Test Bank For Gordis Epidemiology
b b b b
7th Edition By David D Celentano; Moyses Szklo
b b b b b b b
Chapters 1 - 20 Complete
b b b b b
,TABLE OF CONTENTS
b b
Chapterb1bIntroduction
Chapterb2bThebDynamicsbofbDiseasebTransmission
Chapterb3bThebOccurrencebofbDisease
Chapterb4bThebOccurrencebofbDisease
Chapterb5bAssessingbthebValiditybandbReliabilitybofbDiagnosticbandbScreeningbTests
Chapterb6bThebNaturalbHistorybofbDisease
Chapterb7bObservationalbStudies
Chapterb8bCohortbStudies
Chapterb9bComparingbCohortbandbCase-ControlbStudies
Chapterb10bAssessingbPreventivebandbTherapeuticbMeasures
Chapterb11bRandomizedbTrials
Chapterb12bEstimatingbRisk
Chapterb13bMorebonbRisk
Chapterb14bFrombAssociationbtobCausation
Chapterb15bMorebonbCausalbInference
Chapterb16bIdentifyingbthebRolesbofbGeneticbandbEnvironmentalbFactorsbinbDiseasebCausation
Chapterb17bUsingbEpidemiologybtobEvaluatebHealthbServices
Chapterb18bEpidemiologicbApproachbtobEvaluatingbScreeningbPrograms
Chapterb19bEpidemiologybandbPublicbPolicy
Chapterb20bEthicalbandbProfessionalbIssuesbinbEpidemiology
,prepared by stevesalvardo
b b
for any inquiry and further request e
b b b b b b
mail:
Chapterb01:bIntroduction
Celentano:bGordisbEpidemiology,b7thbEditionbTestbBank
MULTIPLEbCHOICE
1. bWhichbofbthebfollowingbisbanbexamplebofbtertiarybprevention?
a. Vaccinationbforbrotavirusbforbchildrenb youngerbthanbthebagebofb1byear
b. Surgicalbamputationbofbanbextremitybwithbosteosarcomab(bonebcancer)
c. Screeningbforbgestationalbdiabetesbafterb24bweeksbofbpregnancy
d. Sexualbeducationbprogrambinbelementarybschools
e. Increasingbtaxesbforbbuyingbcigarettesb
ANSWER:bB
Surgicalbamputationbofbanbextremitybwithbosteosarcomab(bonebcancer)bisbanbexamplebinbwhichbw
henb ab diseaseb isb presentb theb treatmentb (amputation)b isb doneb tob reduceb theb impactb ofb diseasebbyb
preventingbthebtumorbfrombdissemination.bVaccinationbforbrotavirusbforbchildrenbyoungerbthanbt
hebagebofb1byear,bsexualbeducationbprogrambinbelementarybschools,bandbincreasingbtaxesbforbbuyi
ngbcigarettesbrepresentbexamplesbofbprimarybprevention.bScreeningbforbgestationalbdiabetesbafter
b24bweeksbofbpregnancybisbanbexamplebofbsecondarybprevention.
2. Thisbhistoricbcharacterbobservedbthatbchildbedbfeverbmortalitybmorebcommonbamongbwomenbtrea
tedbbybphysiciansbandbmedicalbstudentsbcomparedbwithbwomenbtreatedbbybmidwives.bBasedbonbhi
sbobservations,bhebimplementedbabhandbwashbpolicybthatbresultedbinbadecreasebinbmortality.bNameb
thebcharacterbthatbwebarebtalkingbabout.
a. JohnbSnow
b. EdwardbJenner
c. D.A.bHenderson
d. LeonbGordis
e. IgnazbSemmelweisb
ANSWER:bE
IgnazbSemmelweisbidentifiedbthatbmedicalbstudentsbandbphysiciansbtransmittedbthebdiseasebbybn
otbwashingbtheirbhandsbafterbexaminingbbodiesbatbautopsiesbandbconductingbmultiplebexaminati
onsbinbthebclinic.
3. ThanksbtobthebcontributionsbofbEdwardbJenner,bthebfollowingbdiseasebwasberadicatedblaterbb
ybeffortsborganizedbbybD.A.bHenderson:
a. Cholera
,b. Smallpox
c. Chickenpox
d. Polio
e. Zika
.
,ANSWER:bB
Smallpoxbwasberadicatedbinb1980.bEdwardbJennerbvaccinatedbJamesbPhippsbinb1796bagainstbs
mallpox.bAlmostb200byearsblater,bthebWorldbHealthbOrganizationb(WHO)bcommissioned
D.A.bHendersonbtobleadbthebeffortsbtoberadicatebthebdisease.
4. Overbthebpastbcentury,babmarkedbdeclinebinbthebmortalitybratesbofbmanybinfectiousbdiseasesbh
asbbeenbobserved.bWhichbofbthebfollowingbisbthebmostblikelybreasonbforbthebobservedbdeclinebinb
mortalitybratesbfrombcommonbinfectiousbdiseases?
a. Developmentbofbpenicillin
b. Developmentbofbinsulin
c. Developmentbofbvaccines
d. Improvementbinbsocialbconditions
e. Worsebsanitationbandbunsafebwaterb
ANSWER:bD
Althoughbmedicalbtreatmentsbpotentiallybhelpedbinbthebdecreasebofbinfectiousbdiseases,btheba
dvancementbinbsocialbconditionsbplayedbabmajorbrole.bThesebimprovementsbincludebbetterbsa
nitation,bsafebdisposalbofbwaste,bbetterbnutrition,bandbimprovementbinbhousingbconditions.
