IPMS, KMU
Epidemiology
Final-term Paper
Multiple Choice Questions (Time = 90 minutes)
Name___________________________
1. The epidemiologic triad shows the
interaction of
a. Environment, host and
behavior.
b. Genetics, environment and
behavior.
c. Environment, agent, and host.
d. None
2. An epidemic that unusually widespread
and even global in its reach is referred
to as a ________________.
a. Pandemic
b. Hyper-endemic
c. Spanish flu
3. A disease vector is a (n) ____________.
a. Organism that transmits a
disease
b. Symptom of a disease
c. Environmental condition
associated with a disease
4. Indirect and direct causes of disease
may form a complex network of events
that determines the level of disease in a
community. The complex inter-relation
of events is called the:
a. Necessary cause of disease
b. Iceberg phenomenon
c. Causal web
d. Caeteris parabus
5. Prevalence includes:
A. New cases occurring in a
defined time period
B. Existing cases present at a
single time point
C. New cases, plus existing cases
plus deaths
D. New cases plus existing cases
occurring in a defined time
period
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Calculators are allowed to use by the students
Roll #: _____________________________
6. The first stage in the natural history of
disease is:
a. Subclinical
b. Susceptibility
c. Clinical
d. Recovery, disability, or death
7. The hall mark for case-control study
design is ____________________
A. Disease and disease free groups
B. Cases and experimental groups
C. Exposed and non-exposed
groups
D. Snapshot study
8. When total number of deaths due to
measles is presented in relation to the
total cases of measles, it is best labeled
as:
a. Incidence rate
b. Prevalence rate
c. Case fatality rate
d. Proportional mortality
9. An expert in the field of public health is
required to estimate the magnitude
(burden) of a health problem. Which
rate would he calculate for this?
a. Incidence
b. Prevalence
c. Case Fatality
d. Proportionate Mortality
10. When the number of educated females
is expressed as a percentage of total
females present in a village. It is known
as:
A. Proportion
B. Rate
C. Ratio
D. Frequency
E. Cumulative Frequency
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11. The incidence of pollen allergy at
Faisalabad is 10 cases per thousand
populations. The mean duration of
illness is 3 months from February to
April. The prevalence of pollen allergy
at Faisalabad is:
A). 10
B). 20
C). 30
D). 40
12. When a new treatment is developed
that delays deaths but does not
produce recovery from a chronic
disease, which of the following will
occur.
A. Prevalence of the disease will
decrease
B. Incidence of the disease will
increase
C. Prevalence of the disease will
increase
D. Incidence of the disease will
decrease
13. If the number of deaths from
tuberculosis is expressed in relation to
the total mid-year population, it is:
A. Case fatality rate
B. Proportionate mortality rate
C. Crude death rate
D. Cause specific death rate
14. At Lahore Grammar School a student of
class II developed mumps. He was
isolated from other children till swelling
subsided and his brother of class IV who
looked apparently healthy was also
advised to be away from school for
about a fortnight. His brother’s type of
carrier state is most likely to be:
A. Incubatory
B. Healthy
C. Convalescent
D. Chronic
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15. Cement industry is suspected for more
deaths among its workers. So the
industrialist gets worried and wants to
assess whether more deaths are likely
in these workers or not. The measure
that predicts the mortality in this
industrial group is:
a. Age specific death rate
b. Standardized mortality ratio
c. Cause specific death rate
d. Proportionate mortality
16. The estimate of the average number of
additional years a person could expect
to live if the age specific death rates for
a given year prevail for the rest of his
life, is best expressed by:
A. Survival index
B. Life expectancy
C. Crude death rate
D. Age specific death rate
17. Coronary artery disease (CAD) occurred
at a rate of 131/1000 per year in a
population of males aged 50-59 who
had no previous CAD. This is an example
of:
A. A prevalence rate.
B. A case fatality rate.
C. An incidence rate.
D. A point prevalence rate.
18. Fluoridation of water would be an
example of
A. primary prevention strategy
B. secondary prevention strategy
C. tertiary prevention strategy
D. None of the above
23. The process in which each participant has an
equal and known probability of being assigned
to either the control or the experimental group
is:
A. Randomization
B. Manipulation
C. Research control
D. None of the above
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24. A key feature of a cross-sectional study is
that:
A. It usually provides information on
prevalence rather than incidence
B. It is more useful for descriptive
epidemiology than it is for analytic
epidemiology
C. It is synonymous with survey
D. All of the above
25. An observational design that measures
existing disease and current exposure level at a
single point in time is:
A. Cross –sectional study.
B. Cohort study.
C. Case-control.
D. Case report.
26. In cohort studies, we can measure the
association between the risk factor and the
exposure by:
A. Odd ratio.
B. Incidence rate.
C. Relative risk.
D. Prevalence rate.
27. The presence of a new effective vaccine can
lead to:
A. Increase incidence.
B. Decrease prevalence.
C. Increase prevalence.
D. Decrease incidence.
28. The Framingham Study, in which a group of
residents have been followed since the 1950s to
identify occurrence and risk factors for heart
disease, is an example of which type(s) of
study?
