PREVMED Superexam TOPNOTCH

Which of the following herbal medicines recommended by the DOH is an antihelminthic agent? A. Akapulko B. Bayabas C. Yerba buena D. Ulasimang bato E. Niyog-niyogan

37 E.

Prevention of neonatal tetanus includes the following measures,EXCEPT: A. Community immunization programs for women of reproductive age B. Immunize newborn at birth C. Training midwives and traditional birth attendants D. Maternal immunization E. Immediate immunization of trauma wound

417 B.

Rabies, psittacosis, salmonellosis: A. Bacterial infections B. Zoonoses C. Person-to-person spread D. Viral infections E. Arthropod-borne infections

459 B. Rabies, psittacosis and salmonellosis are zoonoses that is infections transmitted from animals to humans.

A familial aggregation pattern exists for cancer of all the following organs except? A. Breast B. Ovary C. Colon D. Uterus E. Larynx

476 E. Laryngeal CA is related to smoking and alcohol use

The most common site of cancer in persons from developing countries is: A. lungs B. pancreas C. cervix and uterus D. liver E. Colon

477 A. Pretest 7th ed 195, modified

This epidemiological concept states that effects never depend on single isolated cause but rather as result of causation in which each link is the result of complex genealogy and antecedents. A. Epidemiological triad B. Web of causation C. Mutlitple causation D. The wheel E. Lever

48 B. Web of causation is the correct answer.

What is the most commonly used index of fertility? A. Total fertility rate B. Infant mortality rate C. Maternal mortality rate D. Crude birth rate

485 D. Crude birth rate is computed as number of births over the total populations x 1000.

What is the most exposed industry to ergonomic problems? A. mining B. fishing C. manufacturing D. Agriculture

488 C. This is due to repetitive workload.

Most common hepatic malignancy : A hepatoma B hepatocellular carcinoma C metastases D hepatoadenoma

565 C.

This epidemiologic curve has a short ascending limb and longer descending limb A. Classical epidemiological curve B. Propagated epidemiological curve C. Progressive epidemiological curve D. Both B and C E. AOTA

57 A.

Defined as a branch of medical science dealing with methods of preventing the occurrence of disease? A. Public Health B. Family Medicine C. Epidemiology D. Preventive Medicine E. None of the above

662 D. Definition of Preventive medicine

A researcher plans to do a survey to determine the top 10 causes of morbidity in his community. What measure of central tendency is best used? A. Mean B. Mode C. Median D. Range E. Standard deviation

76 B. Mode is defeined as the value that occurs with the greatest frequency in a set of observations. It is oftne used in public health statistics.

Pottery and glass manufacturers are at risk for thiwhc of the following health hazards? A. Carbon monoxide B. Vinyl acetate C. Asbestos D. Hydrogen sulfite E. Silica dust

592 E. Based on no. 312-313 of Pre test 7th ed

Berylliosis is associated with: A. Hay farmer B. Arc welder C. Coal welder D. Radar assembly worker E. Textile worker

637 D.

The major environmental source of lead absorbed in the human blood stream in adults is: A. air B. water C. lead-based paint D. food E. None of the above

640 A.

Fumigants are gases used to eliminate disease-carrier arthropods. One example is Carbon tetrachloride and it is A. Non-flamable B. Combined with CS2 C. Combined with Ethylene dichloride D. A and C only E. All of the above

659 E. MCU Prevmed notes, FCM 3rd edition, page 77

Sources of lead includes the following, except? A. Motor vehicle exhaust B. Metal processing C. Waste incinerators D. Lead acid battery manufacturers E. None

670 A. Motor vehicle exhaust may be a source for ozone poisoning

Treatment outcome for PTB patients characterized as a smear positive patient who has completed treatment but without proof of cure? A. Cured B. Relapse C. Treatment completed D. Failure of treatment E. Default

676 C. A patient who completed treatment but did not meet the criteria for cure or failure. This definition applies to pulmonary smear-positive and smear- negative patients and to patients with extrapulmonary disease.

