

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7
Q

Mammogram has a sensitivity of 0.8 and specificity of 0.9. In a population of 1000, the prevalence of breast cancer is 2%. How many false negatives will there be if this population is screened?

A

4

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8
Q

What kind of outbreak is this in the graph

A

Propagated/person-to-person

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9
Q

PSA - screened group did better than non-screened group

A

Overdiagnosis bias

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10
Q

Drug A vs Drug B. Drug A is better than Drug B according to a study (p<0.01). what does this mean
a) There is a 1% chance of drug A being better
b) The observed difference is <0.01% likely to be due to chance
c) This means the difference observed is unlikely to be due to chance

A

This means the difference observed is unlikely to be due to chance

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11
Q

Most important justification for implementing screening test for specific disease
a) Effective treatment available
b) Low number of false positives
c) Early detection of disease of interest
d) Early detection favourably affects natural history of disease

A

Early detection favourably affects natural history of disease (kind of similar to a but pop off ig)

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12
Q

Doctor wants to measure incidence of Hep C in his/her town. What information should he use?
a) New notifications in last 5 years
b) Number of people with Hep C
c) Number of people with + Hep C antibodies
d) Number of people with Hep recently found through PCR.
e) Number of IV drug users enrolled in practice

A

New notifications last 5 years

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13
Q

Doctor wants to measure prevalence of Hep C in his/her town.
a. New notifications in last 5 years
b. Number of people on treatment for Hep C
c. Number of people with + Hep C antibodies
d. Number of people with positive Hep C PCR

A

Number of people with positive Hep C PCR

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14
Q

Best study design for assessing association between number of common naevus and progression to malignant melanoma?
Case-control
Cohort
RCT
Cross sectional
Ecological

A

Cohort - prob cant remember if they had a mole before idk

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15
Q

Pesticide drift and breast cancer. Used case-control as a study. What is the advantage of using this study?
Good for common outcomes
Good for common exposures
Good for rare outcomes
Good for rare exposures
Temporal sequencing

A

Good for rare outcomes

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16
Q

Man presents with a rash, which of these would need to be notified?
Varicella
Measles
Pityriasis rosea
Drug reaction

A

Measles

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17
Q

Worst hierarchical evidence
Case report
Case control
Meta-analysis
Cohort

A

Case report - just 1 person

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18
Q

Screening population does better due to less aggressive stuff identified. What kind of bias is this?

A

Length bias

(more aggressive diseases are asymptomatic for a shorter period, screening is more likely to detect slower progressing diseases, such as slow-growing tumours, which have a better prognosis, including longer survival.)

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19
Q

Incidence definition

A

Number of new cases over a defined period of time

20
Q

Best intervention for smoking cessation:
telephone counselling
NRT
Hypnotherapy
Brief cessation advice in GP consults

A

NRT

21
Q

Why do you give treatment with pertussis?
· Reduces infectivity
· Reduces complications
· Reduces hospitalisations
· Reduces carrying load
Reduces length of illness

A

Reduces infectivity

Literally just transmission, does not impact on the illness or length of stay in hospital

22
Q

A GP has been asked to conduct a research study of amount of alcohol intake and development of heart disease in middle aged men?
a) Cross sectional
b) Cohort
c) RCT
d) Case study
e) Case cross over

A

Cohort

23
Q

Female 34yo wanting screening for breast cancer: no FH, no symptoms, normal breast exam
Reassurance
Sign up to breast screening
BRCA mutation testing

A

Reassurance

24
Q

What is the sensitivity

A

10/15 = 66%

25
Q

Give equation for OR

A

ad/bc

26
Q

Calculating numbers with sensitivity given. Ottawa ankle rules. Sensitivity 98%, specificity 70%. How many fractures out of 1000 will it miss if 10% have ankle fractures?
20
2
200

A

2

27
Q

Most useful knowledge for lady with negative breast cancer screening result worried about false negative results .
Reliability of mammography
False positive rate
Negative predictive value
Specificity

A

Negative predictive value

28
Q

Guy presenting results from a drug RCT for a drug at a conference, what is the most important thing for this to be reliable?

