EPIDEMIOLOGY 227 FINAL EXAMINATION June 9, 2009, Study notes of Epidemiology

Download EPIDEMIOLOGY 227 FINAL EXAMINATION June 9, 2009 and more Study notes Epidemiology in PDF only on Docsity! 1 EPIDEMIOLOGY 227 FINAL EXAMINATION June 9, 2009 Select the best answer for the multiple choice questions. There are 95 questions and 14 pages on the examination. Notify the instructor if your examination does not have 14 pages. Clearly indicate on the scan form the one best answer to each question among the answers provided. Be sure that you have selected your choice correctly on the scan form. Be sure that you have entered your name and identification number on the scan form and filled out the columns for the letters of your name and numbers of your identification number correctly (see front and back). Use a #2 pencil and fill all circles completely. 1. The first formal ethical code for conducting research was: a. The Declaration of Helsinki b. The Nuremberg Code c. The Belmont Report d. The Council for International Organizations of Medical Science 2. Which of the following first promulgated the three principles of ethical research: respect for persons, beneficence and justice? a. The Declaration of Helsinki b. The Nuremberg Code c. The Belmont Report d. The Council for International Organizations of Medical Science 3. The key factor in conducting ethical research is: a. Informed consent b. Beneficence c. Justice d. Respect for persons 4. Vulnerable and mentally ill persons should not be included in research because they cannot not make informed decisions: a. True b. False 5. Confidentiality means that: a. The identity of the participant is not recorded b. The principal investigator and staff have guaranteed that identifying information will not be revealed c. The principal investigator does not know the identity of the participants d. The funding agency does not know the identity of the participants. 2 6. The informed consent must always be signed to assure that the participant has been informed of all aspects of the proposed study and has willing agreed to participate: a. True b. False 7. In order to receive funding from the National Institutes of Health for funding of studies in developing countries, the principal investigator must receive approval from an ethics committee that: a. Includes epidemiologists b. Includes clergy from the local religions c. Has received a federal-wide assurance d. Has been approved by the Minister of Health of the country e. All of the above 8. All investigators and key staff must receive a certificate of completion of an approved ethics course before they can initiate a research study: a. True b. False 9. The definition of informed consent requires the following: i. Consent given by a competent individual ii. Who has received the necessary information iii. Who has adequately understood the information iv. Who considers the information and has arrived at a decision v. Has not been subjected to coercion, undue influence or inducement, or intimidation a. All are required b. i, ii, iii, and v are required c. i, ii, iii, and iv are required d. ii, iii, iv, and v are required e. None are required 10. Placebos may be used in clinical trials when: a. The alternative treatment is very expensive b. There is no reasonably available alternative treatment c. The standard treatment is associated with a risk of adverse side effects d. All of the above e. a. and c. above 11. Which of the following conditions is ethically required for a clinical or intervention trial in a developing country? a. Provide the treatment/intervention to the control group if successful b. Evaluate only interventions that could potentially be used in the country c. Provide treatment for any adverse outcomes resulting from participating in the trial d. All of the above e. a. and b. above 5 25. A “concentrated HIV/AIDS epidemic” is defined as a: a. Concentration of HIV infection among pregnant women b. Concentration of HIV infection among behavioral risk groups c. Concentration of AIDS cases among children d. Concentration of HIV/AIDS cases among defined ethnic groups e. Concentration of HIV/AIDS cases in a specified geographic area 26. Syphilis and gonorrhea are considered surrogate markers of risky sexual behavior: a. True b. False 27. Injecting drug users in Los Angeles are less likely to be HIV-infected than drug users in New York because: a. They use “black tar” b. They use “China white” c. They infect less frequently than drug users in New York d. They wash their needles after every use 28. Drug users in opioid replacement programs have fewer sexual partners than drug users not in replacement programs: a. True b. False 29. Metamphetamine taken orally does not increase the risk of HIV infection: a. True b. False 30. “Contingency management” refers to: a. Providing drug treatment in emergency situations b. Providing opioid replacement therapy when the drug users can’t get drugs c. Paying drug users for urine that is free of drugs d. Paying drug users to stop using drugs when the county has funds available 31. “PrEP” refers to: a. Strategies to dissolve heroin before injecting b. Taking antiretroviral drugs before engaging in high-risk activities c. Taking antiretroviral drugs immediately after engaging in high-risk activities d. Drawing heroin solution into the syringe prior to injecting 32. The least cost-effective strategy for controlling spread of HIV is targeting: a. Persons with HIV infection b. High-risk individuals c. At-risk individuals d. Low-risk individuals 6 33. If the prevalence of HIV in a community is 10%, at what level will pooling of 10 specimens for testing become more expensive than individual testing? a. 1-2% b. 5-6% c. 9-10% d. 24-25% e. Pooling is never less expensive 34. Structural factors facilitating HIV prevention are: a. Policies, legislation, availability of condoms b. Behavior, local customs c. Prevalence of sex workers d. Prevalence injecting drug users e. Prevalence of drug providers 35. The average “effect size” (% change) resulting from behavioral interventions is: a. 5% b. 10% c. 30% d. 60% e. 90% 36. “Framing” the intervention appropriately is key to success: a. True b. False 37. Using the media to convey