TEST BANK for Epidemiology 101 2nd Edition by Robert Friis | All Chapters 1-12

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Chapter: Chapter 01 – Quiz

Multiple Choice

1. Epidemiologic methods can be applied to which of the following public health–related fields?

A) Health education B) Healthcare administration C) Environmental health D) All of these are correct.

Ans: D Complexity: Easy Ahead: The Concept of an Epidemic Subject: Chapter 1

2. Which of the following is not considered a use of epidemiology?

A) To study the workings of health services in the community B) To diagnose the dimensions and distributions of disease within a community C) To provide healthcare services to specific individuals D) To search for causes of disease and other health outcomes Ans: C Complexity: Moderate Ahead: Brief Overview of Current Uses of Epidemiology Subject: Chapter 1

3. Whether a contaminated food such as tomatoes caused an outbreak of gastrointestinal disease is a simple example of: A) a causal association.

B) the 1918 influenza pandemic.

C) a population.

D) All of these are correct.

Ans: A Complexity: Moderate Ahead: The Concept of an Epidemic Subject: Chapter 1

4. Which of the following is considered a key characteristic of epidemiology?

A) Distribution B) Population focus C) Quantification D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Definition of Epidemiology Subject: Chapter 1

5. Variation in the occurrence of diseases and other health outcomes in populations relates most closely to: A) population focus.

B) distribution.

C) quantification.

D) None of these is correct.

Ans: B Complexity: Easy Ahead: Definition of Epidemiology Subject: Chapter 1

True/False

1. Alexander Fleming discovered the antimicrobial properties of Penicillium notatum.

Ans: True Complexity: Easy Ahead: History of Epidemiology and Development of Epidemiologic Principles Subject: Chapter 1

2. Epidemiology is an observational science that capitalizes on naturally occurring situations.

Ans: True Complexity: Easy Ahead: Application of Descriptive and Analytic Methods to an Observational Science Subject: Chapter 1

3. John Graunt is said to be the first to employ quantitative methods to describe population vital statistics.

Ans: True Complexity: Moderate Ahead: History of Epidemiology and Development of Epidemiologic Principles Subject: Chapter 1

4. The history of epidemiology originated as early as classical antiquity.

Ans: True Complexity: Easy Ahead: History of Epidemiology and Development of Epidemiologic Principles

Subject: Chapter 1

5. Bubonic plague is a bacterial disease caused by Yersinia pestis.

Ans: True Complexity: Easy Ahead: History of Epidemiology and Development of Epidemiologic Principles Subject: Chapter 1

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Chapter: Chapter 02 – Quiz

Multiple Choice

1. Occupational classification is an example of: A) quantitative data.

B) qualitative data.

C) continuous data.

D) dichotomous data.

Ans: B Complexity: Difficult Ahead: Data and Measurement Scales Subject: Chapter 2

2. Multimodal distributions can reflect age-related: A) changes in immune status.

B) changes in lifestyle.

C) operation of latency effects.

D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Distribution Curves Subject: Chapter 2

3. Identify the correct statement: A) An r of −1 is weaker association than an r of +1.

B) An r of +1 is a perfect direct linear association.

C) An association between X and Y is always causal.

D) A scatter plot cannot demonstrate an XY association.

Ans: B Complexity: Difficult Ahead: Analyses of Bivariate Association Subject: Chapter 2

4. According to the Generic Contingency table, the letter of the cell that shows that the exposure is absent and disease is absent is:

Generic Contingency Disease Status Exposure Status

Yes

No

Total

Yes

A

B

A+B

No

C

D

C+D

Total

A+C

B+D

A+B+C+D

A) A. B) B. C) C. D) D. Ans: D Complexity: Difficult Ahead: Analyses of Bivariate Association Subject: Chapter 2

5. According to the Generic Contingency table, the letter of the cell that shows that the exposure is present and disease is absent is: Generic Contingency Disease Status Exposure Status

Yes

No

Total

Yes

A

B

A+B

No

C

D

C+D

Total

A+C

B+D

A+B+C+D

A) A. B) B. C) C. D) D. Ans: B Complexity: Difficult Ahead: Analyses of Bivariate Association Subject: Chapter 2

True/False

1. True or False? Examples of continuous variables are height and weight.

Ans: True Complexity: Easy Ahead: Data and Measurement Scales Subject: Chapter 2

2. True or False? The closer the points lie on a scatter plot, with respect to the straight line of best fit through them, the stronger the association between the variables.

Ans: True Complexity: Moderate Ahead: Analyses of Bivariate Association Subject: Chapter 2

3. True or False? Contingency tables tabulate data according to two dimensions.

Ans: True Complexity: Moderate Ahead: Analyses of Bivariate Association Subject: Chapter 2

4. True or False? A multimodal curve is one that has several peaks in the frequency of a condition.

Ans: True Complexity: Moderate Ahead: Distribution Curves Subject: Chapter 2

5. True or False? A single value chosen to represent the population parameter is called a point estimate.

Ans: True Complexity: Moderate Ahead: Parameter Estimation Subject: Chapter 2

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Chapter: Chapter 03 – Quiz

Multiple Choice

1. All of the following are considered ratios except: A) proportion.

B) time.

C) rate.

D) percentage.

Ans: B Complexity: Moderate Ahead: Mathematical Terms Used in Epidemiology Subject: Chapter 3

2. Epidemiologic measures provide the following type of information: A) Frequency of disease or condition B) Association between exposure and disease C) Strength of relationship between exposure and disease D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Types of Epidemiologic Measures Subject: Chapter 3

3. Those members of the population who are capable of developing a disease or condition are known as: A) incident cases.

B) prevalent cases.

C) the population at risk.

D) the immune fraction.

Ans: C Complexity: Moderate Ahead: General Information Regarding Epidemiologic Measures Subject: Chapter 3

4. On May 1, 2010, the number of residents of Oklahoma who had been diagnosed with asthma at any time during their life was A.

The population on June 30, 2010, was B. During the same year, the number of new cases of asthma was C. Which of the following expressions represents the incidence rate of asthma (per 100,000)?

A) (A/B) × 100,000 B) (C/A) × 100,000 C) (C/B) × 100,000 D) None of these is correct.

Ans: C Complexity: Difficult Ahead: Types of Epidemiologic Measures Subject: Chapter 3

5. On May 1, 2010, the number of residents of Oklahoma who had been diagnosed with asthma at any time during their life was A. The population on June 30, 2010, was B. During the same year, the number of new cases of asthma was C. Which of the following expressions represents the point prevalence (percentage) of asthma?

A) (C/B) × 100 B) (A/B) × 100 C) (C/A) × 100 D) (B/A) × 100 Ans: B Complexity: Difficult Ahead: Types of Epidemiologic Measures Subject: Chapter 3

True/False

1. True or False? Adjusted rates pertain only to mortality rates.

Ans: False Complexity: Moderate Ahead: Epidemiologic Measures Related to Mortality Subject: Chapter 3

2. True or False? The maternal mortality rate encompasses maternal deaths that result from causes associated with pregnancy.

Ans: True Complexity: Easy Ahead: Measures of Natality and Mortality Linked to Natality Subject: Chapter 3

3. True or False? The infant mortality rate is defined as the number of infant deaths among infants age 0 to 1 year divided by the number of live births during the same year.

Ans: True

Complexity: Moderate Ahead: Measures of Natality and Mortality Linked to Natality Subject: Chapter 3

4. True or False? The general fertility rate refers to the number of live births reported in an area during a given time interval divided by the number of women age 15 to 44 years in the area.

Ans: True Complexity: Moderate Ahead: Measures of Natality and Mortality Linked to Natality Subject: Chapter 3

5. True or False? Life expectancy refers to the number of years that a person is expected to live, at any particular year.

Ans: True Complexity: Easy Ahead: Epidemiologic Measures Related to Mortality Subject: Chapter 3

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Chapter: Chapter 04 – Quiz

Multiple Choice

1. The systematic and continuous gathering of information about the occurrence of diseases and other health phenomena is known as: A) syndromic surveillance.

B) vital statistics.

C) public health surveillance.

D) chronic disease surveillance.

Ans: C Complexity: Moderate Ahead: Data from Public Health Surveillance Programs: Three Examples Subject: Chapter 4

2. Using health-related data that precede diagnosis and signal a sufficient probability of a case or an outbreak to warrant further public health response is known as: A) syndromic surveillance.

B) registries.

C) vital events.

D) public health surveillance.

Ans: A Complexity: Moderate Ahead: Data from Public Health Surveillance Programs: Three Examples Subject: Chapter 4

3. Some examples of surveillance systems include those for: A) communicable and infectious diseases.

B) noninfectious diseases.

C) risk factors for chronic diseases.

D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Data from Public Health Surveillance Programs: Three Examples Subject: Chapter 4

4. Examples of information collected by fetal death certificates include: A) name.

B) disposition.

C) congenital anomalies.

D) All of these are correct.

Ans: D Complexity: Easy Ahead: The Vital Registration System and Vital Events Subject: Chapter 4

True/False

1. True or False? The U.S. Bureau of the Census provides information that is useful for defining the denominator in rates.

Ans: True Complexity: Moderate Ahead: U.S. Census Bureau Subject: Chapter 4

2. True or False? In the United States, mortality data have a high degree of completeness.

Ans: True Complexity: Easy Ahead: The Vital Registration System and Vital Events Subject: Chapter 4

3. True or False? Registries can be used to select patients for case-control studies.

Ans: True Complexity: Easy Ahead: Case Registries Subject: Chapter 4

4. True or False? AIDS is an example of a nationally notifiable disease.

Ans: True Complexity: Moderate Ahead: Data from Public Health Surveillance Programs: Three Examples Subject: Chapter 4

5. True or False? The medical examiner or coroner completes and signs the death certificate if the cause of death was an accident, suicide, or homicide or if the attending physician is unavailable.

Ans: True Complexity: Moderate Ahead: The Vital Registration System and Vital Events Subject: Chapter 4

6. True or False? Epidemiology is a quantitative discipline that requires data for descriptive and analytic studies.

Ans: True Complexity: Moderate Ahead: Conclusion Subject: Chapter 4

7. True or False? Public health surveillance programs are used for infectious diseases, noninfectious diseases, and risk factors for chronic diseases.

Ans: True Complexity: Moderate Ahead: Data from Public Health Surveillance Programs: Three Examples Subject: Chapter 4

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Chapter: Chapter 05 – Quiz

Multiple Choice

1. In epidemiology, place variables include: A) localized occurrence of disease.

B) secular trends.

C) point epidemics.

D) socioeconomic status.

Ans: A Complexity: Moderate Ahead: Place Variables Subject: Chapter 5

2. Variations in infectious and chronic diseases from one country to another may be attributed to: A) climate.

B) access to health care.

C) cultural factors.

