CD: Final exam
What is the defining threshold BMI for obesity?
30
The case fatality of MI in developed nations is approximately
30%
The relative mortality from acute conditions (infection, violence, perinatal and maternal disease) in low income nations is approximately
40%
Approximately how many people in the world population are seropositive for HBV?
400 million
What percentage of strokes are ischemic?
85%
Which of the following conditions shows a declining prevalence with aging?
Asthma
At present, the primary route of HCV transmission in the United States is by
Contaminated needles used for injection of illicit drugs
Chronic diseases are largely not preventable.
False
The nation with the greatest longevity is
Japan
Somatic mutations refer to
Non-heritable base pair changes in DNA
Approximately 5.1 million deaths from MI occur in developing nations, typically at relatively early ages (median age ~ 50 years).
True
Approximately one quarter of adults are hypertensive.
True
Disability Adjusted Life Years (DALYs) in underdeveloped countries arise primarily from premature death.
True
Hypertension is clinically defined by systolic blood pressure exceeding 140 mm Hg or diastolic blood pressure exceeding 90 mm Hg.
True
What type of heart arrhythmia increases the risk of stroke more than five-fold?
atrial fibrillation
Most people living with HIV in sub-Saharan Africa are men.
false
Worldwide, the leading cause of cancer death in both men and women is
lung cancer
Cardiovascular disease (CVD) is the leading cause of death worldwide
true
WHO reported that 1.37 million individuals had HIV/AIDS and tuberculosis in 2007, most of whom (~80%) lived in sub-Saharan Africa.
true
Weight reduction is effective in reducing the risk of developing osteoarthritis.
true
Worldwide, the leading cause of cancer death in men is lung cancer.
true
Which of the following is not an example of tertiary prevention?
vaccination
Following osteoporotic fracture, the risk of death is greatest during what time period?
0-6 months post fracture
According to the textbook, approximately how many people die from malaria each year?
1-2 billion
According to recent WHO survey data, approximately what fraction of adults are chronic smokers in the world population?
1/3
Approximately what fraction of adults in the world population smokes?
1/3
Approximately what fraction of lung cancer cases among nonsmokers is attributable to "passive smoking"?
1/3
Secondary hypertension accounts for what percentage of cases?
10%
The case fatality of MI in the US population is currently approximately
10%
Colorectal cancer mortality has been decreasing among US women since about
1950
Approximately how many people in the world population are seropositive for Mycobacterium tuberculosis?
2 billion
What is the elevation in the risk of developing type 2 diabetes in women with a history of gestational diabetes?
2 to 3-fold
After age 55 years, the prevalence of COPD in men exceeds that in women by approximately
2-fold
The average development time (latency period) of lung cancer is approximately
20 years
What percentage of diabetics in the US population remain undiagnosed?
20%
Non-alcoholic fatty liver disease, the most prevalent of all liver diseases, is estimated to afflict what percentage of adults in the US population?
20-30%
What percentage of MIs occur without warning in the absence of prior chest pain or other symptoms?
25%
Approximately what percentage of cancer mortality is attributable to cigarette smoking and other forms of tobacco use?
30%
Mammography has been shown to decrease breast cancer mortality in women over the age of 50 years by about
30%
The global case fatality rate of stroke is approximately
35%
The percentage of hypertensive cases who are unaware of their elevated blood pressure is approximately
40%
Currently, approximately how many people die each year from smoking-related diseases such as heart disease, lung cancer, stroke, COPD?
5-6 million
Approximately what percentage of cancer patients die from their disease in developed countries with effective cancer prevention and treatment services?
50%
About what percentage of HIV/AIDS cases in sub-Saharan Africa are female?
60%
Global relative mortality from chronic diseases is approximately
60%
What percentage of colon cancers arise in the descending colon?
65%
The current world population is approximately
7 billion
Infection by oncogenic HPV strains such as HPV16 and HPV18 has been estimated to account for what percentage of cervical cancer cases?
70%
The case fatality of MI in developing nations is approximately
70%
The relative mortality from chronic diseases (heart disease, cancer, stroke, COPD, diabetes) in high income nations is approximately
75%
Approximately what percentage of cancer patients die from their disease in underdeveloped countries without effective cancer prevention and treatment services?
80%
What percentage of deaths from malaria occur in children under 5 years of age?
85%
Approximately what percentage of deaths from malaria occur in sub-Saharan Africa?
