Epidemiology

Description

Masters Degree Epidemiology Quiz on Epidemiology, created by Maria Margarita Samson on 01/12/2017.
Maria Margarita Samson
Quiz by Maria Margarita Samson, updated more than 1 year ago
Maria Margarita Samson
Created by Maria Margarita Samson over 6 years ago
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Resource summary

Question 1

Question
In the definition of epidemiology, "distribution" refers to EXCEPT:
Answer
  • Who
  • When
  • Where
  • Why

Question 2

Question
In the definition of epidemiology, "determinants" generally includes EXCEPT:
Answer
  • Agents
  • Causes
  • Control measures
  • Risk factors
  • Sources

Question 3

Question
Epidemiology, as defined in this lesson, would NOT include which of the following activities?
Answer
  • Describing the demographic characteristics of persons with acute aflatoxin poisoning in District A
  • Prescribing an antibiotic to treat a patient with community-acquired methicillin-resistantStaphylococcus aureus infection
  • Comparing the family history, amount of exercise, and eating habits of those with and without newly diagnosed diabetes
  • Recommending that a restaurant be closed after implicating it as the source of a hepatitis A outbreak

Question 4

Question
John Snow's investigation of cholera is considered a model for epidemiologic field investigations because it includes the following EXCEPT:
Answer
  • Biologically plausible hypothesis
  • Comparison of a health outcome among exposed and unexposed groups
  • Multivariate statistical model
  • Spot map
  • Recommendation for public health action

Question 5

Question
Public health surveillance does NOT include which of the following activity:
Answer
  • Diagnosing whether a case of encephalitis is actually due to West Nile virus infection
  • Soliciting case reports of persons with symptoms compatible with SARs from local hospitals
  • Creating graphs of the number of dog bites by week and neighborhood
  • Writing a report on trends in seat belt use to share with the state legislature
  • All of the above
  • None of the above

Question 6

Question
The hallmark feature of an analytic epidemiologic study is:
Answer
  • Use of an appropriate comparison group
  • Laboratory confirmation of the diagnosis
  • Publication in a peer-reviewed journal
  • Statistical analysis using logistic regression

Question 7

Question
A number of passengers on a cruise ship from Puerto Rico to the Panama Canal have recently developed a gastrointestinal illness compatible with norovirus (formerly called Norwalk-like virus). Testing for norovirus is not readily available in any nearby island, and the test takes several days even where available. Assuming you are the epidemiologist called on to board the ship and investigate this possible outbreak, your case definition should include, at a minimum:
Answer
  • Clinical criteria, plus specification of time, place, and person
  • Clinical features, plus the exposure(s) you most suspect
  • Suspect cases
  • The nationally agreed standard case definition for disease reporting

Question 8

Question
Compare food histories between persons with Staphylococcus food poisoning and those without
Answer
  • Distribution
  • Determinants
  • Application

Question 9

Question
Compare frequency of brain cancer among anatomists with frequency in general population
Answer
  • Distribution
  • Determinants
  • Application

Question 10

Question
Mark on a map the residences of all children born with birth defects within 2 miles of a hazardous waste site
Answer
  • Distribution
  • Determinants
  • Application

Question 11

Question
Graph the number of cases of congenital syphilis by year for the country
Answer
  • Distribution
  • Determinants
  • Application

Question 12

Question
Recommend that close contacts of a child recently reported with meningococcal meningitis receive Rifampin
Answer
  • Distribution
  • Determinants
  • Application

Question 13

Question
Tabulate the frequency of clinical signs, symptoms, and laboratory findings among children with chickenpox in Cincinnati, Ohio
Answer
  • Distribution
  • Determinants
  • Application

Question 14

Question
Essay entitled “On Airs, Waters, and Places,” suggested that environmental and host factors such as behaviors
Answer
  • Hippocrates
  • John Graunt
  • John Snow

Question 15

Question
first to quantify patterns of birth, death, and disease occurrence, noting disparities between males and females, high infant mortality, urban/rural differences, and seasonal variations
Answer
  • John Graunt
  • John Snow
  • William Farr

Question 16

Question
Father of modern vital statistics and surveillance
Answer
  • William Farr
  • John Snow
  • John Graunt

Question 17

Question
Father of field epidemiology
Answer
  • John Graunt
  • John Snow
  • William Farr

Question 18

Question
Study linking lung cancer to smoking
Answer
  • Doll and Hill
  • John Snow
  • Kannel

Question 19

Question
Reviewing reports of test results for Chlamydia trachomatis from public health clinics
Answer
  • Public health surveillance
  • Field investigation
  • Analytic studies
  • Evaluation
  • Linkages
  • Policy development

Question 20

Question
Meeting with directors of family planning clinics and college health clinics to discuss Chlamydia testing and reporting
Answer
  • Public health surveillance
  • Analytic studies
  • Evaluation
  • Field investigation
  • Linkages
  • Policy development

Question 21

Question
Developing guidelines/criteria about which patients coming to the clinic should be screened (tested) for Chlamydia infection
Answer
  • Public health surveillance
  • Field investigation
  • Analytic studies
  • Evaluation
  • Linkages
  • Policy development

Question 22

Question
Interviewing persons infected with Chlamydia to identify their sex partners
Answer
  • Public health surveillance
  • Field investigation
  • Analytic studies
  • Evaluation
  • Linkages
  • Policy development

Question 23

Question
Conducting an analysis of patient flow at the public health clinic to determine waiting times for clinic patients
Answer
  • Public health surveillance
  • Analytic studies
  • Evaluation
  • Linkages
  • Policy development
  • Field investigation

