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Sample exam questions for Introduction to Epidemiology and Public Health

Note: Questions can be multiple choice (indicate the one correct answer) or multiple response
(squares  indicate all answers that are correct).

1. To be causally associated with disease, the etiological factor should fulfill the following criteria:
Indicate all that apply.

 The factor is present in all subjects with the disease.


 Elimination of the factor reduces risk of the disease.
 The exposure to this factor should precede the development of the disease.
 The factor is more prevalent among those with the disease than among those without the
disease.
Untuk menjadi kausal dikaitkan dengan penyakit, faktor etiologi harus memenuhi kriteria sebagai
berikut: menunjukkan semua yang berlaku.

 (Faktor yang ada dalam semua mata pelajaran dengan penyakit.


 (Penghapusan faktor yang mengurangi risiko penyakit.
 (Paparan faktor ini harus mendahului perkembangan penyakit.
 (Faktor lebih umum di kalangan orang-orang dengan penyakit daripada di antara orang-
orang tanpa penyakit.

2. At the start of a cohort study the exposure is determined with the help of a questionnaire. During
the study there is no "loss to follow-up". At the end of the follow-up time the number of cases is
known and is divided into exposed and unexposed. The odds ratio (OR) is used as the
association measure. Which comment is the most appropriate here?

a. Researchers should have better calculated the risk ratio (=incidence proportion ratio).
b. The OR has no useful interpretation.
c. Researchers should have better calculated the incidence rate ratio.
d. The OR approaches the incidence rate ratio.

Pada awal Studi kohort paparan ditentukan dengan bantuan kuesioner. Selama studi ada
tidak ada "kerugian untuk tindak lanjut". Pada akhir waktu tindak lanjut dikenal jumlah kasus
dan dibagi menjadi terkena dan tidak terpajan. Rasio peluang (atau) digunakan sebagai
ukuran Asosiasi. Komentar yang adalah yang paling tepat di sini?

a) Peneliti harus telah lebih baik menghitung rasio risiko (= insiden proporsi rasio).
b) OR memiliki tidak ada interpretasi yang berguna.
c) Peneliti harus telah lebih baik menghitung rasio tingkat insiden.
d) OR pendekatan rasio tingkat insiden.
3. During a study of 20 years five people are followed to measure the occurrence of upper respiratory
tract infection. As this infection can occur more than once, all disease events are included in this
study.
 1 person is lost to follow-up after 1.5 years.
 2 persons died respectively after 10 and 15 years from a different cause.
 1 person got the first respiratory tract infection after seven years and the second infection after 12
years of follow-up. Both infections take half a year of recovery. This person is followed-up until the
end of the study.
 One person is followed-up the whole period without occurrence of disease.

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What is de incidence rate in this study ?

a. 0.06 per person-year


b. 0.03 per person-year
c. 0.15 per person-year
d. 0.08 per person-year

Selama studi 20 tahun lima orang diikuti untuk mengukur terjadinya infeksi saluran
pernafasan atas. Seperti infeksi ini dapat terjadi lebih dari sekali, Semua penyakit acara
termasuk dalam studi ini.

 1 orang hilang untuk tindak lanjut setelah 1,5 tahun.


 2 orang meninggal karena masing-masing setelah 10 dan 15 tahun dari yang
berbeda menyebabkan.
 1 orang mendapat infeksi saluran pernafasan pertama setelah tujuh tahun dan infeksi
kedua setelah 12 tahun tindak lanjut. Infeksi kedua mengambil setengah tahun
pemulihan. Orang ini adalah ditindaklanjuti sampai akhir studi.
 Satu orang ditindaklanjuti seluruh masa tanpa terjadinya penyakit.

Berapakah tingkat insiden de dalam studi ini?

a) 0,06 per person-year


b) 0.03 per person-year
c) 0,15 per person-year
d) 0,08 per person-year

4. What is the fraction of cases with the disease among the exposed that is attributable to the
exposure?

Unexposed Exposed
Disease 9 17
No disease 7 5

a. 0.27
b. 0.60
c. 0.30
d. 0.77

Apa adalah sebagian kecil dari kasus-kasus dengan penyakit di antara yang terkena itu
disebabkan oleh paparan?

Unexposed Exposed
Disease 9 17
No disease 7 5

a. 0.27
b. 0.60
c. 0.30
d. 0.77

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5. The incidence rate (IR) differs from the incidence proportion (IP) because...
a) IP can be assessed in a closed population, IR not.
b) IR can be assessed in an open population, IP not.
c) IP takes competing mortality into account; IR does not.
d) IR can be assessed more precisely than IP

Tingkat insiden (IR) berbeda dari insiden proporsi (IP) karena...

a. IP dapat dinilai dalam populasi tertutup, IR tidak.


b. IR dapat dinilai dalam populasi yang terbuka, IP tidak.
c. IP mengambil bersaing kematian ke rekening; IR tidak.
d. IR dapat dinilai lebih tepat daripada IP

6.If you want to know the proportion of the disease that could be prevented by eliminating the
exposure in the entire study population, you should calculate the

Jika Anda ingin tahu proporsi penyakit yang dapat dicegah dengan menghilangkan eksposur populasi
seluruh studi, Anda harus menghitung disebabkan sebagian disebabkan oleh:

a. attributable fraction
b. attributable risk
c. population attributable risk percentage
d. negative predictive value

7.Precise measurement of exposure is important in epidemiologic research. Namely, when the


exposure is not precisely measured the association between exposure and effect is likely to be...

. Pengukuran secara tepat dari eksposur penting dalam penelitian epidemiologi. Yaitu, ketika
eksposur tidak tepat diukur Asosiasi antara eksposur dan efek mungkin

a. overestimated
b. confounded
c. underestimated
d. random

8.Which of the following designs is/are suitable for studying a genetic polymorphism in relation to risk
of diabetes mellitus?
Indicate all that apply.

Yang berikut desain adalah/cocok untuk mempelajari polimorfisme genetik berkaitan dengan risiko
diabetes mellitus? Menunjukkan semua yang berlaku.

 Case-control study
 Cross-sectional study
 Cohort study
 Randomized, controlled trial

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9.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?
Indicate all that apply.

Penelitian kanker dan Steroid hormon (CASH), di mana wanita dengan payudara kanker dan
sekelompok sebanding perempuan tanpa kanker payudara ditanya tentang mereka sebelum
menggunakan kontrasepsi oral adalah contoh yang jenis studi? Menunjukkan semua yang
berlaku.

 clinical trial
 cohort study
 cross sectional survey
 case-control study
 observational study
 experimental study

10.The precision of an estimate of a relative risk depends on the ...

Ketepatan perkiraan risiko relatif tergantung pada...

a. generalisability
b. size of the study
c. validity of the study
d. presence of bias

11.In a cohort study the relative risk for COPD for moderate smokers versus non-smokers was 4. For
heavy smokers compared to non-smokers the relative risk was 10.
What would have been the relative risk for COPD in this study if the heavy smokers were used
as the reference category?

Dalam Studi kohort risiko relatif PPOK untuk moderat perokok dibandingkan non-perokok adalah
4. Bagi perokok berat dibandingkan non-perokok risiko relatif adalah 10. Apa yang akan menjadi
risiko relatif PPOK dalam studi ini jika perokok berat yang digunakan sebagai referensi Kategori?

a. for non-smoking 0.1 and for moderate smoking 0.4


b. for non-smoking 0.2 and for moderate smoking 0.6
c. for non-smoking 4 and for heavy smoking 10
d. this cannot be calculated with the available data

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12.An epidemiologist in Tanzania wants to study the efficacy of iron supplementation for the
prevention of HIV infection. He wants to make sure that only subjects who are (still) free of HIV
infection are enrolled in his trial. Therefore, he screens a large group of people using a diagnostic
test. Based on the outcome of the test, he decides who could participate in his iron supplementation
trial. For this purpose, it is very important that the diagnostic test has a high...

Epidemiologi di Tanzania ingin belajar kemanjuran suplementasi besi untuk pencegahan infeksi
HIV. Dia ingin memastikan bahwa hanya subyek yang (masih) gratis infeksi HIV terdaftar di
persidangan. Oleh karena itu, ia layar sekelompok besar orang-orang yang menggunakan tes
diagnostik. Berdasarkan hasil tes, ia memutuskan siapa yang dapat berpartisipasi dalam
suplemen besi percobaan. Untuk tujuan ini, sangat penting bahwa tes diagnostik memiliki
tinggi...

a. sensitivity
b. positive predictive value
c. specificity
d. negative predictive value

13.A diabetes test is being applied in a population of 5000 men. Previous evaluation of the diabetes
test in a different population showed a sensitivity of 70% and an specificity of 80%. The
prevalence of diabetes is 0.5%.
What is the diagnostic value of a positive test in this situation?

