First Session Epidemiology

Chapter 1- Introduction to Epidemiology

1) Which of the following not used in principle of epidemiology?

a-Planning

b-Implementation

c-Control

d-Evaluation

Answer: B-Epidemiology has minimal role in implementation

Chapter 2- Causal

1) What is cause?

Answer: Characteristic/Event/Factor etc. that bring outcome

2)Given the cause pie, Which of the statement is true for smoking for lung cancer?

A- Smooking, B- Esbestos, C-Genetic, E-Radiation

Sufficient- Necessary- Important

a- Yes- Yes- Yes

b- No- Yes- Yes

c- No- No- Yes

d- No- No- No

Answer: C-Since smooking is not present in causal pie ii, thus it is not necessary, subsequently if not necessary it is not sufficient. However it still important. Formulae [SiNI]

3) Which of the following is not Hills Criteria?

a- temporal b-Association c- Propability d- Experimental

e- Relationship f-Coherance g- Consistant h- Specific

i- Sensitive

Answer: I-Formulae is T.A.P.E.R.[.S.].

4) What do you meant by Association in Hills criteria?

Answer: Association defined as when there is a statistical relationship between factor and outcome. It is the first step in determine the cause.

Chapter 3- Natural History of Disease

1) Explain what is natural history of disease?

Answer: It is an event progression of the disease over time without treatment or intervention

2) Which of the following not normal History of Disease?

a-Stage of sub-clinical

b-Stage of susceptible

c-Stage of Post Clinical

d-Stage of Complication

Answer: C-Health condition in natural history of disease include stage of susceptibility, stage of sub-clinical, stage of clinical and stage of recovery/death

3) Which of the following statement is true

a-incubation period and induction period is the same

b-incubation period is longer than induction period

c-induction period extend into stage of clinical from exposure

d-latency period is used in communicable disease

Answer: C-Incubation and induction period are not the same in such a way that induction period extent up to stage of clinical where incubation period only confine to stage of sub-clinical period

4) Given the scenario below, which kind of preventive method was applied?

"screening program in the mall with BP set"

a-primordial

b-primary

c-secondary

d-tertiary

Answer: C-Screening often secondary where to detect individual who sub-clinically apparently healthy. Formula[Screen=Screen]

5) Which of the following was not advantage of using ICD-10

a-Trending across time

b-Easy to used, stored, retrieved, and explained

c-National comparison

d-Surveillance

Answer: D-Advantage of ICD10 formula [T.E.N]- Trending across time, Easy to [S.U.R.E.]used,stored,retrieved and explained, and national comparison. The ICD10 was not useful for surveillance advantage since it too specific where in surveillance require loose and sensitive.

Chapter 4- Measurement of Disease Frequency

1) Which of the following is not prevalence?

a-Autopsy Rate

b-Birth defect rate

c-Attract Rate

d-Point prevalence

Answer: C-Attract rate is incidence as denominator look into individual at risk of say food poisoning. Other incidence rate include mortality rate, morbidity rate, case-fatality rate. This also meant that Pathogenicity, Infectivity and Virulency is a measurement of incidence. For prevalence, the formula is AB [Autopsy-rate and Birth-rate].

2) Which of the following describe incidence of accident by a blue car?

a-Proportion of blue car to that car accident

b-Proportion of car accident to that blue car

c-Proportion of car accident figure in by blue car

d- Proportion of blue car to that non-blue car

Answer: A-Note that all of the statement are correct, but since the accident is an event so it cannot be in the denominator. Remember that when 'to that' the proportion always refer to the denominator. So B and C automatically wrong. where D does not explain the incidence. When figure in mean that it is automatically numerator.

3) Which of the following is the incidence red car accident?

a-proportion of red car among those car accident

b-proportion of car accident among those red car

c-proportion of car accident figure in by red car

d-proportion of red car among non-red car

Answer: B- Remember that when 'among' is present, the proportion now become reffering to numerator while "among" take the denominator. Formula[AM->D). An Event cannot be denominator even-though all the statement is correct.

4) Which of the following not needed in cumulative incidence

a-population size

b-duration of disease

c-duration of study

d-followup rate

Answer: D- All incidence require population size, duration of study and disease. But followup rate only needed in incidence rate/ density.

5) Given the data :

Diabetic Non-diabetic

X Y

After followup for 2 years, only 80% of patient avove response. Number of Z people becoming diabetic. What is the incidence rate?

a- X/(X+Y)

b- Z/(0.8Y*2)

c- Z/(Y-X)

d- 0.8Y/Z*2

Answer: B- Because Z is new case of diabetic so it is the numerator, but population at rik Y only 80% followup for period of 2 years. So denominator become (0.8Y*2)

Chapter 5- Strategies of Epidemiology

1) Which of the following correct flow of the strategies?

i-introduction new fact, ii-testing hypothesis,

iii-Examine existing fact, iv-Generate Hypothesis

a- iii, iv, ii, i

b- i, ii, iii, iv

c- iv, iii, ii, i

d- ii, iii, i, iv

Answer: B- Formula [F->G->H->I]- Fact, Generate, Hypothesis, Introduce(F) then repeat

2) Which of the following not needed in ideal epidemiological hypothesis?

a-cause

b-effect

c-ethical

c-population

d-exposure

e-time

Answer: C- Formulae [C.E.P.E.T]- Cause, Effect, Population, Exposure-Response, Time. In epidemiology and administrative inform-consent can be waved.

