Epidemiology and Population Health Exam
Questions
Course Introduction
Epidemiology and Population Health explores the fundamental principles and methods used to study the distribution and determinants of health and disease in populations. This course covers essential epidemiologic concepts such as study design, measurement of disease frequency and association, sources of error, and outbreak investigation. Students will also examine the social, economic, and environmental factors that influence population health, emphasizing strategies for disease prevention and health promotion. Through case studies and data analysis, learners will gain practical skills in interpreting epidemiologic research and applying evidence-based approaches to improve public health outcomes.
Recommended Textbook
Gordis Epidemiology 6th Edition by Celentano
ScD MHS
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19 Chapters
150 Verified Questions
150 Flashcards
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Chapter 1: Introduction
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Sample Questions
Q1) This historic character observed that childbed fever mortality was more common among women treated by physicians and medical students compared with women treated by midwives.Based on his observations,he implemented a hand wash policy that resulted in a decrease in mortality.Name the character that we are talking about.
A) John Snow
B) Edward Jenner
C) D.A. Henderson
D) Leon Gordis
E) Ignaz Semmelweis
Answer: E
Q2) Which of the following is an example of tertiary prevention?
A) Vaccination for rotavirus for children younger than the age of 1 year
B) Surgical amputation of an extremity with osteosarcoma (bone cancer)
C) Screening for gestational diabetes after 24 weeks of pregnancy
D) Sexual education program in elementary schools
E) Increasing taxes for buying cigarettes
Answer: B
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Page 3
Chapter 2: The Dynamics of Disease Transmission
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Q1) The population of Oriol City in June 2018 was 612,437.According to the Oriol City's health department,there were 329 new cases of Raven's disease during 2018.Counting those new cases,by December 31 it was estimated that there were 6580 persons with Raven's disease in Oriol City.What was the incidence rate of Raven's disease in 2018?
A) 26 per 100,000 population
B) 33 per 100,000 population
C) 54 per 100,000 population
D) 1074 per 100,000 population
E) 5000 per 100,000 population
Answer: C
Q2) What is the name of the occurrence of a clearly higher than expected number of cases of a disease within a limited geographical region?
A) Pandemic
B) Epidemic
C) Endemic
D) Zoonosis
E) Attack rate
Answer: B
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4
Chapter 3: The Occurrence of Disease: Idisease
Surveillance and Measures of Morbidity
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Sample Questions
Q1) An epidemiologist decides to investigate the incidence of diabetes in a population of 300 older adults who live in a nursing home.She visits the nursing home in January 1,2017 and later in December 31 of the same year.She looks into the records of these patients and learns that in her first visit,25 patients had diabetes and 35 in her second visit.What number should be included in the denominator for her calculation of incidence?
A) 10
B) 25
C) 35
D) 300
E) 275
Answer: E
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5
Chapter 4: The Occurrence of Disease: II Mortality and Other Measures
of Disease Impact
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Sample Questions
Q1) In 2016 there were 7,467 million people in the world.According to the World Health Organization,in the same year there were 56.9 million deaths worldwide; of those,15.2 million were due to ischemic heart disease or stroke.What was the proportionate mortality of those two causes combined for that year?
A) 0.8%
B) 0.2%
C) 3.7%
D) 13.5%
E) 26.7 %
Q2) For a disease such as seasonal influenza,which is less fatal and of short duration?
A) Incidence rates and mortality rates will be similar.
B) Mortality rates will be much higher than incidence rates.
C) Incidence rates will be much higher than mortality rates.
D) Incidence rates will be unrelated to mortality rates.
E) None of the above.
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6
Chapter 5: Assessing the Validity and Reliability of Diagnostic and Screening Tests
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Sample Questions
Q1) A physical examination,digital rectal exam,was used to screen for prostate cancer in 290 men with biopsy-proven prostate cancer and in 516 age- and race-matched control men,all of whom showed no evidence of cancer at biopsy.The results of the physical examination were positive in 136 cases and in 165 control men.Now,the health commissioner in City A decides to use a physical exam,digital rectal exam,as a primary screening test for prostate cancer.What will be the positive predictive value of the physical examination?
A) 45%
B) 47%
C) 68%
D) 82%
E) Cannot calculate it based on given information
Q2) A diagnostic test with a very high sensitivity but very low specificity has the following problem:
A) It will miss a big proportion of true cases (label them as negatives).
B) It will correctly identify all negative cases.
C) It will label a big proportion of healthy people as sick (false-positives).
D) It will be very expensive to administer.
E) Specificity is the single most important characteristic of a test.