.
,Chapter 02: The Dynamics of Disease Transmission
b b b b b b
Celentano:bGordisbEpidemiology,b7thbEditionb
MULTIPLEbCHOICE
1. Whichbtermbmostbaccuratelybdescribesbthebfollowingbdefinition?b“Theboccurrencebinbabcom
munityborbregionbofbcasesbofbanbillness,bspecificbhealth-relatedbbehavior,borbotherbhealth-
brelatedbevents bclearlybinbexcessbofbnormalbexpectancy.”b[PortabM,bed.bAbDictionarybof
Epidemiology.bNewbYork:bOxfordbUniversitybPress;b2014.]
a. Endemic
b. Epidemic
c. Pandemic
d. Attackbrate
e. Incubationbperiodb
ANSWER:bB
Anbepidemicbisbtheboccurrencebofbhealth-
relatedbeventsbinbabcommunityborbregion,binbclearbexcessbofbnormalbexpectation.bEndemicbisbno
tbtruebbecausebitbisbdefinedbasbthebconstantboccurrencebofbabdisease,bdisorder,borbnoxiousbinfecti
ousbagentbinbabgeographicbareaborbpopulationbgroup.bPandemicbisbnotbtruebbecausebitbisbdefinedb
asbanbepidemicboccurringboverbabverybwidebarea,bcrossingbinternationalbboundaries,bandbusuall
ybaffectingbablargebnumberbofbpeople.bAttackbratebisbnotbtruebbecausebitbisbdefinedbasbnumberbofb
peoplebatbriskbinbwhombabcertainbillnessbdevelopsboverbtotalbnumberbofbpeoplebatbrisk.bIncubatio
nbperiodbisbnotbtruebbecausebitbisbthebintervalbfrombreceiptbofbinfectionbtobthebtimebofbonsetbofbcli
nicalbillnessb(thebonsetbofbrecognizablebsymptoms).
2. Whatbisbthebmostbaccuratebdefinitionbofbthebincubationbperiodb(ofbanbinfectiousbdisease)?
a. Thebtimebofbonsetbofbclinicalbillnessborbthebonsetbofbrecognizablebsymptoms
b. Thebintervalbfrombreceiptbofbinfectionbtobthebtimebofbonsetbofbclinicalbillnessb(thebonsetbofbr
ecognizablebsymptoms)
c. Thebtimebofbinvasionbbybanbinfectiousbagent
d. Thebtimebbetweenbinitiationbofbinfectionbandbfirstbsheddingborbexcretionbofbthebagent
e. Thebperiodbbetweenbexposurebandbthebonsetbofbinfectiousnessb
ANSWER:bB
Thebincubationbperiodbisbdefinedbasbthebintervalbfrombreceiptbofbinfectionbtobthebtimebofbonsetbof
bclinical billnessb(thebonset bofbrecognizablebsymptoms);binbotherbwords,bthebtimebbetweenbthebmo
mentbofbdevelopingbsymptomsbandbthebmomentbofbinvasionbbybanbinfectiousbagent.b“Thebtimebo
fbonsetbofbclinicalbillnessborbthebonsetbofbrecognizablebsymptoms”bisbnotbtruebasbitbcorrespondsbt
ob“timebofbonset.”b“Thebtimebofbinvasionbbybanbinfectiousbagent”bisbnotbtruebasbitbcorrespondsbtob
“timebofbinfection.”b“Thebtimebbetweenbinitiationbofbinfectionbandbfirstbsheddingborbexcretionbo
fbthebagent”bandb“Thebperiodbbetweenbexposurebandbthebonsetbofbinfectiousness”barebnotbtruebasb
theybcorrespondbtobtheblatentbperiod.b(Theblatentbperiodbis
,focusingbonbthebonsetbofbinfectiousness,bbutbthebincubationbperiodbisbfocusingbonbthebonsetbofbt
hebsymptom.)
3. TherebwasbabfoodbpoisoningboutbreakbonbAprilb1,b2018,batbthebCitybZbFoodbSafetybConferenc
e.bTherebwereb1,000bpeoplebregisteredbforbthebconferencebwithbluncheon,b100bvolunteersbtobhost
battendees, bandb50bpeoplebwhobservedbthebluncheonbduringbthebconference. bExceptbforb50bpeopl
ebwhobservedbthebfood,ballbofbthebparticipantsbandbvolunteersbatebthebfoodbfrombthebluncheonbatbt
hebconferencebonbAprilb1,b2018.bBasedbonlybonbthebinformationbgivenbinbthisbquestion,bhowbman
ybpeoplebarebatbriskbinbthisbfoodbpoisoningboutbreak?
a.b1,000
b.b1,100
c.b1,150
d.b150
e.b50bAN
SWER:bB
Peoplebatbriskbinbthisboutbreakbarebpeoplebwhobwerebexposedbtobthebfoodbatbthebconference.bEve
nbthoughb1,150bpeoplebwerebatbthebconference,b50bpeoplebwhobservedbthebfoodbdidbnotbeatbthebfo
od.bThereforebwebhavebtobexcludebthoseb50bpeople.
