A pandemic is an epidemic occurring worldwide or crossing international boundaries
true
epidemiology is an experimental science that uses human subjects
false
contact with a disease causing factor or the amount of the factor that affects a group of individuals is referred to as an exposure
true
a population is defined as all of the inhabitants of a given country or area considered together
true
it is NOT possible for a single case of a disease to represent an epidemic
false
which of the following is considered a key characteristic of epidemiology
all of the above, distribution, population focus, quantification
illness due to a specific disease or health condition is known as
morbidity
any factor that brings about change in a health condition or other defined characteristic is known as
determinant
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 an
epidemic
which of the following is NOT considered a use of epidemiology
to provide healthcare services to specific individuals
descriptive epidemiology refers to studies that are concerned with characterizing the amount and distribution of health and disease within a population
true
a method for providing quantitative measurements of risks to health is known as
risk assessment
epidemilogy searches for associations between exposures and
health outcomes
the term epidemiologic transition describges a shift in the patterns of morbidity and mortality from causes related primarily to chronic diseases to causes associated with infectious diseases
false
operations research illustrates which of the following uses epidemiology
health services use
a stage that takes place during the early phases of pathogenesis and includes activities that limit the profression of disease
secondary prevention
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
risk
which of the following disease outbreaks occurred between 1346 and 1352 and claimed up to one third of the population of europe
plague
alexander fleming discovered the antimicrobial properties of penicillium notatum
true
john snow is said to be the first to employ quantitative methods to describe population vital statistics
false
working during the renaissance, paracelsus was one of the founder of the field of toxicology
true
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 was
john snow
the physician who determined that a human disease was caused by a specific living organism and proceeded to develop four postulates to demonstrate the associateion between a microorganism and a disease was
robert koch
in a ratio, the numerator and denominator do not necessarily have a specific relationship
true
all of the following are considered ratios except
time
epidemiologic measure provide the following types of information
all of the above:
strength of relationship between exposure and disease, association between exposure and disease, frequency of disease or condition.
what is one of the first steps in presenting data after they have been reviewed for accuracy and completeness
count and tabulate cases
those members of the population who are capable of developing a disease or condition are known as
the population at risk
comparisons between populations that differ in size can be accomplished directly by using frequency or prevalence data
false
prevalence measures do not aid in
determining the risk of disease
which factors can decrease an observed prevalence
decrease in incidence, improved cure rates of disease
the number of deaths due to a disease that occur among persons who are afflicted with the disease is known as the
case fatality rate
adjusted rates pertain only to mortality ratres
false
if a equals the number of deaths in 2009 and b equals the population at the midpoint of 2009 and c equals the number of persons aged 15-24, then crude death rate per 100,000 population qould be
(A/B) x 100,000
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. the 2010 incidence rate for asthma (per 100,000) would abe expressed as
(C/B) x 100,000
using the same data from question 35, the point prevalence of ashma on may 1 (percent), would be expressed as
(A/B) x 100
Representativeness, or external validity, refers to the generalizability of the findings to the population from which the data have beent aken
true
there are no written laws or regulations requiring physicians and other health care providers to report cases of disease to heath authorities.