Question 24

Question
Comparing persons with symptomatic versus asymptomatic Chlamydia infection to identify predictors
Answer
  • Public health surveillance
  • Field investigation
  • Evaluation
  • Linkages
  • Policy development
  • Analytic studies

Question 25

Question
Comparing numbers and rates of illness in a community, rates are preferred for
Answer
  • Conducting surveillance for communicable diseases
  • Deciding how many doses of immune globulin are needed
  • Estimating subgroups at highest risk
  • Telling physicians which strain of influenza is most prevalent

Question 26

Question
For the cruise ship scenario described in Question 7, how would you display the time course of the outbreak?
Answer
  • Endemic curve
  • Epidemic curve
  • Seasonal trend
  • Secular trend

Question 27

Question
For the cruise ship scenario described in Question 7, if you suspected that the norovirus may have been transmitted by ice made or served aboard ship, how might you NOT display "place"?
Answer
  • Spot map by assigned dinner seating location
  • Spot map by cabin
  • Shaded map of United States by state of residence
  • Shaded map by whether passenger consumed ship's ice or no

Question 28

Question
Which variables might you include in characterizing the outbreak described in Question 7 by person?
Answer
  • Age of passenger
  • Detailed food history (what person ate) while aboard ship
  • Status as passenger or crew
  • Symptoms

Question 29

Question
When analyzing surveillance data by age, which of the following age groups is preferred?
Answer
  • 1-year age groups
  • 5-year age groups
  • 10-year age groups
  • Depends on the disease

Question 30

Question
A study in which children are randomly assigned to receive either a newly formulated vaccine or the currently available vaccine, and are followed to monitor for side effects and effectiveness of each vaccine, is an example of which type of study?
Answer
  • Cohort
  • Case-control
  • Clinical trial
  • Cross Sectional

Question 31

Question
The Iowa Women's Health Study, in which researchers enrolled 41,837 women in 1986 and collected exposure and lifestyle information to assess the relationship between these factors and subsequent occurrence of cancer, is an example of which type(s) of study?
Answer
  • Cohort
  • Case-control
  • Clinical trial
  • Cross Sectional

Question 32

Question
British investigators conducted a study to compare measles-mumps-rubella (MMR) vaccine history among 1,294 children with pervasive development disorder (e.g., autism and Asperger's syndrome) and 4,469 children without such disorders. (They found no association.) This is an example of which type(s) of study?
Answer
  • Cohort
  • Case-control
  • Clinical trial
  • Cross Sectional

Question 33

Question
A cohort study differs from a case-control study in that:
Answer
  • Subjects are enrolled or categorized on the basis of their exposure status in a cohort study but not in a case-control study
  • Subjects are asked about their exposure status in a cohort study but not in a case-control study
  • Cohort studies require many years to conduct, but case-control studies do not
  • Cohort studies are conducted to investigate chronic diseases, case-control studies are used for infectious diseases

Question 34

Question
A key feature of a cross-sectional study EXCEPT:
Answer
  • It usually provides information on prevalence rather than incidence
  • It is limited to health exposures and behaviors rather than health outcomes
  • It is more useful for descriptive epidemiology than it is for analytic epidemiology
  • It is synonymous with survey

Question 35

Question
The epidemiologic triad of disease causation refers to
Answer
  • Agent, host, environment
  • Time, place, person
  • Source, mode of transmission, susceptible host
  • John Snow, Robert Koch, Kenneth Rothman

Question 36

Question
For each of the following, identify the appropriate letter from the time line in Figure 1.27 representing the natural history of disease.
Answer
  • Onset of symptoms
  • Usual time of diagnosis
  • Exposure
  • Latency Period

Question 37

Question
For each of the following, identify the appropriate letter from the time line in Figure 1.27 representing the natural history of disease.
Answer
  • Exposure
  • Onset of symptoms
  • Pathologic Changes
  • Usual Time of Diagnosis

Question 38

Question
For each of the following, identify the appropriate letter from the time line in Figure 1.27 representing the natural history of disease.
Answer
  • Exposure
  • Onset of symptoms
  • Usual Time of Diagnosis
  • Pathologic Changes

Question 39

Question
For each of the following, identify the appropriate letter from the time line in Figure 1.27 representing the natural history of disease.
Answer
  • Exposure
  • Onset of symptoms
  • Usual Time of Diagnosis
  • Pathologic Changes

Question 40

Question
A reservoir of an infectious agent can be:
Answer
  • An asymptomatic human
  • A symptomatic human
  • An animal
  • The environment
  • All of the above

Question 41

Question
Indirect transmission includes which of the following EXCEPT?
Answer
  • Droplet spread
  • Mosquito-borne
  • Foodborne
  • Doorknobs or toilet seats

Question 42

Question
Disease control measures are generally directed at which of the followingEXXCEPT ?
Answer
  • Eliminating the reservoir
  • Eliminating the vector
  • Eliminating the host
  • Interrupting mode of transmission
  • Reducing host susceptibility

Question 43

Question
Disease 1: usually 40–50 cases per week; last week, 48 cases
Answer
  • Endemic
  • Outbreak
  • Pandemic
  • Sporadic

Question 44

Question
Disease 2: fewer than 10 cases per year; last week, 1 case
Answer
  • Endemic
  • Outbreak
  • Pandemic
  • Sporadic

Question 45

Question
Disease 3: usually no more than 2–4 cases per week; last week, 13 cases
Answer
  • Endemic
  • Outbreak
  • Pandemic
  • Sporadic

Question 46

Question
A propagated epidemic is usually the result of what type of exposure?
Answer
  • Point source
  • Continuous common source
  • Intermittent common source
  • Person-to-person

Question 47

Question
Which of the following are frequency measures?
Answer
  • Birth rate
  • Incidence
  • Mortality rate
  • Prevalence