4. TherebwasbabfoodbpoisoningboutbreakbonbAprilb1,b2018,batbthebCitybZbFoodbSafetybConfere
nce.bTherebwereb1,000bpeoplebregisteredbforbthebconferencebwithbluncheon,b100
volunteersbtobhostbattendees,bandb50bpeoplebwhobservedbthebluncheonbduringbthebconference.bE
xceptbforb50bpeoplebwhobservedbthebfood,ballbofbthebparticipantsbandbvolunteersbatebthebfoodbfro
mbthebluncheonbatbthebconferencebonbAprilb1,b2018.bAfterbanbinitialboutbreakbofbfoodbpoisoningb
isbreported,banbepidemiologistbsendsbsurveysbtoballbpeoplebatbriskbtobinvestigatebthe
cause.bHowever,bonlyb900bpeoplebamongbthosebatbriskbanswerbthebsurvey.bAfterbanalysisbofb900
bsurveybresults,bthebepidemiologistbconcludesbthatbthebmost bsuspectedbfoodsbinbtheboutbreakbare
bpepperonibpizzabandbmeatballbspaghetti.bWhat bisbtheboverall battackbratebforbthosebwhobatebmeat
ballbspaghetti?bUsebthebfollowingbtablebtobanswerbthebquestion.
SummarybofbSurveybResponses
Numberbofbpeoplebwhobdevel Numberbofbpeoplebwhobatebtheb
opedbthebcasebdefinitionbsymp food
toms
Pepperonibpizzabonly 113 275
Meatballbspaghettibonly 62 375
Bothbpepperonibpizzabandb 57 150
meatballbspaghetti
Neitherbofbpepperonibpizzaborb 10 100
meatballbspaghetti
a.b41%
b.b38%
c.b27%
,d.b40%
e.b23%bA
NSWER:b
E
Tobcalculatebthebfood-
specificbattackbrate,bwebneedbtobdefinebhowbmanybpeoplebarebexposedbtobthebspecificbfoodbandbh
owbmanybpeoplebdevelopbthebsymptomsbinbthebcasebdefinition.bInbthisbquestion,bwebarebaskingba
boutb“overall”battackbratebinbthosebpeoplebwhobatebmeatballbspaghetti,bsobwebhavebtobaddb“meat
ballbspaghettibonly”bandb“bothbpepperonibpizzabandbmeatballbspaghetti”btobgetbtheboverallbrate.b
Whichbisb525b(375bplusb150),bwhobarebatbriskbofbexposure,bandb119b(62bplusb57),bwhobdevelope
dbthebsymptoms,bcorrespondingbtob23%bofbattackbrate.
5. TherebwasbabfoodbpoisoningboutbreakbonbAprilb1,b2018,batbthebCitybZbFoodbSafetybConferen
ce.bTherebwereb1,000bpeoplebregisteredbforbthebconferencebwithbluncheon,b100bvolunteersbtobh
ostbattendees,bandb50bpeoplebwhobservedbthebluncheonbduringbthebconference.bExceptbforb50bp
eoplebwhobservedbthebfood,ballbofbthebparticipantsbandbvolunteersbatebthebfoodbfrombthebluncheo
nbatbthebconferencebonbAprilb1,b2018.bAfterbanbinitialboutbreakbofbfoodbpoisoningbisbreported,ba
nbepidemiologistbsendsbsurveysbtoballbpeoplebatbriskbtobinvestigatebthebcause.bHowever,bonlyb90
0bpeoplebamongbthosebatbriskbanswerbthebsurvey.bAfterbanalysisbofb900bsurveybresults,bthebepid
emiologistbconcludesbthatbthebmostbsuspectedbfoodsbinbtheboutbreakbarebpepperonibpizzabandb
meatballbspaghetti.bWhatbisbthebmostbsuspectedbfoodbforbfoodbpoisoningbafterbcross-
tabulation?bUsebthebfollowingbtablebtobanswerbthebquestion.
SummarybofbSurveybResponses:
Numberbofbpeoplebwhobdevel Numberbofbpeoplebwhobatebtheb
opedbthebcasebdefinitionbsymp food
toms
Pepperonibpizzabonly 113 275
Meatballbspaghettibonly 62 375
Bothbpepperonibpizzabandb 57 150
meatballbspaghetti
Neitherbofbpepperonibpizzaborb 10 100
meatballbspaghetti
a. Pepperonibpizzabonly
b. Meatballbspaghettibonly
c. Bothbpepperonibpizzabandbmeatballbspaghetti
d. Neitherbpepperonibpizzabnorbmeatballbspaghetti
e. Webcannotbdeterminebthebcausebofbfoodbbasedbonbthisbinformationb
ANSWER:bA
Pepperonibpizzabonlybattackbratebisb41.09%b(113bdividedbbyb275),bandbmeatballbspaghettibonlybis
b16.53%b(62bdividedbbyb375).bThebattackbratebofbbothbpepperonibpizzabandbmeatballbspaghettibisb3
8.00%b(57bdividedbbyb150).bSomebmaybchoosebbothbofbthembwhichbarebthebmostbsuspected
,food.bIfbbothbthebfoodsbwerebthebmostbsuspectedbfood,bwebshouldbhavebabhigherbattackbratebinbme
atballbspaghettibonlybgroupbasbwell.
6. Whatbisbthebnamebofbtheboccurrencebofbabclearlybhigherbthanbexpectedbnumberbofbcasesbofbabd
iseasebwithinbablimitedbgeographicalbregion?
a. Pandemic
b. Epidemic
c. Endemic
d. Zoonosis
e. Attackbrateb
ANSWER:bB
Thebdefinitionbofbepidemicbisbpreciselybtheboccurrencebofbabclearlybhigherbthanbhabitualbnumber
bofbcasesbofbabdiseasebwithinbabcertain bgeographicbregion. bPandemicbrefersbtobabworldwidebepide
mic.bEndemicbrefersbtobthebhabitualboccurrence.bZoonosisbdescribesbabdiseasebthatbisbtransmitted
bfrombanimals btobhumans.