D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Place Variables Subject: Chapter 5

3. Urban diseases and causes of mortality are more likely to be those associated with: A) person-to-person contact.

B) toxic pesticide exposures.

C) injuries from farm equipment.

D) arduous outdoor working conditions.

Ans: A Complexity: Moderate Ahead: Place Variables Subject: Chapter 5

4. Increases and decreases in the frequency of a disease within a year or over a period of several years are known as:

A) secular trends.

B) cyclic trends.

C) point epidemic.

D) clustering.

Ans: B Complexity: Moderate Ahead: Time Variables Subject: Chapter 5

5. Gradual changes in the frequency of diseases over long periods are known as: A) secular trends.

B) cyclic trends.

C) point epidemics.

D) clustering.

Ans: A Complexity: Moderate Ahead: Time Variables Subject: Chapter 5

True/False

1. True or False? Descriptive epidemiology characterizes health according to person, place, and time.

Ans: True Complexity: Moderate Ahead: Types of Descriptive Epidemiologic Studies Subject: Chapter 5

2. True or False? The causes of morbidity and mortality differ according to the stage of life.

Ans: True Complexity: Easy Ahead: Person Variables Subject: Chapter 5

3. True or False? Assignment of some individuals to a particular racial classification on the basis of observed characteristics may be difficult.

Ans: True Complexity: Easy Ahead: Person Variables Subject: Chapter 5

4. True or False? Those who occupy the lowest socioeconomic positions have excesses of morbidity and mortality from various causes.

Ans: True Complexity: Moderate

Ahead: Person Variables Subject: Chapter 5

5. True or False? The Behavioral Risk Factor Surveillance System (BRFSS) is an example of an ongoing cross-sectional study.

Ans: True Complexity: Moderate Ahead: Types of Descriptive Epidemiologic Studies Subject: Chapter 5

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Chapter: Chapter 06 – Quiz

Multiple Choice

1. For which of the following criteria do epidemiologists need to observe the cause before the effect?

A) Biological gradient B) Coherence C) Temporality D) Consistency Ans: C Complexity: Difficult Ahead: The Criteria of Causality Subject: Chapter 6

2. The web of causation model specifies a type of causal relationship that is: A) specific.

B) consistent.

C) coherent.

D) multifactorial.

Ans: D Complexity: Moderate Ahead: The Criteria of Causality Subject: Chapter 6

3. The process of defining measurement procedures for the variables used in a study is: A) operationalization.

B) dose-response assessment.

C) causal modeling.

D) hypothesis formulation.

Ans: A Complexity: Moderate Ahead: Epidemiologic Research and the Search for Associations Subject: Chapter 6

4. The process of passing from observations and axioms to generalizations is known as: A) inference.

B) point estimation.

C) power testing.

D) None of these is correct.

Ans: A Complexity: Moderate Ahead: Defining the Role of Chance in Associations Subject: Chapter 6

5. A range of values that with a certain degree of probability contain the population parameter is known as a: A) point estimate.

B) confidence interval estimate.

C) ballpark estimate.

D) None of these is correct.

Ans: B Complexity: Moderate Ahead: Defining the Role of Chance in Associations Subject: Chapter 6

True/False

1. True or False? The overriding question that epidemiologists ask is whether a particular exposure is causally associated with a given outcome.

Ans: True Complexity: Moderate Ahead: Epidemiologic Research and the Search for Associations Subject: Chapter 6

2. True or False? One-to-one causation is unusual because many diseases have more than one causal factor.

Ans: True Complexity: Moderate Ahead: The Criteria of Causality Subject: Chapter 6

3. True or False? A noncausal association is one that may be due to chance or random factors.

Ans: True Complexity: Difficult Ahead: Types of Associations Found among Variables Subject: Chapter 6

4. True or False? A necessary cause is sufficient by itself to produce the effect.

Ans: False Complexity: Moderate

Ahead: Deterministic and Probabilistic Causality in Epidemiology Subject: Chapter 6

5. True or False? A sufficient cause is sufficient by itself to produce the effect.

Ans: True Complexity: Moderate Ahead: Deterministic and Probabilistic Causality in Epidemiology Subject: Chapter 6

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Chapter: Chapter 07 – Quiz

Multiple Choice

1. Used in case-control studies, a type of indirect measure of the association between frequency of exposure and frequency of outcome is known as the: A) odds ratio.

B) population risk difference.

C) attributable risk.

D) All of these are correct.

Ans: A Subject: Chapter 7 Ahead: Case-Control Studies Complexity: Moderate

2. Disadvantages of case-control studies include all except which of the following?

A) measurement of exposure may be inaccurate.

B) they provide indirect estimates of risk.

C) they can be used to study low-prevalence conditions.

D) representativeness of cases and controls may be unknown.

Ans: C Subject: Chapter 7 Ahead: Case-Control Studies Complexity: Moderate

3. Participants are classified according to their exposure to a factor of interest and then are observed over time to document the incidence of disease in what type of study?

A) Prospective cohort study B) Case-control study C) Cross-sectional study D) Retrospective cohort study Ans: A Subject: Chapter 7 Ahead: Case-Control Studies Complexity: Moderate

4. The ratio of the incidence rate of a disease in an exposed group to the incidence rate of the disease in a nonexposed group is the: A) odds ratio.

B) relative risk.

C) population risk difference.

D) None of these is correct.

Ans: B Subject: Chapter 7 Ahead: Cohort Studies Complexity: Difficult

5. Advantages of cohort studies include all except which of the following?

A) Exposure factor is well defined in cohort studies.

B) Cohort studies permit direct observation of risk.

C) Exposures can be misclassified in cohort studies.

D) Uncommon exposures in a population can be studied in cohort studies.

Ans: C Subject: Chapter 7 Ahead: Cohort Studies Complexity: Difficult

True/False

1. True or False? Ecologic studies use the group rather than the individual as the unit of analysis.

Ans: True Subject: Chapter 7 Ahead: Ecologic Studies Complexity: Easy

2. True or False? A case-control study can examine only a single outcome or a limited set of outcomes.

Ans: True Subject: Chapter 7 Ahead: Case-Control Studies Complexity: Moderate

3. True or False? Edward Jenner used a control group for his development of a smallpox vaccine.

Ans: False Subject: Chapter 7 Ahead: Experimental Studies Complexity: Moderate

4. True or False? In a crossover design, participants may be switched among treatment groups.

Ans: True Subject: Chapter 7

Ahead: Experimental Studies Complexity: Moderate

5. True or False? An intervention designed for the purpose of educational and behavioral changes at the population level is a community intervention.

Ans: True Subject: Chapter 7 Ahead: Experimental Studies Complexity: Easy

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Chapter: Chapter 08 – Quiz

Multiple Choice

1. Individuals who are involved in policy formulation, including members of the legislature, citizens, lobbyists, and advocacy-group representatives, are known as: A) policy actors.

B) stakeholders.

C) interest groups.

D) population representatives.

Ans: A Complexity: Easy Ahead: What Is a Health Policy?

Subject: Chapter 8

2. The adoption of policies, laws, and programs that are supported by empirical data refers to: A) policy implementation.

B) policy establishment.

C) evidence-based public health.

D) None of these is correct.

Ans: C Complexity: Easy Ahead: What Is a Health Policy?

Subject: Chapter 8

3. The process for identifying adverse consequences and their associated probability is known as: A) hazard identification.

B) risk assessment.

C) cost-effectiveness analysis.

D) exposure assessment.

Ans: B Complexity: Moderate Ahead: Decision Analysis Based on Perceptions of Risks and Benefits Subject: Chapter 8

4. The relationship between the amount of exposure and the occurrence of the unwanted health effects refers to: A) exposure assessment.

B) dose-response assessment.

C) risk assessment.

D) risk characterization.

Ans: B Complexity: Moderate Ahead: Decision Analysis Based on Perceptions of Risks and Benefits Subject: Chapter 8

5. When referring to a toxic substance, exposure assessment must take into account: A) where the exposure occurs.

B) how much exposure occurs.

C) how the substance is absorbed by the body.

D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Decision Analysis Based on Perceptions of Risks and Benefits Subject: Chapter 8

True/False

1. True or False? A health policy is one that pertains to the health arena—for example, public health.

Ans: True Complexity: Moderate Ahead: What Is a Health Policy?

Subject: Chapter 8

2. True or False? The policy cycle refers to the distinct phases involved in the policy-making process.

Ans: True Complexity: Moderate Ahead: What Is a Health Policy?

Subject: Chapter 8

3. True or False? Legitimization refers to the process of making policies legitimate, meaning to be acceptable to the norms of society.

Ans: True Complexity: Easy Ahead: What Is a Health Policy?

Subject: Chapter 8

4. True or False? Ethics refers to norms for conduct that distinguish between acceptable and unacceptable behavior in research.

Ans: True Complexity: Moderate Ahead: Ethics and Epidemiology Subject: Chapter 8

5. True or False? The Tuskegee Study exemplified a research project that violated ethical standards for research.

Ans: True Complexity: Moderate Ahead: Ethics and Epidemiology Subject: Chapter 8

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Chapter: Chapter 09 – Quiz

Multiple Choice

1. Sensitivity and specificity of a screening test refer to its: A) reliability.

B) validity.

C) yield.

D) repeatability.

Ans: B Complexity: Moderate Ahead: Measures Used in Screening Subject: Chapter 9

The next two questions refer to the following table: Fourfold Table for Classification of Screening Test Results Condition According to Gold Standard Present Absent Test result Positive a b Negative

c

d

Total

a+c b+d Sensitivity Specificity a/(a + c) d/(b = d) 2. Which cell in the table represents false positives?

A) b B) a C) c D) d Ans: C Complexity: Difficult Ahead: Measures Used in Screening Subject: Chapter 9

3. Which cell in the table represents true positives?

A) a

Total a+b

Predictive value (+) a/(a + b) c+d Predictive value (−) d/(c + d) Grand total a + b + c+ d

B) b C) c D) d Ans: A Complexity: Difficult Ahead: Measures Used in Screening Subject: Chapter 9

The next two questions refer to the following information: A screening examination was performed on 250 persons for Factor X, which is found in disease Y. A definitive diagnosis for disease Y among the 250 persons had been obtained previously. The results of diagnoses are charted here: Test Results Positive for Factor X Negative for Factor X

Disease Present 40 10

Disease Absent 60 140

4. Based on the information provided, which of the following expresses the sensitivity of this test?

A) 30% B) 70% C) 56% D) 80% Ans: D Complexity: Moderate Ahead: Measures Used in Screening Subject: Chapter 9

5. Based on the information provided, which of the following expresses the specificity of this test?

A) 30% B) 70% C) 56% D) 7% Ans: B Complexity: Moderate Ahead: Measures Used in Screening Subject: Chapter 9

True/False

1. True or False? The natural history of disease refers to the time course of disease from its beginning to its final clinical endpoints.