A. Cohort
B. Case-control
C. Experimental
D. Observational
E. Cross-sectional
29. The problem with using volunteers in
research is that
A. Volunteers may be more reactive to
the procedures of the study.
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B. Volunteers are not perfectly
representative of the general
population.
C. There may be differences between
two species.
D. There may be history effect.
30. In an experiment, a researcher must control
extraneous variables to prevent them from
becoming ____ variables.
A. Independent
B. Dependent
C. Confounding
D. Randomized
31. In an experiment, participants are usually
assigned to treatments using random
assignment. The reason for using random
assignment is
A. To allow the experimenter to
manipulate participant variables.
B. To allow the experimenter to
manipulate environmental variables.
C. To help control extraneous variables.
D. It is a required component of all
experiments.
32. Dr. Kim systematically varies the amount of
caffeine in cola (0, 10, and 20 mg) and observes
that his participants’ anxiety levels increase.
The 0-mg condition represents the
A. Experimental group.
B. Control group.
C. No-treatment control group.
D. Waiting-list control group.
33. Epidemiologists define disease occurrence
in terms of:
A. Agent
B. Host
C. Environment
D. All of the above
E. A. And b. Above
34. The incubation period is the interval
between:
A. The time of infection and death
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B. Appearance of clinical symptoms and
death
C. The time of infection and appearance
of clinical symptoms
D. Time of infection and appearance of
antibodies
E. Tiem of infection and the appearance
of igm agent specific immunoglobulins
35. 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?
A. Experimental
B. Observational
C. Cohort
D. Case-control
E. Clinical trial
36. 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?
A. Experimental
B. Observational
C. Cohort
D. Case-control
E. Clinical trial
37. The Cancer and Steroid Hormone (CASH)
study, in which women with breast cancer and a
comparable group of women without breast
cancer were asked about their prior use of oral
contraceptives, is an example of which type(s)
of study?
A. Clinical trial
B. Cohort study
C. Cross sectional survey
D. Case-control study
E. Experimental study
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38. Select the correct statement concerning the
selection of controls in a case-control study
A. Randomization can help assure
comparability of cases and controls.
B. Matching can be used to reduce
confounding bias.
C. It is best to identify controls with
conditions that are related to the
outcome in the case-control study.
D. It is less important to assure
comparability of cases and controls in a
case control study
39. The criteria for validity of a screening test
are:
A. Accuracy
B. Predictability
C. Sensitivity and specificity
E. Cost effectiveness
40. A pharmaceutical company showed the
following in an article: "1500 subjects with a
cold were treated with our new medicine.
Within three days, 95% were asymptomatic and
this result was statistically significant." The
company claims the new medicine was
effective. Is this conclusion justified?
A. Yes, because the effect was very
large (95% of the subjects benefitted
from treatment).
B. No, because statistical significance
indicates that the null hypothesis ("no
effect") was correct.
C. No, because no control group was
involved in the study.
D. Yes, because the effect of treatment
could not be explained by chance.
41. The problem of confounding can be solved
by
A. Choosing a prospective design.
B. Increasing the precision of the
measurements.
C. Stratification during data analysis.
D. This cannot be solved.
42. In 1945, there were 1,000 women who
worked in a factory painting radium dials on
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watches. The incidence of bone cancer in these D. Concerned with measuring the
women up to 1975 was compared to that of frequency of new cases with reliability
1,000 women who worked as telephone E. None of the above
operators in 1945. Twenty of the radium dials
painters and four of the telephone operators
developed bone cancer between 1945 and
1975. What study design is this?
A. Cohort study
B. Experimental study 46. Most of the major health problems in
C. Clinical trial the poorer nations are due to ______.
D. Cross-sectional study
E. Case-control study A. Parasitic worms and
microorganisms
43. Researchers set out to demonstrate that a B. Psychological tension resulting
new drug is more effective in lowering systolic from work
blood pressure than beta-blockers. They select C. Air pollution
two groups from among a number of previously D. None of the above
uncontrolled hypertensive patients to receive
either the new drug or a beta-blocker using a 47. Modes of horizontal transmission of
computer program to make the allocation disease, except
purely by chance. What is this method of a. Contact
assignment called? b. Vector
A. Matching c. Common Vehicle
B. Randomization d. Genetic
C. Blinding
D. Cross-over 48. An infected person is less likely to
E. Factorial encounter a susceptible person when a
large proportion of the members of the
44. A screening test for breast cancer was group are immune
administered to 400 women with biopsy-proven a. Active immunity
breast cancer and to 400 women without breast b. Passive immunity
cancer. The test results were positive for 100 of c. Herd immunity
the proven cases and 50 of the normal women. d. Specific immunity
What is the sensitivity of this screening test?