90%
Approximately what percentage of lung cancer is attributable to cigarette smoking?
90%
Approximately what percentage of suicide cases had a prior psychiatric diagnosis at the time of death?
90%
Compared to women of normal weight, gravid obesity (BMI of 35 or more) increases the risk of type 2 diabetes by
90-fold
Strategies for the prevention of bladder cancer include all of the following except
Abstinence from alcoholic beverages
What US subgroup has the highest risk of developing prostate cancer?
African AMericans
In the United States, the relative frequency of HIV/AIDS is highest in which ethnic group?
African Americans
Which ethnic group in the US has the highest incidence of MI?
African Americans
Serum levels of what ovarian protein have been used to monitor the regression/progression of disease in women with ovarian cancer?
CA-125
Which of the following is not a major risk factor for the development of the adenocarcinoma of the lower esophagus?
Chronic H. pyloris infection of the stomach
Acute diseases cause more deaths than chronic diseases in the world population.
False
Cardiovascular diseases are largely not preventable through public health strategies and evidence-based risk factor interventions.
False
Disability Adjusted Life Years (DALYs) in developed countries arise primarily from premature death.
False
In impoverished nations, chronic diseases cause more deaths than acute diseases.
False
Most CVD deaths occur in high income countries.
False
The fertility rate in the USA is approximately 2.0 per woman during childbearing years, which is slightly above the global average.
False
In developing countries, liver cancer ranks second regarding deaths from cancer due to relatively high exposure to all of the agents listed below except
HIV
Which of the following is not a proven risk factor for hypertension?
High LDL cholesterol
Explanations for the Japanese Paradox include all of the following except
High rates of alcohol abuse
What gender-ethnic group has the highest mortality rate due to cirrhosis of the liver?
Hispanic American men
The clinical management of Multiple Sclerosis has improved considerably primarily due to
Imaging techniques such as MRI
Which nation(s) has/have recently experienced increased rates of CVD?
India, Latin America, Russian Fed
Mycotic contaminantion of what grain is associated with increasing rates of esophageal cancer in Southern Africa and other sub-Saharan countries of Africa?
Maize
All of the following are risk factors for the development of Alzheimer's disease except
Nonsterodidal anti-inflammatory drugs (NSAIDs)
Epidemiologic studies of kidney cancer and type 2 diabetes may suffer from what type of bias?
Reverse causality bias
Deficiency of which of the following neurotransmitters has been found to have a significant association with suicidal ideation, depression and suicide?
Seratonin
Which of the following behavioral changes have been shown to help reduce kidney dysfunction in patients with diabetic nephropathy?
Smoking cessation Blood pressure reduction Glucose control weight reduction
There is recent evidence that screening for lung cancer may be enhanced by
Spiral computerized tomography of the lungs
The highest annual death rates worldwide are found in
Sub-Saharan Africa
Epidemiologic investigations have consistently found that ovarian cancer risk is decreased by
Sustained use of oral contraceptives
Hypertension prevalence has increased more in US women than men in the last two decades.
True
Of the 10 million children who die before reaching 5 years of age, 6 million deaths are attributable to malnutrition and starvation.
True
Since 1970, US mortality rates from coronary heart disease and stroke have declined more than 50%.
True
The Russian Federation has one of the highest mortality rates in the world, likely due to high rates of chronic smoking and alcohol abuse.
True
The annual mortality rate in sub-Saharan Africa is approximately twofold higher than the rest of the world.
True
The global smoking prevalence is about 40% in men and 10% in women.
True
What biomarker of inflammation has recently proven to be an effective predictor of impending stroke/TIA?
a)C Reactive Protein
Which of the following statements are true?
a)CVD mortality is 40% higher in men than women. c)CVD mortality is 38% higher in African Americans than Caucasian Americans.
Which of the following statements are true?
a)CVD mortality is 40% higher in men than women. c)CVD mortality os 38% higher in African Americans than Caucasian Americans.
The higher prevalence of hypertension in postmenopausal women compared to men of the same age is most likely a consequence of
a)Greater longevity b)Reduced circulating estrogen c)Increasing obesity
Which of the following are risk factors for CVD?
a)High LDL cholesterol c)Low HDL cholesterol
The risk of colon cancer is inversely related to the
a)High intake of Omega-3 fatty acids c)High intake of insoluble dietary fiber
Th epidemiologic transition refers to
a)increasing rates of chronic disease and decreasing rates of acute disease
The demographic transition is due to which of the following?
a)population aging c)declining fertility
Congestive heart failure arises when
a)the heart pumps insufficient blood. b)the ejection fraction falls below 50%. c)antecedent heart disease compromises heart function.