Ans: True Complexity: Easy Ahead: Screening and the Natural History of Disease Subject: Chapter 9

2. True or False? Reliability is synonymous with precision, whereas validity is synonymous with accuracy.

Ans: True Complexity: Moderate Ahead: Measures used in Screening Subject: Chapter 9

3. True or False? Tertiary prevention is directed toward the later stages of pathogenesis and involves programs for restoring the patient’s optimal functioning.

Ans: True Complexity: Moderate Ahead: Screening and the Natural History of Disease Subject: Chapter 9

4. True or False? Screening for disease provides only preliminary information that needs to be followed by diagnostic information.

Ans: True Complexity: Easy Ahead: Overview of Screening Subject: Chapter 9

5. True or False? Although a measure that is invalid can be reliable, it is never possible for a measure that is unreliable to be valid.

Ans: True Complexity: Moderate Ahead: Measures used in Screening Subject: Chapter 9

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Chapter: Chapter 10 – Quiz

Multiple Choice

1. An inanimate object that carries infectious disease agents is a: A) vector.

B) fomite.

C) host.

D) None of these is correct.

Ans: B Complexity: Easy Ahead: How Infectious Disease Agents Are Transmitted Subject: Chapter 10

2. An animate, living insect or animal that is involved with the transmission of disease agents is a: A) vector.

B) fomite.

C) host.

D) None of these is correct.

Ans: A Complexity: Easy Ahead: How Infectious Disease Agents Are Transmitted Subject: Chapter 10

3. The likely transmission of severe acute respiratory syndrome (SARS) during a 2003 flight to Beijing is thought to have been a(n): A) vector-borne infection.

B) waterborne infection.

C) airborne infection.

D) sexually transmitted infection.

Ans: C Complexity: Moderate Ahead: How Infectious Disease Agents Are Transmitted Subject: Chapter 10

4. Which of the following is a mode of transmission for human immunodeficiency virus?

A) Unprotected sexual intercourse B) Contact with infected blood C) Transmission from an infected mother to her child D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Examples of Significant Infectious Diseases Subject: Chapter 10

5. Foodborne illnesses can be prevented by: A) washing hands and surfaces where food is prepared.

B) eating home-canned food.

C) storing food at room temperature.

D) All of these are correct.

Ans: A Complexity: Moderate Ahead: Examples of Significant Infectious Diseases Subject: Chapter 10

6. Examples of zoonotic diseases include: A) rabies.

B) anthrax.

C) rabies and anthrax.

D) measles.

Ans: C Complexity: Moderate Ahead: Examples of Significant Infectious Diseases Subject: Chapter 10

7. Determination of the incubation period for a disease outbreak helps to: A) demonstrate the location of the outbreak.

B) show the distribution of cases by time of onset.

C) verify that an epidemic has occurred.

D) identify possible infectious agents.

Ans: D Complexity: Moderate Ahead: Methods of Outbreak Investigation Subject: Chapter 10

True/False

1. True or False? A reservoir can be human beings, animals, insects, soils, and/or plants.

Ans: True Complexity: Easy Ahead: Environment and Infectious Diseases Subject: Chapter 10

2. True or False? Escherichia coli O157:H7 is an example of an emerging infection.

Ans: True Complexity: Moderate Ahead: Examples of Significant Infectious Diseases Subject: Chapter 10

Essay

1. Describe the components that make up the epidemiologic triangle. Indicate how these components could be implicated in an outbreak of foodborne illness (e.g., an illness outbreak caused by Salmonellacontaminated tomatoes).

Ans: Answers will vary Complexity: Difficult Ahead: The Epidemiologic Triangle: Agent, Host, and Environment Subject: Chapter 10

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Chapter: Chapter 11 – Quiz

Multiple Choice

1. Life events that are sustained over a long period of time are known as: A) chronic strains.

B) stressful life events.

C) risk factors.

D) social events.

Ans: A Complexity: Moderate Ahead: Stress and Health Subject: Chapter 11

2. Which of the following is an adverse health outcome associated with cigarette smoking?

A) Coronary heart disease B) Stroke C) Lung diseases D) All of these are correct.

Ans: D Complexity: Easy Ahead: Tobacco Use Subject: Chapter 11

3. The involuntary breathing of cigarette smoke by nonsmokers in an environment where there are cigarette smokers present is known as: A) passive smoking.

B) secondhand exposure to cigarette smoke.

C) sidestream exposure to cigarette smoke.

D) All these are correct.

Ans: D Complexity: Moderate Ahead: Tobacco Use Subject: Chapter 11

4. A pattern of drinking that results in harm to one’s health, interpersonal relationships, or ability to work is known as: A) alcohol abuse.

B) alcohol dependence.

C) binge drinking.

D) All of these are correct.

Ans: A Complexity: Moderate Ahead: Alcohol Consumption Subject: Chapter 11

5. Alcohol consumption by underage persons is associated with which of the following consequences?

A) Improved driving ability B) Forming many strong friendships C) Problems at school D) None of these is correct.

Ans: C Complexity: Easy Ahead: Alcohol Consumption Subject: Chapter 11

6. Which of the following health problems is associated with binge drinking among college students?

A) Violence B) Sexually transmitted diseases C) Unintentional injuries D) All of these are correct.

Ans: D Complexity: Easy Ahead: Alcohol Consumption Subject: Chapter 11

7. Severe tooth decay and loss of teeth occur most commonly among: A) binge drinkers.

B) methamphetamine users.

C) passive smokers.

D) All of these are correct.

Ans: B Complexity: Easy Ahead: Substance Abuse Subject: Chapter 11

8. The study of the occurrence of major depressive episodes in the population is one of the concerns of: A) behavioral epidemiology.

B) social epidemiology.

C) psychiatric epidemiology.

D) cultural epidemiology.

Ans: C Complexity: Moderate

Ahead: Psychiatric Epidemiology Subject: Chapter 11

True/False

1. True or False? Lung cancer is the leading cause of cancer death for both men and women in the United States.

Ans: True Complexity: Moderate Ahead: Tobacco Use Subject: Chapter 11

2. True or False? Social and behavioral dimensions that impact human health include social adversities, stress, and lifestyle practices.

Ans: True Complexity: Easy Ahead: Defining Social and Behavioral Epidemiology Subject: Chapter 11

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Chapter: Chapter 12 – Quiz

Multiple Choice

1. Highly toxic chemicals that persist in the environment have been associated with disruption of the: A) immune system.

B) reproductive system.

C) nervous system.

D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Environmental Epidemiology Subject: Chapter 12

2. The term unintentional injury is preferred to the term: A) unpreventable event.

B) accident.

C) random event.

D) None of these is correct.

Ans: B Complexity: Easy Ahead: Unintentional Injuries Subject: Chapter 12

3. Which of the following categories of unintentional injuries has shown a declining trend in death rates in the United States between the mid-1960s and 2014?

A) motor vehicle traffic deaths B) firearm deaths C) poisoning deaths D) deaths from falls Ans: A Complexity: Moderate Ahead: Unintentional Injuries Subject: Chapter 12

4. In 2013, the largest number of deaths due to motor vehicle accidents occurred among persons age:

A) 0 to 4 years B) 15 to 24 years C) 40 to 64 years D) 65 years and older Ans: B Complexity: Moderate Ahead: Unintentional Injuries Subject: Chapter 12

5. Sewage wastewater systems contain measurable levels of human metabolic end-products of prescription medications and illicit drugs. In the context of sewage epidemiology, the acronym DTR refers to?

A) Differential relative risks B) Drug trafficking responses C) Drug transport residues D) Drug temporality reports Ans: C Complexity: Moderate Ahead: Sewage Epidemiology Subject: Chapter 12

6. Which factors are related to physical dating violence?

A) Being sexually active B) Episodic heavy drinking C) Having attempted suicide D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Other Applications of Epidemiology Subject: Chapter 12

7. Which of the following methods is applied to forensic epidemiology?

A) Detection of unusual occurrence of disease B) Use of ongoing surveillance systems C) Case identification and confirmation D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Other Applications of Epidemiology Subject: Chapter 12

8. Pharmacoepidemiology involves the study of the: A) distribution of drug-related events in populations.

B) determinants of drug-related events in populations.

C) efficacious treatment of drug-related events in populations.

D) All of these are correct.

Ans: D Complexity: Moderate

Ahead: Other Applications of Epidemiology Subject: Chapter 12 9. Which of the following statements regarding hazardous exposures in the job environment is true?

A) exposures to occupational hazards cannot be prevented B) job-related exposures are often higher than those outside of work C) the community is not impacted by chemicals from industries D) poisoning is the leading cause of nonfatal occupational injuries Ans: B Complexity: Difficult Ahead: Epidemiology and Occupational Health Subject: Chapter 12 Essay

1. What is one of the major consequences of children’s exposure to environmental lead? Suggest two methods for reducing such exposure.

Ans: Answers will vary Complexity: Moderate Ahead: Environmental Epidemiology Subject: Chapter 12

2. Briefly define the terms disaster epidemiology and extreme epidemiology, giving an example of each one.

Ans: Answers will vary Complexity: Moderate Ahead: Other Applications of Epidemiology Subject: Chapter 12

Chapter 1 eBook Quiz

True/False 1. Epidemiology can help solve a variety of today’s health-related problems, ranging from smoking to youth violence. <Answer: True> <Complexity: Easy> <A-head: Introduction> <Subject: Chapter 1>

True/False 2. It is possible for a single case of a disease to represent an epidemic. <Answer: True> <Complexity: Moderate> <A-head: The Concept of an Epidemic> <Subject: Chapter 1>

True/False 3. A pandemic is an epidemic occurring worldwide or crossing international boundaries. <Answer: True> <Complexity: Easy> <A-head: The Concept of an Epidemic> <Subject: Chapter 1>

True/False 4. Epidemiology is concerned with the distribution and determinants of health and diseases, morbidity, injuries, disability, and mortality in populations. <Answer: True> <Complexity: Moderate> <A-head: Definition of Epidemiology> <Subject: Chapter 1>

True/False 5. A population is defined as all of the inhabitants of a given country or area considered together. <Answer: True> <Complexity: Moderate> <A-head: Definition of Epidemiology> <Subject: Chapter 1>

Multiple Choice 6. The occurrence in a community or region of cases of an illness, specific health behavior, or other health-related events clearly in excess of normal expectancy is known as which of the following?

[1] Prevalence [2] Epidemic [3] Pandemic [4] None of these is correct. <Answer: B> <Complexity: Difficult> <A-head: The Concept of an Epidemic> <Subject: Chapter 1>

Multiple Choice 7. Any factor that brings about change in a health condition or other defined characteristic is known as a(n): [1] determinant.

[2] exposure.

[3] distribution.

[4] risk factor. <Answer: A> <Complexity: Moderate> <A-head: Definition of Epidemiology> <Subject: Chapter 1>

Multiple Choice 8. Illness due to a specific disease or health condition is known as: [1] morbidity.