Question 48

Question
In a state that did not require varicella (chickenpox) vaccination, a boarding school experienced a prolonged outbreak of varicella among its students that began in September and continued through December. To calculate the probability or risk of illness among the students, which denominator would you use?
Answer
  • Number of susceptible students at the ending of the period (i.e., June)
  • Number of susceptible students at the midpoint of the period (late October/early November)
  • Number of susceptible students at the beginning of the period (i.e., September)
  • Average number of susceptible students during outbreak

Question 49

Question
All proportions are ratios, but not all ratios are proportions.
Answer
  • True
  • False

Question 50

Question
Many of the students at the boarding school, including 6 just coming down with varicella, went home during the Thanksgiving break. About 2 weeks later, 4 siblings of these 6 students (out of a total of 10 siblings) developed varicella. The secondary attack rate among siblings was, therefore,:
Answer
  • 4 ⁄ 6
  • 4 ⁄ 10
  • 4 ⁄ 16
  • 6 ⁄ 10

Question 51

Question
Investigators enrolled 100 diabetics without eye disease in a cohort (follow-up) study. The results of the first 3 years were as follows: Year 1: 0 cases of eye disease detected out of 92; 8 lost to follow-up Year 2: 2 new cases of eye disease detected out of 80; 2 had died; 10 lost to follow-up Year 3: 3 new cases of eye disease detected out of 63; 2 more had died; 13 more lost to follow-up The person-time incidence rate is calculated as:
Answer
  • 5 ⁄ 100
  • 5 ⁄ 63
  • 5 ⁄ 235
  • 5 ⁄ 250

Question 52

Question
The units for the quantity you calculated in Question 8 could be expressed as:
Answer
  • cases per 100 persons
  • percent
  • cases per person-year
  • cases per person per year

Question 53

Question
Measure of risk
Answer
  • Incidence
  • Prevalence

Question 54

Question
Generally preferred for chronic diseases without clear date of onset
Answer
  • Incidence
  • Prevalence

Question 55

Question
Used in calculation of risk ratio
Answer
  • Incidence
  • Prevalence

Question 56

Question
Affected by duration of illness
Answer
  • Incidence
  • Prevalence

Question 57

Question
Use the following information for Questions 57–61. Within 10 days after attending a June wedding, an outbreak of cyclosporiasis occurred among attendees. Of the 83 guests and wedding party members, 79 were interviewed; 54 of the 79 met the case definition. The following two-by-two table shows consumption of wedding cake (that had raspberry filling) and illness status. Ate wedding cake? Ill Well Total Yes 50 3 53 No 4 22 26 Total 54 25 79 The fraction 54 ⁄ 79 is a/an:
Answer
  • Food-specific attack rate
  • Attack rate
  • Incidence proportion
  • Proportion

Question 58

Question
The fraction 50 ⁄ 54 is a/an:
Answer
  • Attack rate
  • Food-specific attack rate
  • Incidence proportion
  • Proportion

Question 59

Question
The fraction 50 ⁄ 53 is a/an:
Answer
  • Attack rate
  • Food-specific attack rate
  • Incidence proportion
  • Proportion

Question 60

Question
The best measure of association to use for these data is a/an:
Answer
  • Food-specific attack rate
  • Odds ratio
  • Rate ratio
  • Risk ratio

Question 61

Question
The best estimate of the association between wedding cake and illness is:
Answer
  • 6.1
  • 7.7
  • 68.4
  • 83.7
  • 91.7
  • 94.3

Question 62

Question
The attributable proportion for wedding cake is:
Answer
  • 6.1%
  • 7.7%
  • 68.4%
  • 83.7%
  • 91.7%
  • 94.3%

Question 63

Question
Use the following diagram for Questions 63 and 64. Assume that the horizontal lines in the diagram represent duration of illness in 8 different people, out of a community of 700. What is the prevalence of disease during July?
Answer
  • 3 ⁄ 700
  • 4 ⁄ 700
  • 5 ⁄ 700
  • 8 ⁄ 700

Question 64

Question
What is the incidence of disease during July?
Answer
  • 3 ⁄ 700
  • 4 ⁄ 700
  • 5 ⁄ 700
  • 8 ⁄ 700

Question 65

Question
Which of the following mortality rates use the estimated total mid-year population as its denominator?
Answer
  • Age-specific mortality rate
  • Sex-specific mortality rate
  • Crude mortality rate
  • Cause-specific mortality rate

Question 66

Question
Vaccine efficacy measures are:
Answer
  • The proportion of vaccinees who do not get the disease
  • 1 − the attack rate among vaccinees
  • The proportionate reduction in disease among vaccinees
  • 1 − disease attributable to the vaccine

Question 67

Question
To study the causes of an outbreak of aflatoxin poisoning in Africa, investigators conducted a case-control study with 40 case-patients and 80 controls. Among the 40 poisoning victims, 32 reported storing their maize inside rather than outside. Among the 80 controls, 20 stored their maize inside. The resulting odds ratio for the association between inside storage of maize and illness is:
Answer
  • 3.2
  • 5.2
  • 12.0
  • 33.3

Question 68

Question
The crude mortality rate in Community A was higher than the crude mortality rate in Community B, but the age-adjusted mortality rate was higher in Community B than in Community A. This indicates that:
Answer
  • Investigators made a calculation error
  • No inferences can be made about the comparative age of the populations from these data
  • The population of Community A is, on average, older than that of Community B
  • The population of Community B is, on average, older than that of Community A

Question 69

Question
public health surveillance includes which activities EXCEPT?
Answer
  • Data collection.
  • Data analysis.
  • Data interpretation.
  • Data dissemination.
  • Disease control.