The term for programmed cell death is
apoptosis
Based on results from the INTERHEART Study, which of the following is the strongest risk factor for MI?
b) Apo B / Apo A1 ratio
The primary risk factor for hepatocellular carcinoma in the US population is
b) Chronic alcohol abuse leading to liver cirrhosis.
Animal studies and some human studies suggest that breast cancer risk is decreased by high intake of
b)n-3 fatty acids such as linolenic acid. d)fish oil.
The most important vehicle for transimssion of HBV is
blood
Worldwide, the leading cause of cancer death in women is
breast cancer
The British Physician Study of daily aspirin intake (500 mg) showed that
c)Aspirin reduced lung cancer mortality
In the INTERHEART Study, what measure of obesity was the strongest predictor of acute MI?
c)Elevated Waist/Hip Ratio
Which of the following agents shows chemopreventive effects against the development of liver cirrhosis?
caffeine
The leading cause of death in the world is
cardiovascular disease
What form of cancer causes the most deaths among women in developing countries?
cervical cancer
What form of CVD is increasing in developed nations?
congestive heart failure
Invasive cancer is typically treated by
d) Evidence-based combinations of the above procedures
The onset of Multiple Sclerosis typically occurs during the
early 30s
An elevation in which of the following hormones is not associated with the development of secondary hypertension?
estrogen
The lower prevalence of hypertension in premenopausal women compared to men of the same age is most likely due to
estrogen
African Americans have a higher prevalence of Multiple Sclerosis than White Americans and Asians.
false
Among infants and children who experience epilepsy, environmental factors are the most important class of risk factors.
false
Benign prostatic hypertrophy (BPH) is considered a precancerous lesion that may evolve into prostate cancer.
false
Chronic tobacco smoking does not increase the risk of nephropathy in diabetic patients.
false
Colrectal cancer is much more common in developing countries than developed countries.
false
Evidence from epidemiologic investigations suggests that light (or moderate) alcohol consumption significantly increases the risk of stroke whereas heavy drinking may offer slight protection.
false
Glucosamine and Chondroitin clearly show benefit in reducing pain and reversing progression of osteoarthritis.
false
Hypertension rarely goes undetected
false
In developing countries, the rates of esophageal cancer are always higher in men than in women
false
In developing nations, the leading cause of cancer death among women is breast cancer.
false
Individuals who consume a diet with a low glycemic index are at increased risk of developing type 2 diabetes.
false
Low dietary fiber has not been etiologically linked to the development of colon cancer.
false
Oral contraceptive use increases the risk of developing rheumatoid arthritis in women.
false
Parkinson's disease is frequently diagnosed in adults under 50 years of age.
false
Passive smoking is not a confirmed risk factor for lung cancer
false
The age-specific prevalence of Parkinson's disease is higher in women than men.
false
The incidence of MI has declined dramatically in the US population.
false
The rising incidence rates of kidney cancer may be partially attributed to improvements in imaging tehniques; thus, these better detection methods do explain the worldwide increase in mortality.
false
Vaccination against HPV strains 16 and 18 is not a form of primary prevention.
false
Very few of those who commit suicide have a psychiatric diagnosis at the time of death.
false
Which of the following is not a proven risk factor for stroke?
high LDL cholesterol
Risk factors for type 2 diabetes include all of the following except
high dietary magnesium
Risk factors for adult onset asthma include all of the following except
immunization history
The mortality from stroke in the US shows considerable overlap with mortality from which of the following diseases?
lung cancer
The presence of COPD significantly increases the risk of which of the following forms of cancer?
lung cancer
What form of cancer shows the greatest increase in mortality in US women since 1950?
lung cancer
Barrett's esophagus, a premalignant lesion, increases the risk of esophageal adenocarcinoma by
more than 30-fold
Vasoconstrictive agents include all of the following except
nitric oxide
Aromatase-catalyzed biosynthesis of estrogen by adipose tissue has been advanced to explain observations of elevated ovarian cancer risk in association with which of the following risk factors?
obesity
Non-infectious Risk factors for active TB include all of the following except
obesity
The strongest predictor of stroke mortality among nations is the
per capita income
What biomarker of inflammation has recently proven to be an effective predictor of impending MI?