[2] mortality.

[3] exposure.

[4] risk factor. <Answer: A> <Complexity: Easy> <A-head: Definition of Epidemiology> <Subject: Chapter 1>

Multiple Choice 9. A method for providing quantitative measurements of risks to health is known as: [1] the interdisciplinary approach.

[2] a natural experiment.

[3] risk assessment.

[4] disease management. <Answer: C> <Complexity: Moderate> <A-head: Brief Overview of Current Uses of Epidemiology> <Subject: Chapter 1>

Multiple Choice 10. Which stage takes place during the early phases of pathogenesis and includes activities that limit the progression of disease?

[1] Tertiary prevention.

[2] Secondary prevention.

[3] Primary prevention.

[4] Determinant. <Answer: B> <Complexity: Difficult> <A-head: Brief Overview of Current Uses of Epidemiology> <Subject: Chapter 1>

Chapter 2 eBook Quiz

True/False 1. A parameter is a measureable attribute of a population. <Answer: True> <Complexity: Easy> <A-head: Terminology of Samples> <Subject: Chapter 2>

True/False 2. The universe describes the total set of elements from which the sample is selected. <Answer: True> <Complexity: Easy> <A-head: Terminology of Samples> <Subject: Chapter 2>

True/False 3. The unbiasedness property guarantees a representative sample. <Answer: False> <Complexity: Moderate> <A-head: Terminology of Samples> <Subject: Chapter 2>

True/False 4. Convenience samples sometimes are called “grab bag samples.” <Answer: True> <Complexity: Easy> <A-head: Terminology of Samples> <Subject: Chapter 2>

True/False 5. The number of doctor visits is an example of a continuous variable. <Answer: False> <Complexity: Moderate> <A-head: Data and Measurement Scales> <Subject: Chapter 2>

Multiple Choice 6. Which of the following measurement scales has a true zero point?

[A] Ordinal [B] Nominal [C] Continuous [D] Ratio <Answer: D> <Complexity: Difficult> <A-head: Data and Measurement Scales> <Subject: Chapter 2>

Multiple Choice 7. Epidemiologists can plot data and present it graphically through: [A] bar graphs.

[B] line graphs.

[C] pie chart.

[D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: Presentation of Epidemiologic Data> <Subject: Chapter 2>

Multiple Choice 8. What is one of the first steps in presenting data after they have been reviewed for accuracy and completeness?

[A] Calculate crude rates [B] Draw a bar graph [C] Draw a pie chart [D] Count and tabulate cases <Answer: D> <Complexity: Moderate> <A-head: Presentation of Epidemiologic Data> <Subject: Chapter 2>

Multiple Choice 9. Which of the following statements is correct?

[A] A histogram is used to display qualitative, discrete data.

[B] A histogram is used to display continuous data.

[C] A pie chart shows case frequencies in proportional sizes.

[D] A histogram is used to display continuous data, and a pie chart shows case frequencies in proportional sizes. <Answer: D> <Complexity: Moderate> <A-head: Presentation of Epidemiologic Data> <Subject: Chapter 2>

Multiple Choice 10. The advantage of stratified sampling is that it: [A] can improve parameter estimates.

[B] involves the use of convenience samples.

[C] is a variation of systematic sampling.

[D] All of these are correct. <Answer: A> <Complexity: Difficult> <A-head: Terminology of Samples> <Subject: Chapter 2>

Chapter 3 eBook Quiz

True/False 1. In a ratio, the numerator and denominator do not necessarily have a specific relationship. <Answer: True> <Complexity: Difficult> <A-head: Mathematical Terms Used in Epidemiology> <Subject: Chapter 3>

True/False 2. Incidence and prevalence are interrelated concepts. <Answer: True> <Complexity: Moderate> <A-head: Types of Epidemiologic Measures> <Subject: Chapter 3>

True/False 3. Lifetime prevalence refers to all cases of a disease diagnosed at any time during a person’s lifetime. <Answer: True> <Complexity: Moderate> <A-head: Types of Epidemiologic Measures> <Subject: Chapter 3>

True/False 4. Comparisons among populations that differ in size cannot be accomplished directly by using frequency or prevalence data. <Answer: True> <Complexity: Difficult> <A-head: Types of Epidemiologic Measures> <Subject: Chapter 3>

True/False 5. Rates can be expressed in terms of any unit size of population that is convenient. <Answer: True> <Complexity: Moderate> <A-head: Epidemiologic Measures Related to Mortality> <Subject: Chapter 3>

Multiple Choice

6. The death of a fetus when it is in the uterus and before it has been delivered is known as: [A] perinatal mortality.

[B] infant mortality.

[C] fetal mortality.

[D] None of these is correct. <Answer: C> <Complexity: Easy> <A-head: Measures of Natality and Mortality Linked to Natality> <Subject: Chapter 3>

Multiple Choice 7. The number of live births reported in an area during a given time interval divided by the number of women age 15 to 44 is known as the: [A] crude birth rate.

[B] general fertility rate.

[C] perinatal fertility rate.

[D] maternal mortality rate. <Answer: B> <Complexity: Moderate> <A-head: Measures of Natality and Mortality Linked to Natality> <Subject: Chapter 3>

Multiple Choice 8. The number of late fetal deaths after 28 weeks or more gestation plus infant deaths within 7 days of birth divided by the number of live births plus late fetal deaths during a year is the: [A] prenatal mortality rate.

[B] perinatal mortality rate.

[C] fetal mortality rate.

[D] infant mortality rate. <Answer: B> <Complexity: Moderate> <A-head: Measures of Natality and Mortality Linked to Natality> <Subject: Chapter 3>

Multiple Choice 9. Which of the following measures helps to make comparisons across age groups?

[A] Cause-specific rates [B] Age-specific rates [C] Sex-specific rates [D] Proportional mortality ratios <Answer: B> <Complexity: Easy> <A-head: Specific Rates> <Subject: Chapter 3>

Multiple Choice 10. Which statement about crude and age-adjusted rates is true?

[A] Since 1980, the age-adjusted death rate in the United States has declined more steeply than the crude death rate.

[B] In 2013, the age-adjusted death rate in the United States was higher than the crude death rate.

[C] Higher crude death rates in some U.S. states are a reflection of younger populations in those states.

[D] The standard U.S. population for age adjustment is the U.S. population in the year 1940. <Answer: A> <Complexity: Moderate> <A-head: Adjusted Rates> <Subject: Chapter 3>

Chapter 4 eBook Quiz

True/False 1. Representativeness, or external validity, refers to the generalizability of the findings to the population from which the data have been taken. <Answer: True> <Complexity: Easy> <A-head: Factors That Affect the Quality of Epidemiologic Data> <Subject: Chapter 4>

True/False 2. Birth statistics include statistics on both live births and fetal deaths. <Answer: True> <Complexity: Easy> <A-head: The Vital Registration System and Vital Events> <Subject: Chapter 4>

True/False 3. By law, physicians and other healthcare providers must report cases of certain diseases, known as reportable and notifiable diseases, to health authorities. <Answer: True> <Complexity: Moderate> <A-head: Data from Public Health Surveillance Programs: Three Examples> <Subject: Chapter 4>

True/False 4. The major deficiency of reportable and notifiable data for epidemiologic research purposes is the possible incompleteness of population coverage. <Answer: True> <Complexity: Moderate> <A-head: Data from Public Health Surveillance Programs: Three Examples> <Subject: Chapter 4>

True/False 5. The World Health Organization and the European Union are two examples of organizations that provide international and foreign data regarding diseases and health. <Answer: True> <Complexity: Moderate> <A-head: Data from International Organizations> <Subject: Chapter 4>

Multiple Choice 6. The Behavioral Risk Factor Surveillance System (BRFSS): [A] focuses on personal health behaviors.

[B] is a state-based system.

[C] collects data monthly.

[D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: Data from Public Health Surveillance Programs: Three Examples> <Subject: Chapter 4>

Multiple Choice 7. Which of the following sources could be used for determining life expectancy?

[A] National Health Interview Survey [B] National Vital Statistics System [C] National Health and Nutrition Examination Survey [D] None of the above <Answer: B> <Complexity: Difficult> <A-head: Data from the National Center for Health Statistics> <Subject: Chapter 4>

Multiple Choice 8. All except which of the following are considered vital events?

[A] Deaths [B] Graduation [C] Marriages [D] Divorces <Answer: B> <Complexity: Moderate> <A-head: The Vital Registration System and Vital Events> <Subject: Chapter 4>

Multiple Choice 9. Death certificate data in the United States include which of the following?

[A] Demographic characteristics [B] Date and place of death [C] Cause of death [D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: The Vital Registration System and Vital Events> <Subject: Chapter 4>

Multiple Choice 10. Monitoring cancer trends in the U.S. population over time is a major application of: [A] registries.

[B] reportable and notifiable diseases.

[C] the U.S. Census Bureau.

[D] vital events data. <Answer: A> <Complexity: Difficult> <A-head: Case Registries> <Subject: Chapter 4>

Chapter 5 eBook Quiz

True/False 1. One objective of descriptive epidemiology is to evaluate trends in health and disease in order to monitor known diseases and identify emerging problems. <Answer: True> <Complexity: Moderate> <A-head: What Is Descriptive Epidemiology?> <Subject: Chapter 5>

True/False 2. Case reports are accounts of a single occurrence of a noteworthy health-related incident. <Answer: True> <Complexity: Easy> <A-head: Types of Descriptive Epidemiologic Studies> <Subject: Chapter 5>

True/False 3. The example of meningoencephalitis associated with amoeba illustrates a case report. <Answer: False> <Complexity: Moderate> <A-head: Types of Descriptive Epidemiologic Studies> <Subject: Chapter 5>

True/False 4. Cross-sectional studies measure relationships between diseases and other variables at a particular time. <Answer: True> <Complexity: Moderate> <A-head: Types of Descriptive Epidemiologic Studies> <Subject: Chapter 5>

True/False 5. A cross-sectional study is a type of prevalence study. <Answer: True> <Complexity: Difficult> <A-head: Types of Descriptive Epidemiologic Studies> <Subject: Chapter 5>

Multiple Choice 6. Descriptive epidemiology provides information for: [A] evaluating health services.

[B] conducting additional research.

[C] targeting interventions.

[D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: Types of Descriptive Epidemiologic Studies> <Subject: Chapter 5>

Multiple Choice 7. In epidemiology, person variables include: [A] socioeconomic status.

[B] race.

[C] secular trends.

[D] socioeconomic status and secular trends. <Answer: D> <A-head: Person Variables> <Subject: Chapter 5> <Complexity: Moderate>

Multiple Choice 8. For both males and females, what type of cancer is the leading cause of cancer mortality?