Question 70

Question
Current public health surveillance targets which of the following?
Answer
  • Chronic diseases.
  • Communicable diseases.
  • Health-related behaviors.
  • Occupational hazards.
  • Presence of viruses in mosquitoes.
  • All of the above

Question 71

Question
Public health surveillance can be described primarily as which of the following?
Answer
  • A method to monitor occurrences of public health problems.
  • A program to control disease outbreaks.
  • A system for collecting health-related information.
  • A system for monitoring persons who have been exposed to a communicable disease.

Question 72

Question
Public health surveillance is only conducted by public health agencies.
Answer
  • True
  • False

Question 73

Question
Common uses and applications of public health surveillance include which of the following?
Answer
  • Detecting individual persons with malaria so that they can receive prompt and appropriate treatment.
  • Helping public health officials decide how to allocate their disease control resources.
  • Identifying changes over time in the proportion of children with elevated blood lead levels in a community.
  • Documenting changes in the incidence of varicella (chickenpox), if any, after a law requiring varicella vaccination took effect.
  • All of the above

Question 74

Question
Data collected through which of the following methods is NOT commonly used for surveillance?
Answer
  • Vital registration.
  • Randomized clinical trials.
  • Disease notifications.
  • Population surveys.

Question 75

Question
Health-care providers might be important sources of surveillance data used by public health officials, and they should receive feedback to close the surveillance loop as a courtesy; however, the results almost never have any relevance to patient care provided by those health-care providers.
Answer
  • True
  • False

Question 76

Question
Vital statistics are important sources of data on which of the following?
Answer
  • Morbidity.
  • Mortality.
  • Health-related behaviors.
  • Injury and disability.
  • Outpatient health-care usage.

Question 77

Question
Vital statistics provide an archive of certain health data. These data do not become surveillance data until they are analyzed, interpreted, and disseminated with the intent of influencing public health decision-making or action.
Answer
  • True
  • False

Question 78

Question
Key sources of morbidity data include which of the following EXCEPT?
Answer
  • Environmental monitoring data.
  • Hospital discharge data.
  • Laboratory results.
  • Notifiable disease reports.

Question 79

Question
Notifiable disease surveillance usually focuses on morbidity from the diseases on the list and does not cover mortality from those diseases.
Answer
  • True
  • False

Question 80

Question
The list of diseases that a physician must report to the local health department is typically compiled by the…
Answer
  • Local health department.
  • State health department.
  • Centers for Disease Control and Prevention (CDC).
  • Council of State and Territorial Epidemiologists (CSTE).
  • Medical licensing board.

Question 81

Question
A physician working in an emergency room in Town A, USA, has just examined a tourist from Southeast Asia with watery diarrhea. The physician suspects the man might have cholera. The physician should notify the …
Answer
  • Local (town or county) health agency.
  • State health department.
  • Centers for Disease Control and Prevention (CDC).
  • U.S. Department of State.
  • Washington, D.C., embassy of country of origin (ask for health attaché).

Question 82

Question
[blank_start]Notifiable disease surveillance[blank_end] State-based, with subsequent reporting to CDC.
Answer
  • Notifiable disease surveillance
  • Surveillance for consumer product-relate

Question 83

Question
[blank_start]Notifiable disease surveillance[blank_end]Focused on identifying individual cases.
Answer
  • Notifiable disease surveillance
  • Surveillance for consumer product-relate
  • Both.
  • Neither

Question 84

Question
[blank_start]Both[blank_end] Can monitor trends over time.
Answer
  • Both
  • Notifiable disease surveillance
  • Surveillance for consumer product-relate
  • Neither

Question 85

Question
Based on statistically valid sample.
Answer
  • Notifiable disease surveillance
  • Surveillance for consumer product-related injuries
  • Both.
  • Neither

Question 86

Question
Complete, unbiased reporting
Answer
  • Notifiable disease surveillance
  • Surveillance for consumer product-related injuries
  • Both.
  • Neither.

Question 87

Question
Evaluating and improving surveillance should address which of the following EXCEPT?
Answer
  • Purpose and objectives of surveillance.
  • Resources needed to conduct surveillance.
  • Effectiveness of measures for controlling the disease under surveillance.
  • Presence of characteristics of well-conducted surveillance.

Question 88

Question
Criteria for prioritizing health problems for surveillance include which of the following EXCEPT?
Answer
  • Incidence of the problem.
  • Public concern about the problem.
  • Number of previous studies of the problem.
  • Social and economic impact of the problem.

Question 89

Question
Watches for individual cases of disease of public health importance.
Answer
  • Surveillance based on a specific case definition for a disease (e.g., listeriosis).
  • Syndromic surveillance based on symptoms, signs, or other characteristics of a disease, rather than specific clinical or laboratory diagnostic criteria.
  • Both.
  • Neither

Question 90

Question
Watches for diseases that might be caused by acts of biologic or chemical terrorism.
Answer
  • Surveillance based on a specific case definition for a disease (e.g., listeriosis).
  • Syndromic surveillance based on symptoms, signs, or other characteristics of a disease, rather than specific clinical or laboratory diagnostic criteria.
  • Both.
  • Neither

Question 91

Question
Can watch for disease before a patient seeks care from a health-care provider.
Answer
  • Surveillance based on a specific case definition for a disease (e.g., listeriosis).
  • Syndromic surveillance based on symptoms, signs, or other characteristics of a disease, rather than specific clinical or laboratory diagnostic criteria.
  • Both.
  • Neither

Question 92

Question
Requires little effort on the part of the health department.
Answer
  • Surveillance based on a specific case definition for a disease (e.g., listeriosis).
  • Syndromic surveillance based on symptoms, signs, or other characteristics of a disease, rather than specific clinical or laboratory diagnostic criteria.
  • Both
  • Neither

Question 93

Question
Routine analysis of notifiable disease surveillance data at the state health department might NOT include looking at the number of cases of a disease reported this week …
Answer
  • and during the previous 2–4 weeks.
  • and the number reported during the comparable weeks of the previous 2–5 years.
  • simultaneously by age, race, and sex of the patient.
  • by county.
  • by county, divided by each county's population (i.e., county rates).

