EPIDEMIOLOGY
2nd Long Examination Samplex
Vea, C., Villanueva, AR, A, & CM | April 11, 2018
For numbers 1 to 5 choose the appropriate RESEARCH STUDY DESIGN
from the choices below for the given situations. Choices may be used
more than once or not used at all.
A. Case Study/ Case Report
B. Case Series
C. Cross- Sectional Study
D. Ecological Study
1. In 1981, a previously healthy homosexual man presented with
serous fluid build- up in his lungs and recurrent episodes of
pneumonia. He was eventually diagnosed to have a rare
Pneumocystis carinii pneumonia, a fungal infection not commonly
seen in immunocompetent individuals. (A)
2. Also in 1981, a group of young men having sex with other men
(MSM) in their second and third decades of life from New York City
were suffering from Kaposi’s sarcoma, an aggressive rare form of
skin cancer. All men shared similar high risk lifestyle and
comparable clinical presentations. (B)
3. Now in 2018, people having Pneumocystis carinii (i.e., taxonomic
reclassification as Pneumocystis jiroveci) pneumonia have been
more common; thus, there is a need for the study of the true
prevalence rate of the said disease. (C)
4. A province found to have high consumption of fat also had a high
prevalence of cancer which uses the population of a specified
geographic area as the subject. (D)
5. Which of the following research designs could study the association
of multiple exposures and multiple outcomes at the same time? (C)
6. Which of the following is NOT a USE OF DESCRIPTIVE STUDIES?
a) Delineating syndromes of disease entities
b) Establishing the natural history of the disease
c) Classification of signs, clinical manifestations, and diseases
d) Testing of a theoretical hypothesis
Testing of theoretical hypothesis is a use of analytical study
7. The findings of the following descriptive study design/s CANNOT BE
GENERALIZED:
a) Case Study
b) Case Series
c) Ecological Study
d) All of the above
8. Which of the following is TRUE regarding CASE SERIES?
a) It has a comparison group separate from the study subjects.
b) It uses statistical test for validation of comparison of
associations.
c) It may be prospective or retrospective in nature.
d) It is used to study common diseases in the population.
9. The scatterplot below suggests what TYPE OF CORRELATION?
a) Positive correlation
b) Negative correlation
c) Neutral correlation
d) No correlation
10. The scatterplot below suggests what TYPE OF CORRELATION?
a) Positive correlation
b) Negative correlation
c) Neutral correlation
d) No correlation
There is no such thing as Neutral correlation
TRANS GROUP #28 Vea, C., Villanueva, AR, A, & CM
AND RESEARCH
METHODS I
LE 2
11. The correlation between consumption of carbohydrates and
prevalence of diabetes mellitus (DM) was calculated to have a
Pearson’s r value of 0.88 with a p- value of 0.01. How should these
VALUES be INTERPRETED?
a) Carbohydrate consumption and DM have an excellent
correlation that is statistically significant.
b) Carbohydrate consumption and DM have an excellent
correlation that is not statistically significant.
c) Carbohydrate consumption and DM have little or no
correlation that is statistically significant.
d) Carbohydrate consumption and DM have little or no
correlation that is not statistically significant.
r-value is for the magnitude of correlation and the p-value is
for the statistical significance. R- value of has a strong positive
correlation and a p-value of 0.01 is a statistically significant.
12. Which of the following can be (a) CASE REPORT/S?
a) Investigating the efficacy of Moringa oleifera (malunggay)
cream in resolving bacterial skin infections as compared to
mupirocin cream
b) Adverse events of glutathione capsules in five adult women
residing in an urban community
c) The onset of generalized acneiform eruption on a teenage
male given oral corticosteroids for optic neuritis
d) All of the above
(A) is for clinical or experimental trial
(B) is for case series
13. Which of the following does not belong to the category of
ANALYTICAL STUDIES?
a) Cross- Sectional Study
b) Ecological Study
c) Experimental Study
d) Non- Concurrent Cohort Study