[A] Lung and bronchus cancer [B] Breast cancer [C] Prostate cancer [D] Colon cancer <Answer: A> <Complexity: Moderate> <A-head: Person Variables <Subject: Chapter 5>

Multiple Choice 9. What factors may be considered when measuring socioeconomic status?

[A] Income level [B] Occupation type [C] Education level [D] All of these are correct. <Answer: D> <Complexity: Easy> <A-head: Person Variables> <Subject: Chapter 5>

Multiple Choice 10. Differences in the occurrence of diseases and adverse health conditions in the population are known as: [A] age variables.

[B] place variables.

[C] health disparities.

[D] None of these is correct. <Answer: C> <Complexity: Moderate> <A-head: Person Variables> <Subject: Chapter 5>

Chapter 6 eBook Quiz

True/False 1. The Greek philosopher Hippocrates argued that environmental influences are associated with diseases. <Answer: True> <Complexity: Easy> <A-head: Disease Causality in History> <Subject: Chapter 6>

True/False 2. Theory of spontaneous generation postulated that simple life forms could arise spontaneously from nonliving materials. <Answer: True> <Complexity: Easy> <A-head: Disease Causality in History> <Subject: Chapter 6>

True/False 3. The word association refers to a link between or among variables. <Answer: True> <Complexity: Easy> <A-head: Deterministic and Probabilistic Causality in Epidemiology> <Subject: Chapter 6>

True/False 4. Some examples of deterministic models can be derived from physics. <Answer: True> <Complexity: Moderate> <A-head: Deterministic and Probabilistic Causality in Epidemiology> <Subject: Chapter 6>

True/False 5. A variable is any quantity that varies or any attribute, phenomenon, or event that can have different values. <Answer: True> <Complexity: Easy> <A-head: Deterministic and Probabilistic Causality in Epidemiology> <Subject: Chapter 6>

Multiple Choice 6. The cycle of epidemiologic research includes which of the following categories?

[A] Theory [B] Hypothesis [C] Operationalization [D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: Epidemiologic Research and the Search for Associations> <Subject: Chapter 6>

Multiple Choice 7. With respect to derivation of hypotheses, a situation in which all of the factors in two or more domains are the same except for a single factor is known as: [A] method of concomitant variation.

[B] operationalization.

[C] method of difference.

[D] None of these is correct. <Answer: C> <Complexity: Difficult> <A-head: Epidemiologic Research and the Search for Associations> <Subject: Chapter 6>

Multiple Choice 8. With respect to derivation of hypotheses, a type of association in which the frequency of an outcome increases with the frequency of exposure to a factor is known as: [A] method of concomitant variation.

[B] method of difference.

[C] operationalization.

[D] None of these is correct. <Answer: A> <Complexity: Moderate> <A-head: Epidemiologic Research and the Search for Associations> <Subject: Chapter 6>

Multiple Choice 9. Coronary heart disease is an example of a disease that illustrates: [A] necessary and sufficient causality.

[B] neither necessary nor sufficient causality.

[C]sufficient but not necessary causality.

[D] necessary but not sufficient causality. <Answer: B> <Complexity: Moderate> <Ahead: Deterministic and Probabilistic Causality in Epidemiology> <Subject: Chapter 6>

Multiple Choice 10. Hill’s criteria of causality include which of the following?

[A] Temporality [B] Analogy [C] Strength [D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: The Criteria of Causality> <Subject: Chapter 6>

Chapter 7 eBook Quiz

True/False 1. The Hawthorne effect is a bias that results from participants’ knowledge of being in a study. <Answer: True> <Complexity: Moderate> <A-head: Challenges to the Validity of Study Designs> <Subject: Chapter 7>

True/False 2. Confounding means that the effect of an exposure on an outcome has been distorted by an extraneous factor that has entered into the exposure–disease association. <Answer: True> <Complexity: Difficult> <A-head: Challenges to the Validity of Study Designs> <Subject: Chapter 7>

True/False 3. Analytic studies focus on causal associations between exposures and outcomes. <Answer: True> <Complexity: Moderate> <A-head: Overview of Study Designs> <Subject: Chapter 7>

True/False 4. Analytic studies can be either observational or experimental. <Answer: True> <Complexity: Easy> <A-head: Overview of Study Designs> <Subject: Chapter 7>

True/False 5. The term retrospective means obtaining information about exposures that occurred in the past. <Answer: True> <Complexity: Easy> <A-head: Overview of Study Designs> <Subject: Chapter 7>

Multiple Choice

6. Random assignment of subjects to study groups helps to control for: [A] directionality of exposure.

[B] biases due to confounding.

[C] timing of data collection.

[D] None of these is correct. <Answer: B> <Complexity: Moderate> <A-head: Overview of Study Designs> <Subject: Chapter 7>

Multiple Choice 7. Which factor distinguishes study designs from one another?

[A] Data collection methods [B] Unit of observation [C] Timing of data collection [D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: Overview of Study Designs> <Subject: Chapter 7>

Multiple Choice 8. Groups that are selected for an ecologic study might be residents of a particular: [A] state.

[B] county.

[C] census tract.

[D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: Ecologic Studies> <Subject: Chapter 7>

Multiple Choice 9. Outcome variables of an ecologic study can include: [A] all-cause mortality.

[B] occupational injuries.

[C] breast cancer mortality.

[D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: Ecologic Studies> <Subject: Chapter 7>

Multiple Choice

10. An erroneous inference that may occur because an association observed between variables on an aggregate level does not necessarily reflect the association at an individual level is known as an: [A] odds ratio.

[B] ecologic correlation.

[C] ecologic fallacy.

[D] None of these is correct. <Answer: C> <Complexity: Difficult> <A-head: Ecologic Studies> <Subject: Chapter 7>

Chapter 8 eBook Quiz

True/False 1. Laws and regulations are developed as methods of policy implementation. <Answer: True> <Complexity: Easy> <A-head: What Is a Health Policy?> <Subject: Chapter 8>

True/False 2. The policy cycle involves five phases: problem definition/formulation/reformulation, agenda setting, policy establishment, policy implementation, and policy assessment. <Answer: True> <Complexity: Moderate> <A-head: What Is a Health Policy?> <Subject: Chapter 8>

True/False 3. The first phase of the policy cycle is regarded as the most crucial phase of the policy development process. <Answer: True> <Complexity: Moderate> <A-head: What Is a Health Policy?> <Subject: Chapter 8>

True/False 4. A weakness of exposure assessment is that high-quality data on exposures are often unavailable. <Answer: True> <Complexity: Moderate> <A-head: Decision Analysis Based on Perceptions of Risks and Benefits> <Subject: Chapter 8>

True/False 5. Epidemiology can aid with the accomplishment of at least three of the 10 essential public health services. <Answer: True> <Complexity: Moderate> <A-head: Policy and the 10 Essential Public Health Services> <Subject: Chapter 8>

Multiple Choice 6. A plan, or course of action, as of a government, political party, or business, intended to influence and determine decisions, actions, and other matters is known as: [A] agenda setting.

[B] a policy.

[C] evidence-based public health.

[D] All of these are correct. <Answer: B> <Complexity: Moderate> <A-head: What Is a Health Policy?> <Subject: Chapter 8>

Multiple Choice 7. A procedure that contrasts the costs and health effects of an intervention is a(n): [A] risk assessment.

[B] exposure assessment.

[C] cost-effectiveness analysis.

[D] None of these is correct. <Answer: C> <Complexity: Moderate> <A-head: What Is a Health Policy?> <Subject: Chapter 8>

Multiple Choice 8. Which of the following is included in the policy cycle?

[A] Problem definition [B] Agenda setting [C] Hazard identification [D] Problem definition and agenda setting <Answer: D> <Complexity: Moderate> <A-head: What Is a Health Policy?> <Subject: Chapter 8>

Multiple Choice 9. Which of the following is among the ways that epidemiologists can contribute to health policy?

[A] Serving as an expert witness [B] Working as an advocate [C] Conducting and disseminating research [D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: Epidemiologists’ Roles in Policy Development> <Subject: Chapter 8>

Multiple Choice 10. A group of persons working on behalf of or strongly supporting a particular cause, such as an item of legislation, an industry, or a special segment of society, is known as: [A] an interest group.

[B] stakeholders.

[C] policy actors.

[D] None of these is correct. <Answer: A> <Complexity: Moderate> <A-head: What Is a Health Policy?> <Subject: Chapter 8>

Chapter 9 eBook Quiz

True/False 1. Screening tests are administered to people who appear to be well. <Answer: True> <Complexity: Moderate> <A-head: Overview of Screening> <Subject: Chapter 9>

True/False 2. Selective screening is likely to result in the greatest yield of true cases. <Answer: True> <Complexity: Moderate> <A-head: Overview of Screening> <Subject: Chapter 9>

True/False 3. Primary prevention involves the prevention of disease before it occurs. <Answer: True> <Complexity: Moderate> <A-head: Screening and the Natural History of Disease> <Subject: Chapter 9>

True/False 4. The phenomenon of overdiagnosis may result in unwarranted medical testing and procedure. <Answer: True> <Complexity: Moderate> <A-head: Overview of Screening> <Subject: Chapter 9>

True/False 5. Screening tests need to demonstrate reliability and validity. <Answer: True> <Complexity: Easy> <A-head: Measures Used in Screening> <Subject: Chapter 9>

Multiple Choice

6. Which of the following is an example of “simple” health policy questions that pertain to the use of screening tests?

[A] Who should be screened?

[B] What conditions should be screened?

[C] At what age should screening begin?

[D] All of these are correct. <Answer: D> <Complexity: Easy> <A-head: Overview of Screening> <Subject: Chapter 9>

Multiple Choice 7. The ability of a screening test to identify correctly all screened individuals who actually have the disease refers to the test’s: [A] sensitivity.

[B] specificity.

[C] predictive value (−).

[D] predictive value (+). <Answer: A> <Complexity: Difficult> <A-head: Measures Used in Screening> <Subject: Chapter 9>

Multiple Choice 8. The ability of a test to identify only nondiseased individuals who actually do not have the disease refers to the test’s: [A] sensitivity.

[B] specificity.

[C] predictive value (−).

[D] predictive value (+). <Answer: B> <Complexity: Moderate> <A-head: Measures Used in Screening> <Subject: Chapter 9>

Multiple Choice 9. The ability of a measuring instrument to give consistent results in repeated trials is known as the instrument’s: [A] reliability.

[B] predictivity.

[C] specificity.

[D] sensitivity. <Answer: A> <Complexity: Moderate> <A-head: Measures Used in Screening> <Subject: Chapter 9>

Multiple Choice 10. A definitive diagnosis that has been determined by biopsy, surgery, autopsy, or other methods and has been accepted as the standard is known as: [A] predictive value (−).

[B] predictive value (+).

[C] gold standard.