A. 88% 49. Type of design where both exposure
B. 67% and disease are determined
C. 25% simultaneously for each subject
D. 33% a. Case study
E. 12% b. Cross sectional study
c. Case control study
45. Validity can be defined as: d. Cohort study
A. The degree to which an instrument
measures what it is supposed to 50. Public health is the study of the
measure distribution and determinants of health
B. The degree to which results are and disease in populations.
consistent on a repeat measurement a. True
C. A measure of the degree or strength b. False
of association between two variables

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50. Reliability can be defined as:
A. The degree to which an instrument
measures what it is supposed to
measure
B. The degree to which results are
consistent
C. A measure of the degree or strength
of association between two variables
D. Concerned with measuring the
frequency of new cases with reliability
E. Ensuring that patients all take a test
under the same conditions
51. The ratio between the incidence of disease
among exposed and non-exposed is called:
A. Causal risk
B. Attributable risk
C. Relative risk
D. Odd's ratio
52. Prevalence of disease in a community can
be found out by: (right ans is cross sectional)
A. Case control study
B. Cohort study
C. Case report
D. Experimental study
53. Obtaining information about exposures that
occurred in the past is considered a/an:
A. Prospective approach
B. Retrospective approach
C. Ecological fallacy
D. Incidence study
54. The measure of association used in a case-
control study is:
A. Ecologic Correlation
B. Odds Ratio
C. Relative Risk
D. Chi square
C. Ecological Fallacy
D. Residual Confounder
56. A measure that refers to the mortality rate
associated with a specific cause of death
divided by the population size at the midpoint
of a time period times a multiplier is the:
A. Crude death rate
B. Sex-specific rate
C. Cause-specific mortality rate
D. Age specific rate
57. The term that refers to the number of
deaths due to a disease that occur among
persons who are afflicted with that disease is
the:
A. Crude Death Rate
B. Case-Fatality Rate
C. Proportional mortality ratio
D. YPLL
58. Systematic and continuous gathering of
information about the occurrence of disease
and other health phenomena is:
A. Data Analysis
B. Public health surveillance
C. Syndrome Surveillance
D. Data Collection
59. The following refers to maternal deaths that
result from causes associated with pregnancy:
A. Fetal Mortality
B. Infant Mortality
C. Maternal Mortality
D. Neonatal Mortality

55. This term refers to the observation that 60. Which of the following is an example of a
employed populations tend to have a lower type of descriptive epidemiologic study?
mortality experience than the general A. Case-Control Study
population: B. Case Reports
A. Hawthorne Effect C. Cohort Study
B. Healthy Worker Effect D. RCT

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61. A test to detect prostate cancer in men had
a sensitivity of 95%. This means that
A. 95% of the men who test positive will
actually have prostate cancer.
B. 95% of the men with prostate cancer
will test positive.
C. 95% of the men who do not have
prostate cancer will test negative.
D. 95% of the men who test negative
will actually not have prostate cancer.
62. A test to detect prostate cancer in men had
a specificity of 80%. This means that
A. 80% of the men who test positive will
actually have prostate cancer.
B. 80% of the men with prostate cancer
will test positive.
C. 80% of the men who do not have
prostate cancer will test negative.
D. 80% of the men who test negative
will actually not have prostate cancer.
63. In an outbreak of cholera in a village of
2,000 population, 20 cases have occurred and 5
died. Case fatality rate is:
A. 1%
B. 0.25%
C. 5%
D. 25%
64. Descriptive epidemiology is study in relation
to:
A. Time
B. Place
C. Person
D. All of the above
65. Residents of three villages with three
different types of water supply were asked to
participate in a study to identify cholera
carriers. Because several cholera deaths had
occurred in the recent past, virtually everyone
occurred in the time submitted to examination.
The proportion of carriers in each village who
were carriers was computed and compared.
The study is a:
A. Cross-sectional study
B. Case-control study
C. Concurrent-cohort study
D. Non-concurrent case control study
66. To compare two populations, the best index
is:
A. Standardized death rate
B. Infant mortality rate
C. Crude birth rate
D. Couple protection rate
67. Incidence is defined as:
A. Number of cases existing in a given
population at a given moment
B. Number of cases existing in a given
period
C. Number of new cases occurring
during a specific period
D. Number of old cases present
68. Double blind study means:
A. Observer is blind about the study
B. Person or group being observed is
blind about the study
C. participant and researcher are blind
about the study (if researcher is not
statistician)
D. None of the Above
69. All are true about cohort studies, except:
A. Prospective
B. Useful for rare diseases
C. Necessary for incidence
D. Expensive
70. Which is the most appropriate method of
research for studying incidence of diarrhea in a
community?
A. Cross-sectional study
B. Cohort study
C. Case control study
D. Double-blind placebo study