reactive protein
A meta-analysis of 21 prospective cohort studies found that obesity increases the risk of cardiovascular disease by 81%.
true
Across all age groups, cancer currently ranks second, behind heart disease, as a leading cause of global death
true
Adiposity and weight gain are strong risk factors for gout while weight loss is protective.
true
Aflatoxin exposure through ingestion of moldy grain significantly increases the risk of liver cancer.
true
Age-adjusted mortality rates due to liver cirrhosis are 2 to 3-fold higher in men than women.
true
An effective vaccine has been developed against HBV.
true
Approximately 2.1 million deaths from MI occur developed nations, typically at later ages (median age ~ 65 years).
true
Approximately 90% of all gout cases are due to defective renal clearance of uric acid.
true
Bariatric surgery to reduce gastric capacity has proven to be effective in the treatment of morbid obesity in some patients.
true
Barrett's esophagus is a premalignant lesion that is treatable.
true
Based on results of the INTERHEART Study, the best predictive risk factor for MI is the Apo B / Apo A1 ratio.
true
Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death among women (only lung cancer causes more deaths).
true
Carcinoma of the prostate is the second most common form of cancer in men and the sixth leading cancer deaths worldwide.
true
Childhood asthma constitutes more than two-thirds of all cases in most populations surveyed.
true
Chronic Obstructive Pulmonary Disease (COPD) causes nearly 3 million deaths annually in the world population.
true
Chronic alcohol drinking and cigarette smoking are major risk factors for squamous cell carcinoma of the esophagus.
true
Chronic exposure to radon gas has been found to increase the risk of developing lung cancer.
true
Combined results from epidemiologic studies suggest there is a significant dose-response in COPD risk with increasing duration of exposure to environmental tobacco smoke.
true
Deficiencies in Vitamin D and calcium are also prominent causes of two related bone disorders, rickets and osteomalacia.
true
Denis Burkitt recommended intake of 40 grams of fiber daily for the prevention of colorectal cancer
true
Each year, about 15.5 million people suffer strokes in the world
true
Epilepsy is diagnosed by confirmation of two or more unprovoked seizures separated by at least 24 hours in an individual.
true
Global estimates of the deaths caused by malaria each year range from 1 million to more than 2 million.
true
Global estimates of the new cases of malaria diagnosed each year range from 250 million to more than 500 million.
true
Globally, annual mortality rates due to cardiovascular disease (CVD) is approximately 29% of all deaths.
true
Hematopoietic (blood) cancers (leukemias and lymphomas) arise from lymphocytes, granulocytes, or other dividing cells of the bone marrow and the lymphatic system
true
Hepatocellular carcinoma is usually fatal within 6 months of diagnosis.
true
Higher rates of colon cancer have been found in association with increased dietary intake of omega-6 fatty acids from beef, corn oil, or lard in the diet.
true
Hyperglycemia is associated with an increase in the risk of developing osteoarthritis.
true
Hypertension is relatively common in the Stroke Belt of the United States.
true
Hypertension, hyperlipidemia and obesity are independent risk factors for renal nephrosis
true
In 2018, approximately 1.3 new cases of prostate cancer were diagnosed and 250,000 died from the disease globally.
true
In areas of low HBV endemicity, such as in North America, Australia and Europe, HBV and HIV infection are usually acquired in adolescence or adulthood through sexual contact or intravenous drug injection
true
In countries where euthanasia is legal, the number of assisted suicides has risen dramatically in the past two decades.
true
In countries with intermediate and high HBV endemicity, the main routes of transmission of HBV are perinatal or in early childhood.
true
In endemic areas of TB, the risk of developing active disease is highest during the first year of life
true
In nearly all nations, the suicide rate in males far exceeds the rate in females
true
In postmenopausal women, estrogen replacement therapy (ERT) has consistently been found to protect against osteoporosis.
true
In the INTERSALT Study, restriction of dietary salt to less than 6 grams per day was found to significantly reduce the risk of stroke.
true
In the INTERSTROKE Study, the strongest risk factor for stroke was hypertension.
true
In the year 2009, estimated 2.6 million new HIV infections were detected and 1.8 million people died from HIV/AIDS.
true
Incident cases of active TB detected detected globally in 2017 were estimated to be about 10.0 million
true
Infection by respiratory syncytial viruses and/or rhinoviruses have been found to increase the risk of asthma development in children.
true
Inhalation of wood smoke independently increases the risk of developing lung cancer in nonsmokers.
