SELF-ASSESSMENT QUIZ
Now that you have read Lesson 1 and have completed the exercises, you should be ready to take
the self-assessment quiz. This quiz is designed to help you assess how well you have learned the
content of this lesson. You may refer to the lesson text whenever you are unsure of the answer.
Unless instructed otherwise, choose ALL correct answers for each question.
1. In the definition of epidemiology, “distribution” refers to:
A. Who T
B. When T
C. Where T
D. Why F
2. In the definition of epidemiology, “determinants” generally includes:
A. Agents T
B. Causes T
C. Control measures
F
D. Risk factors T
E. Sources T
3. Epidemiology, as defined in this lesson, would include which of the following activities?
A. Describing the demographic characteristics of persons with acute aflatoxin poisoning in
District A T
B. Prescribing an antibiotic to treat a patient with community-acquired methicillin resistant
Staphylococcus aureus infection
F
C. Comparing the family history, amount of exercise, and eating habits of those with and without
newly diagnosed diabetes T
D. Recommending that a restaurant be closed after implicating it as the source of a hepatitis A
outbreak
T
4. John Snow’s investigation of cholera is considered a model for epidemiologic field
investigations because it included a:
A. Biologically plausible hypothesis T
B. Comparison of a health outcome among exposed and unexposed groups T
C. Multivariate statistical model F
D. Spot map T
E. Recommendation for public health action T
5. Public health surveillance includes which of the following activities:
A. Diagnosing whether a case of encephalitis is actually due to West Nile virus infection F
B. Soliciting case reports of persons with symptoms compatible with SARS from local hospitals
T
C. Creating graphs of the number of dog bites by week and neighborhood T
D. Writing a report on trends in seat belt use to share with the state legislature T
E. Disseminating educational materials about ways people can reduce their risk of Lyme disease
F
Introduction to Epidemiology F
6. The hallmark feature of an analytic epidemiologic study is: (Choose one best answer)
A. Use of an appropriate comparison group T
B. Laboratory confirmation of the diagnosis F
C. Publication in a peer-reviewed journal F
D. Statistical analysis using logistic regression F
7. A number of passengers on a cruise ship from Puerto Rico to the Panama Canal have recently
developed a gastrointestinal illness compatible with norovirus (formerly called Norwalk-like
virus). Testing for norovirus is not readily available in any nearby island, and the test takes
several days even where available. Assuming you are the epidemiologist called on to board the
ship and investigate this possible outbreak, your case definition should include, at a minimum:
(Choose one best answer)
A. Clinical criteria, plus specification of time, place, and person T
B. Clinical features, plus the exposure(s) you most suspect F
C. Suspect cases F
D. The nationally agreed standard case definition for disease reporting
F
8. A specific case definition is one that:
A. Is likely to include only (or mostly) true cases T
B. Is considered “loose” or “broad” F
C. Will include more cases than a sensitive case definition
D. May exclude mild cases T
F
9. Comparing numbers and rates of illness in a community, rates are preferred for: (Choose one
best answer)
A. Conducting surveillance for communicable diseases F
B. Deciding how many doses of immune globulin are needed F
C. Estimating subgroups at highest risk T
D. Telling physicians which strain of influenza is most prevalent F
10. For the cruise ship scenario described in Question 7, how would you display the time course
of the outbreak? (Choose one best answer)
A. Endemic curve F
B. Epidemic curve T
C. Seasonal trend F
D. Secular trend F
11. For the cruise ship scenario described in Question 7, if you suspected that the norovirus may
have been transmitted by ice made or served aboard ship, how might you display “place”?
A. Spot map by assigned dinner seating location T
B. Spot map by cabin
T
C. Shaded map of United States by state of residence T
D. Shaded map by whether passenger consumed ship’s ice or not
Introduction to Epidemiology
F
12. Which variables might you include in characterizing the outbreak described in Question 7 by
person?
A. Age of passenger T
B. Detailed food history (what person ate) while aboard ship F
C. Status as passenger or crew T
D. Symptoms F
13 When analyzing surveillance data by age, which of the following age groups is preferred?
(Choose one best answer)
A. 1-year age groups F
B. 5-year age groups F
C. 10-year age groups F
D. Depends on the disease T
14. A study in which children are randomly assigned to receive either a newly formulated
vaccine or the currently available vaccine, and are followed to monitor for side effects and
effectiveness of each vaccine, is an example of which type of study?
A. Experimental T
B. Observational F
C. Cohort F
D. Case-control F
E. Clinical trial T
15. The Iowa Women’s Health Study, in which researchers enrolled 41,837 women in 1986 and
collected exposure and lifestyle information to assess the relationship between these factors and
subsequent occurrence of cancer, is an example of which type(s) of study?