Question 94

Question
One week, a state health department received substantially more case reports of a disease in one county than had been reported during the previous 2 weeks. No increase was reported in neighboring counties. Possible explanations for this increase include which of the following?
Answer
  • An outbreak in the county.
  • Batch reports.
  • Duplicate reports.
  • Increase in the county's population.
  • Laboratory error.
  • All of the above

Question 95

Question
The primary reason for preparing and distributing periodic surveillance summaries is which of the following?
Answer
  • Document recent epidemiologic investigations.
  • Provide timely information on disease patterns and trends to those who need to know it.
  • Provide reprints ofMMWR articles, reports, and recommendations.
  • Acknowledge the contributions of those who submitted case reports.

Question 96

Question
Surveillance detected 23 of 30 actual cases of a disease.
Answer
  • Predictive value positive.
  • Sensitivity.
  • Specificity.
  • Validity

Question 97

Question
Of 16 statistically significant aberrations (deviations from baseline) detected by syndromic surveillance, only one represented an actual outbreak of disease.
Answer
  • Predictive value positive.
  • Sensitivity.
  • Specificity.
  • Validity.

Question 98

Question
Underreporting is not a problem for detecting outbreaks of notifiable diseases because the proportion of cases reported tends to remain relatively stable over time.
Answer
  • True
  • False

Question 99

Question
Initiating surveillance for a public health problem or adding a disease to the notifiable disease list is justified for which of the following reason?
Answer
  • If it is a communicable disease with a high case-fatality rate.
  • If the problem is new and systematically collected data are needed to characterize the disease and its impact on the public.
  • If a program at CDC has recommended its addition to better understand national trends and patterns.
  • all of the above

Question 100

Question
The case definition used for surveillance of a health problem should be the same as the case definition used for clinical (treatment) purposes.
Answer
  • True
  • False

Question 101

Question
A state health department decides to strengthen its notifiable disease reporting. The one best action to take is to …
Answer
  • allow reporting through use of the Internet.
  • require more disease-specific forms from local health departments.
  • ensure that all persons with a responsibility to report understand the requirements and reasons for reporting and how reports will be used.
  • reduce the number of diseases on the list.

Question 102

Question
Which of the following best describes the similarities and differences in the three distributions shown in Figure 2.11?
Answer
  • Same mean, median, mode; different standard deviation
  • Same mean, median, mode; same standard deviation
  • Different mean, median, mode; different standard deviation
  • Different mean, median, mode; same standard deviation

Question 103

Question
Which of the following terms accurately describe the distribution shown in Figure 2.12?
Answer
  • Negatively skewed
  • Positively skewed
  • Symmetrical

Question 104

Question
What is the likely relationship between mean, median, and mode of the distribution shown in Figure 2.12?
Answer
  • Mean < median < mode
  • Mean = median = mode
  • Mean > median > mode
  • Mode < mean and median, but cannot tell relationship between mean and median

Question 105

Question
The mode is the value that:
Answer
  • Is midway between the lowest and highest value
  • Occurs most often
  • Has half the observations below it and half above it
  • Is statistically closest to all of the values in the distribution

Question 106

Question
The median is the value that:
Answer
  • Is midway between the lowest and highest value
  • Occurs most often
  • Has half the observations below it and half above it
  • Is statistically closest to all of the values in the distribution

Question 107

Question
Is statistically closest to all of the values in the distribution
Answer
  • Is midway between the lowest and highest value
  • Occurs most often
  • Has half the observations below it and half above it
  • Is statistically closest to all of the values in the distribution

Question 108

Question
The geometric mean is the value that:
Answer
  • Is midway between the lowest and highest value on a log scale
  • Occurs most often on a log scale
  • Has half the observations below it and half above it on a log scale
  • Is statistically closest to all of the values in the distribution on a log scale

Question 109

Question
In epidemiology, the measure of central location generally preferred for summarizing skewed data such as incubation periods is the:
Answer
  • Mean
  • Median
  • Midrange
  • Mode

Question 110

Question
The measure of central location generally preferred for additional statistical analysis is the:
Answer
  • Mean
  • Median
  • Midrange
  • Mode

Question 111

Question
Which of the following is NOT considered measures of spread?
Answer
  • Interquartile range
  • Percentile
  • Range
  • Standard deviation

Question 112

Question
The measure of spread most affected by one extreme value is the:
Answer
  • Interquartile range
  • Range
  • Standard deviation
  • Mean

Question 113

Question
The interquartile range covers what proportion of a distribution?
Answer
  • 25%
  • 50%
  • 75%
  • 100%

Question 114

Question
The measure of central location most commonly used with the interquartile range is the:
Answer
  • Arithmetic mean
  • Geometric mean
  • Median
  • Midrange
  • Mode

Question 115

Question
The measure of central location most commonly used with the standard deviation is the:
Answer
  • Arithmetic mean
  • Median
  • Midrange
  • Mode

Question 116

Question
The algebraic relationship between the variance and standard deviation is that:
Answer
  • The standard deviation is the square root of the variance
  • The variance is the square root of the standard deviation
  • The standard deviation is the variance divided by the square root of n
  • The variance is the standard deviation divided by the square root of n

