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When is initiating surveillance for a new public health problem justified?
- A. If it is a communicable disease with a high case-fatality rate.
- B. If the problem is new and systematically collected data are needed to characterize the disease.
- C. If a program at CDC has recommended its addition to better understand national trends and patterns.
- D. To guide, monitor, and evaluate programs to prevent or control the problem.
Correct Answer: D
Rationale: Surveillance is essential to guide and evaluate prevention and control strategies.
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What are key sources of morbidity data?
- A. Environmental monitoring data.
- B. Hospital discharge data.
- C. Laboratory results.
- D. Notifiable disease reports.
Correct Answer: D
Rationale: Notifiable disease reports provide critical data on specific diseases of public health importance.
Surgeons at hospital A report that the mortality rate at the end of a 1-year follow-up after a new coronary bypass procedure is 15%. At hospital B, the surgeons report a 1-year mortality rate of 8% after the same procedure. Before concluding that the surgeons at hospital B had vastly superior skill, which of the following possible confounding factors would you examine?
- A. The severity(stage) of disease of the patients at the two hospitals at baseline.
- B. The start of the one-year follow-up at both hospitals(after operation versus after discharge).
- C. Differences in postoperative care at the two hospitals.
- D. Equality of follow-up for mortality.
Correct Answer: D
Rationale: All listed factors (a-d) could contribute to differences in mortality rates, making 'all of the above' the most comprehensive answer. Since we shift 'E' options to 'D', D is correct.
For the cruise ship scenario, if you suspected ice as a transmission source, how might you display 'place'?
- A. Spot map by assigned dinner seating location
- B. Spot map by cabin
- C. Shaded map of United States by state of residence
- D. Shaded map by whether passenger consumed ship's ice or not
Correct Answer: D
Rationale: Mapping by exposure to ice helps identify potential sources of infection.
Which of the following is the strength of Case control study?
- A. rare disease
- B. bias can be minimized
- C. temporal relationship can be established
- D. relative risk can be calculated
Correct Answer: A
Rationale: Case-control studies are particularly useful for studying rare diseases.
What is the RR of dying of lung cancer for smokers versus nonsmokers?
- A. 7
- B. 10.14
- C. 15
- D. 20
Correct Answer: B
Rationale: RR = (Death rate among smokers / Death rate among nonsmokers) = 71 / 7 = 10.14. This indicates that smokers are approximately 10 times more likely to die of lung cancer than nonsmokers.