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Chapter 6: The Natural History of Disease: Ways of Expressing Prognosis
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Q1) The following table describes the survival of patients treated from disease X from 2015 to 2017 followed for 3 years (assuming no loss to follow-up).If a person is treated and using all the information from the table,what is the probability of surviving 3 years after treatment? \(\begin{array}{r}
\text { Number alive at the end of year }\quad \\
\begin{array}{|l|l|l|l|l|}
\hline \text { Year of treatment } & \text { Number of patients treated } & \quad 1 \text { year } & \quad 2 \text { year } &\quad 3 \text { year } \\
\hline 2015 & 100 & 67 & 42 & 30 \\
\hline 2016 & 50 & 31 & 18 & \\
\hline 2017 & 75 & 52 & & \\
\hline \text { Totals } & 225 & 150 & 60 & 30 \\
\hline
\end{array}\end{array}\)
A) 0.29
B) 0.33
C) 0.61
D) 0.67
E) 0.71
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Chapter 7: Observational Studies
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Sample Questions
Q1) A researcher study of Baltimore's neighborhoods showed that those neighborhoods with lower median household income experienced a higher teen pregnancy rate.What type of study design was used?
A) Cohort
B) Case-control
C) Ecologic
D) Experimental
E) Randomized trial
Q2) A researcher study of Baltimore neighborhoods showed that those with lower median household income experience a higher teen pregnancy rate.After reading this,someone concludes that a teenager with low income is more likely to get pregnant.What is the name of this mistaken conclusion?
A) Selection bias
B) Information bias
C) Confounding
D) Ecologic fallacy
E) Group misinterpretation
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Chapter 8: Cohort Studies
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Sample Questions
Q1) In which of the following study designs is possible to calculate incidence rate?
A) Cross-sectional
B) Case-control
C) Cohort
D) Case-series
E) Report of a case
Q2) The main difference between a cohort study and a randomized trial is that
A) cohort studies are longitudinal and randomized trials are cross-sectional.
B) only clinical trials can evaluate the effect of a drug.
C) randomized trials are experimental and cohort studies are observational.
D) clinical trials are observational and cohort studies are experimental.
E) at the beginning of a clinical trial, participants are free of disease, and cohort studies start with patients with a disease.
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Chapter 10: Assessing Preventive and Therapeutic
Measures: Randomized Trials
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Q1) In a clinical trial,researchers might influence the selection of participants into a group (intervention or control),hence introducing bias into the study.What can be done to prevent from this threat to the validity of the study?
A) Confounding
B) Randomization
C) Concealment of random allocation
D) Masking
E) Effect modifiers
Q2) Participants in a clinical trial might report different symptoms when they know they are part of the intervention group instead of the control group.To avoid that,researchers use the following:
A) Confounding
B) Randomization
C) Concealment of random allocation
D) Masking
E) Effect modifiers
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11
Chapter 11: Randomized Trials: Some Further Issues
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Q1) Epidemiologists decided to investigate the effect of sunscreens on sunburns.They ran an epidemiologic study to see the association of sunscreens and sunburns.Overall,460 people have enrolled in the study.Investigators randomly allocated 230 people to the treatment group (sunscreens) and 230 to the control group (placebo).They exposed those 460 people to the high mountain trail on a sunny day.At the end of the study,30 people developed sunburns in the sunscreen group and 130 people developed sunburns in the placebo group.What type of study design is this?
A) Cross-sectional study
B) Prospective cohort study
C) Case-control study
D) Randomized trial
E) Case-control study.
Q2) What is the primary purpose of randomization?
A) To prevent bias in the assignment of treatment
B) To provide a probability basis for statistical testing
C) To ensure the same number of people are randomized to each group
D) To ensure that the subjects not to know which group they are assigned to
E) To guarantee the comparability of the different treatment groups
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Chapter 12: Estimating Risk: Is There an Association
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Sample Questions
Q1) Epidemiologists decided to investigate the effect of sunscreens on sunburns.They ran an epidemiologic study to see the association of sunscreens and sunburns.Overall,460 people have enrolled in the study.Investigators randomly allocated 230 people to the treatment group (sunscreens) and 230 to the control group (placebo).They exposed those 460 people to the high mountain trail on a sunny day.At the end of the study,30 people developed sunburns in the sunscreen group and 130 people developed sunburns in the placebo group.What is the risk of developing sunburns in the placebo group?
A) 0.13
B) 0.15
C) 0.23
D) 0.57
E) 1
Q2) Which of the following measures represents the absolute risk of getting a disease?
A) Prevalence
B) Odds ratio
C) Risk ratio
D) Incidence
E) Risk difference
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Chapter 13: More on Risk: Estimating the Potential for Prevention
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Q1) In a cohort study of smoking and myocardial infarction in City A,the number of myocardial infarctions were 250 cases among 7,000 smokers and the number of myocardial infarctions were 150 cases among 20,000 nonsmokers.From another source,a cross-sectional study,we know that 30% of the total population in City A were smokers.What is the population proportion attributable risk of smoking in City A?
A) 15%
B) 30%
C) 53%
D) 79%
E) 90%
Q2) In a cohort study of smoking and myocardial infarction in City A,the number of myocardial infarctions were 250 cases among 7,000 smokers and the number of myocardial infarctions were 150 cases among 20,000 nonsmokers.What is the relative risk of smoking in this cohort study?