intervention messages typically has an “effect size” of: a. 1-2% b. 10% c. 30% d. 60% e. 90% 38. Behavioral interventions need to: a. Identify the specific actions that are required b. Address structural barriers c. Build cognitive, affective and behavioral self-management skills d. All of the above e. a. and c. above 39. The advantage of biologic interventions such as circumcision, vaccination, etc. is that they do not depend on behavioral factors: a. True b. False 40. Evidence shows that abstinence-only programs delay sexual debut, rates of unprotected sex, teen pregnancy, and prevalence of STDs: a. True b. False 7 41. The highest priority of the 2009 financial year U.S Federal budget request for HIV/AIDS is: a. Prevention of HIV/AIDS b. Global programs for HIV/AIDS c. Housing for HIV patients d. Research e. Treatment of HIV/AIDS 42. Qualitative research seeks to answer the question “why?”, whereas epidemiologic research often seeks to answer the question “how many?” a. True b. False 43. Which of the following is/are common strategies for collecting qualitative data? a. In-depth interviews of individuals b. Focus group discussions c. Participant observation d. All of the above e. a. and b. above 44. The individual in-depth interview is a very useful tool for collecting information when which of the following are true? a. Topic is complex b. Topic is sensitive c. Geographically dispersed respondents d. Peer pressure and social desirability can affect validity e. All of the above 45. African-Americans in the U.S. account for: a. 60% of infected women b. 59% of children less than 13 years old c. 59% of heterosexual persons at risk d. All of the above e. a. and c. above 46. The highest rate of HIV infection among African-Americans is in: a. Alabama b. Georgia c. Washington, D.C. d. Mississippi e. Florida 47. The differential rate of HIV infection between African-Americans and European- Americans is greatest for: a. Men b. Women c. Children less than 13 years old d. Residents of Idaho 10 62. “Core transmitters” are key to population-based control of sexually transmitted diseases: a. True b. False 63. The majority of HIV infection from mother to child in the absence of treatment occurs: a. In utero b. During the birth process c. During breast feeding d. Risk is equal in all the above stages 64. In countries with limited resources, the most effective regimen to give mothers prior to delivery to reduce HIV infection to their infants is: a. Nevirapine b. AZT c. Nevirapine + AZT d. Tetracycline e. Penicillin 65. In most very poor developing countries, the best strategy for avoiding HIV transmission from an infected mother to her uninfected baby in the first 6-8 months is: a. Exclusive breast feeding, stopping at 6 months b. Initiation of supplementary feeding at 3 months c. Exclusive breast feeding for three months and switching to formula d. Avoiding breast feeding 66. If untreated, the perinatal risk of transmission to an infant in Africa is: a. 5% b. 16% c. 40% d. 68% e. 90% 67. Latino women in the United States expect their husband to have other sexual partners: a. True b. False 68. Which of the following factors contribute to Latina women’s vulnerability to violence and STD infection? a. The “macho” culture b. Gender inequality c. Strong family ties d. All of the above e. a. and b. above 69. Almost half of Latinos infected with HIV were born in the United States: a. True b. False 11 70. What is the major risk factor for HIV infection among Latina women? a. Injection drug use b. Multiple partners c. Transfusions d. Ear piercing e. Their husbands/partners 71. The proportion of HIV-infected persons diagnosed late in their disease course is lowest for which risk group? a. African-Americans b. European-Americans c. Hispanic-American 72. Which of the following CDC categories of HIV infection constitute a diagnosis of AIDS? a. HV neurologic conditions b. Opportunistic infectious diseases c. Opportunistic cancers d. All of the above e. b. and c. above 73. Early AIDS dementia is usually manifested by: a. Cognitive slowing b. Motor slowing c. Loss of memory d. All of the above e. a. and b. above 74. In order to diagnose AIDS dementia, it is usually necessary to: a. Rule out depression b. Observe a decline in cognitive functioning over time c. Rule out schizophrenia d. All of the above e. a. and b. above 75. Which strategy below focuses on identifying an individual in order to put her/him under treatment? a. Surveillance b. Screening c. Sentinel surveillance d. Monitoring 76. Elimination of smallpox from the world was due to: a. Development of a new vaccine b. An infusion of money for childhood immunizations c. Innovative use of surveillance to contain spread 12 77. Which of the following is more important for surveillance? a. Precision b. Timeliness 78. The “window period” refers to: a. Time interval late in HIV infection, during which tests for HIV may be negative, although infection may still be transmitted b. Time interval early in HIV infection, during which tests for HIV may be negative, but infection is not transmitted c. Time interval early in HIV infection during which tests for HIV may be negative, but infection may still be transmitted d. Time interval early in HIV infection, during which tests for HIV may be positive, but infection will not be transmitted 79. Which of the following is the most functional epidemiologic design for implementing surveillance? a. Cohort b. Cross-sectional c. Serial cross-sectional d. Case reports e. Case-control 80. The MACS is an example of which of the following types of studies? a. Unlinked anonymous b. Voluntary anonymous c. Voluntary confidential d. Mandatory e. Compulsory 81. A major objective of many HIV surveillance programs is to stimulate political and social action: a. True b. False 82. Behavioral surveillance is useful for determining: a. The proportion of HIV-infected persons in a population b. The level of risk of a population for an HIV epidemic c. To predict future trends of an HIV epidemic d. All of the above e. b. and c. above 83. The Morbidity and Mortality Weekly Report published by the U.S. Centers for Disease Control is an example of: a. Active surveillance b. Passive surveillance