Question 117

Question
Before calculating a standard deviation, one should ensure that:
Answer
  • The data are somewhat normally distributed
  • The total number of observations is at least 50
  • The variable is an interval-scale or ratio-scale variable
  • All of the above

Question 118

Question
Simply by scanning the values in each distribution below, identify the distribution with the largest standard deviation.
Answer
  • 1, 10, 15, 18, 20, 20, 22, 25, 30, 39
  • 1, 3, 8, 10, 20, 20, 30, 32, 37, 39
  • 1, 15, 17, 19, 20, 20, 21, 23, 25, 39
  • 41, 42, 43, 44, 45, 45, 46, 47, 48, 49

Question 119

Question
Given the area under a normal curve, which two of the following ranges are the same? (Circle the TWO that are the same.)
Answer
  • From the 2.5th percentile to the 97.5th percentile
  • From the 5th percentile to the 95th percentile
  • From the 25th percentile to the 75th percentile
  • From 1 standard deviation below the mean to 1 standard deviation above the mean
  • None of the above

Question 120

Question
The primary use of the standard error of the mean is in calculating the:
Answer
  • confidence interval
  • error rate
  • standard deviation
  • variance

Question 121

Question
Tables and graphs are NOT important tools for which tasks of an epidemiologist?
Answer
  • Data collection
  • Data summarization (descriptive epidemiology)
  • Data analysis
  • Data presentation

Question 122

Question
A table in a report or manuscript should include EXCEPT:
Answer
  • Title
  • Row and column labels
  • Footnotes that explain abbreviations, symbols, exclusions
  • Source of the data
  • Explanation of the key findings

Question 123

Question
The following table is unacceptable because the percentages add up to 99.9% rather than 100.0% Age group No. Percent < 1 year 10 19.6 1–4 9 17.6 5–9 9 17.6 10–14 17 33.3 ≥15 6 11.8 Total 53
Answer
  • True
  • False

Question 124

Question
In the following table, the total number of persons with the disease is: Cases Controls Total Exposed 22 12 34 Unexposed 3 13 16 Total 25 25 50
Answer
  • 3
  • 22
  • 25
  • 34
  • 50

Question 125

Question
A table shell is the:
Answer
  • Box around the outside of a table
  • Lines ("skeleton") of a table without the labels or title
  • Table with data but without the title, labels or data
  • Table with labels and title but without the data

Question 126

Question
The best time to create table shells is:
Answer
  • Just before planning a study
  • As part of planning the study
  • Just after collecting the data
  • Just before analyzing the data
  • As part of analyzing the data

Question 127

Question
Recommended methods for creating categories for continuous variables include:
Answer
  • Basing the categories on the mean and standard deviation
  • Dividing the data into categories with similar numbers of observations in each
  • Dividing the range into equal class intervals
  • Using categories that have been used in national surveillance summary reports
  • Using the same categories as your population data are grouped
  • All of the above
  • None of the above

Question 128

Question
In frequency distributions, observations with missing values should be excluded.
Answer
  • True
  • False

Question 129

Question
The following are reasonable categories for a disease that mostly affects people over age 65 years: Age Group < 65 years 65–70 70–75 75–80 80–85 85
Answer
  • True
  • False

Question 130

Question
In general, before you create a graph to display data, you should put the data into a table.
Answer
  • True
  • False

Question 131

Question
On an arithmetic-scale line graph, the x-axis and y-axis each should:
Answer
  • Begin at zero on each axis
  • Have labels for the tick marks and each axis
  • Use the same tick mark spacing on the two axes
  • All of the above

Question 132

Question
[blank_start]Semilogarithmic-scale line graph[blank_end]A wide range of values can be plotted and seen clearly, regardless of magnitude
Answer
  • Semilogarithmic-scale line graph
  • Arithmetic-scale line graph
  • Both
  • Neither

Question 133

Question
[blank_start]Arithmetic-scale line graph[blank_end]A constant rate of change would be represented by a curved line
Answer
  • Arithmetic-scale line graph
  • Semilogarithmic-scale line graph
  • Both
  • Neither

Question 134

Question
[blank_start]Semilogarithmic-scale line graph[blank_end]The y-axis tick labels could be 0.1, 1, 10, and 100
Answer
  • Semilogarithmic-scale line graph
  • Arithmetic-scale line graph
  • Both
  • Neither

Question 135

Question
[blank_start]Both[blank_end] Can plot numbers or rates
Answer
  • Both
  • Arithmetic-scale line graph
  • Semilogarithmic-scale line graph
  • Neither

Question 136

Question
[blank_start]Bar chart[blank_end]Used for categorical variables on the x-axis
Answer
  • Bar chart
  • Histogram
  • Both
  • Neither

Question 137

Question
[blank_start]Both[blank_end] Columns can be subdivided with color or shading to show subgroups
Answer
  • Both
  • Bar Chart
  • Histogram
  • Neither

Question 138

Question
[blank_start]Histogram[blank_end]Displays continuous data
Answer
  • Histogram
  • Bar chart
  • Both
  • Neither

Question 139

Question
[blank_start]Histogram[blank_end] Epidemic curve
Answer
  • Histogram
  • Bar Chart
  • Both
  • Neither

Question 140

Question
Which of the following shapes of a population pyramid is most consistent with a young population?
Answer
  • Tall, narrow rectangle
  • Short, wide rectangle
  • Triangle base down
  • Triangle base up

Question 141

Question
A frequency polygon differs from a line graph because a frequency polygon:
Answer
  • Displays a frequency distribution; a line graph plots data points
  • Can show percentages on the y-axis; a line graph cannot
  • Cannot be used to plot data over time
  • All of the above

Question 142

Question
Y-axis shows percentages from 0% to 100%
Answer
  • Cumulative frequency curve
  • Survival curve
  • Both
  • Neither