true
Linolenic acid, an n-3 polyunsaturated fatty acid prominent in marine diets, has been found to reduce tumor growth and development.
true
Malaria transmission can be reduced substantially by preventing mosquito bites by distribution of inexpensive mosquito nets and insect repellents, or by mosquito-control measures such as spraying insecticides inside houses and draining standing water where mosquitoes lay their eggs.
true
Many non-infectious risk factors such as smoking, COPD and diabetes significantly heighten the risk of developing active TB among patients with latent disease
true
More than 300 million people suffer from asthma in the world population.
true
Multiple sclerosis is characterized by disruptions in the blood brain barrier, inflammatory processes, and demyelination and death of neurons.
true
Mycobacterium tuberculosis can be transmitted by ingestion of contaminated milk or meat
true
Myocardial infarctions (MI) are most commonly due to occlusion (blockage) of a coronary artery caused by atherosclerosis or following the rupture of a vulnerable atherosclerotic plaque.
true
Myocardial infarctions cause approximately 7.2 million deaths annually in the world.
true
Nephritis is an inflammatory disease of the kidneys evidenced by the presence of inflammatory cells of the immune system.
true
Nephrosis is kidney disease with proteinuria (excess loss of protein in the urine) in the absence of inflammatory disease.
true
Occupational cadmium exposure is a risk factor for osteoporosis
true
Overall, COPD ranks fifth in cause-specific mortality and is projected to climb even higher in the coming years.
true
Primary prevention refers to avoidance of exposure to disease-causing risk factors.
true
Regular intake of nonsteroidal anti-inflammatory drugs in smokers may reduce their risk of developing lung cancer.
true
Renal cell carcinoma, arising from epithelial cells that line the renal tubules, is the most common type of kidney cancer, accounting for approximately 85-90% of all malignant kidney tumors.
true
Secondary prevention refers to screening for the detection of antecedent conditions that predispose one to disease and are curable by effective treatment or detection of disease at an early stage when effective treatment is likely to restore health.
true
Since 1970, US hospitalization rates for congestive heart failure have quadrupled.
true
Since almost any neurological symptom can appear in patients with multiple sclerosis, other conditions must be ruled out in reaching the diagnosis.
true
Specific food allergies (e.g., milk, eggs and peanuts) increase the risk of developing childhood asthma.
true
Strokes are classified as either ischemic or hemorrhagic which constitute about 85% and 15% of cases, respectively.
true
The classical risk factors for breast cancer include familial and genetic predisposition, early menses, delayed reproductive history, nulliparity, and absence of lactation, late menopause and the natural process of aging.
true
The dominant risk factor for transitional cell urinary bladder cancer is cigarette smoking, which accounts for about two thirds of new cases in men and one third of new cases in women
true
The evolution of solid tumors is typically a long term process spanning many years and often decades
true
The global rise in CVD in developing nations reflects increases in key risk factors (such as heightened consumption of westernized diets, declining physical activity and increased tobacco addiction) associated with industrialization, urbanization, economic development and market globalization.
true
The metabolic syndrome and its components increase the risk of developing gout.
true
The pathogenesis of bone loss and osteoporosis is modulated by multiple risk factors including aging, nutritional deficiencies (vitamin D and calcium), postmenopausal estrogen deficiency in women, and various lifestyle factors including smoking, alcohol abuse, lack of exercise, low body mass and certain environmental exposures.
true
The predominant etiologic agent in the genesis of both emphysema and chronic bronchitis is cigarette smoking (or any other form of smoking tobacco).
true
The prevalence of epilepsy in developed countries is approximately 6-9 per 1,000.
true
The prevalence of obesity is up to 10-fold higher in populations residing in urban areas than in rural areas.
true
The risk of osteoporosis is 2-3 time higher in women than men at all ages.
true
The size of fat cells (adipocytes) fluctuates widely in adults depending upon storage of triacylglycerol for energy reserve.
true
The two major forms of CVD, ischemic (coronary) heart disease and stroke cause approximately 25% of all deaths.
true
Tobacco Smoking increases the risk of developing rheumatoid arthritis.
true
Uncontrolled cell division, invasion of contiguous tissue and metastasis distinguish cancerous growths from benign cellular growths, the latter being self-limiting with no ability to invade tissue or metastasize.
true
High levels of what mineral were recently found associated with significantly improved survival among Swedish men with invasive prostate cancer?
zinc