false
the us bureau of the census provides information that is useful for defining the numberator in rates
false
in the us, mortality data have a high degree of completeness
true
which of the following sources could be used for determining life expectancy
vital statistics cooperative program
the BRFSS
collects data monthly, is a state based system, focuses on personal health behaviors
monitoring cancer trends in the us population over time is a major application of
registries
the systematic and continuous gathering of information about the occurrence of disease and other health phenomena is known as
public health surveillance
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
syndromic surveillance
at the top of the asthma surveillance pyramid is
mortality
birth statistics include statistics on both live births and fetal deaths
true
the number of live births reported in an area during a given time interval divided by the number of women aged 15-44 is known as the
general fertility rate
studies of the effects of exposure to teratogens have used data from
birth certificates
descriptive epidemiology provides information for
all of the above: evaluating health sevices, conducting additional research, targeting interventions
one objective of descriptive epidemiology is to monitor known diseases as well as identify emerging problems
true
in epidemilogy, person variables include
socioeconomic status, race
for both males and females, waht type of cancer is the leading cause of cancer mortality
lung and bronchus cancer
differences in the occurrence of diseases and adverse health conditions in the population are known as
health disparities
urban diseases and causes of mortaility are more likely to be those spread by
both person to person contact and crowding
the term that indicates cases of disease that occur in a specific geographic region is
spatial clutstering
increases and decreases in the fewquency of a disease within a year or orver a period of several years are known as
cyclic trends
gradual changes in the frequency of diseases over long periods refer to
secular trends
what factors may be considered when measuring socioeconomic status
all the above: income level, occupation type, education level
the behavioral risk factor surveillance system (BRFSS) is an example of an ongoing cross sectional study
true
those who occupy the highest socioeconomic positions have excesses of morbidity and mortality from various causes
false
assignment of some individuals to a particular racial classification on the basis of observed characteristics may be difficult
true
the closer the points lie on a scatter plot, with respect to the straight line of best fit through them, the weaker the association between the variables
false
examples of continuous variables are height and weight
true
a graphic plotting of the distribution of cases by time of onset is an
epidemic curve
when the value of one variable increases and the value of another variable decreases, the association is
negative
the lowest dose at which a particular response occurs is known as the
threshold
the time period between initial exposure and a measureable response is known as
latency
a multimodal curve is one that has several peaks in the frequency of a condition
true
the overriding question that epidemiologists ask is whether a prticular exposure is casually associated with a given outcome
true
for which of the following criteria do epidemiologists need to observe the cause befor the effect
temporality
a range of values that which a certain degree of probability contain the population parameter is known as a
confidence interval estimate
the ability of a study to demonstrate an association if one exists is known as
power
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 the
method of concomitant variation
the web of causation model specifies a type of casual relationship that is
multifactoral
the hawthorne effect is a bias that results from participants' knowledge of being in a study
true
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
true
a case control study can examine only a single outcome or a limited set of outcomes
true
an intervention designed for the purpose of educational and behavioral changes at the population level is a community intervention
true
random assignment of subjects to study groups helps to control for
biases due to confounding
which factors distinguish study designs from one another
all of the above: data collection methods, unit of observation, timing of data collection
groups that are selected for an ecologic study can include
all of the above: all cause mortality, occupational injuries, breast cancer mortality.
groups that are slected for an ecologic study might be residents of a particular
al of the above: state, county, census tract
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
ecological fallacy
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
odds ratio
all of the following are disadvantages of case control studies except
exposures can be miscalssified
all of the following are disadvantages of case control studies except
can be used to study low prevalence conditions
subjects 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
prospective cohort study
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
relative risk
randomized controlled trials include
all of the above: prophylactic trials, therapeutic trials, clinical trials
randomized controlled trials contain which of the following components
all of the above: rigorous inclusion and exclusion criteria, blinding or masking to prevent bias, comparable measurement of outcomes in treatment and control conditions
laws and regulations are developed as methods of policy implementation
true
a weakness of exposure assessment is that high quality data on exposures are often unavailable
true
screening tests need to demonstrate both reliability and validity
true
reliability is synonymous with accuracy, whereas validity is synonymous with precision
false
although a measure that is reliable can be invalid, it is never possible for a measure that is valid to be unreliable
false
the likelihood of experiencing an adverse effect is called a
risk
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
policy
a procedure that contrasts the costs and health effects of an intervention is a
cost effective analysis
which of the following is not included in the policy cycle
hazard identification
a group of persons working on behalf of or strongly supporting a particular cause, such as an item of legistlation, an industry, or a special segment of society is known as
interest group
individuals who are involved in policy formulation, including members of the legislature citizens, lobbyists and advocacy group representatives are known as
policy actors
the adoption of health related policies, laws, and programs that are supported by empirical data refers to
evidence based public health
the process for identifying adverse consequences and their associated probability is known as
risk assessment
the relationship between the amount of exposure and the occurrence of the unwanted health effects refers to
dose response assessment
when referring to a toxic substance, exposure assessment must take into account
all of the above: where the exposure occurs, how much exposure occurs, how the substance is absorbed by the body.