7. MalariabisbabparasiticbdiseasebtransmittedbbybthebAnophelesbmosquitobbite.bThisbmodebofbt
ransmissionbisbcalled
a. direct.
b. singlebexposure.
c. multiplebexposure.
d. mosquitosis.
e. vector.
ANSWER:bE
Diseasesbtransmittedbbybmosquitosbarebcalledbvectorbborne.bDirect,bsinglebexposure,bandbmulti
plebexposurebrepresentbotherbmodesbofbtransmission,bandbmosquitosisbdoesbnotbexist.
8. AnboutbreakbofbmeaslesboccurredbinbCitybA.bTherebwereb1,000bconfirmedbcasesbamongbchil
drenbyoungerbthanb10byearsbold.bUnfortunately,b50bchildrenbdiedbofbmeasles.bFiftybrepresentb5
%bofbthebtotalbnumberbofbcases.bWhatbconceptbisbbeingbillustratedbinbthisbexample?
a. Attackbrate
b. Secondarybattackbrate
c. Case-fatalitybrate
d. Incubationbperiod
e. Subclinicalbdiseaseb
ANSWER:bC
Case-
fatalitybratebisbdefinedbasbthebproportionbofbpeoplebwhobdiebofbabdisease,bamongbthebtotalbnumber
bofbcasesbofbthatbdisease.bAttackbratebandbsecondarybattackbratebreferbtobthebproportionbofbpeopleb(
atbrisk)bwhobdevelopbabdiseasebamongbthebtotalbnumberbofbpeoplebwhobwerebatbriskbforbthebdiseas
e.bIncubationbperiodbdescribesbthebperiodbbetweenbtheboriginbofbdiseasebandbonsetbofbclinicalbsym
ptoms.bSubclinicalbdiseasebdescribesbabdiseasebthatbdoesbnotbmanifestbclinically.
, 9. DuringbthebconquestbofbMexico,boutbreaksbplayedbanbimportantbrolebthatbfavoredbthebSpani
ards.bTherebwerebseveralboutbreaksbofbsmallpoxbthatbkilledbthousandsbofbnatives.bSmallpoxbwa
sbintroducedbintobAmericabbybthebEuropeans.bWhybwerebthebnativesbparticularlybafflictedbbybs
mallpoxboutbreaks?
a. Amongbnatives,bthebproportionbofbsusceptiblesbwasbhigher.
b. AmongbSpaniards,bthebproportionbofbimmunesbwasbextremelyblow.
c. Spaniardsbhadbthebcurebforbsmallpox.
d. Nativesbhadbabgenebthatbmadebthembmorebpronebtobdiebfrombsmallpox.
e. Spaniardsbwerebprotectedbfrombsmallpoxbbecausebtheybhadbarmors.
ANSWER:bA
BecausebnativesbwerebnotbintroducedbtobthebsmallpoxbvirusbuntilbafterbthebSpaniardsbarrived,bal
lbofbthembwerebsusceptibles.bInbabpopulationbwithbabhigherbproportionbofbsusceptibles,boutbreak
sbcanbinitiatebandbspreadbeasily.bSpaniardsbhadbabbetterbbalancebbetweenbsusceptiblesbandbimmu
nes;bthereforebtheblikelihoodbofbanboutbreakbhappeningbamongbthembwasbmuchblower.
10. ThebpopulationbofbOriolbCitybinbJuneb2018bwasb612,437.bAccordingbtobthebOriolbCity’sbheal
thbdepartment,btherebwereb329bnewbcasesbofbRaven’sbdiseasebduringb2018.bCountingbthosebnewb
cases,bbybDecemberb31bitbwasbestimatedbthatbtherebwereb6580bpersonsbwithbRaven’sbdiseasebinb
OriolbCity.bWhatbwasbthebincidencebratebofbRaven’sbdiseasebinb2018?
a. 26bperb100,000bpopulation
b. 33bperb100,000bpopulation
c. 54bperb100,000bpopulation
d. 1074bperb100,000bpopulation
e. 5000bperb100,000bpopulationb
ANSWER:bC
Thebnumeratorbtobcalculatebthebincidencebratebisbthebtotalbnumberbofbnewbcasesb(329),bandbthebd
enominatorbisbthebtotalbnumberbofbpeoplebwhobwerebatbriskbofbdevelopingbthebconditionb(inbthisb
casebwebusebthebpopulationbatbthebmiddlebofbthatbperiod,b612,437).bWebexpressbthebincidencebrat
ebperb100,000btobavoidbthebdecimals:b329/612,437b=b0.000537bb100,000b=b53.7.