[D] reliability. <Answer: C> <Complexity: Easy> <A-head: Measures Used in Screening> <Subject: Chapter 9>

Chapter 10 eBook Quiz

True/False 1. The host, agent, and environment make up the epidemiologic triangle. <Answer: True> <Complexity: Easy> <A-head: Epidemiologic Triangle> <Subject: Chapter 10>

True/False 2. In developed countries, chronic health problems have replaced infectious diseases as the leading killers during the past century. <Answer: True> <Complexity: Moderate> <A-head: Introduction> <Subject: Chapter 10>

True/False 3. Passive immunity is acquired from antibodies produced by another person or animal. <Answer: True> <Complexity: Moderate> <A-head: Host Characteristics> <Subject: Chapter 10>

Multiple Choice 4. The entry and development or multiplication of an infectious agent in the body of persons or animals is known as: [A] a host.

[B] an infection.

[C] an agent.

[D] None of these is correct. <Answer: B> <Complexity: Moderate> <A-head: Terms Used to Describe Infectious Diseases> <Subject: Chapter 10>

Multiple Choice 5. The severity of a disease produced by an infectious agent is referred to as: [A] infectivity.

[B] toxigenicity.

[C] virulence.

[D] None of these is correct.

<Answer: C> <Complexity: Moderate> <A-head: Infectious Disease Agents> <Subject: Chapter 10>

Multiple Choice 6. The first case of a disease to come to the attention of authorities is the: [A] host.

[B] index case.

[C] carrier.

[D] vector. <Answer: B> <Complexity: Moderate> <A-head: Host Characteristics> <Subject: Chapter 10>

Multiple Choice 7. The resistance of an entire community to an infectious agent as a result of the immunity of a large proportion of individuals in that community to the agent is known as: [A] passive immunity.

[B] herd immunity.

[C] active immunity.

[D] None of these is correct. <Answer: B> <Complexity: Moderate> <A-head: Host Characteristics> <Subject: Chapter 10>

Multiple Choice 8. The external environment comprises: [A] physical components.

[B] social components.

[C] economic components.

[D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: Environment and Infectious Diseases> <Subject: Chapter 10>

Multiple Choice 9. Portals of exit include: [A] respiratory passages.

[B] alimentary canal.

[C] skin lesions.

[D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: How Infectious Disease Agents Are Transmitted> <Subject: Chapter 10>

Multiple Choice 10. Examples of infections caused by indirect transmission of disease agents include: [A] vehicle-borne infections.

[B] airborne infections.

[C] vector-borne infections.

[D] All of these are correct. <Answer: D> <Subject: Chapter 10> <A-head: How Infectious Disease Agents Are Transmitted> <Complexity: Moderate>

Chapter 11 eBook Quiz

True/False 1. Stressful life events fall into domains such as health related, monetary, and employment associated. <Answer: True> <Complexity: Moderate> <A-head: Stress and Health> <Subject: Chapter 11>

True/False 2. For some people, stress may be a positive experience that provides challenges. <Answer: True> <Complexity: Moderate> <A-head: Stress and Health> <Subject: Chapter 11>

True/False 3. Children exposed to secondhand smoke have an increased risk for sudden infant death syndrome (SIDS). <Answer: True> <Complexity: Easy> <A-head: Tobacco Use> <Subject: Chapter 11>

True/False 4. Marijuana is the illicit drug that is used most commonly among all persons age 12 or older. <Answer: True> <Complexity: Moderate> <A-head: Substance Abuse> <Subject: Chapter 11>

Multiple Choice 5. The study of the social distribution of and social determinant of states of health is: [A] behavioral epidemiology.

[B] social epidemiology.

[C] cultural epidemiology.

[D] psychiatric epidemiology. <Answer: B> <Complexity: Moderate> <A-head: Defining Social and Behavioral Epidemiology> <Subject: Chapter 11>

Multiple Choice 6. The study of the roles of consumption of high-fat foods and sedentary lifestyle in health is the domain of: [A] behavioral epidemiology.

[B] social epidemiology.

[C] cultural epidemiology.

[D] psychiatric epidemiology. <Answer: A> <Complexity: Moderate> <A-head: Defining Social and Behavioral Epidemiology> <Subject: Chapter 11>

Multiple Choice 7. The choice of behavioral factors that affect how we live is known as: [A] chronic strains.

[B] social support.

[C] coping skills.

[D] lifestyle. <Answer: D> <Complexity: Moderate> <A-head: Defining Social and Behavioral Epidemiology> <Subject: Chapter 11>

Multiple Choice 8. A physical, chemical, or emotional factor that causes bodily or mental tension and may be a factor in disease causation is: [A] a negative life event.

[B] a positive life event.

[C] stress.

[D] a risk factor. <Answer: C> <Complexity: Moderate> <A-head: Stress and Health> <Subject: Chapter 11>

Multiple Choice 9. Which of the following health effects is studied in relation to stress?

[A] Substance abuse [B] Chronic diseases [C] Impaired immune function [D] All of these are correct. <Answer: D> <Complexity: Moderate>

<A-head: Stress and Health> <Subject: Chapter 11>

Multiple Choice 10. Techniques for managing or removing sources of stress are known as: [A] chronic strains.

[B] social support.

[C] coping skills.

[D] lifestyle. <Answer: C> <Complexity: Moderate> <A-head: Stress and Health> <Subject: Chapter 11>

Chapter 12 eBook Quiz

True/False 1. Molecular epidemiology uses molecular markers in addition to genes to establish exposure–disease relationships. <Answer: True> <Complexity: Moderate> <A-head: Molecular and Genetic Epidemiology> <Subject: Chapter 12>

True/False 2. Certain genes can be markers for susceptibility but do not confer risk on their own. <Answer: True> <Complexity: Moderate> <A-head: Molecular and Genetic Epidemiology> <Subject: Chapter 12>

True/False 3. Global warming is a controversial topic that refers to the gradual increase in the earth’s temperature over time. <Answer: True> <Complexity: Easy> <A-head: Environmental Epidemiology> <Subject: Chapter 12>

Multiple Choice 4. A host factor that enhances some step in the progression between exposure and disease such that the downstream step is more likely to occur is known as a: [A] genetic mutation.

[B] genetic marker of susceptibility.

[C] All of these are correct.

[D] None of these is correct. <Answer: B> <Complexity: Difficult> <A-head: Molecular and Genetic Epidemiology> <Subject: Chapter 12>

Multiple Choice 5. The identification of inherited factors that influence disease is a focus of: [A] molecular epidemiology.

[B] genetic epidemiology.

[C] both molecular and genetic epidemiology.

[D] the Human Genome Project. <Answer: B> <Complexity: Moderate> <A-head: Molecular and Genetic Epidemiology> <Subject: Chapter 12>

Multiple Choice 6. All except which of the following are examples of diseases known or believed to have a genetic basis?

[A] Hemophilia [B] Chlamydia [C] Down syndrome [D] Tay-Sachs disease <Answer: B> <Complexity: Moderate> <A-head: Molecular and Genetic Epidemiology> <Subject: Chapter 12>

Multiple Choice 7. Major structural birth defects are defined as conditions that: [A] result from a malformation, deformation, or disruption in one or more parts of the body.

[B] are present at birth.

[C] have a serious, adverse effect on health.

[D] All of these are correct. <Answer: D> <Complexity: Moderate> <A-head: Molecular and Genetic Epidemiology> <Subject: Chapter 12>

Multiple Choice 8. Environmental epidemiology includes the health effects of exposure to: [A] radiation.

[B] heavy metals.

[C] air pollution.

[D] All of these are correct. <Answer: D> <Complexity: Easy> <A-head: Environmental Epidemiology> <Subject: Chapter 12>

Multiple Choice 9. Air pollution is linked to which of the following consequences?

[A] Mortality [B] COPD (chronic obstructive pulmonary disease) [C] Mortality and COPD

[D] Obesity <Answer: C> <Complexity: Moderate> <A-head: Environmental Epidemiology> <Subject: Chapter 12>

Multiple Choice 10. The events that occurred in Donora, Pennsylvania (1948), and London, England (1952), were related to: [A] extreme air pollution episodes.

[B] an unintentional release of radiation.

[C] global warming.

[D] exposure to dioxins. <Answer: A> <Complexity: Moderate> <A-head: Environmental Epidemiology> <Subject: Chapter 12>

Import Settings: Base Settings: Brownstone Default Information Field: Complexity Information Field: Ahead Information Field: Subject Highest Answer Letter: D Multiple Keywords in Same Paragraph: No

Chapter: Final

Multiple Choice

1. Which of the following disease outbreaks occurred between 1346 and 1352 and claimed up to onethird of the population of Europe: A) Cholera epidemic B) Black Death C) Pandemic influenza D) Tuberculosis epidemic Ans: B Complexity: Moderate Ahead: History of Epidemiology and Development of Epidemiologic Principles Subject: Chapter 1

2. Operations research illustrates which of the following uses of epidemiology?

A) Historical use B) Community health use C) Risk assessment use D) Health services use Ans: D Complexity: Moderate Ahead: Brief Overview of Current Uses of Epidemiology Subject: Chapter 1

3. The probability that an event will occur—an individual will become ill or die within a stated period of time or by a certain age—is known as: A) risk factor.

B) risk assessment.

C) risk.

D) None of these is correct.

Ans: C Complexity: Moderate Ahead: Definition of Epidemiology Subject: Chapter 1

4. A type of correlative association between an exposure and an effect is a: A) negative relationship.

B) positive relationship.

C) dose-response relationship.

D) None of these is correct.

Ans: C Complexity: Moderate Ahead: Analyses of Bivariate Association Subject: Chapter 2

5. The lowest dose at which a particular response occurs is known as the: A) threshold.

B) mode.

C) epidemic curve.

D) None of these is correct.

Ans: A Complexity: Moderate Ahead: Analyses of Bivariate Association Subject: Chapter 2

6. The category in a frequency distribution that has the highest frequency of cases is known as the: A) threshold.

B) mode.

C) mean.

D) None of these is correct.

Ans: B Complexity: Moderate Ahead: Measures of Central Tendency Subject: Chapter 2

7. Examples of reportable and notifiable diseases include: A) tetanus.

B) rubella.

C) measles.

D) All of these are correct.

Ans: D Complexity: Easy Ahead: Data from Public Health Surveillance Programs: Three Examples Subject: Chapter 4

8. The purpose of state cancer registries is: A) surveillance.

B) to help set priorities.

C) to advance research.

D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Case Registries

Subject: Chapter 4

9. Studies of the effects of exposure to teratogens have used data from: A) death certificates.

B) birth certificates.

C) cancer registries.

D) None of these is correct.

Ans: B Complexity: Moderate Ahead: The Vital Registration System and Vital Events Subject: Chapter 4

10. Randomized controlled trials include: A) prophylactic trials.

B) therapeutic trials.

C) clinical trials.