Cross sectional can either be Observational or Analytical
Experimental and non-concurrent cohort are analytical studies
14. The CASE- CONTROL STUDY:
a) Employs an ambispective approach
b) Can examine a large number of predictor variables
c) Can examine a large number of outcome variables
d) Is best used for establishing prevalence
15. When selecting “CASES” in CASE- CONTROL STUDIES:
a) It is better to use prevalent than incident cases
b) Requires a suitable case definition (e.g., from databases,
registries, etc.)
c) Bias is acceptable because the controls can be matched anyway
d) Bias is easily avoided because all events recorded are in the
past
16. Which of the following is TRUE about the “CONTROLS” in CASE-
CONTROL STUDIES?
a) Selection of controls may be done from the general
population
b) They are just as motivated as the cases to recall details of their
histories
c) They must be different from the cases in all ways possible
because they are controls
d) The optimal match is one case to six controls.
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17. The basic DIFFERENCE between an OBSERVATIONAL DESCRIPTIVE
study and an OBSERVATIONAL ANALYTICAL study is:
a) The outcome variable
b) The statistical test chosen
c) The stated level of significance
d) The presence of a comparison group
18. The WEAKNESS/ES of a CASE- CONTROL STUDY lie/s in:
a) Selection bias
b) Recall bias
c) Expense to access and review past data
d) A and B only
e) All of the above
19. The finding that females diagnosed with clear cell adenocarcinoma
of the lower genital tract had 40 times higher odds that their
mothers had prenatal exposure to diethylstilbestrol (DES) was
derived from what TYPE OF STUDY?
a) Cross- Sectional Study
b) Case- Control Study
c) Concurrent Cohort Study
d) Non- Concurrent Cohort Study
First clue is the use of odds and the second is the association is from
outcome going to exposure
20. In a CROSS- SECTIONAL STUDY:
a) The outcome variables are measured in a single point in time
and the exposure variables are plotted across different
timelines
b) A clear temporal relationship is established
c) Exposure and outcome variables are designated based on
biological plausibility and background information
d) Examining associations are rarely done
21. Which is/ are TRUE about COHORT STUDIES?
a) It begins with a group at the start of the investigation that is
seen only once
b) The study participants should resemble the population to
which the study results will be generalized
c) An example is the Birmingham Heart Study
d) B and C only.
e) All of the above.
22. In general, CROSS- SECTIONAL STUDIES:
a) Require a smaller sample size than a case- control study when
studying uncommon cases
b) Provide weaker evidence for causality than cohort studies
c) Are best in determining incidence rates
d) B and C only
e) All of the above
A cross sectional study does not require a small sample size.
Cohort studies are best in determining incidence rates
23. One of the ADVANTAGES of CROSS- SECTIONAL STUDIES is that:
a) True incidence rates of disease of are determined
b) True prevalence rates of disease are determined
c) They are most effective for rare diseases
d) A and C only
e) All of the above
(A)For cohort study
(C) Case-Control study
24. In which TYPE/S OF STUDY can MULTIPLE OUTCOMES be
designed?
a) Cross- Sectional Study
b) Case- Control Study
c) Cohort Study (Concurrent)
d) A and C only
e) All of the above
25. A cross sectional study was performed on 9417 males and 7755
females who underwent a comprehensive health examination. The
association of serum uric acid (SUA) and intercranial artery stenosis
(ICAS) was analyzed using multivariate logistic regression. In
females, the multivariate- adjusted odds ratio for ICAS was 1.52
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(confidence interval 1.13- 2.04) in the third quartile of SUA and 1.45
(confidence interval 1.05- 2.00) in the highest quartile, compared to
the reference (p for trend is 0.008). SUA was not significantly
associated with the prevalence of ICAS among males. Based on this
study, which of the following statements is TRUE?