11. ThebpopulationbofbOriolbCitybinbJuneb2018bwasb612,437.bAccordingbtobthebOriolbCity’sbheal
thbdepartment,btherebwereb329bnewbcasesbofbRaven’sbdiseasebduringb2018.bCountingbthosebnewb
cases,bbybDecemberb31bitbwasbestimatedbthatbtherebwereb6580bpersonsbwithbRaven’sbdiseasebinb
OriolbCity.bWhatbwasbthebprevalencebofbRaven’sbdiseasebinb2018?
a. 26bperb100,000bpopulation
b. 33bperb100,000bpopulation
c. 54bperb100,000bpopulation
d. 1074bperb100,000bpopulation
e. 5000bperb100,000bpopulationb
ANSWER:bD
b b b b
7th Edition By David D Celentano; Moyses Szklo
b b b b b b b
Chapters 1 - 20 Complete
b b b b b
,TABLE OF CONTENTS
b b
Chapterb1bIntroduction
Chapterb2bThebDynamicsbofbDiseasebTransmission
Chapterb3bThebOccurrencebofbDisease
Chapterb4bThebOccurrencebofbDisease
Chapterb5bAssessingbthebValiditybandbReliabilitybofbDiagnosticbandbScreeningbTests
Chapterb6bThebNaturalbHistorybofbDisease
Chapterb7bObservationalbStudies
Chapterb8bCohortbStudies
Chapterb9bComparingbCohortbandbCase-ControlbStudies
Chapterb10bAssessingbPreventivebandbTherapeuticbMeasures
Chapterb11bRandomizedbTrials
Chapterb12bEstimatingbRisk
Chapterb13bMorebonbRisk
Chapterb14bFrombAssociationbtobCausation
Chapterb15bMorebonbCausalbInference
Chapterb16bIdentifyingbthebRolesbofbGeneticbandbEnvironmentalbFactorsbinbDiseasebCausation
Chapterb17bUsingbEpidemiologybtobEvaluatebHealthbServices
Chapterb18bEpidemiologicbApproachbtobEvaluatingbScreeningbPrograms
Chapterb19bEpidemiologybandbPublicbPolicy
Chapterb20bEthicalbandbProfessionalbIssuesbinbEpidemiology
,prepared by stevesalvardo
b b
for any inquiry and further request e
b b b b b b
mail:
Chapterb01:bIntroduction
Celentano:bGordisbEpidemiology,b7thbEditionbTestbBank
MULTIPLEbCHOICE
1. bWhichbofbthebfollowingbisbanbexamplebofbtertiarybprevention?
a. Vaccinationbforbrotavirusbforbchildrenb youngerbthanbthebagebofb1byear
b. Surgicalbamputationbofbanbextremitybwithbosteosarcomab(bonebcancer)
c. Screeningbforbgestationalbdiabetesbafterb24bweeksbofbpregnancy
d. Sexualbeducationbprogrambinbelementarybschools
e. Increasingbtaxesbforbbuyingbcigarettesb
ANSWER:bB
Surgicalbamputationbofbanbextremitybwithbosteosarcomab(bonebcancer)bisbanbexamplebinbwhichbw
henb ab diseaseb isb presentb theb treatmentb (amputation)b isb doneb tob reduceb theb impactb ofb diseasebbyb
preventingbthebtumorbfrombdissemination.bVaccinationbforbrotavirusbforbchildrenbyoungerbthanbt
hebagebofb1byear,bsexualbeducationbprogrambinbelementarybschools,bandbincreasingbtaxesbforbbuyi
ngbcigarettesbrepresentbexamplesbofbprimarybprevention.bScreeningbforbgestationalbdiabetesbafter
b24bweeksbofbpregnancybisbanbexamplebofbsecondarybprevention.
2. Thisbhistoricbcharacterbobservedbthatbchildbedbfeverbmortalitybmorebcommonbamongbwomenbtrea
tedbbybphysiciansbandbmedicalbstudentsbcomparedbwithbwomenbtreatedbbybmidwives.bBasedbonbhi
sbobservations,bhebimplementedbabhandbwashbpolicybthatbresultedbinbadecreasebinbmortality.bNameb
thebcharacterbthatbwebarebtalkingbabout.
a. JohnbSnow
b. EdwardbJenner
c. D.A.bHenderson
d. LeonbGordis
e. IgnazbSemmelweisb
ANSWER:bE
IgnazbSemmelweisbidentifiedbthatbmedicalbstudentsbandbphysiciansbtransmittedbthebdiseasebbybn
otbwashingbtheirbhandsbafterbexaminingbbodiesbatbautopsiesbandbconductingbmultiplebexaminati
onsbinbthebclinic.
3. ThanksbtobthebcontributionsbofbEdwardbJenner,bthebfollowingbdiseasebwasberadicatedblaterbb
ybeffortsborganizedbbybD.A.bHenderson:
a. Cholera
,b. Smallpox
c. Chickenpox
d. Polio
e. Zika
.
,ANSWER:bB
Smallpoxbwasberadicatedbinb1980.bEdwardbJennerbvaccinatedbJamesbPhippsbinb1796bagainstbs
mallpox.bAlmostb200byearsblater,bthebWorldbHealthbOrganizationb(WHO)bcommissioned
D.A.bHendersonbtobleadbthebeffortsbtoberadicatebthebdisease.
4. Overbthebpastbcentury,babmarkedbdeclinebinbthebmortalitybratesbofbmanybinfectiousbdiseasesbh
asbbeenbobserved.bWhichbofbthebfollowingbisbthebmostblikelybreasonbforbthebobservedbdeclinebinb
mortalitybratesbfrombcommonbinfectiousbdiseases?
a. Developmentbofbpenicillin
b. Developmentbofbinsulin
c. Developmentbofbvaccines
d. Improvementbinbsocialbconditions
e. Worsebsanitationbandbunsafebwaterb
ANSWER:bD
Althoughbmedicalbtreatmentsbpotentiallybhelpedbinbthebdecreasebofbinfectiousbdiseases,btheba
dvancementbinbsocialbconditionsbplayedbabmajorbrole.bThesebimprovementsbincludebbetterbsa
nitation,bsafebdisposalbofbwaste,bbetterbnutrition,bandbimprovementbinbhousingbconditions.
