1) At an initial examination in Oxford, Mass

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1) At an initial examination in Oxford, Mass., migraine headache was found in 5 of 1,000 men aged 30 to 35 years and in 10 of 1,000 women aged 30 to 35 years. The inference that women have a two times greater risk of developing migraine headache than do men in this age group is: a. correct b. incorrect, because a ratio has been used to compare male and female rates c. incorrect, because of failure to recognize the effect of age in the two groups d. incorrect, because no data for a comparison or control group are given e. incorrect, because of failure to distinguish between incidence and prevalence 2. A prevalence survey conducted from January 1 through December 31, 2003, identified 1,000 cases of schizophrenia in a city of 2 million persons. The incidence rate of schizophrenia in this population is 5/100,000 persons each year. What percent of the 1,000 cases were newly diagnosed in 2003? 3. What would be the effect on age-specific incidence rates if women with hysterectomies were excluded from the denominator of calculations, assuming that there are some women in each age group who have had hysterectomies? a. the rates would remain the same b. the rates would tend to decrease c. the rates would tend to increase d. the rates would increase in older groups and decrease in younger groups e. it cannot be determined whether the rates would increase or decrease 4. A survey was conducted among the nonhospitalized adult population of the United States during 1988 through 1991. The results from this survey are shown below. The researchers stated that there was an age-related increase in the risk of hypertension in this population. You conclude that the researchers' interpretation: a. is correct b. is incorrect because it was not based on rates c. is incorrect because incidence rates do not describe risk d. is incorrect because prevalence is used e. is incorrect because the calculations are not age-adjusted Age Group Persons with Hypertension (%)     18-29 years   4     30-39 years   10     40-49 years   22     50-59 years   43     60-69 years   54     70 and older   64

Questions 5 and 6 use the information below: Population of the city of Atlantis on March 30, 2003 = 183,000 No. of new active cases of TB occurring between January 1 and June 30, 2003 = 26 No. of active TB cases according to the city register on June 30, 2003 = 264 5. The incidence rate of active cases of TB for the 6-month period was: a. 7 per 100,000 population b. 14 per 100,000 population c. 26 per 100,000 population d. 28 per 100,000 population e. 130 per 100,000 population 6. The prevalence rate of active TB as of June 30, 2003, was: a. 14 per 100,000 population b. 130 per 100,000 population c. 144 per 100,000 population d. 264 per 100,000 population e. none of the above Questions 7 and 8 are based on the information given below: In an Asian country with a population of 6 million people, 60,000 deaths occurred during the year ending December 31, 1995. These included 30,000 deaths from cholera in 100,000 people who were sick with cholera. 7. What was the cause-specific mortality rate from cholera in 1995? 8. What was the case-fatality rate from cholera in 1995? 9. Age-adjusted death rates are used to: a. Correct death rates for errors in the statement of age b. Determine the actual number of deaths that occurred in specific age groups in a population c. Correct death rates for missing age information d. Compare deaths in persons of the same age group e. Eliminate the effects of differences in the age distributions of populations in comparing death rates 10. The mortality rate from disease X in city A is 75/100,000 in persons 65 to 69 years old. The mortality rate from the same disease in city B is 150/100,000 in persons 65 to 69 years old. The inference that disease X is two times more prevalent in persons 65 to 69 years old in city B than it is in persons 65 to 69 years old in city A is: a. Correct b. Incorrect, because of failure to distinguish between period and point prevalence c. Incorrect, because of failure to adjust for differences in age distributions d. Incorrect, because of failure to distinguish between prevalence and mortality e. Incorrect, because a proportion is used when a rate is required to support the inference 11. The incidence rate of a disease is five times greater in women than in men, but the prevalence rates show no sex difference. The best explanation is that: a. The crude all-cause mortality rate is greater in women b. The case-fatality rate for this disease is lower in women c. The case-fatality rate for this disease is greater in women d. The duration of this disease is shorter in men e. Risk factors for the disease are more common in women 12. Of 2,872 persons who had received radiation treatment in childhood because of an enlarged thymus, cancer of the thyroid developed in 24 and a benign thyroid tumor developed in 52. A comparison group consisted of 5,055 children who had received no such treatment (brothers and sisters of the children who had received radiation treatment). During the follow-up period, none of the comparison group developed thyroid cancer, but benign thyroid tumors developed in 6. Calculate the relative risk for benign thyroid tumors: 13. In a study of a disease in which all cases that developed were ascertained, if the relative risk for the association between a factor and the disease is equal to or less than 1.0, then: a. There is no association between the factor and the disease b. The factor protects against development of the disease c. Either matching or randomization has been unsuccessful d. The comparison group used was unsuitable, and a valid comparison is not possible e. There is either no association or a negative association between the factor and the disease Questions 14 and 15 are based on the information given in the table below. Table I01-5. Rates of Atherosclerotic Heart Disease (ASHD) per 10,000 Population, By Age and Sex, Framingham, Massachusetts     MEN WOMEN           Age at Beginning of Study (yr) ASHD Rates at Initial Exam Yearly Follow-up Exams (Mean Annual Incidence) ASHD Rates at Initial Exam Yearly Follow-up Exams (Mean Annual Incidence)           29-34   76.7 19.4 0.0 0.0           35-44   90.7 40.0 17.2 2.1           45-54   167.6 106.5 111.1 29.4           55-62   505.4 209.1 211.1 117.8 14. The relative risk for developing ASHD subsequent to entering this study in men as compared to women is: a. Approximately equal in all age groups b. Lowest in the oldest age group c. Lowest in the youngest and oldest age groups, and highest at ages 35-44 and 45-54 years d. Highest in the youngest and oldest age groups, and lowest at ages 35-44 and 45-54 years e. Highest in the oldest age group 15. The most likely explanation for the differences in rates of ASHD between the initial examination and the yearly follow-up examinations in men is: a. The prevalence and incidence of ASHD increase with age in men b. Case-fatality rates of ASHD are higher at younger ages in men c. The rates of ASHD in men is declining. d. The case-fatality rate in ASHD is highest in the first 24 hours following a heart attack e. The initial examination measures the prevalence of ASHD, whereas the subsequent examinations primarily measure the incidence of ASHD 16. Several studies have found that approximately 85% of cases of lung cancer are due to cigarette smoking. This measure is an example of: a. An incidence rate b. An attributable risk c. A relative risk d. A prevalence risk e. A proportionate mortality ratio Questions 17 and 18 refer to the following information: The results of a 10-year cohort study of smoking and coronary heart disease (CHD) are shown below:     OUTCOME AFTER 10 YRS       At Beginning of Study CHD Developed CHD Did Not Develop       2,000 Healthy smokers   65 1,935       4,000 Healthy nonsmokers   20 3,980 17. The incidence of CHD in smokers that can be attributed to smoking is: 18. The proportion of the total incidence of CHD in smokers that is attributable to smoking is: Questions 19 and 20 are based on the following information: In a cohort study of smoking and lung cancer, the incidence of lung cancer among smokers was found to be 9/1,000 and the incidence among nonsmokers was 1/1,000. From another source we know that 45% of the total population were smokers. 19. The incidence of lung cancer attributable to smoking in the total population is: 20. The proportion of the risk in the total population that is attributable to smoking is: