STEP I Multiple Choice questions- Smruti Karale

I) A group of scientists distribute a questionnaire to 240 patients in a diabetes camp

on a particular day. Various questions included in the questionnaire enquire about
the age, weight, exercise, sun exposure, consumption of fruits, smoking habits etc.
210 of these patients are found to have less than the required sun exposure. What
can they conclude ?
1) There is no association between diabetes and sun exposure
2)Less sun exposure causes diabetes
3) Diabetes and less sun exposure are co-related
4)Every diabetic patient has less sun exposure
5)More sun exposure helps prevent diabetes
Answer: (3)

II) A pharmaceutical company is sponsoring a clinical trial involving 50 subjects,

which includes random people from different races, ages , sex. All the subjects
receive a drug "Q" intended to reduce the duration of viability of hypnozoites (post
Malarial infection) to less than one month. They receive the drug once orally every
other day for 2 weeks and are assessed for six months later . They are assessed for
amount of drug absorbed in the GI tract, its bioavailability, rate of excretion in the
urine and overall safety. Which is the phase described in this study?
1) Phase I
2)Phase II
3)Phase III
4)Phase IV
5)Phase V
Answer: (1)

III) A 30 year old man with a long history of SLE visiting your office complains of a
severe pain in his right knee. He denies any history of fall or injury. His temperature
is 100.2 F and skin shows an erythematous rash. He gives history of multiple male
sexual partners and is afraid he has syphilis. After appropriate tests you diagnose
him with Gonorrhea and order VDRL which returns positive. You order FTA-ABS. You
inform the patient that if this test returns negative then we can be 98% sure that he
does not have syphilis. The patient is not satisfied and asks you -'Under what
circumstances could you be 100% sure? Your answer would be..
1) Higher test sensitivity
2)Lower test sensitivity
3)Higher test specificity
4)Lower test specificity
6)Higher disease prevalence
Answer: (1)

(IV) A group of researchers are now studying cases of acute fatal arrhythmia caused
by a rare strain of vibrio in the Ashland county of Oregon in the November 1958.
They obtain medical reports of 200 patients diagnosed with the condition and
admitted to the county hospital's cardiac unit, of which 50 died. They aim to outline
the disease course. They conclude that quarter of the patients infected with the
virus are likely to develop acute fatal arrhythmia while others regain normal health
status
a)Which bias is most likely ?
1) Lead Time
2) Late look
3) Length time
4)Berkson
Answer: (2)
b)what is the solution to this bias?
1)Randomization
2)Stratification
3)Double blinding

Answer : (2)

V) A large clinical trial is assessing efficacy of a new drug X for treating diastolic
hypertension.50 subjects randomized for age,sex,race receive the drug and 50 are
given placebo, the study is double blinded. After six months, diastolic pressures of
all subjects are recorded. The mean and confidence interval is plotted on a graph
and compared. The drug is found more effective as compared to the placebo. Which
of the following would make the study results statistically significant?
1)bigger sample size
2)smaller error
3)p value of <0.5
4)non overlapping confidence interval
Answer: (4)

VI) In a classroom of 54,students are randomly divided into groupsRed(15),blue(12),green(13), yellow(14) . The teacher would like to assess and
compare the performances of students in different groups . She gives them a
surprise quiz on a weekday and its results are either graded pass or fail. Which test
should the teacher use to assess the performance of different groups on this test?
1)t test
2)ANOVA
3)Chi square
4)Pearson co-efficient
Answer : (3)

VII) You are interviewing a 16 year old girl who is accompanied by her 16 year old
boyfriend. She experienced worsening nausea and vomiting since a week after
which she took a home-pregnancy test which reported positive. You are a long time
health care provider for her family. She wishes to confirm the pregnancy and
continue it. She is doing well at school and is financially supported by her parents.
With her consent, you run the pregnancy test and tests for STD's. She is pregnant
and found to be positive for Chlamydia . She is very upset with the results because
she has never been sexually involved with anybody other than her boyfriend. You
suggest she communicates with her parents regarding this but she refuses. She
pleads you not to inform her parents. What is the best response?
1) I understand your concern, but I am obligated to inform your parents since you
are under 18 years of age
2) I understand your concern, but I am obligated to inform your parents since
neither you or your boyfriend are above 18 years of age.
3) I need to first screen your boyfriend for possible STD's.
4) I understand your concern, I will not inform your parents
5) I understand your concern but I am obligated to inform your parents because you
are at risk of developing more STD's
6) I understand your concern but I need to inform your parents since you are not
financially independent.
Answer: (4)

VIII)

Causes of death

This pi chart above obtained from cdc.com represents the distribution of causes of
death in men and women belonging to the age group 45-64. Which of the following
causes represents "b"
1)Heart disease
2)Cancer
3)Chronic lung disease
4)Chronic liver disease
5)Injuries
Answer: (1)

IX) A tertiary care centre in a large city has invented a new intravenous drug
delivery system which is intended to reduce medical errors in calculating dosage.
The system is being extensively studied and rigorously tested. It is found that,
although better than the conventional system, the new device is prone to some
errors. Efforts are made to find out the sources of these errors, expected frequency
and analyzing ways to reduce these errors. This process is described as:
1)Root Cause Analysis
2)Advanced Implementation Quality planning
3)Failure mode and effects analysis
4)Process flow mapping
Answer: (2)
X)As a part of their final year volunteering activity, a group of medical students in
India have been organizing a camp in their village. It is aimed at raising the
awareness of the importance of PAP smear among the adult women of the village
and has been taking place for over five years. The villagers are given appropriate
information about the importance of PAP smear testing and offered free testing. It is
now found that the mortality related to cervical cancer has decreased significantly.
This is an example of1) Primary prevention
2) Secondary prevention
3) Tertiary prevention
4)Quaternary prevention
Answer: (2)