.
,Chapter 02: The Dynamics of Disease Transmission
b b b b b b
Celentano:bGordisbEpidemiology,b7thbEditionb
MULTIPLEbCHOICE
1. Whichbtermbmostbaccuratelybdescribesbthebfollowingbdefinition?b“Theboccurrencebinbabcom
munityborbregionbofbcasesbofbanbillness,bspecificbhealth-relatedbbehavior,borbotherbhealth-
brelatedbevents bclearlybinbexcessbofbnormalbexpectancy.”b[PortabM,bed.bAbDictionarybof
Epidemiology.bNewbYork:bOxfordbUniversitybPress;b2014.]
a. Endemic
b. Epidemic
c. Pandemic
d. Attackbrate
e. Incubationbperiodb
ANSWER:bB
Anbepidemicbisbtheboccurrencebofbhealth-
relatedbeventsbinbabcommunityborbregion,binbclearbexcessbofbnormalbexpectation.bEndemicbisbno
tbtruebbecausebitbisbdefinedbasbthebconstantboccurrencebofbabdisease,bdisorder,borbnoxiousbinfecti
ousbagentbinbabgeographicbareaborbpopulationbgroup.bPandemicbisbnotbtruebbecausebitbisbdefinedb
asbanbepidemicboccurringboverbabverybwidebarea,bcrossingbinternationalbboundaries,bandbusuall
ybaffectingbablargebnumberbofbpeople.bAttackbratebisbnotbtruebbecausebitbisbdefinedbasbnumberbofb
peoplebatbriskbinbwhombabcertainbillnessbdevelopsboverbtotalbnumberbofbpeoplebatbrisk.bIncubatio
nbperiodbisbnotbtruebbecausebitbisbthebintervalbfrombreceiptbofbinfectionbtobthebtimebofbonsetbofbcli
nicalbillnessb(thebonsetbofbrecognizablebsymptoms).
2. Whatbisbthebmostbaccuratebdefinitionbofbthebincubationbperiodb(ofbanbinfectiousbdisease)?
a. Thebtimebofbonsetbofbclinicalbillnessborbthebonsetbofbrecognizablebsymptoms
b. Thebintervalbfrombreceiptbofbinfectionbtobthebtimebofbonsetbofbclinicalbillnessb(thebonsetbofbr
ecognizablebsymptoms)
c. Thebtimebofbinvasionbbybanbinfectiousbagent
d. Thebtimebbetweenbinitiationbofbinfectionbandbfirstbsheddingborbexcretionbofbthebagent
e. Thebperiodbbetweenbexposurebandbthebonsetbofbinfectiousnessb
ANSWER:bB
Thebincubationbperiodbisbdefinedbasbthebintervalbfrombreceiptbofbinfectionbtobthebtimebofbonsetbof
bclinical billnessb(thebonset bofbrecognizablebsymptoms);binbotherbwords,bthebtimebbetweenbthebmo
mentbofbdevelopingbsymptomsbandbthebmomentbofbinvasionbbybanbinfectiousbagent.b“Thebtimebo
fbonsetbofbclinicalbillnessborbthebonsetbofbrecognizablebsymptoms”bisbnotbtruebasbitbcorrespondsbt
ob“timebofbonset.”b“Thebtimebofbinvasionbbybanbinfectiousbagent”bisbnotbtruebasbitbcorrespondsbtob
“timebofbinfection.”b“Thebtimebbetweenbinitiationbofbinfectionbandbfirstbsheddingborbexcretionbo
fbthebagent”bandb“Thebperiodbbetweenbexposurebandbthebonsetbofbinfectiousness”barebnotbtruebasb
theybcorrespondbtobtheblatentbperiod.b(Theblatentbperiodbis
,focusingbonbthebonsetbofbinfectiousness,bbutbthebincubationbperiodbisbfocusingbonbthebonsetbofbt
hebsymptom.)
3. TherebwasbabfoodbpoisoningboutbreakbonbAprilb1,b2018,batbthebCitybZbFoodbSafetybConferenc
e.bTherebwereb1,000bpeoplebregisteredbforbthebconferencebwithbluncheon,b100bvolunteersbtobhost
battendees, bandb50bpeoplebwhobservedbthebluncheonbduringbthebconference. bExceptbforb50bpeopl
ebwhobservedbthebfood,ballbofbthebparticipantsbandbvolunteersbatebthebfoodbfrombthebluncheonbatbt
hebconferencebonbAprilb1,b2018.bBasedbonlybonbthebinformationbgivenbinbthisbquestion,bhowbman
ybpeoplebarebatbriskbinbthisbfoodbpoisoningboutbreak?
a.b1,000
b.b1,100
c.b1,150
d.b150
e.b50bAN
SWER:bB
Peoplebatbriskbinbthisboutbreakbarebpeoplebwhobwerebexposedbtobthebfoodbatbthebconference.bEve
nbthoughb1,150bpeoplebwerebatbthebconference,b50bpeoplebwhobservedbthebfoodbdidbnotbeatbthebfo
od.bThereforebwebhavebtobexcludebthoseb50bpeople.