Tes diabetes sedang diterapkan pada populasi 5000 orang. Sebelumnya Evaluasi uji diabetes
dalam populasi berbeda menunjukkan kepekaan 70% dan spesifisitas 80%. Prevalensi diabetes
adalah 0,5%. Berapakah nilai diagnostik tes positif dalam situasi ini?

a. 2%
b. 47 %
c. 4%
d. 70 %

14.Information bias in a cohort study can be avoided by ensuring that...


Indicate all that apply.

Informasi bias dalam Studi kohort dapat dihindari dengan memastikan bahwa... Menunjukkan
semua yang berlaku.

 no competing diseases do occur.


 follow-up is complete.
 the persons who assess the disease are not aware of the exposure of the participant.
 disease assessment is highly standardized.
 the persons who collect the data are not aware of the study hypothesis.

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15.A cohort study shows a RR of 1.8 (95% CI 1.4-2.2) for alcohol consumption and breast cancer.
Another cohort study shows a RR of 1.8 (95% CI 0.6-3.5) for smoking and breast cancer.
What can be concluded from the results of this study?
Indicate all that apply.

Studi kohort menunjukkan RR 1,8 (95% CI 1.4-2.2) untuk alkohol konsumsi dan kanker
payudara. Lain Studi kohort menunjukkan RR 1,8 (95% CI 0,6-3,5) untuk rokok dan kanker
payudara. Apa bisa disimpulkan dari hasil studi ini? Menunjukkan semua yang berlaku.

 Both associations are likely to be due to chance.


 Both associations are biased.
 The study on smoking is probably smaller than the study on alcohol.
 Alcohol and smoking both cause breast cancer.

16.When studying diet and risk of chronic diseases, a cohort study generally has the following
advantage compared to a case-control study:

a. Potential confounders can be taken into account


b. Selection bias does not occur
c. Various dietary exposures can be studied at the same time
d. It has higher internal validity

Ketika mempelajari diet dan risiko penyakit kronis, Studi kohort umumnya memiliki keuntungan
berikut dibandingkan dengan studi kasus-kontrol:
a) Potensi confounders dapat diperhitungkan
b) seleksi bias tidak terjadi
c) berbagai Diet eksposur dapat dipelajari pada saat yang sama memiliki
d) validitas internal yang lebih tinggi

17.What is a disadvantage of a cohort study compared to a clinical trial?

a. The external validity is lower


b. It is more prone to confounding
c. It is less suitable for studying clinical outcomes
d. Participants can drop out during follow-up

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18.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?

Framingham belajar, di mana sekelompok penduduk telah diikuti sejak tahun 1950-an untuk
mengidentifikasi terjadinya dan faktor risiko untuk penyakit jantung, adalah contoh yang jenis
studi?

 cohort
 case-control
 experimental
 observational
 clinical trial
 cross-sectional

19.Researchers prospectively follow a group of 100 vegetarians and 200 non-vegetarians.


After 30 years of follow-up, 8 of the vegetarians and 20 of the non-vegetarians develop heart
disease. The 95% confidence interval on the relative risk of 0.8 ranges from 0.6 to 0.9.
Select the best statement.

a. Vegetarians were 80% less likely to develop heart disease during 30 years of follow-up
compared with non-vegetarians.
b. The researchers should have calculated an odds ratio rather than a relative risk.
c. The relative risk of 0.8 is not statistically significant as the 95% confidence interval contains
the value 0.8.
d. Vegetarians were 20% less likely to develop heart disease during 30 years of follow-up
compared with non-vegetarians.

