HSA 535 FINAL EXAM PART 2 : Solution Essays

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Question 1 

In the Yearly Mortality Bill for 1632, consumption referred to:

  

dysentery

 

tuberculosis

 

smallpox

 

edema

Question 2 

Cyclic variations in the occurrence of pneumonia and influenza mortality may reflect:

  

seasonal variations in cases of influenza.

 

the fact that influenza is a disappearing disorder.

 

long-term changes in mortality trends.

 

both A and B

Question 3 

Which of the following is not usually an aim of epidemiology?

  

To describe
  the health status of the population

 

To fund new public health programs

 

To explain
  the etiology of disease

 

To predict
  the occurrence of disease

 

To control
  the distribution of disease

Question 4 

Indicate the level of prevention that is represented by screening for breast cancer

  

Primary Prevention Active

 

Primary Prevention Passive

 

Secondary Prevention

 

Tertiary Prevention

Question 5 

The difference between primary and secondary prevention of disease is:

  

primary prevention means control of causal factors, while   secondary prevention means control of symptoms.

 

primary prevention means control of acute disease, while   secondary prevention means control of chronic disease.

 

primary prevention means control of causal factors, while   secondary prevention means early detection and treatment of disease.

 

primary prevention means increasing resistance to disease,   while secondary prevention means decreasing exposure to disease.

Question 6 

Indicate the level of prevention that is represented by pasteurization of milk

  

Primary Prevention Active

 

Primary Prevention Passive

 

Secondary Prevention

 

Tertiary Prevention

Question 7 

Determining workload and planning the scope of facilities and manpower needs, particularly for chronic disease. Is this a use for incidence or prevalence data?

  

This is a use primarily for incidence data.

 

This is a use primarily for prevalence data.

 

This application could apply equally for both incidence and   prevalence data.

 

This is a use for neither incidence data nor prevalence data.

Question 8 

An epidemiologic survey of roller-skating injuries in Metroville, a city with a population of 100,000 (during the midpoint of the year), produced the following data for a particular year:
 

  

Number of skaters in   Metroville during any given month

12,000

 

Roller-skating   injuries in Metroville

600

 

Total number of   residents injured from roller-skating

1,800

 

Total number of   deaths from roller-skating

90

 

Total number of   deaths from all causes

900

 

The cause-specific mortality rate from roller-skating was:

  

90/600 × 100,000

 

90/100,000 × 100,000

 

90/1,800 × 100,000

 

90/900 × 100,000

Question 9 

To provide a direct estimate of the risk of developing a disease. Is this a use for incidence or prevalence data?

  

This is a use primarily for incidence data.

 

This is a use primarily for prevalence data.

 

This application could apply equally for both incidence and   prevalence data.

 

This is a use for neither incidence data nor prevalence data.

Question 10 

Which of the following statements most accurately expresses the breeder hypothesis for schizophrenia?

  

The conditions of life in lower-class society favor its   development.

 

The conditions of life in upper-class society favor its   development.

 

The illness leads to the clustering of psychosis in the impoverished   areas of a city.

 

The illness is associated with increases in creative talents,   which contribute to wealth-enhancing achievements.

Question 11 

Descriptive epidemiology has the following characteristics (Choose the incorrect
option):

  

provides the basis for planning and evaluation of health   services.

 

allows causal inference from descriptive data.

 

allows comparisons by age, sex, and race.

 

uses case reports, case series, and cross-sectional studies.

 

identifies problems to be studied by analytic methods.

Question 12 

A null hypothesis is most similar to which of the following?

  

Positive declaration

 

Negative declaration

 

Implicit question

 

Explicit question

Question 13 

Which of the following data sources is most likely to provide a representative sample of the general health status of a population?

  

hospital outpatient statistics

 

absenteeism data

 

data from public health clinics

 

a morbidity survey of the general population

Question 14 

Cautious use of information from death certificates is warranted because:

  

certificates are not available for everyone who dies

 

certificates are often erroneous for date of death and sex

 

cause of death information may not be correct

 

autopsy results are not included

Question 15 

Ecologic studies:

  

are expensive and require a great deal of time to conduct

 

are a good approach for generating hypotheses

 

provide accurate measurements of exposure

 

yield results that can be applied directly to individuals

Question 16 

A large medical center’s oncology program reported an increased number of cases of pancreatic cancer during a certain month. The hospital’s epidemiologist decided to research the problem. Tumor registry records were searched to identify all cases of pancreatic cancer during a five-year period; cancer patients were matched with patients treated for other diseases during the same five-year period. All subjects in the study were questioned about lifestyle factors including alcohol, tea, and coffee consumption. The resulting data are as follows:

  

DATA

 

Cancer Patients

Other Patients

 

Men

Women

Men

Women

 

LIFESTYLE VARIABLE

 

Alcohol

185

120

270

260

 

Tea Drinking

140

110

230

225

 

Coffee Drinking

190

140

270

240

 

Note:   Total number of male cancer patients = 200.
            Total number of female cancer patients = 150.
            Total number of male patients (other diseases) = 300.
            Total number of female patients (other diseases) = 300.
 