4. TherebwasbabfoodbpoisoningboutbreakbonbAprilb1,b2018,batbthebCitybZbFoodbSafetybConfere
nce.bTherebwereb1,000bpeoplebregisteredbforbthebconferencebwithbluncheon,b100
volunteersbtobhostbattendees,bandb50bpeoplebwhobservedbthebluncheonbduringbthebconference.bE
xceptbforb50bpeoplebwhobservedbthebfood,ballbofbthebparticipantsbandbvolunteersbatebthebfoodbfro
mbthebluncheonbatbthebconferencebonbAprilb1,b2018.bAfterbanbinitialboutbreakbofbfoodbpoisoningb
isbreported,banbepidemiologistbsendsbsurveysbtoballbpeoplebatbriskbtobinvestigatebthe
cause.bHowever,bonlyb900bpeoplebamongbthosebatbriskbanswerbthebsurvey.bAfterbanalysisbofb900
bsurveybresults,bthebepidemiologistbconcludesbthatbthebmost bsuspectedbfoodsbinbtheboutbreakbare
bpepperonibpizzabandbmeatballbspaghetti.bWhat bisbtheboverall battackbratebforbthosebwhobatebmeat
ballbspaghetti?bUsebthebfollowingbtablebtobanswerbthebquestion.
SummarybofbSurveybResponses
Numberbofbpeoplebwhobdevel Numberbofbpeoplebwhobatebtheb
opedbthebcasebdefinitionbsymp food
toms
Pepperonibpizzabonly 113 275
Meatballbspaghettibonly 62 375
Bothbpepperonibpizzabandb 57 150
meatballbspaghetti
Neitherbofbpepperonibpizzaborb 10 100
meatballbspaghetti
a.b41%
b.b38%
c.b27%
,d.b40%
e.b23%bA
NSWER:b
E
Tobcalculatebthebfood-
specificbattackbrate,bwebneedbtobdefinebhowbmanybpeoplebarebexposedbtobthebspecificbfoodbandbh
owbmanybpeoplebdevelopbthebsymptomsbinbthebcasebdefinition.bInbthisbquestion,bwebarebaskingba
boutb“overall”battackbratebinbthosebpeoplebwhobatebmeatballbspaghetti,bsobwebhavebtobaddb“meat
ballbspaghettibonly”bandb“bothbpepperonibpizzabandbmeatballbspaghetti”btobgetbtheboverallbrate.b
Whichbisb525b(375bplusb150),bwhobarebatbriskbofbexposure,bandb119b(62bplusb57),bwhobdevelope
dbthebsymptoms,bcorrespondingbtob23%bofbattackbrate.
5. TherebwasbabfoodbpoisoningboutbreakbonbAprilb1,b2018,batbthebCitybZbFoodbSafetybConferen
ce.bTherebwereb1,000bpeoplebregisteredbforbthebconferencebwithbluncheon,b100bvolunteersbtobh
ostbattendees,bandb50bpeoplebwhobservedbthebluncheonbduringbthebconference.bExceptbforb50bp
eoplebwhobservedbthebfood,ballbofbthebparticipantsbandbvolunteersbatebthebfoodbfrombthebluncheo
nbatbthebconferencebonbAprilb1,b2018.bAfterbanbinitialboutbreakbofbfoodbpoisoningbisbreported,ba
nbepidemiologistbsendsbsurveysbtoballbpeoplebatbriskbtobinvestigatebthebcause.bHowever,bonlyb90
0bpeoplebamongbthosebatbriskbanswerbthebsurvey.bAfterbanalysisbofb900bsurveybresults,bthebepid
emiologistbconcludesbthatbthebmostbsuspectedbfoodsbinbtheboutbreakbarebpepperonibpizzabandb
meatballbspaghetti.bWhatbisbthebmostbsuspectedbfoodbforbfoodbpoisoningbafterbcross-
tabulation?bUsebthebfollowingbtablebtobanswerbthebquestion.
SummarybofbSurveybResponses:
Numberbofbpeoplebwhobdevel Numberbofbpeoplebwhobatebtheb
opedbthebcasebdefinitionbsymp food
toms
Pepperonibpizzabonly 113 275
Meatballbspaghettibonly 62 375
Bothbpepperonibpizzabandb 57 150
meatballbspaghetti
Neitherbofbpepperonibpizzaborb 10 100
meatballbspaghetti
a. Pepperonibpizzabonly
b. Meatballbspaghettibonly
c. Bothbpepperonibpizzabandbmeatballbspaghetti
d. Neitherbpepperonibpizzabnorbmeatballbspaghetti
e. Webcannotbdeterminebthebcausebofbfoodbbasedbonbthisbinformationb
ANSWER:bA
Pepperonibpizzabonlybattackbratebisb41.09%b(113bdividedbbyb275),bandbmeatballbspaghettibonlybis
b16.53%b(62bdividedbbyb375).bThebattackbratebofbbothbpepperonibpizzabandbmeatballbspaghettibisb3
8.00%b(57bdividedbbyb150).bSomebmaybchoosebbothbofbthembwhichbarebthebmostbsuspected
,food.bIfbbothbthebfoodsbwerebthebmostbsuspectedbfood,bwebshouldbhavebabhigherbattackbratebinbme
atballbspaghettibonlybgroupbasbwell.
6. Whatbisbthebnamebofbtheboccurrencebofbabclearlybhigherbthanbexpectedbnumberbofbcasesbofbabd
iseasebwithinbablimitedbgeographicalbregion?
a. Pandemic
b. Epidemic
c. Endemic
d. Zoonosis
e. Attackbrateb
ANSWER:bB
Thebdefinitionbofbepidemicbisbpreciselybtheboccurrencebofbabclearlybhigherbthanbhabitualbnumber
bofbcasesbofbabdiseasebwithinbabcertain bgeographicbregion. bPandemicbrefersbtobabworldwidebepide
mic.bEndemicbrefersbtobthebhabitualboccurrence.bZoonosisbdescribesbabdiseasebthatbisbtransmitted
bfrombanimals btobhumans.