Peneliti prospektif mengikuti sekelompok vegetarian 100 dan 200 non-vegetarian. Setelah 30
tahun tindak lanjut, 8 dari vegetarian dan 20 dari non-vegetarian mengembangkan penyakit
jantung. Interval kepercayaan 95% pada risiko relatif 0.8 berkisar 0,6-0,9. Pilih pernyataan
terbaik.

a) Vegetarian adalah 80% lebih kecil kemungkinannya untuk mengembangkan penyakit


jantung selama 30 tahun tindak lanjut dibandingkan dengan non-vegetarian.
b) Para peneliti harus telah menghitung rasio peluang daripada risiko relatif.
c) Risiko relatif 0.8 ini tidak signifikan secara statistik karena interval kepercayaan 95%
mengandung nilai 0,8.
d) Vegetarian adalah 20% lebih kecil kemungkinannya untuk mengembangkan penyakit
jantung selama 30 tahun tindak lanjut dibandingkan dengan non-vegetarian.

20.In the Netherlands there is an increase in the prevalence of cardiovascular diseases.


This is a consequence of

a. deterioration of the food pattern


b. increase in hypertension
c. improved treatment
d. increase in obesity

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21.General practitioners decide to intensify pharmacological treatment of patients when their absolute
10-year risk of cardiovascular mortality exceeds 20%. Which risk factors form the basis for
calculating this absolute risk?

Dokter umum memutuskan untuk mengintensifkan pengobatan farmakologis pasien ketika risiko
10 tahun mutlak angka kematian kardiovaskuler melebihi 20%. Faktor-faktor risiko yang
membentuk dasar untuk menghitung risiko ini mutlak?

a. Age, gender, smoking, isolated systolic hypertension and serum triglyceride levels
b. Age, gender, smoking, blood pressure and presence of diabetes mellitus
c. Age, gender, smoking, systolic blood pressure and serum total cholesterol
d. Age, gender, smoking, body mass index and family history

22.In a hospital-based study of the association between coffee consumption and the occurrence of
stroke, a group of patients hospitalized after suffering a stroke was compared to a control
population hospitalized for other reasons. The patients hospitalized for stroke were found to
consume significantly more coffee than the controls.
All of the following statements represent possible explanations for the observed positive
association between coffee consumption and stroke, EXCEPT:

Dalam studi berbasis rumah sakit dari Asosiasi antara konsumsi kopi dan terjadinya stroke,
kelompok pasien yang dirawat di rumah sakit setelah menderita stroke dibandingkan dengan
populasi kontrol yang dirawat di rumah sakit untuk alasan lain. Pasien dirawat di rumah sakit
untuk stroke ditemukan untuk mengkonsumsi kopi signifikan lebih daripada kontrol. Semua
pernyataan-pernyataan berikut mewakili penjelasan yang mungkin untuk diamati hubungan
positif antara konsumsi kopi dan stroke, k ecuali:

a. Heavy coffee consumers may also be heavy smokers, so smoking rather than coffee drinking
is the relevant causal factor
b. The patients restricted their coffee intake after suffering a stroke.
c. The hospitalized controls consume less coffee, on the average, than individuals in the general
population, resulting in a spurious association between coffee consumption and stroke.
d. Excessive coffee consumption can cause a stroke.

23.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 than
comparability of study arms in a randomized controlled trial.

24.In a case-control study the association was examined between smoking and risk of Parkinson's
disease. The table below provides the results. Which of the following odds ratios is correct?

Controls Cases
Smokers 55 30
Non smokers 45 70

a. 0.35
b. 2.85
c. 1.83
d. 0.55

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25.Indicate three types of cancers that are most frequently occurring in Westernized countries.

 lymphoma
 bladder cancer
 cervical cancer
 colon cancer
 prostate cancer
 breast cancer

26.An epidemiologist performed a double-blind, randomized, placebo-controlled trial to examine the


effect of fish oil supplementation on memory complaints. In the group that received fish oil, 19%
of the participants forgot to take their daily supplements during the study whereas this was only
3% in the placebo group. Is this a problem?
Epidemiologi dilakukan double blind, acak, plasebo-terkontrol percobaan untuk menguji efek
dari suplemen minyak ikan pada memori keluhan. Dalam kelompok yang menerima minyak
ikan, 19% peserta lupa untuk mengambil suplemen sehari-hari mereka selama studi
sedangkan ini hanya 3% dalam kelompok plasebo. Apakah ini masalah?

a. Yes, because this affects the external validity of the study.


b. Yes, because the study outcome can be biased.
c. No, because participants and investigators were blinded towards the type of treatment in both
groups
d. No, because all confounders were equally distributed over both groups due to randomization

27.An epidemiologist wants to assess the effect of tea drinking on blood pressure. He decides to do
an intervention study.
Which of the following measures does not increase the internal validity of the study?