A. Experimental F
B. Observational T
C. Cohort
T
D. Case-control F
E. Clinical trial F
16. British investigators conducted a study to compare measles-mumps-rubella (MMR) vaccine
history among 1,294 children with pervasive development disorder (e.g., autism and Asperger’s
syndrome) and 4,469 children without such disorders. (They found no association.) This is an
example of which type(s) of study?
A. Experimental F
B. Observational T
C. Cohort F
D. Case-control F
E. Clinical trial F
Source: Smeeth L, Cook C, Fombonne E, Heavey L, Rodrigues LC, Smith PG, Hall AJ. MMR
vaccination and pervasive developmental disorders. Lancet 2004;364:963–9.
Introduction to Epidemiology
17. A cohort study differs from a case-control study in that:
A. Subjects are enrolled or categorized on the basis of their exposure status in a cohort study but
not in a case-control study T
B. Subjects are asked about their exposure status in a cohort study but not in a casecontrol study
F
C. Cohort studies require many years to conduct, but case-control studies do not F
D. Cohort studies are conducted to investigate chronic diseases, case-control studies are used for
infectious diseases F
18. A key feature of a cross-sectional study is that:
A. It usually provides information on prevalence rather than incidence T
B. It is limited to health exposures and behaviors rather than health outcomes F
C. It is more useful for descriptive epidemiology than it is for analytic epidemiology T
D. It is synonymous with survey T
19. The epidemiologic triad of disease causation refers to: (Choose one best answer)
A. Agent, host, environment T
B. Time, place, person
F
C. Source, mode of transmission, susceptible host F
D. John Snow, Robert Koch, Kenneth Rothman F
20. For each of the following, identify the appropriate letter from the time line in Figure 1.27
representing the natural history of disease.
__ C__ Onset of symptoms
__D___ Usual time of diagnosis
__A___ Exposure
Figure 1.27 Natural History of Disease Timeline
21. A reservoir of an infection us agent can be:
A. An asymptomatic human T
B. A symptomatic human T
C. An animal T
D. The environment T
Introduction to Epidemiology
22. Indirect transmission includes which of the following?
A. Droplet spread F
B. Mosquito-borne T
C. Foodborne T
D. Doorknobs or toilet seats T
23. Disease control measures are generally directed at which of the following?
A. Eliminating the reservoir T
B. Eliminating the vector T
C. Eliminating the host F
D. Interrupting mode of transmission T
E. Reducing host susceptibility T
24. Which term best describes the pattern of occurrence of the three diseases noted below in a
single area?
A. Endemic
B. Outbreak
C. Pandemic
D. Sporadic
__A__ Disease 1: usually 40–50 cases per week; last week, 48 cases
_D___ Disease 2: fewer than 10 cases per year; last week, 1 case
_B___ Disease 3: usually no more than 2–4 cases per week; last week, 13 cases
25. A propagated epidemic is usually the result of what type of exposure?
A. Point source F
B. Continuous common source F
C. Intermittent common source
F
D. Person-to-person
T
CHAPTER 2
14. In epidemiology, the measure of central location generally preferred for summarizing skewed
data such as incubation periods is the:
A. Mean F
B. Median T
C. Midrange F
D. Mode F
15. The measure of central location generally preferred for additional statistical analysis is the:
A. Mean T
B. Median F
C. Midrange F
D. Mode F
16. Which of the following are considered measures of spread?
A. Interquartile range T
B. Percentile F
C. Range T
D. Standard deviation T
E. variance
T
17. The measure of spread most affected by one extreme value is the:
A. Interquartile range F
B. Range T
C. Standard deviation F
D. Mean F
18. The interquartile range covers what proportion of a distribution?
A. 25% F
B. 50% T
C. 75% F
D. 100% F
19. The measure of central location most commonly used with the interquartile range is the:
A. Arithmetic mean F
B. Geometric mean F
C. Median T
D. Midrange F
E. Mode F
20. The measure of central location most commonly used with the standard deviation is the:
A. Arithmetic mean T
B. Median F
C. Midrange F
D. Mode F
21. The algebraic relationship between the variance and standard deviation is that:
A. The standard deviation is the square root of the variance T
B. The variance is the square root of the standard deviation F
C. The standard deviation is the variance divided by the square root of n F
D. The variance is the standard deviation divided by the square root of n F
22. Before calculating a standard deviation, one should ensure that:
A. The data are somewhat normally distributed T
B. The total number of observations is at least 50 F
C. The variable is an interval-scale or ratio-scale variable F
D. The calculator or software has a square-root function T
23. Simply by scanning the values in each distribution below, identify the distribution with the
largest standard deviation.