A) 0.5
B) 1.7
C) 3.5
D) 4.8
E) 7.5
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Chapter 14: From Association to Causation: Deriving
Inferences From Epidemiologic Studies
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Q1) In a hypothetical cross-sectional study,marriage was found to be strongly associated with increased levels of happiness.Authors concluded that marriage was a cause of happiness.However,a reviewer of this study argued that because it is a cross-sectional study,it could not be determined whether marriage caused happiness or happiness caused marriage.What criterion of causal relationships was not met in the study according to the reviewer?
A) Strength of association
B) Biologic plausibility
C) Dose response
D) Temporal relationship
E) Replication of findings
Q2) Temporal relationship is a necessary criterion to establish causality.Which of the following epidemiologic study design allows to evaluate temporal relationship?
A) Cross-sectional
B) Case-control
C) Transversal
D) Cohort
E) Literature review
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Q1) This table shows incidence rates (per 100,000) of groups exposed to neither risk factors or to one or two risk factors for lung cancer.What is the expected value of incidence rate X on asbestos exposure group among smokers in additive scale? Incidence Rates of Lung Cancer by Asbestos and Smoking Exposure Status \[\begin{array}{r}
\text { Smoking status }\quad\\ \text { Asbestos exposure } \begin{array} {|l|l|l|}
\hline& \text { Yes } \quad \quad& \text { No }\quad\quad \\
\hline \text { Yes (regular exercise) } & 2.0 & 2.6 \\
\hline \text { No (no exercise) } & 4.0 & x\\
\hline
\end{array}\end{array}\]
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Page 16
Chapter 16: Identifying the Roles of Genetic and Environmental Factors
in Disease
Causation
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Q1) The following suggests environmental factors causing a disease:
A) Monozygotic twins getting the same disease
B) Family history of disease
C) Early development
D) A rapid change in the trends of disease over time
E) Biologic brothers adopted by different families getting the same disease
Q2) A total of 1,500 pairs of adult twins,600 monozygotic and 900 dizygotic,were studied to estimate the concordance for a childhood cancer.In the 600 monozygotic twins,40 of the pairs were concordant for the disease,60 of the pairs were discordant for the disease,and neither twin had the disease in the remaining 500 pairs.In the 900 dizygotic twins,30 of the pairs were concordant for the disease,120 of the pairs were discordant for the disease,and neither twin had the disease in the remaining 750 pairs.What is the discordance rate,in dizygotic twins,of the disease in twin pairs with at least one affected member?
A) 0.1
B) 0.2
C) 0.6
D) 0.8
E) 1.5
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Chapter 17: Using Epidemiology to Evaluate Health Services
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Q1) In general terms,a health indicator is a A) rare disease that reflects how the system deals with complex conditions.
B) sentinel condition that is assumed to reflect the general level of health care.
C) disease that reflects infant health.
D) disease that reflects maternal and child health.
E) statistical test used to compare the health situation of two countries.
Q2) When testing whether we can achieve a less expensive and better way to treat a disease with an intervention that has shown to work previously,we are looking for A) efficacy.
B) effectiveness.
C) efficiency.
D) power.
E) feasibility.
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Chapter 18: Epidemiologic Approach to Evaluating Screening Programs
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Q1) The following is a reason for an apparent lack of benefit from a screening program:
A) The available treatments are not effective even when administered early in the disease progression.
B) The clinical phase of disease is long and usually ends with the death of the patient.
C) The usual diagnosis of disease happens very late in the disease progression.
D) The preclinical phase of disease is very long.
E) The current therapies are very effective when administered in the preclinical phase of disease.
Q2) In the model of the Natural History of Disease,the period of time between the onset of signs and symptoms of disease and its ultimate outcome (cure,control,or death) is known as
A) preclinical phase.
B) clinical phase.
C) clinical horizon.
D) incubation period.
E) latent period.
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19
Chapter 19: Epidemiology and Public Policy
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Q1) What is the name of the chart that is typically used to depict the results of a meta-analysis?
A) Forest plot
B) Pie chart
C) Box plot
D) Manhattan plot
E) Bar chart
Q2) When decision makers are in the process of assessing whether a new policy should be implemented to avoid a certain health risk,besides considering the scientific evidence available,they should also take into account the following societal consideration:
A) If that decision would make them look good with constituents
B) The proportion of the population would be protected by such policy
C) If that new policy was proposed by prestigious academics
D) The media's opinion about the policy
E) The incidence rate of the disease
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Chapter 20: Ethical and Professional Issues in Epidemiology
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Q1) What of the following is an obligation that researchers have with study participants?
A) Provide a financial incentive to participate in the study.
B) Provide free treatment for any condition the subjects have.
C) Communicate the study results clearly.
D) Enroll all family members of the participants if they want to be part of the study.
E) Provide free diagnostic procedures, even if those are not related with the study.
Q2) A challenge in epidemiologic research that explores the effect of race on cardiovascular disease is that
A) measuring race is hard because is a poorly understood concept and its validity is questionable.
B) measuring race requires DNA testing.
C) there are too many human races.
D) race is usually not associated with health outcomes.
E) cardiovascular disease is not well defined.
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21