7. MalariabisbabparasiticbdiseasebtransmittedbbybthebAnophelesbmosquitobbite.bThisbmodebofbt
ransmissionbisbcalled
a. direct.
b. singlebexposure.
c. multiplebexposure.
d. mosquitosis.
e. vector.
ANSWER:bE
Diseasesbtransmittedbbybmosquitosbarebcalledbvectorbborne.bDirect,bsinglebexposure,bandbmulti
plebexposurebrepresentbotherbmodesbofbtransmission,bandbmosquitosisbdoesbnotbexist.
8. AnboutbreakbofbmeaslesboccurredbinbCitybA.bTherebwereb1,000bconfirmedbcasesbamongbchil
drenbyoungerbthanb10byearsbold.bUnfortunately,b50bchildrenbdiedbofbmeasles.bFiftybrepresentb5
%bofbthebtotalbnumberbofbcases.bWhatbconceptbisbbeingbillustratedbinbthisbexample?
a. Attackbrate
b. Secondarybattackbrate
c. Case-fatalitybrate
d. Incubationbperiod
e. Subclinicalbdiseaseb
ANSWER:bC
Case-
fatalitybratebisbdefinedbasbthebproportionbofbpeoplebwhobdiebofbabdisease,bamongbthebtotalbnumber
bofbcasesbofbthatbdisease.bAttackbratebandbsecondarybattackbratebreferbtobthebproportionbofbpeopleb(
atbrisk)bwhobdevelopbabdiseasebamongbthebtotalbnumberbofbpeoplebwhobwerebatbriskbforbthebdiseas
e.bIncubationbperiodbdescribesbthebperiodbbetweenbtheboriginbofbdiseasebandbonsetbofbclinicalbsym
ptoms.bSubclinicalbdiseasebdescribesbabdiseasebthatbdoesbnotbmanifestbclinically.
, 9. DuringbthebconquestbofbMexico,boutbreaksbplayedbanbimportantbrolebthatbfavoredbthebSpani
ards.bTherebwerebseveralboutbreaksbofbsmallpoxbthatbkilledbthousandsbofbnatives.bSmallpoxbwa
sbintroducedbintobAmericabbybthebEuropeans.bWhybwerebthebnativesbparticularlybafflictedbbybs
mallpoxboutbreaks?
a. Amongbnatives,bthebproportionbofbsusceptiblesbwasbhigher.
b. AmongbSpaniards,bthebproportionbofbimmunesbwasbextremelyblow.
c. Spaniardsbhadbthebcurebforbsmallpox.
d. Nativesbhadbabgenebthatbmadebthembmorebpronebtobdiebfrombsmallpox.
e. Spaniardsbwerebprotectedbfrombsmallpoxbbecausebtheybhadbarmors.
ANSWER:bA
BecausebnativesbwerebnotbintroducedbtobthebsmallpoxbvirusbuntilbafterbthebSpaniardsbarrived,bal
lbofbthembwerebsusceptibles.bInbabpopulationbwithbabhigherbproportionbofbsusceptibles,boutbreak
sbcanbinitiatebandbspreadbeasily.bSpaniardsbhadbabbetterbbalancebbetweenbsusceptiblesbandbimmu
nes;bthereforebtheblikelihoodbofbanboutbreakbhappeningbamongbthembwasbmuchblower.
10. ThebpopulationbofbOriolbCitybinbJuneb2018bwasb612,437.bAccordingbtobthebOriolbCity’sbheal
thbdepartment,btherebwereb329bnewbcasesbofbRaven’sbdiseasebduringb2018.bCountingbthosebnewb
cases,bbybDecemberb31bitbwasbestimatedbthatbtherebwereb6580bpersonsbwithbRaven’sbdiseasebinb
OriolbCity.bWhatbwasbthebincidencebratebofbRaven’sbdiseasebinb2018?
a. 26bperb100,000bpopulation
b. 33bperb100,000bpopulation
c. 54bperb100,000bpopulation
d. 1074bperb100,000bpopulation
e. 5000bperb100,000bpopulationb
ANSWER:bC
Thebnumeratorbtobcalculatebthebincidencebratebisbthebtotalbnumberbofbnewbcasesb(329),bandbthebd
enominatorbisbthebtotalbnumberbofbpeoplebwhobwerebatbriskbofbdevelopingbthebconditionb(inbthisb
casebwebusebthebpopulationbatbthebmiddlebofbthatbperiod,b612,437).bWebexpressbthebincidencebrat
ebperb100,000btobavoidbthebdecimals:b329/612,437b=b0.000537bb100,000b=b53.7.
11. ThebpopulationbofbOriolbCitybinbJuneb2018bwasb612,437.bAccordingbtobthebOriolbCity’sbheal
thbdepartment,btherebwereb329bnewbcasesbofbRaven’sbdiseasebduringb2018.bCountingbthosebnewb
cases,bbybDecemberb31bitbwasbestimatedbthatbtherebwereb6580bpersonsbwithbRaven’sbdiseasebinb
OriolbCity.bWhatbwasbthebprevalencebofbRaven’sbdiseasebinb2018?
a. 26bperb100,000bpopulation
b. 33bperb100,000bpopulation
c. 54bperb100,000bpopulation
d. 1074bperb100,000bpopulation
e. 5000bperb100,000bpopulationb
ANSWER:bD