Question 143

Question
Plotted curve usually begins in the upper left corner
Answer
  • Cumulative frequency curve
  • Survival curve
  • Both
  • Neither

Question 144

Question
Plotted curve usually begins in the lower left corner
Answer
  • Cumulative frequency curve
  • Survival curve
  • Both
  • Neither

Question 145

Question
Horizontal line drawn from 50% tick mark to plotted curve intersects at median
Answer
  • Cumulative frequency curve
  • Survival curve
  • Both
  • Neither

Question 146

Question
A scatter diagram is the graph of choice for plotting:
Answer
  • Anabolic steroid levels measured in both blood and urine among a group of athletes
  • Mean cholesterol levels over time in a population
  • Infant mortality rates by mean annual income among different countries
  • Systolic blood pressure by eye color (brown, blue, green, other) measured in each person

Question 147

Question
Which of the following requires more than one variable?
Answer
  • Frequency distribution
  • One-variable table
  • Pie chart
  • Scatter diagram
  • Simple bar chart

Question 148

Question
Compared with a scatter diagram, a dot plot:
Answer
  • Is another name for the same type of graph
  • Differ because a scatter diagram plots two continuous variables; a dot plot plots one continuous and one categorical variable
  • Differ because a scatter diagram plots one continuous and one categorical variable; a dot plot plots two continuous variables
  • Plots location of cases on a map

Question 149

Question
A spot map must reflect numbers; an area map must reflect rates.
Answer
  • True
  • False

Question 150

Question
To display different rates on an area map using different colors, select different colors that have the same intensity, so as not to bias the audience.
Answer
  • True
  • False

Question 151

Question
In an oral presentation, three-dimensional pie charts and three-dimensional columns in bar charts are desirable because they add visual interest to a slide.
Answer
  • True
  • False

Question 152

Question
A 100% component bar chart shows the same data as a stacked bar chart. The key difference is in the units on the x-axis.
Answer
  • True
  • False

Question 153

Question
When creating a bar chart, the decision to use vertical or horizontal bars is usually based on:
Answer
  • The magnitude of the data being graphed and hence the scale of the axis
  • Whether the data being graphed represent numbers or percentages
  • Whether the creator is an epidemiologist (who almost always use vertical bars)
  • Which looks better, such as whether the label fits below the bar

Question 154

Question
[blank_start]Grouped bar chart[blank_end] Number of cases of dog bites by age group (adult or child) and sex of the victim
Answer
  • Grouped bar chart
  • Histogram
  • Line graph
  • Pie chart

Question 155

Question
[blank_start]Pie chart[blank_end]Number of cases of dog bites by breed of the dog
Answer
  • Pie chart
  • Grouped bar chart
  • Histogram
  • Line graph

Question 156

Question
[blank_start]Line graph[blank_end]Number of cases of dog bites per 100,000 population over time
Answer
  • Line graph
  • Grouped bar chart
  • Histogram
  • Pie Chart

Question 157

Question
Number of cases of dog bites over time
Answer
  • Grouped bar chart
  • Histogram
  • Line graph
  • Pie chart

Question 158

Question
Which are the most common ways that a local health department uncovers outbreaks?
Answer
  • Performing descriptive analysis of surveillance data each week
  • Performing time series analysis to detect deviations from expected values based on the previous few weeks and comparable periods during the previous few years
  • Receiving calls from affected residents
  • Receiving calls from healthcare providers
  • Reviewing all case reports received each week to detect common features

Question 159

Question
Factors that influence a health department's decision whether or not to conduct a field investigation in response to one or more cases of disease include
Answer
  • The nature of the disease
  • The number of cases
  • Resources available
  • Health department's traditional attitude toward conducting field investigations
  • All of the above

Question 160

Question
If a particular outbreak presents an unusual opportunity to learn more about the disease and its epidemiology by conducting a study, but early disease control measures would interfere with the study, one should conduct the study quickly, then implement control measures immediately afterwards.
Answer
  • True
  • False

Question 161

Question
Outbreak with known causative agent, source, and mode of transmission
Answer
  • Disease control and prevention efforts take priority over investigation efforts
  • Investigation efforts take priority over disease control and prevention efforts

Question 162

Question
Outbreak with known causative agent, but unknown source and mode of transmission
Answer
  • Disease control and prevention efforts take priority over investigation efforts Investigation efforts take priority over disease control and prevention efforts
  • If the agent is known but the source and mode of transmission are not known (example: Salmonella eventually traced to marijuana), then the health department does not know how to target its intervention. Investigation to learn the source and/or mode is necessary.

Question 163

Question
Outbreak with unknown causative agent, source, and mode of transmission
Answer
  • Disease control and prevention efforts take priority over investigation efforts
  • Investigation efforts take priority over disease control and prevention efforts

Question 164

Question
Use the following steps of an outbreak investigation for Question 5: 1. Analyze data by time, place, and person 2. Conduct a case-control study 3. Generate hypotheses 4. Conduct active surveillance for additional cases 5. Verify the diagnosis 6. Confirm that the number of cases exceeds the expected number 7. Talk with laboratorians about specimen collection For an investigation of an outbreak, what is the logical conceptual order of the steps listed above?
Answer
  • 1-2-3-4-5-6-7
  • 5-6-4-1-2-3-7
  • 6-5-3-1-2-7-4
  • 6-5-7-4-1-3-2

Question 165

Question
To avoid skipping a critical step, investigators should conduct the steps of an outbreak investigation in the precise order you answered in Question 164.
Answer
  • True
  • False

Question 166

Question
200 cases of Marburg virus infection in several districts in Angola over several months (usually none)
Answer
  • Cluster
  • Epidemic
  • Outbreak