which of the following involves the formal adoption of the policies, programs, and procedures that are designed to protect society from public health hazards
policy establishment
the ability of a screening test to identify correctly all screened individuals who actually have the disease refers to
sensitivity
the ability of a test to identify only non diseased individuals who actually do not have the disease refers to
specificity
the ability of a measuring instrument to give consistent results in repeated trials is known as
reliability
a definitive diagnosis that has been determined by biopsy, surgery, autopsy, or other methods and has been accepted as the standard is known as
gold standard
active immunity is acquired from antibodies produced by another person or animal
false
a reservoir can be human beings, animls, insects, soils, and or plants
true
the entry and development or multiplication of an infectious agent in the body of persons or animals is known as
an infection
the severity of a disease produced by an infectious agent is referred to as
virulence
the first case of a disease to come to the attention of authorities is the
index case
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
herd immunity
examples of infections caused by indirect transmission of diease agents include
all of the above: passive immunity, herd immunity, active immunity.
an inanimate object that carries infectious disease agents is a
fomite
an animate, living insect or animal that is involved with the transmission of disease agents is a
vector
the likely transmission of SARS during at 2003 flight to beijing is throught to have been an
airborne infection
foodborne illnesses can be largely prevented by
washing hands and surfaces where food is prepared
examples of zoonotic diseases include
rabies and anthrax, but not measles
determination of the incubation period for a disease outbreak helps to
identify possible infectious agents
smoking around children increases the risk for sudden infant death syndrome
true
meth is the illicit drug that is most commonly used among all persons aged 12 or older
false
lung cancer is the leading cause of cancer death for men, while cervical cancer is the number one for women in the US
false
chronic strains are stressful life events that are sustained over a long period of time
true
in epidemiology, social support refers to help received from family members only
false
posttraumatic stress disorder among veterans is linked with increased levels of both health problems and healthcare utilization
true
the study of the social distribution of and social determinant of states of health is
social epidemiology
the study of the roles of consumption of high fat foods with sedentary lifestyles in health is the domain of
behavioral epidemiology
the choice of behavioral factors that affect how we live is known as
lifestyle
a physical, chemical, or emotional factor that causes bodily or mental tension and may be a factor in disease causation is
stress
which of the following health effects are studied in relation to stress
all of the above: substance abuse, chronic diseases, impaired immune function
techniques for managing or removing sources of stress are known as
coping skills
life events that are sustained over a long period of time are known as
chronic strains
which of the following is an adverse health outcome associated with cigarette smoking
all of the above: coronary heart disease, stroke, lung disease
the involuntary breathing of cigarette smoke by nonsmokers in an environment where there are cigarette smokers present is known as
all of the above: passive smoking, secondhand exposure to cigarette smoke, sidestream exposure to cigarette smoke
a pattern of drinking that results in harm to one's health, interpersonal relationships, or ability to work is known as
alcohol abuse
alcohol consumption by underaged persons is associated with which of the following consequences
problems at school
which of the following health problems are associated with binge drinking among college students
all of the above: violence, sexually transmitted diseases, unintentional injuries
severe tooth decay and loss of teeth occur most commonly among
methamphetamine users
the study of the occurrence of major depressive episodes in the population is one of the concerns of
psychiatric epidemiology
the lifetime prevalence of major depressive episodes among us adults aged 17-39 years is higher among men than women
false
an anxiety disorder that some people develop after seeing orl iving through an event that caused or threatened serious harm or death is known as
posttraumatic stress disorder
a condition that impairs functioning in the social, communication, and behavioral domains is known as
autism
mood disorders include which of the following
all of the above: dysthymia, any bipolar disorder, major depressive episodes
the co-occurrence of two or more mental disorders is known as
psychiatric comorbidity
in epidemiology, overweight means BMI=30 or more
false
alpha radiation is non penetrating and therefore
it is dangerous when ingested or inhaled and localizes in certain tissues
the vector for the hantavirus pulmonary syndrome in the southwestern united states is
rodents
a measure of the absorbed dose of radiation is
the rad or gray
of the following routes of exposure, which one has the most rapid effect?