a) Females with higher serum uric acid levels are at increased
risk of ICAS compared to females with normal serum uric acid
levels.
b) Females with higher serum uric acid levels are at increased
risk of ICAS than males with higher serum uric acid levels.
c) Males at any serum uric acid level are at increased risk for
ICAS.
d) None of the above.
Given the following information there was no intention of comparison
between males and females
26. ADVANTAGES of EXPERIMENTAL DESIGNS over ANALYTIC
OBSERVATIONAL DESIGNS include the following, EXCEPT:
a) Achieves comparability of subjects for known and unknown
factors that might affect the outcome
b) Establishes temporal relationship between exposure and
outcome
c) Guarantees high external validity of the study results
d) Not susceptible to recall bias when ascertaining exposure
27. A CLINICAL TRIAL STUDY PROTOCOL is expected to contain the
following information, EXCEPT:
a) Research hypothesis
b) Measures of both the exposure and outcome variables
c) Permitted medications for co- morbid conditions
d) Statistical analysis to be applied to the data
e) Approximate budget needed to implement the study
In a protocol, it is purely the method of your research that is stated, while
a proposal considers the budget of research
28. Which of the following statements regarding EXPERIMENTAL
STUDIES is/ are TRUE?
a) Informed consent is an absolute requirement of
randomized controlled trial.
b) Blinding is a necessary step to equalize the characteristics of
the groups being compared.
c) Ransom allocation of treatment leads to a homogenous study
population.
d) A and B only.
e) All of the above.
Random allocation equalize the characteristics if the groups being
compared
Eligibility criteria is what leads to homogenous study population
29. Which of the COMMON TERMINOLOGIES used in CLINICAL TRIALS
is/ are NOT CORRECTLY DEFINED?
a) External validity of a study refers to the degree to which the
observed difference between groups can be attributed to the
treatment assignment.
b) Intention- to- treat (ITT) refers to the extent to which the
findings of the trial can be extended to the general population
of eligible persons.
c) Per- protocol- analysis counts observations/ events to patient’s
assigned treatment when the event occurred.
d) A and B only.
e) All of the above.
(A) is for Internal validity
(B) is for External validity
(C) is for Intention to Treat analysis
For numbers 30 to 31, refer to the following FICTIONAL CLINICAL STUDY
adapted from ClinicalTrials.gov:
A study was conducted to determine efficacy of a new molecule
Remuverol in alleviating chronic arthritic pain. 1 Participants were
recruited based on physician referral at three academic medical centers
between February 2010 and January 2011.2 The first participant was
enrolled in March 2010, and the last participant was enrolled in
December 2010. 3 Participants were randomly allocated to one of three
groups, (1) Remuverol 15 mg twice daily, (2) twice daily COX- 2 inhibitor,
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or (3) matching placebo also given twice daily.4 Primary outcome was (+) Stroke (-) Stroke TOTAL
defined as change from baseline to week 8 in SPS- 11 24- Hour Pain Anti-hypertensive 89 5,079 5,168
Score.5 SPS-11 is a validated, self- reported instrument assessing average plus statins
pain intensity over the past 24- hour period.6 Possible scores range from Anti-hypertensive 121 5,016 5,137
0 (no pain) to 10 (worst possible pain). Change was computed as (week 8 plus placebo
score- baseline score).7 Analysis was done on the intent- to- treat TOTAL 210 10,095 10,305
population with last observation carried forward (LOCF) imputation
method.8 Positive response was defined as reduction in SPS- 11 pan score 35. ABSOLUTE RISK REDUCTION (ARR):
greater than or equal to 50% from baseline to endpoint. 9 a) (121/ 5,137) – (89/ 5,168)
b) 1/ [(121/ 5,137) – (89/ 5, 168)]
30. This CLINICAL TRIAL DESIGN is an EXAMPLE OF: c) (89/ 5,168) ÷ (121/ 5,137)
a) Parallel Group Design d) 1 – [(89/ 5,168) ÷ (121/ 5,137)]
b) Cross- Over Design
c) Uncontrolled Clinical Trial
ARR = (C/C+D) – (A/A+B)
d) Factorial Design