A. 1, 10, 15, 18, 20, 20, 22, 25, 30, 39 F
B. 1, 3, 8, 10, 20, 20, 30, 32, 37, 39 T
C. 1, 15, 17, 19, 20, 20, 21, 23, 25, 39 F
D. 41, 42, 43, 44, 45, 45, 46, 47, 48, 49 F
24. Given the area under a normal curve, which two of the following ranges are the same?
(Circle the TWO that are the same.)
A. From the 2.5th percentile to the 97.5th percentile T
B. From the 5th percentile to the 95th percentile F
C. From the 25th percentile to the 75th percentile F
D. From 1 standard deviation below the mean to 1 standard deviation above the mean F
E. From 1.96 standard deviations below the mean to 1.96 standard deviations above the mean T
25. The primary use of the standard error of the mean is in calculating the:
A. confidence interval T
B. error rate F
C. standard deviation F
D. variance F
CHAPTER4
1. Tables and graphs are important tools for which tasks of an epidemiologist?
A. Data collection F
B. Data summarization (descriptive epidemiology) T
C. Data analysis T
D. Data presentation T
2. A table in a report or manuscript should include:
A. Title T
B. Row and column labels T
C. Footnotes that explain abbreviations, symbols, exclusions T
D. Source of the data T
E. Explanation of the key findings F
7. Recommended methods for creating categories for continuous variables include:
A. Basing the categories on the mean and standard deviation T
B. Dividing the data into categories with similar numbers of observations in each T
C. Dividing the range into equal class intervals T
D. Using categories that have been used in national surveillance summary reports T
E. Using the same categories as your population data are grouped T
10. In general, before you create a graph to display data, you should put the data into a table.
A. True T
B. False
11. On an arithmetic-scale line graph, the x-axis and y-axis each should:
A. Begin at zero on each axis F
B. Have labels for the tick marks and each axis T
C. Use equal distances along the axis to represent equal quantities (although the quantities
measured on each axis may differ) T
D. Use the same tick mark spacing on the two axes F
CHAPTER 5
1. As described in this lesson, public health surveillance includes which activities?
A. Data collection. T
B. Data analysis. T
C. Data interpretation. T
D. Data dissemination. T
E. Disease control. F
2. Current public health surveillance targets which of the following?
A. Chronic diseases. T
B. Communicable diseases. T
C. Health-related behaviors. T
D. Occupational hazards. T
E. Presence of viruses in mosquitoes. T
3. Public health surveillance can be described primarily as which of the following?
A. A method to monitor occurrences of public health problems. T
B. A program to control disease outbreaks. F
C. A system for collecting health-related information. F
D. A system for monitoring persons who have been exposed to a communicable disease.
4. Public health surveillance is only conducted by public health agencies.
F
A. True.
B. False. F
5. Common uses and applications of public health surveillance include which of the
following?
A. Detecting individual persons with malaria so that they can receive prompt and
appropriate treatment. T
B. Helping public health officials decide how to allocate their disease control resources. T
C. Identifying changes over time in the proportion of children with elevated blood lead
levels in a community. T
D. Documenting changes in the incidence of varicella (chickenpox), if any, after a law
requiring varicella vaccination took effect. T
6. Data collected through which of the following methods is commonly used for surveillance?
A. Vital registration. T
B. Randomized clinical trials. F
C. Disease notifications T
D. Population surveys. T
7. Health-care providers might be important sources of surveillance data used by public
health officials, and they should receive feedback to close the surveillance loop as a
courtesy; however, the results almost never have any relevance to patient care provided
by those health-care providers.
A. True.
B. False. F
8. Vital statistics are important sources of data on which of the following?
A. Morbidity. F
B. Mortality. T
C. Health-related behaviors. F
D. Injury and disability. F
E. Outpatient health-care usage. F
9 Vital statistics provide an archive of certain health data. These data do not become
surveillance data until they are analyzed, interpreted, and disseminated with the intent
of influencing public health decision-making or action.
A. True. T
B. False.
10. Key sources of morbidity data include which of the following?
A. Environmental monitoring data. F
B. Hospital discharge data. T
C. Laboratory results. T
D. Notifiable disease reports. T
E. Vital records. F
11 Notifiable disease surveillance usually focuses on morbidity from the diseases on the list
and does not cover mortality from those diseases.
A. True.
B. False. F
12. The list of diseases that a physician must report to the local health department is
typically
compiled by the . . .
A. Local health department.
B. State health department.
T
C. Centers for Disease Control and Prevention (CDC).
F
D. Council of State and Territorial Epidemiologists (CSTE). F
E. Medical licensing board. F