intravenous
the infectious agent for plague is a
bacterium
the most dangerous health effect linked to cell phone use is
traffic accidents
the most deadly form of malaria is caused by
p. falciparum
DDT has been found to
accumulate in the tissues of many animals and persist in the environment
bodily injury from radiation depends on
all of the above: exposure dose (rems), the cumulative effects of exposure, whether the whole body or part of the body is exposed, individual susceptibility
the type of fish that has not been identified as having potentially dangerous levels of mercury is
salmon
examples of disease vectors are
all of the above: rats and mice, mosquitoes, ticks, sand flies
in the western united states, the natural reservoir for plague is
ground squirrels
for fetuses, infants, and children, the hazards of heavy metals include
all of the above: impairment of physical and mental development, damage to internal organs, brain damage, some forms of cancer
the superfund was provided for by which of the following acts
CERCLA
which of the following is untrue
chemical disease agents are solely the product of man's actions in the biosphere.
which of the following statements about anthrax is untrue
the inhalation form is untreatable
the most effective protection of the population against the risks of man made radiation exposure is to
limit exposure to cases where the benefits outweigh the risks
the symptoms of long term exposure to lower levels of toxic metals include
chronic illness effects
match the pesticide with the group to which it belongs
sevin
carbamate
match the pesticide with the group to which it belongs
chlordane
chlorinated hydrocarbon
match the pesticide with the group to which it belongs
diazinon
organophosphate
match the pesticide with the group to which it belongs
pyrethrin
naturally occuring substance
match the pesticide with the group to which it belongs
metam sodium
carbamate
used in cohort studies, the relative risk is a measure of the strength of association between a possible risk factor and a disease
true
an event that became a symbol for the anti-nuclear movement was
the three mile island accident
which statement about dioxins is untrue
they are never produced in the natural environment
which of the following metals is not classified as a major toxic metal with multiple effects
silver
which of the following outcomes is not usually associated with world population growth
prosperity
the concept of environmental justice specifies that
all people must receive fair treatment in the enforcement of environmental laws
methods for transmission of zoonotic pathogens include
all of the above: contact with the skin, bite or scratch of an animal, direction inhalation, ingestion of contaminated foods.
lead exposure can arise from
all of the above: lead paint used in homes, certain types of pottery, lead dusts brought home from work, tap water from soldered pipes.
bioaccumulation of heavy metals is a particular hazard associated with
mercury
which of the following forms of radiation can only penetrate up to a 2 cm layer of skin tissue
beta particles
one of the differences between Lyme disease and rocky mountain spotted fever is that
lyme disease is caused by a bacterium and rocky mountain spotted fever is caused by a rickettsial agent
erin brockovich was a successful advocate against groundwater pollution from
chromium
the poisonous substance in amanita phalloides is an example of a
toxin
the risk of acquiring a given disease during a time period is best determined by
the incidence rate for that disease in a given period of time
substances on the national priorities list have the following characteristics
all of the above: they have known or suspected toxicity, they have potential for human exposure, they appear frequently in uncontrolled or abandoned waste sites, they are scheduled for possible remediation under superfund
which of the following is not classified as an arboviral disease
none of the above: west nile virus, tick borne viral encephalitis, japanese encephalitis, st. louis encephalitis
in what sense is influenza a zoonic disease
it has animal reservoirs, especially birds and swine
sources of nonionizing radiation include
all of the above: radiation from power lines, radio waves, infrared radiation, visible light radiation
minimata disease was associated with ingestion of seafoods tainted with
mercury
the natural population replacement fertility rate is estimated to be
2.1 births per woman
one of the concerns that surrounded the use of agent orange was that it
contained very small amounts of dioxin
the epa standard for the amount of arsenic permitted in drinking water is
10 micrograms per liter
a measure of radiation dose related to biological effect is
the rem or sievert
the term "hydrophobia" is also known as
rabies
polychlorinated biphenyls are
persistent in the environment
concerns regarding pesticide use include
all of the above: potential harm to agricultural workers, undesirable effects upon cattle, drift into schools and homes, unintentional killing of pets
pesticides are
none of the above: always highly toxic to humans, all synthetic chemicals, always the best weapon against insect pests.