Does this study have an exposure status variable?

  

No

 

Yes, lifestyle

 

Yes, disease type

 

Yes, sex of patient

Question 17 

In case-control studies, the odds ratio is used as an estimate of the relative risk. In order for this approximation to be reasonable, some conditions must be met. Which of the following conditions is not necessary in order to use the odds ratio to estimate the relative risk?

  

With respect to exposure, controls are representative of the   population to which you want to generalize your results.

 

The event (disease) under study is rare in the population.

 

The exposure in question is rare in the population.

 

Cases are representative of all cases.

Question 18 

As an epidemiologist you are going to investigate the effect of a drug suspected of causing malformations in newborn infants when the drug in question is taken by pregnant women during the course of their pregnancies. As your sample you will use the next 200 single births occurring in a given hospital. For each birth a medication history will be taken from the new mother and from her doctor; in addition, you will review medical records to verify use of the drug. [N.B.: These mothers are considered to have been followed prospectively during the entire course of their pregnancies, because a complete and accurate record of drug use was maintained during pregnancy.]
The resultant data are:
Forty mothers have taken the suspected drug during their pregnancies. Of these mothers, 35 have delivered malformed infants. In addition, 10 other infants are born with malfunctions.
 

The number of individuals who both did not take the drug and did not give birth to infants who were malformed was:

  

140

 

150

 

155

 

160

 

170

Question 20 

Which of the following individuals helped draw people’s attention to the method of cohort analysis?

  

Snow

 

Frost

 

Graunt

 

Hill

Question 21 

A new screening test for Lyme disease is developed for use in the general population. The sensitivity and specificity of the new test are 60% and 70%, respectively. Three hundred people are screened at a clinic during the first year the new test is implemented. Assume the true prevalence of Lyme disease among clinic attendees is 10%.
Calculate the following values:
 

The predictive value of a positive test is:

  

33.0%

 

18.2%

 

94.0%

 

22.2%

 

6.0%

Question 22 

Drs. Poke and Jab (2014) conducted an employee health program that used 5 screening tests at the same time to detect diseases among workers. Which type of program is this?

  

Selective screening

 

Mass screening

 

Ad hoc screening

 

Multiphasic screening

Question 23 

Sensitivity and specificity of a screening test refer to its:

  

reliability

 

validity

 

yield

 

repeatability

Question 24 

You have just finished administering a food/drink questionnaire to ill and non-ill participants in a Minnesota summer picnic party. The ill individuals developed moderate to severe diarrhea 16 to 46 hours after the picnic. Six persons experienced vomiting. The following data were collected:

  

ATE

DID NOT EAT

 

Number of people

Number of people

 

Food item

Ill

Not ill

Total

Ill

Not ill

Total

 

Hot dogs

40

30

70

10

20

30

 

Hamburgers

32

8

40

20

40

60

 

Potato salad

45

25

70

15

25

40

 

Ice cream

48

12

60

2

38

40

 

Lemonade

20

40

60

20

20

40

 

Which food item appears to be the most probable vehicle for the salmonella (agent) infection associated with the illness?

  

Hot dogs

 

Hamburgers

 

Potato salad

 

Ice cream

 

Lemonade

Question 25 

An outbreak of salmonellosis occurred after an epidemiology department luncheon, which was attended by 485 faculty and staff. Assume everyone ate the same food items. Sixty-five people had fever and diarrhea, five of these people were severely affected. Subsequent laboratory tests on everyone who attended the luncheon revealed an additional 72 cases.
 

Foods served at the luncheon included home-canned olives, chicken salad, homemade flavored drink mix, freshly baked rolls, and raw vegetables. Based on your understanding of foods that potentially are capable of transmitting salmonella, the most likely source of the outbreak was:

  

home-canned olives

 

chicken salad

 

drink mix

 

freshly baked rolls

 

raw vegetables

Question 26 

The site where a disease agent enters the body is the:

  

reservoir

 

portal of entry

 

vehicle

 

portal of exit

Question 27 

A situation in which the combined effect of several exposures is greater than the sum of the individual effects:

  

threshold

 

latency

 

synergism

 

square

Question 28 

It has been suggested that occupational exposure to benzene in the petroleum industry increases the risk of developing leukemia. The levels of benzene to which workers in this industry have been exposed were high from 1940 to 1970, but since 1970 have been significantly reduced. What kind of study design, using petroleum workers, would provide the most useful information on whether benzene affects incidence rates of leukemia in this industry? You may assume that records of individual worker assignments to jobs involving benzene exposure have been maintained by the industry.

  

Experimental

 

Retrospective cohort

 

Prospective cohort

 

Case-control

 

Cross-sectional

Question 29 

The type A behavior pattern is hypothesized to be a risk factor for:

  

chronic obstructive pulmonary disease

 

coronary heart disease

 

rheumatoid arthritis

 

retirement

Question 30 

Which of the following statements describes a stressful life event?

  

discrepancy between husband and wife in social and educational   status

 

goodness of fit between the characteristics of the person and   environment

 

an occurrence that might cause readjustments in people’s   activities

 

sleeping

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