Question 167

Question
40 cases ofSalmonella Enteritidis in 1 week traced to a single meal served at a cafeteria (usually none)
Answer
  • Cluster
  • Epidemic
  • Outbreak

Question 168

Question
10 cases of cancer diagnosed over 2 years among residents of a single neighborhood (previous data not available)
Answer
  • Cluster
  • Epidemic
  • Outbreak

Question 169

Question
Why should an investigator who has no clinical background nonetheless talk to a patient or two as an early step in the outbreak investigation?
Answer
  • To advise the patient about common risk factors and the usual course of the illness, after reviewing such information in appropriate reference material
  • To develop hypotheses about the cause of the outbreak
  • To learn more about the clinical manifestations of the disease
  • To verify the clinical findings as part of verifying the diagnosis
  • To verify the laboratory findings as part of verifying the diagnosis

Question 170

Question
A case definition during an outbreak investigation should NOT specify:
Answer
  • Clinical features
  • Time
  • Place
  • Person
  • Hypothesized exposure

Question 171

Question
Ideally, a case definition is 100% accurate in identifying who does and does not have the disease in question, but in reality few case definitions achieve this ideal.
Answer
  • True
  • False

Question 172

Question
Once a case definition for an outbreak investigation has been established, it should not be changed.
Answer
  • True
  • False

Question 173

Question
Common methods of identifying additional cases (expanding surveillance) as part of an outbreak investigation include:
Answer
  • Advising the public through newspapers, TV, radio, and the health department's website to contact the local health department
  • Asking case-patients who they were with at the time of exposure (if known)
  • Sending a fax to healthcare providers
  • Telephoning the infection control practitioners at local hospitals
  • All of the above
  • None of the above

Question 174

Question
A case report form devised for an outbreak investigation usually includes which of the following types of information?
Answer
  • Identifying information
  • Demographic information
  • Clinical information
  • Risk factor information
  • Reporter, interviewer, or data abstractor information
  • All of the above
  • None of the above

Question 175

Question
Descriptive epidemiology is essential for "characterizing the outbreak" by time, place, and person, but has little bearing on the analytic epidemiology.
Answer
  • True
  • False

Question 176

Question
A malfunctioning space heater was used each time the outside temperature dropped below freezing

Question 177

Question
At the Eclipse Restaurant, sodium nitrite was mistaken for table salt in the preparation of breakfast one morning only

Question 178

Question
Common cold passed from classmate to classmate

Question 179

Question
A group of tourists on a weeklong bus tour of a European country experienced an outbreak of norovirus. The group had followed a consistent meal time pattern: each morning they had breakfast together in whichever hotel they had stayed from 6:00 a.m. to 7:00 a.m., stopped for lunch from 1:00 p.m. to 2:00 p.m., then had dinner together either at the next hotel or at a restaurant at about 7:00 p.m. The incubation period for norovirus is about 24-48 hours, with a median of about 33 hours. On which day and at which meal was exposure most likely?
Answer
  • April 19 Dinner
  • April 20 Breakfast
  • April 20 Lunch
  • April 20 Dinner
  • April 21 Breakfast

Question 180

Question
Possible explanations for a case that occurs substantially later than the other cases in an outbreak include:
Answer
  • Similar but unrelated disease
  • Secondary case
  • Case with unusually long incubation period
  • Time of exposure later than others
  • Error in recording date
  • All of the above
  • None of the above

Question 181

Question
A spot map is particularly useful for displaying:
Answer
  • Geographic location of exposure of each case-patient
  • Residence of each case-patient
  • Incidence rate of disease by area
  • Prevalence rate of disease by area

Question 182

Question
Which of the following may be useful in generating hypotheses in an outbreak setting?
Answer
  • Review the literature
  • Look at the descriptive epidemiology
  • Look at the outliers
  • Talk with the local health authorities
  • Talk with a few of the case-patients
  • Talk with subject matter experts
  • All of the above
  • None of the above

Question 183

Question
The key feature of an analytic (epidemiologic) study is
Answer
  • Analysis by time, place, and person
  • Calculation of a risk ratio or odds ratio
  • Use of Epi Info to analyze the data
  • Presence of a comparison group

Question 184

Question
Disease control measures can be directed at the:
Answer
  • Agent
  • Source
  • Mode of transmission
  • Portal of entry
  • Host susceptibility
  • All of the above
  • None of the above

Question 185

Question
Use the information in the following paragraph and data in the table for Questions 185–188. An outbreak of gastrointestinal disease occurred 24-36 hours after people had attended a wedding. Of the 203 attendees (including the bride and groom), 200 completed questionnaires, and 50 reported illness compatible with the case definition. Tabulated food consumption histories are presented in the table below. Ate Specified Food Did Not Eat Specified Food Food Item Ill Well Total Ill Well Total Punch 46 (25%) 138 184 4 (25%) 12 16 Wedding Cake 45 (45%) 55 100 5 (5%) 95 100 Sushi 10 (91%) 1 11 40 (21%) 149 189 What is the following study?
Answer
  • Case Control
  • Cohort
  • Cross Sectional
  • Randomized Control Trial

Question 186

Question
The most appropriate measure of association for these data is the:
Answer
  • Attributable risk percent
  • Chi-square
  • Odds ratio
  • Risk ratio

Question 187

Question
Which food is the most likely culprit?
Answer
  • Punch
  • Wedding cake
  • Sushi
  • Can't determine from the data presented.
  • Must be more than one food.

Question 188

Question
Results of this outbreak investigation should be communicated to EXEPT:
Answer
  • The caterer
  • Local officials
  • Wedding party family and attendees
  • World Health Organization
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