31. Which of the following methodological step/s conducted in the

study was/ were meant to increase the study’s INTERNAL 36. RELATIVE RISK (RR):
VALIDITY? a) (121/ 5,137) – (89/ 5,168)
a) Statement 4 b) 1/ [(121/ 5,137) – (89/ 5,168)]
b) Statement 6 c) (89/5,168) ÷ (121/ 5,137)
c) Statement 8 d) 1 – [(89/ 5,168) ÷ (121/ 5,137)]
d) B and C only
e) All of the above RR = (A/A+B) / (C/C+D)

For numbers 32 to 34, identify what PHASE OF A CLINICAL TRIAL is

being exemplified in each of the following CASE STUDIES using the 37. RELATIVE RISK REDUCTION (RRR):
following choices: a) (121/ 5,137) – (89/ 5,168)
A. Phase 1 Clinical Trial b) 1/ [(121/ 5,137) – (89/ 5, 168)]
B. Phase 2 Clinical Trial c) (89/ 5,168) ÷ (121/ 5,137)
C. Phase 3 Clinical Trial d) 1 – [(89/ 5,168) ÷ (121/ 5,137)]
D. Phase 4 Clinical Trial
RRR = 1-RR
32. Administration of a single dose atazanavir (800 mg) with a light
meal increased Cmax by 57% and AUC by 70%; a high-fat meal
increased AUC by 35% with no change in Cmax. (A) 38. NUMBER NEEDED TO TREAT (NNT)
a) (121/ 5,137) – (89/ 5,168)
33. Bitopertin, when added to conventional drugs, improved negative b) 1/ [(121/ 5,137) – (89/ 5, 168)]
symptoms of patients with schizophrenia in a study that followed c) (89/ 5,168) ÷ (121/ 5,137)
over 1,800 patients for more than a year compared to conventional d) 1 – [(89/ 5,168) ÷ (121/ 5,137)]
drugs alone. (C)
NNT = 1/ARR
34. Tumor volume measured using computed tomography (CT)/
magnetic resonance imaging (MRI) led to complete response in one,
partial response in three, and stable disease in twenty-four patients
39. In ASSESSING A COMMUNITY’S NEEDS, which of the following
among a total of fifty-five (55) patients with advanced
should be TAKEN INTO ACCOUNT?
hepatocellular carcinoma who received a daily dose of Brivanib.
a) The community’s internal problem-solving capacity
Manageable safety profile for these patients was also reported. (B)
b) The community’s health and social statistics
c) The community’s social dynamics
Phase 1 (Pharmacology and toxicology): determine the metabolic actions d) All of the above
and the maximally tolerated dose of a drug
Phase 2 (Efficacy and safety): evaluate effectiveness, determine the short- 40. Which of the following is/ are the OBJECTIVE/S of a COMMUNITY
term side effects and identify common risks for the specific population DIAGNOSIS?
and disease. a) To determine the health needs and concerns of a community
Phase 3 (Treatment comparison): obtain additional information about the b) To know health-seeking behavior of members of the
effectiveness and clinical outcomes and evaluate the overall risk-benefit community
ratio in the demographically diverse population c) To identify the healthcare providers in the community
Phase 4 (Post marketing surveillance): monitor ongoing safety in large d) All of the above
populations and identify additional uses of the agent that might be
approved. For numbers 41-46, choose the STEP or COMPONENT OF THE
EPIDEMIOLOGIC METHOD for conducting a COMMUNITY DIAGNOSIS
For numbers 35 to 38, refer to the following scenario and identify the corresponding to the following statements from the choices below:
APPROPRIATE FORMULA / EQUATION to use to compute the given A. Definition of the Problem
TREATMENT EFFECT. B. Appraisal of Existing Facts
C. Hypothesis Formation
A study was conducted among 10, 305 hypertensive patients with D. Practical Application
average cholesterol levels and two additional cardiovascular risk factors
in order to determine if addition of statins (i.e. HMG-CoA reductase 41. The increase in the number of new cases of human
inhibitors) to anti-hypertensive regimen would decrease incidence of immunodeficiency virus (HIV) infection in the younger age groups
fatal and non-fatal stroke compared to placebo. Results are as follows: (i.e. 20-35 years old) may be due to this age groups’ risky sexual
behavior. (C)

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42. Feeding programs, such as the “soup kitchen,” organized by non- Exercise 6: Cross-Sectional Studies
governmental organization (NGOs) aid in addressing the problem of 53. How did the investigators determine the presence of ERROR OF
childhood malnutrition in urban poor and rural communities. (D) REFRACTION among the study participants?
a) Determined using a Snellen chart
43. Based on the National Diabetes Statistics Report 2017 about 7.2 b) Utilized a photoscreener
million Americans (23.84%) remained to be undiagnosed to have c) Examined using a slit lamp
diabetes mellitus. (B) d) Determined using school health records