D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Experimental Studies Subject: Chapter 7

11. Randomized controlled trials contain which of the following components?

A) Rigorous inclusion and exclusion criteria B) Blinding or masking to prevent bias C) Comparable measurement of outcomes in treatment and control conditions D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Experimental Studies Subject: Chapter 7

12. Which of the following involves the formal adoption of the policies, programs, and procedures that are designed to protect society from public health hazards?

A) Policy implementation B) Policy establishment C) Policy assessment D) Agenda setting Ans: B Complexity: Moderate Ahead: What Is a Health Policy?

Subject: Chapter 8

13. The likelihood of experiencing an adverse effect is called a: A) risk.

B) hazard.

C) dread.

D) None of these is correct.

Ans: A Complexity: Easy Ahead: Decision Analysis Based on Perceptions of Risks and Benefits Subject: Chapter 8

14. According to the natural history of disease model, the time before the precursors of disease and the host interact is called the period of: A) prepathogenesis.

B) pathogenesis.

C) primogenesis.

D) pathogenesis and primogenesis.

Ans: A Complexity: Moderate Ahead: Screening and the Natural History of Disease Subject: Chapter 9

15. Which form of prevention takes place after the precursors of disease interact with the host?

A) Tertiary B) Secondary C) Primary D) Tertiary and secondary Ans: D Complexity: Moderate Ahead: Screening and the Natural History of Disease Subject: Chapter 9

16. Which of the following screening tests is most appropriate for newborns?

A) Phenylketonuria B) Autism C) Cholesterol D) Colon cancer Ans: A Complexity: Moderate Ahead: Overview of Screening Subject: Chapter 9

17. The lifetime prevalence of major depressive episodes among U.S. adults age 17 to 39 years is: A) 6% among men and 11% among women.

B) 11% among men and 6% among women.

C) higher among women than among men.

D) 6% among men and 11% among women and higher among women than among men.

Ans: D Complexity: Moderate Ahead: Psychiatric Epidemiology and Mental Health Subject: Chapter 11

18. An anxiety disorder that some people develop after seeing or living through an event that caused or threatened serious harm or death is known as: A) autism.

B) posttraumatic stress disorder.

C) major depressive disorder.

D) bipolar disorder.

Ans: B Complexity: Easy Ahead: Stress and Health Subject: Chapter 11

19. A condition that impairs functioning in the social, communication, and behavioral domains is known as: A) autism.

B) posttraumatic stress disorder.

C) chronic strain.

D) psychiatric comorbidity.

Ans: A Complexity: Moderate Ahead: Psychiatric Epidemiology and Mental Health Subject: Chapter 11

20. Mood disorders include which of the following?

A) Dysthymia B) Any bipolar disorder C) Major depressive episode D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Psychiatric Epidemiology and Mental Health Subject: Chapter 11

21. The co-occurrence of two or more mental disorders is known as: A) autism.

B) dysthymia.

C) psychiatric comorbidity.

D) None of these is correct.

Ans: C Complexity: Moderate Ahead: Psychiatric Epidemiology and Mental Health Subject: Chapter 11

22. Who was the physician who determined that a human disease was caused by a specific living organism and then developed four postulates to demonstrate the association between a microorganism and a disease?

A) William Farr

B) John Snow C) Edward Jenner D) Robert Koch Ans: D Complexity: Moderate Ahead: History of Epidemiology and Development of Epidemiologic Principles Subject: Chapter 1

23. Whose name is associated with a natural experiment carried out during an outbreak of cholera in London?

A) Edward Jenner B) John Snow C) William Farr D) Robert Koch Ans: B Complexity: Moderate Ahead: History of Epidemiology and Development of Epidemiologic Principles Subject: Chapter 1

True/False

1. True or False? Age is the least variable person variable.

Ans: False Complexity: Moderate Ahead: Person Variables Subject: Chapter 5

2. True or False? Clustering can be spatial or temporal.

Ans: True Complexity: Moderate Ahead: Time Variables Subject: Chapter 5

3. True or False? Determining whether a particular exposure to a disease is related to a given outcome should involve formulating a hypothesis.

Ans: True Complexity: Moderate Ahead: Epidemiologic Research and the Search for Associations Subject: Chapter 6

4. True or False? An association between an exposure factor and an outcome could be direct or noncausal.

Ans: True Complexity: Difficult

Ahead: Types of Associations Found among Variables Subject: Chapter 6

5. True or False? The odds ratio is a direct measure of risk.

Ans: False Complexity: Moderate Ahead: Case-Control Studies Subject: Chapter 7

6. True or False? Virulence is a measure of the infectivity of a disease agent.

Ans: False Complexity: Moderate Ahead: Infectious Disease Agents Subject: Chapter 10

7. True or False? An antigen contains dead microbial agents.

Ans: False Complexity: Moderate Ahead: Host Characteristics Subject: Chapter 10

8. True or False? Droplet nuclei can be involved in indirect transmission of diseases.

Ans: True Complexity: Moderate Ahead: How Infectious Disease Agents Are Transmitted Subject: Chapter 10

9. True or False? The Centers for Disease Control and Prevention classifies tularemia and Ebola as category A bioterrorism agents.

Ans: True Complexity: Moderate Ahead: Examples of Significant Infectious Diseases Subject: Chapter 10

10. True or False? Stressful life events can be classified as either positive or negative.

Ans: True Complexity: Easy Ahead: Stress and Health Subject: Chapter 11

11. True or False? Chronic strains are life events that are sustained over a long period of time.

Ans: True

Complexity: Easy Ahead: Stress and Health Subject: Chapter 11

12. True or False? Social support refers to help received from other people when one is under stress.

Ans: True Complexity: Easy Ahead: Defining Social and Behavioral Epidemiology Subject: Chapter 11

13. True or False? Posttraumatic stress disorder among veterans is linked with increased levels of both health problems and healthcare utilization.

Ans: True Complexity: Moderate Ahead: Stress and Health Subject: Chapter 11

14. True or False? In the United States (2006), 94% of the category of nonfatal occupational injury and illness consisted of injuries.

Ans: True Complexity: Moderate Ahead: Epidemiology and Occupational Health Subject: Chapter 12

15. True or False? Sewage epidemiology monitors levels of excreted drugs in the sewer system in order to assess the level of illicit drug use in a community.

Ans: True Complexity: Moderate Ahead: Other Applications of Epidemiology Subject: Chapter 12

Essay

1. Define and compare the following measures: infant mortality rate, fetal death rate, and perinatal mortality rate.

Ans: Answers will vary Complexity: Moderate Ahead: Measures of Natality and Mortality Linked to Natality Subject: Chapter 3

2. Give an example of a hypothetical ecologic study. Name and describe one advantage and one disadvantage of ecologic studies.

Ans: Answers will vary Complexity: Moderate Ahead: Ecologic Studies Subject: Chapter 7

3. Describe, briefly, the challenges to the validity of study designs; relate these challenges to case-control studies, cohort studies, and randomized controlled trials.

Ans: Answers will vary Complexity: Difficult Ahead: Challenges to the Validity of Study Designs Subject: Chapter 7

4. In a few lines, compare and contrast internal validity and external validity. Be sure to define these terms and give one example of each.

Ans: Answers will vary Complexity: Difficult Ahead: Challenges to the Validity of Study Designs Subject: Chapter 7

5. Do you have a smoke-free bars law in your community? What considerations led to the development of such laws in communities that have adopted them? What are three policy implications of smoke-free bars laws?

Ans: Answers will vary Complexity: Difficult Ahead: Examples of Public Health Policies and Laws Subject: Chapter 8

6. Explain what is meant by the risk management component of risk assessment. From your own experience, discuss how risk management applies to the regulation of pesticides for home use.

Ans: Answers will vary Complexity: Difficult Ahead: Decision Analysis Based on Perceptions of Risks and Benefits Subject: Chapter 8

7. Describe the Tuskegee Study and discuss two ethical violations that occurred. How might current ethics guidelines for epidemiologists reduce the possibility of such violations?

Ans: Answers will vary Complexity: Difficult Ahead: Ethics and Epidemiology Subject: Chapter 8

8. Give one example each of primary, secondary, and tertiary prevention of motor vehicle crashes among teenage drivers.

Ans: Answers will vary

Complexity: Moderate Ahead: Screening and the Natural History of Disease Subject: Chapter 9

9. Give one argument for and one argument against the proposition that vaccine-preventable diseases represent a diminished hazard to society.

Ans: Answers will vary Complexity: Difficult Ahead: Examples of Significant Infectious Diseases Subject: Chapter 10

10. Explain the trends of obesity in the United States over time. Compare the trends among children and teenagers versus adults.

Ans: Answers will vary Complexity: Moderate Ahead: Overweight and Obesity Subject: Chapter 11

11. What is the triad of disorders reported for children with severe emotional or behavioral difficulties?

Discuss the implications of these disorders for the social functioning of children.

Ans: Answers will vary Complexity: Difficult Ahead: Psychiatric Epidemiology and Mental Health Subject: Chapter 11

12. Describe two epidemiologic characteristics that are associated with Down syndrome. In your own opinion and in light of these epidemiologic associations, what preventive measures could be taken?

Ans: Answers will vary Complexity: Moderate Ahead: Molecular and Genetic Epidemiology Subject: Chapter 12

Import Settings: Base Settings: Brownstone Default Information Field: Complexity Information Field: Ahead Information Field: Subject Highest Answer Letter: D Multiple Keywords in Same Paragraph: No

Chapter: Midterm

Multiple Choice

1. Epidemiology searches for associations between exposures and: A) quantification.

B) determinants.

C) health outcomes.

D) All of these are correct.

Ans: C Complexity: Moderate Ahead: The Concept of an Epidemic Subject: Chapter 1

2. Specializations that contribute to epidemiology include: A) sociology.

B) history.

C) law.

D) All of these are correct.

Ans: D Complexity: Moderate Ahead: The Evolving Conception of Epidemiology as a Liberal Art Subject: Chapter 1

3. Who created a vaccine that provided immunity to smallpox?

A) Sir Percival Pott B) Edward Jenner C) Ramazzini D) John Snow Ans: B Complexity: Moderate Ahead: History of Epidemiology and Development of Epidemiologic Principles Subject: Chapter 1

4. Name the English anesthesiologist who linked cholera outbreaks to contaminated water and innovated several of the key epidemiologic methods that remain valid and in use today.

A) John Snow B) William Farr C) John Graunt D) Sir Percival Pott Ans: A Complexity: Moderate Ahead: History of Epidemiology and Development of Epidemiologic Principles Subject: Chapter 1

5. Name the ancient Greek who contributed to epidemiology by departing from superstitious reasons for disease outbreaks.

A) Aristotle B) Hippocrates C) Paracelsus D) Ramazzini Answer: B Complexity: Moderate Ahead: History of Epidemiology and Development of Epidemiologic Principles Subject: Chapter 1

6. All of the following are measures of central tendency except: A) midrange.

B) median.

C) mean.