methods for the control of mosquito borne diseases include
all of the above: monitoring the presence of viruses in seninel chickens and birds, removing standing water around the home, use of mosquito eating fish, wearing long clothing
the limitations of environmental epidemiology include the fact that
all of the above: accurate assessment of exposure is difficult, environmentally associated diseases often have low incidence and prevalence, long latency periods often occur between initial exposures and disease outcomes.
agent orange is an example of a
herbicide
the portion of the optical spectrum that has been most closely associated with adverse human health effects is
UVB
the amount of exposure to radiation that a person receives is not affected by
size or weight of the radioactive source
identify the correct fact about rabies
post exposure prophylaxis has prevented human rabies successfully
the effects of rapid growth of the world's population include
all of the above: urbanization, overtaxing carrying capacity, food insecurity
which of the following statemetns about heavy metals is true
their specific gravity exceeds that of water by five or more times
a major concen of exposure to extremely low frequency radiation has been
childhood leukemia and brain cancers
lindane, mirex, and DDT all belong to a group of pesticides called
chlorinated hydrocarbons
the causative agent for leishmaniasis is a
protozoan
an ecologic study is one that examines individual cases as the unit of analysis
false
the research of muzaffer aksoy showed an association between leukemia and
benzene
the definition of emerging zoonoses covers
both new and perviously known agents, appearance of agents in regions not usually affected.
diffuse and spotted melanosis is associated with ingestion of
arsenic
environmental risk transition is most likely to be characterized by
control of household risks and creation of a new set of problems
the estimated global burden of disease linked to environmental sources is
25-33%
a measure used to describe the amount of radioactivity in a sample of material is
the curie or becquerel
itai-itai disease was a form of poisoning associated with ingestion of
cadmium
the effects of ionizing radiation include
all of the above: formation of radionuclides, changes in DNA molecules, formation of ion pairs in exposed atoms, removal of tightly bound electrons from atoms
the health effects of exposure to dioxins include
all of the above: chloracne, skin rashes, liver damage, endocrine effects
identify the incorrect statement
alpha and beta particles pose little or no hazard to human health
aluminum has been studied as a factor that may be linked to
alzheimer's disease
low dietary levels of copper may be associated with
deficiency
A human can survive longer without food than without water
true
in the united states, the average person uses about 400 gallons of water per day.
false
production of one barrel of beer requires 1500 gallons of water
true
about 90% of the world lacks safe drinking water
false
drinking water treatment involves all of the following except
removal of all dissolved chemicals
a thermal inversion causes
greater concentration of pollutants
the worldwide death toll from outdoor air pollution has been estimated to range up to approximately
600,000/year
a major contributor to acid rain is
SO2
which of the following is an example of a known carcinogen that is found in urban air
VOCs
the main difference between sick building syndrome and building related illness is
that SBS is temporary and BRI is a diagnosable illness
and BRI can be related to specific pollutants and SBS cannot.
]food additives are used to achieve all the following except keep food free from
rodent filth
irradiation as a method of food preservation is
best for many types of meat and some fruit
which of the following is an interpretation of the delaney clause
carcinogenic chemicals are not permitted in food in any amounts
the most favored method for waste management is
source reduction
which of the following is inappropriate for composting
fats, oils, grease
one of the most frequently recycled materials is used
automobile batteries
paper contributes the following percentage of the total municipal solid waste stream
30-40%
a product (that could be used as fuel) of anaerobic decomposition of garbage in a landfill is