44. According to Presidential Communications Secretary Martin
Andanar, President Rodrigo Duterte’s intensified anti-drug
operations had pulled down the country’s crime rate by 32% in
2017. (B)
45. Complications from measles and other vaccine preventable diseases
still claim the lives of children in impoverished communities. (A)
46. The various communities of indigenous cultural people (ICP) have
health concerns different from urban poor and rural communities.
(B)
For numbers 47 to 48, choose “A” if the statement is TRUE, choose “B” if
the statement is FALSE.
47. Primary data are quantified health data obtained by the investigator
personally or from previously existing information to aid in
answering different objectives or purposes set for the study. (B)
Previously existing information is for secondary data.
48. The cost of prevention for a given medical condition is the product
of the number of cases and the sum of the cost of medication,
hospitalization cost, and other medical expenses. (B)
Snellen chart is used in experiment 7 (Case control study)
54. Which of the following CHARACTERISTICS were found to be
ASSOCIATED with PRESENCE OF ERROR OF REFRACTION?
a) Students having other family members that use eyeglasses
b) Students who watch television daily
c) Students who play video games daily
d) Students who regularly play outdoors or are into sports
Exercise 7: Case-Control Study
55. How did the investigators IDENTIFY THE CASES for the study?
a) Determine visual acuity using a Snellen chart
b) Identified by the faculty based on school performance
c) Measured eye refraction using a slit lamp
d) Reported by the students using a self-administered
questionnaire
56. A student spends SEVEN (7) HOURS exposed to screen media each
day. Based on the investigators’ criteria, the student’s EXPOSURE
DURATION can be CLASIFIED as:
a) mild
b) moderate
c) severe
d) fatal

That is for the Cost of Treatment. Cost of prevention is the quotient of the Mild = 1-3
total health budget allotted for a specific disease over the disorder. Moderate = 4-6
Severe = 7-9
Very severe = >9
For numbers 49 to 60, refer to the given MANUAL EXERCISE:

Exercise 4: Case Report and Case Series 57. Which of the following VARIABLES has a STATISTICALLY
49. The patient diagnosed with Mayer-Rokitansky-Kuster-Hauser SIGNIFICANT RELATIONSHIP with VISUAL ACUITY:
Syndrome INITIALLY PRESENTED with: a) Distance of exposure
a) Abnormal vaginal bleeding b) Duration of exposure
b) Incidental finding on ultrasound c) Frequency of exposure
c) Persistent abdominal pain d) All of the above
d) Primary amenorrhea
Exercise 8: Cohort Study
50. On workup, ALL five pediatric patients with autoimmune gastritis 58. What is the INDEPENDENT VARIABLE of the study?
(AIG) presenting with iron-deficiency anemia (IDA) were FOUND TO a) Cigarette smoking
HAVE: b) Job type
a) Strong family history of cancer c) Prostate cancer development
b) Slight nodular duodenitis d) Work schedule
c) Presence of parietal cell antibody (PCA)
d) Presence of IgG for Helicobacter pylori 59. How did the investigators measure/ obtain INFORMATION
regarding the INDEPENDENT VARIBLE of the study?
Exercise 5: Ecologic Study a) Direct observation of study participants
51. Which of the following has the HIGHEST CORRELATION with b) Review of employment records
PANCREATIC CANCER INCIDENCE? c) Using a self-administered questionnaire
a) Hazardous waste d) All of the above
b) Median household income
c) Percent cigarette smokers 60. How did the investigators measure/ obtain INFORMATION
d) Solid waste regarding the DEVELOPMENT OF PROSTATE CANCER among the
study participants?
52. DATA USED in the study were OBTAINED FROM: a) Cancer registry data
a) Cancer registry b) Hospital/ clinic records review
b) Hospital records review c) Periodic physical examination
c) Household interview d) Self-reporting of prostate cancer diagnosis
d) Multi-county survey

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Answer Key
1. A
2. B
3. C
4. D
5. C
6. D
7. D
8. C
9. A
10. D
11. A
12. C
13. B
14. B
15. B
16. A
17. D
18. D
19. B
20. C
21. B
22. B
23. B
24. D
25. A
26. C
27. E
28. A
29. E
30. A
31. E
32. A
33. C
34. B
35. A
36. C
37. D
38. B
39. D
40. D
41. C
42. D
43. B
44. B
45. A
46. B
47. B
48. B
49. D
50. C
51. D
52. A
53. B
54. C
55. A
56. C
57. B
58. D
59. C
60. A

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