D) mode.

Answer: A Complexity: Moderate Ahead: Measures of Central Tendency Subject: Chapter 2

7. Calculate the standard deviation by using the deviation score method for the following information: {n = 10, Σ(X − X̅)2 = 144}.

A) 2.1 B) 3.3 C) 4.0 D) 3.8 Answer: C Complexity: Difficult Ahead: Measures of Variation Subject: Chapter 2

8. Calculate the median for the data set {99, 102, 110, 136, 509}.

A) 99 B) 110 C) 102 D) 136 Answer: B Complexity: Difficult

Ahead: Measures of Central Tendency Subject: Chapter 2

9. For a confidence interval (CI), how does increasing n affect the length of the interval?

A) When n increases, the CI narrows.

B) When n increases, the CI widens.

C) When n increases, the CI is less precise.

D) When n increases, the CI widens and is less precise.

Answer: A Complexity: Difficult Ahead: Parameter Estimation Subject: Chapter 2

10. What is the range of the data set {55, 21, 5, 30, 7, 600, 31, 21}?

A) 86 B) 43 C) 595 D) 21 Answer: C Complexity: Moderate Ahead: Measures of Variation Subject: Chapter 2

11. When the value of one variable increases and the value of another variable decreases, what is the association?

A) Positive B) Negative C) Continuous D) None of these is correct.

Answer: B Complexity: Moderate Ahead: Analyses of Bivariate Association Subject: Chapter 2

12. A graphic plotting of the distribution of cases by time of onset is a(n): A) dose-response curve.

B) epidemic curve.

C) multimodal curve.

D) threshold curve.

Answer: B Complexity: Moderate Ahead: Distribution Curves Subject: Chapter 2

13. When the value of one variable increases and the value of a second variable increases, what is the association?

A) Negative B) Nonlinear C) Curvilinear D) Positive Answer: D Complexity: Moderate Ahead: Analyses of Bivariate Association Subject: Chapter 2

14. When the incidence rate of a disease increases, the prevalence will: A) increase.

B) decrease.

C) remain the same.

D) None of these is correct.

Ans: A Complexity: Easy Ahead: Types of Epidemiologic Measures Subject: Chapter 3

15. Prevalence measures do not aid in: A) assessing variations in disease occurrence.

B) the development of hypotheses.

C) determining the risk of disease.

D) describing the scope of health problems.

Ans: C Complexity: Moderate Ahead: Types of Epidemiologic Measures Subject: Chapter 3

16. Which factors can decrease an observed prevalence?

A) Decrease in incidence B) Better reporting of diagnoses C) Improved cure rates of disease D) A decrease in incidence and improved cure rates of the disease Ans: D Complexity: Moderate Ahead: Types of Epidemiologic Measures Subject: Chapter 3

17. The number of deaths due to a disease that occur among persons who are afflicted with the disease is known as the: A) crude death rate.

B) case-fatality rate.

C) cause-specific rate.

D) None of these is correct.

Ans: B Complexity: Moderate Ahead: Epidemiologic Measures Related to Mortality

Subject: Chapter 3

18. If A equals the number of deaths in 2009, B equals the population at the midpoint of 2009, and C equals the number of persons ages 15 to 24, what would be the crude death rate per 100,000 population?

A) (A/B) × 100,000 B) (C/B) × 100,000 C) (B/A) × 100,000 D) (B/C) × 100,000 Ans: A Complexity: Difficult Ahead: Epidemiologic Measures Related to Mortality Subject: Chapter 3

19. The number of live births during a specified period, such as a year, per the resident population during the midpoint of the year is the: A) crude birth rate.

B) general fertility rate.

C) perinatal fertility rate.

D) fetal mortality rate.

Ans: A Complexity: Moderate Ahead: Epidemiologic Measures Related to Mortality Subject: Chapter 3

20. A centralized database for collection of information about diseases such as cancer is known as a: A) census archives.

B) registry.

C) syndromic surveillance system.

D) None of these is correct.

Ans: B Complexity: Moderate Ahead: Case Registries Subject: Chapter 4

21. At the top of the asthma surveillance pyramid is: A) hospitalization.

B) scheduled office visits.

C) mortality.

D) triggers.

Ans: C Complexity: Moderate Ahead: Data from Public Health Surveillance Programs: Three Examples Subject: Chapter 4

22. A limitation of clinical data for epidemiologic research is:

A) incomplete population coverage.

B) highly selective nature of the data.

C) limited availability of the data.

D) All of these are correct.

Ans: D Complexity: Moderate Ahead: Miscellaneous Data Sources Subject: Chapter 4

23. Which term indicates cases of disease that occur in a specific geographic region?

A) Spatial clustering B) Temporal clustering C) Both spacial clustering and temporal clustering D) None of these is correct.

Ans: A Complexity: Moderate Ahead: Time Variables Subject: Chapter 5

24. Health events that are related in time reflect: A) spatial clustering.

B) temporal clustering.

C) both spacial clustering and temporal clustering.

D) None of these is correct.

Ans: B Complexity: Easy Ahead: Time Variables Subject: Chapter 5

25. The ability of a study to demonstrate an association if one exists is known as: A) inference.

B) quantification.

C) power.

D) estimation.

Ans: C Complexity: Moderate Ahead: Defining the Role of Chance in Associations Subject: Chapter 6

26. The example of polio and spongy tar demonstrated: A) a causal association, indirect.

B) a causal association, direct.

C) an association, inverse.

D) an association, spurious.

Ans: D Complexity: Moderate Ahead: Types of Associations Found among Variables Subject: Chapter 6

27. Coronary heart disease is an example of a disease that illustrates: A) necessary and sufficient causality.

B) neither necessary nor sufficient causality.

C) sufficient but not necessary causality.

D) necessary but not sufficient causality.

Ans: B Complexity: Moderate Ahead: Deterministic and Probabilistic Causality in Epidemiology Subject: Chapter 6

True/False

1. True or False? The term epidemiologic transition describes a shift in the patterns of morbidity and mortality from causes related primarily to infectious diseases to causes associated with chronic diseases.

Ans: True Complexity: Moderate Ahead: Brief Overview of Current Uses of Epidemiology Subject: Chapter 1

2. True or False? Contact with a disease-causing factor or the amount of the factor that affects a group of individuals is referred to as exposure.

Ans: True Complexity: Easy Ahead: Definition of Epidemiology Subject: Chapter 1

3. True or False? Descriptive epidemiology refers to studies that are concerned with characterizing the amount and distribution of health and disease within a population.

Ans: True Complexity: Moderate Ahead: Application of Descriptive and Analytic Methods to an Observational Science Subject: Chapter 1

4. True or False? Robert Koch developed four postulates to demonstrate the association between a microorganism and a disease.

Ans: True Complexity: Moderate Ahead: History of Epidemiology and Development of Epidemiologic Principles Subject: Chapter 1

5. True or False? Working during the Renaissance, Paracelsus was one of the founders of the field of toxicology.

Ans: True Complexity: Moderate Ahead: History of Epidemiology and Development of Epidemiologic Principles Subject: Chapter 1

6. True or False? Three factors that affect the quality of epidemiologic data are availability, completeness, and the nature of the data.

Ans: True Complexity: Moderate Ahead: Factors That Affect the Quality of Epidemiologic Data Subject: Chapter 4

7. True or False? The three Vs of big data are volume, variety, and velocity.

Ans: True Complexity: Moderate Ahead: Epidemiology in the Era of Big Data Subject: Chapter 4

8. True or False? Data mining involves gathering and exploring large troves of data.

Ans: True Complexity: Easy Ahead: Epidemiology in the Era of Big Data Subject: Chapter 4

9. True or False? Disease surveillance can be conducted only with infectious diseases.

Ans: False Complexity: Moderate Ahead: Data from Public Health Surveillance Programs: Three Examples Subject: Chapter 4

10. True or False? Measuring suicide trends in a population over a 3-month period is an example of a secular trend.

Ans: False Complexity: Moderate Ahead: Time Variables Subject: Chapter 5

11. True or False? Cross-sectional studies are the most basic type of descriptive study.

Ans: False Complexity: Moderate Ahead: Types of Descriptive Epidemiologic Studies Subject: Chapter 5

12. True or False? An age-adjusted male to female death-rate ratio of 1.4 to 1 means that males have a higher mortality rate than females.

Ans: True Complexity: Difficult Ahead: Person Variables Subject: Chapter 5

13. True or False? John Snow proposed that the miasma theory accounted for the cholera epidemic during the 1880s.

Ans: False Complexity: Moderate Ahead: Disease Causality in History Subject: Chapter 6

14. True or False? A stochastic causality model is also called a probabilistic causality model.

Ans: True Complexity: Moderate Ahead: Deterministic and Probabilistic Causality Subject: Chapter 6

15. True or False? An association between the number of cigarettes smoked and the rate of lung cancer deaths is an example of a biological gradient.

Ans: True Complexity: Easy Ahead: The Criteria of Causality Subject: Chapter 6

Essay

1. Discuss the differences among rates, proportions, and percentages.

Ans: Answers will vary Complexity: Difficult Ahead: Mathematical Terms Used in Epidemiology Subject: Chapter 3

2. Distinguish among crude rates, specific rates, and adjusted rates. Name one advantage of using specific rates over crude rates.

Ans: Answers will vary Complexity: Difficult Ahead: Epidemiologic Measures Related to Mortality Subject: Chapter 3

3. Describe an appropriate use for each of the following data sources: surveillance systems, reportable and notifiable disease statistics, and death certificate data.

Ans: Answers will vary Complexity: Difficult Ahead: Data from Public Health Surveillance Programs: Three Examples Subject: Chapter 4

4. Define the term cross-sectional study, indicating the appropriate uses of such studies.

Ans: Answers will vary Complexity: Moderate Ahead: Types of Descriptive Epidemiologic Studies Subject: Chapter 5

5. Explain two factors that relate to urban versus rural variations in morbidity and mortality in the United States. What are three interventions that could be introduced to improve the health of rural residents?

Ans: Answers will vary Complexity: Difficult Ahead: Place Variables Subject: Chapter 5

6. In few sentences, describe the relationship between socioeconomic status and health disparities, giving an example. Be sure to define the terms socioeconomic status and health disparities.

Ans: Answers will vary Complexity: Difficult Ahead: Person Variables Subject: Chapter 5

7. Explain what is meant by the cycle of epidemiologic research. Identify three components of the cycle.

Apply the cycle to a hypothetical research project that would examine teenage binge drinking.

Ans: Answers will vary Complexity: Difficult Ahead: Epidemiologic Research and the Search for Associations Subject: Chapter 6

8. Draw a diagram that shows the web of causation for coronary heart disease. List at least five hypothetical causal factors and describe their interrelationships.

Ans: Answers will vary Complexity: Difficult Ahead: Epidemiologic Research and the Search for Associations Subject: Chapter 6