Epidemiologi ingin menilai efek teh minum pada tekanan darah. Ia memutuskan untuk
melakukan studi intervensi. Mana langkah-langkah berikut tidak meningkatkan validitas internal
stud

a. Careful monitoring of blood pressure during the study


b. Inclusion of a control group
c. Randomization
d. Random selection of participants from the general population

28.The main advantage of a randomized controlled trial (RTC) compared to all other epidemiology
study designs is that the RCT:

a. equally distributes characteristics that may be independent risk factors for the outcome of
interest over the study arms.
b. is prospective thereby eliminating the need for historical data.
c. is less expensive.
d. guarantees that confounding bias will not occur.

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Keuntungan utama dari uji acak terkontrol (RTC) dibandingkan dengan desain studi
epidemiologi lainnya adalah bahwa RCT:

a. sama-sama mendistribusikan karakteristik yang mungkin faktor risiko independen


untuk menjadi hasil yang menarik atas lengan studi.
b. calon sehingga menghilangkan kebutuhan untuk data historis.
c. ini lebih murah.
d. menjamin bahwa membingungkan bias tidak akan terjadi.

29.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.

Sebuah perusahaan farmasi menunjukkan berikut dalam artikel: "1500 subyek dengan dingin
diperlakukan dengan obat baru kami. Dalam tiga hari, 95% asimptomatik dan hasil ini secara
statistik signifikan." Klaim perusahaan obat-obatan baru adalah efektif. Kesimpulan ini
dibenarkan?

a. Ya, karena efek yang sangat besar (95% dari subyek diuntungkan dari pengobatan).
b. Tidak, karena signifikansi Statistik menunjukkan bahwa hipotesis null ("tidak ada
efek") adalah benar.
c. Tidak, karena tidak ada kelompok kontrol terlibat dalam studi.
d. Ya, karena efek pengobatan tidak dapat dijelaskan secara kebetulan.

30.Public health surveillance includes various activities.


Which one is not part of public health surveillance?

a. Data collection
b. Data dissemination
c. Disease control
d. Data analysis

31.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.

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32.The number of DALYs (Disability Adjusted Life Years) lost in each person's life history can be
calculated. By combining all life histories in this population of three persons, the population
health in terms of DALYs can be described for this population.
Which of the following combinations is correct?

Jumlah DALYs (Cacat disesuaikan hidup tahun) hilang dalam sejarah kehidupan setiap orang
dapat dihitung. Dengan menggabungkan semua sejarah kehidupan pada populasi ini tiga orang,
populasi kesehatan dalam hal DALYs dapat digambarkan untuk penduduk ini. Mana kombinasi
berikut benar?

a. In the life history of person A 35 DALYs are lost and the total loss of DALYs for the population
of three is 70
b. In the life history of person A 15 DALYs are lost and the total loss of DALYs for the population
of three is 55.5
c. In the life history of person B 5 DALYs are lost and the total loss of DALYs for the population
of three is 9.5
d. In the life history of person C 19.5 DALYs are lost and the total loss of DALYs for the
population of three is 79.5

33.In a study on the prevalence of disease X in nursing homes A and B you get the following data.

Nursing home A = index 1 Persons Number of cases Prevalence rate


with disease X (per 100)
Age

Young 200 4 2.0

Old 400 24 6.0

Total 600 28 4.7

Nursing home B = index 2 Persons Number of cases Prevalence rate


with disease X (per 100)
Age

Young 800 24 3.0

Old 100 8 8.0

Total 900 32 3.6

Nursing home A + B = standard Persons Number of cases Prevalence rate


with disease X (per 100)

Age

Young

Old

Total

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One can calculate the standardized prevalence rate and comparative mortality figure (CMF) by
means of direct standardization, using the joint population of nursing home A and B as the
standard. Which calculation is correct?

Seseorang dapat menghitung standar prevalensi dan angka kematian perbandingan (PHM)
dengan standardisasi langsung, menggunakan penduduk bersama panti jompo A dan B sebagai
standar. Perhitungan yang benar?

a. The standardized rate of nursing home A is 3.3/100


b. The CMF of nursing home A is 0.97
c. The standardized rate of nursing home A is 2.4/100
d. The standardized rate of nursing home B is 6.3/10

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