Chapter 6- Source Data

1) Which of the statement is correct

a- De facto and de jure are the same

b- data from death certificate almost totally complete

c- civil registration represent total population but not continuous

d- data linkage and data sharing is same

Answer: B- Because death are unlikely to go unrecorded.

Chapter 7- Age Standardization

1) Why is it important to do age standardization?

Answer: For comparison between two group as age is co-founder for mortality outcome. It is method type of matching.

2) Can two very different population have different crude death rate but same Age Specific Death Rate implied?

Answer: Because age composition between this two population markedly different but if population being compared had same age composition the risk of dying is same.

3) What do you need in direct method of age standardization?

a- population

b- death

c- death rate

d- sex

Answer: population of reference is needed to standardized although it is theoretically.

4) Which of the following needed in Indirect method?

i- population ii-Expected death iii- Observed death iv-Death Rate

a- i, ii

b- iii, iv

c- i, iv

d- i, iii, iv

Answer: since population already given the investigator need total observed death and referral death rate.

5) What the different between SMR and ASDR?

Answer: Standardized mortality rate (SMR) is using indirect method where population is known and total number of death is given. If >1, more death occurred than expected, because [observe/expected]. Age Standardized Death Rate (ASDR) is using direct method where age-specific death rate is given but population of references is needed.

Chapter 8- Measurement and Error

1) What is measurement?

a- variable

b- abstract

c- concrete

d- test

Answer: A- measurement=variable. However, test is not a measurement since characteristic of measurement and test is different.

2) What is not characteristic of variable?

a- Reliable

b- Empirical

c- Attributable

d- Assigned

Answer: A- Formula for characteristic of measurement [A.R.E.A]- attribute, rules, empirical, assigned. Variable not necessarily must reliable, if not reliable still a variable, if not reliable still variable. Becareful formula for Systematic Error [AR^S]- Attrition, Response, Volunteer, Self

3) How do you increased the quality of measurement?

Answer: Quality of measurement can be increased by (down) Error, (up) Validity, and (up) Reliability

4) In epidemiology, which of the following is not source of error?

a- man

b- machine

c- method

d- material

Answer: D-In epidemiology, as study of human/social science, material is not included. Man (Observer, Subject), method (input, process) . machine(instrument).

5) What is not the characteristic of observer error?

a- knowledge

b- Behaviour

c- Attitute

d- Skills

Answer: B-Characteristic of observer error include: formulae [KAP+S]- Knowledge, Attitute, Practice and Skills

6) What is not the characteristic of subject error?

a- Behaviour

b- Howthrone Effect

c- Biological

d- Skills

Answer: D-Characteristic of subject error include behavioral, biological, hawthrow effect (Bias)

7) Which of the following not error in instrument?

a- sofwere

b- single index

c- Instruction

d- Callibration

Answer: A-Error in machine (instrument) include single index, instruction, form (checklist), callibration. Sofwere is not instrument but it is type of method.

8) Which of the following is not error in method?

a- single index

b- coding

c- uncoding

d- sofwere

Answer: A-Error in method including input (coding-uncoding) and process (transcription, sofwere, abstraction, virus). Single Index reffer to instrument used.

9) Given: " The doctors in Barangai (Y) mostly agree that patient have truely contacted with Tuberculosis"

a- valid & Reliable

b- Not valid but Reliable

c- Not valid not reliable

d- not reliable but valid

Answer: A-Since there more than 2 doctors= reliable, and its true= valid.

10) Which of the following is not characteristic of validity?

a- sensitivity

b- Positive predictive value

c- False positive

d- Prevalence

Answer: C- Validity can be measure through sensitivity, sepcificity, PPV, NPV, Prevalence, Incidence. Where single Index Instrument is machine(instrument) component that only look for concrete measurement.

11) Which of the following best describe this valid measurement?

" Proportion of not without disease who were not detected negative in test"

a- Sensitivity

b- Specificity

c- PPV

d- NPV

Answer: A- Not without disease= positive disease; and not negative= test positive and when no word 'among it' can be twisted and so definition for sensitivity.

12) Which of the following is false?

+ -

+ A B A+B

- C D C+D

A+C B+D [A+B+C+D]

a- PPV= A/A+B

b- Sensitivity= A/A+C

c- NPV= D/C+D

d- Specificity= B/B+D

Answer: D- Specificity should be D/B+D

13) Which of the statement true or false?

i- Valid measurement is reliable. Answer:TRUE

ii- Reliable measurement is valid. Answer: FALSE

14) In graph of Popl Vs Haemoglobin Level which of the area under the curve is false positive?

(Direction of graph 0->infinity; A,B,C,D)

Answer: B- Because FP is among those who are test detected positive but it belong to normal (no disease graph)

15) In graph of Popl Vs HBA1C Level which of the area under the curve is false positive?

(Direction of graph 0->infinity; A,B,C,D)

Answer: C- Same explaination

16) Which of the following is valid but not reliable?

a- Doctors say Thomas has diabetes

b- Doctor says Thomas has true anemia

c- Doctors say Thomas has true cholera

d- Doctor says Thomas has Chikugunyia

Answer: B- There only 1 doctor so not reliable but the diagnosis is true disease which valid so B is valid but not reliable.