A

Equivalent drug dose used

29
Q

Ottawa Charter. Suggestion to introduce mileage tax on car usage which could result in fewer road deaths and overall increase in physical activity such as biking. What strand of the Ottawa charter is this?
a. Build Healthy Public Policy
b. Create supportive environment
c. Reorient health services
d. Strengthen community action

A

Build Healthy Public Policy

30
Q

Ottawa Charter. Implemented over Matariki. Doing community projects and building connections up communities, finding their resources and their needs
a. Strengthen Community Action
b. Create Supportive Environment
c. Reorient health services
d. Public policy

A

Strengthen Community Action

31
Q

45-year-old Māori lady coming in for a smear - practice software notifies its time to start cardiovascular screening. What does this describe?
a. Primordial prevention
b. Primary prevention
c. Secondary prevention
d. Tertiary prevention
e. Health equity assessment
f. Health needs assessment

A

Secondary prevention (screening is always secondary)

32
Q

In NZ about 150 new cases of testicular cancer are diagnosed each year. Apart from a genetic component, there have been suggestions that smoking, diet and other environmental toxins/ lifestyle factors play a role. Which study would be best?

a. Case control +16
b. Retrospective cohort +5
c. RCT
d. Case studies
e. Prospective cohort +3

A

Hate these questions. Best in what way?

Probably retrospective cohort since it is rare.

33
Q

Post-COVID vaccine (Pfizer) had myocarditis. Suspecting vaccine reaction. Who to report to?
a. CARM
b. Ashley Bloomfield
c. ESR
d. Medical officer of Health
e. IMAC
g. Local pharmacy who administered it
h. Pfizer

A

Centre for Adverse Reactions Monitoring

34
Q

Screening may find more indolent cases of screening. This misses rapidly
progressive disease leading to the overestimation of the benefit of screening.
What kind of bias is this?

A

Length bias

35
Q

Chef diagnosed with salmonella

A

= Notifiable disease (acute gastro if spread likely)

36
Q

What is overdiagnosis bias?

A

Overdiagnosis bias occurs when cancers are diagnosed in individuals who would not have presented with clinical symptoms during their lifetimes in the absence of screening

37
Q

Explain this confidence interval. 95% confidence interval 1.4-1.7.

A

We are 95% confident that the true value is 1.4-1.7x

38
Q

Doctor chose 150 neonatal jaundiced kids and then 150 without jaundice, then looked at maternal characteristics and other exposures. What type of study is this?
a) Case control
b) Cohort
c) Cross-sectional

A

Case control

39
Q

Doctor
a) New notifications in last 5 years
b) Number of people with Hep C
c) Number of people with + Hep C antibodies
d) Number of people with Hep recently found through PCR.
e) Number of IV drug users enrolled in practice

A

NEW CONDITIONS OVER A PERIOD OF TIME!!!
New notifications in last 5 years

40
Q

Doctor wants to measure prevalence of Hep C in their town. How? a) New Hep C notifications in the last 5 years
b) Number of people on treatment for Hep C
c) Number of people with positive Hep C antibodies
d) Number of people with positive Hep C on PCR

A

Number of people with positive Hep C on PCR

41
Q

Wanting to see the effect vitamin C has on the common cold. What study will give the best evidence?
a) Case control
b) Cohort
c) RCT
d) Meta-analysis

A

RCT

42
Q

PSA testing shows that screening population had 8% prevalence of prostate cancer vs control group having 4%. People in the screened group had relative risk of dying from prostate cancer died from cancer of 0.8 (CI 0.6-0.95). What is the bias involved with the screening group prevalence?
a) Lead time bias
b) Overdiagnosis bias
c) Selection bias
d) Length time bias
e) Recall bias

A

Overdiagnosis bias = cancer dx in individuals who would not have presented with clinical sx during lifetime in absence of screening – likely die from other causes before dx

43
Q

a) High PPV
b) Sensitivity
c) No adverse outcomes
d) Specificity
e) Fast result processing

A

No adverse outcomes

44
Q

Want to do a study to see if wearing face masks decreases cold/flu. Have some students wear masks, others not wear masks. What’s the most important thing to consider to ensure validity of the study?
a) Double blinding
b) Matching
c) Randomisation
d) Random sampling
e) Historic controls

A

Randominsation

Cannot double blind this lol

45
Q

Doctor notices more and more of his patients have diabetes. Which study is best to figure out how common diabetes is in the community?
a) Cross sectional survey
b) Cohort
c) Case control
d) RCT

A

Cross sectional survey

46
Q
A

Heaven ૮ ˶ᵔ ᵕ ᵔ˶ ა (27 decks)

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