Drug of choice for Chloroquine resistant malaria? A. Chloroquine B. Primaquine C. Mefloquine D. Sulfadoxine + Pyrimethamine E. None

679 D. also known as fansidar

This statistical rate reflects primarily environmental factors and is a senstive indicator of the socio-economic delopment of a community? A. General fertility rate B. Perinatal mortality rate C. Neonatal mortality rate D. Child mortality rate E. Infant mortality rate

68 D. Pls refer to your Prevmed Topnotch handouts

Primary Health Care (PHC) refers to A. The first contact of a patient with a professional health care provider B. A sub-system of the health care delivery system C. A type of health care program designed for communities D. An approach to making health care available and accessible to the population

684 D. As a strategy, primary health care focuses on individual and community strengths (assets) and opportunities for change (needs); maximizes the involvement of the community; includes all relevant sectors but avoids duplication of services; and uses only health technologies that are accessible, acceptable, affordable and appropriate. Primary health care needs to be delivered close to the people; thus, should rely on maximum use of both lay and professional health care practitioner.

Pertaining to the previous question, what is the negative predictive value of the test? A. 21.9% B. 35.5% C. 45.5% D. 54.5% E. 64.3%

73 E. Positive predictive value is TP/(TP+FP)= 21.9% and negative predictive value is TN/(TN+FN)= 64.3%

Pertaining to the previous question, what is the prevalence rate of the disease? A. 28.9% B. 35.5% C. 26.5% D. 33.8% E. 30.0%

74 A. Prevalence rate is (TP + FN) / (TP+FP+FN+TN) = 28.9%

The incidence rate of cirrhosis is 80/100,000 person years for heavy alcoholic beverage drinkers and 10/100,000 for non alcoholic beverage drinkers. What is the relative risk of developing cirrhosis for heavy alcoholic beverage drinkers and nonalcoholic beverage drinkers? A. 1/8 B. 0.8 C. 8 D. 80 E. 800

8 C. Relative risk is the incidence among the exposed divided by incidence among the unexposed. Source: Topnotch handout on preventive medicine

15. Which of the following refers to consistency and reproducibility of a test and the absence of random variation in a test? a. accuracy b. validity c. precision d. all of the above e. none of the above

95 C. A - refers to trueness of measurements (validity) and the absence of systematic error or bias in a test USMLE first AID 2015

16. A normal statistical distribution is represented by a Gaussian curve or bell shaped curve where mean = mode = median. In nonnormal statistical distributions, there is asymmetry of the curve. Which of the following refers to a bimodal distribution? a. metabolic polymorphisms of fast and slow acetylators b. age of onset of Hodgkin’s lymphoma c. suicide rate by age d. all of the above e. only B and C

96 D. USMLE first AID 2015

17. “It is a mathematical fact that fifty percent of all doctors graduate in the bottom half of their class.†Bias and study errors must be avoided to make the study valid and reliable. WHat is the best strategy to reduce bias in the Pygmalion effect or the self - fulfilling prophecy? a. blinding b. standardized method of data collection c. crossover studies d. randomization e. decrease time from exposure to follow up

97 A. Blinding and use of placebo reduce influence of participants and researchers on procedures and interpretation of outcomes as neither are aware of group allocation. Pygmalion effect refers to researcher’s belief in the efficacy of a treatment changes the outcome of that treatment (observer - expectancy bias). Blinding is also used for procedure bias. B - measurement bias. C - confounding bias. D - selection bias. E - recall bias USMLE first AID 2015

What is the PPV in the above case: A. 44% B. 89% C. 73% D. 69% E. 42%

112 C. Page 3 of pearls. Positive predictive value= number of true positives divided by the number of people who tested positive for the disease. The probability of having a condition given a positive test. PPV=27/37= 73%

This study is well-suited in studying rare disorders: A. Prospective cohort B. Retrospective cohort C. Cross-sectional D. Case Report E. Case-control

126 E. Case-control studies are well sud to studying rare disoders with multiple potential causes. They are also less expensive than prospective studies. Verbatim from handout: Case report; to address all clinical question or issue commonly used to report unusual or unexpected events. Case control: provide opportuinity to investigate RARE diseases as well as those with long period of latency

Which of the following substances is usually associated with pneumoconiosis? A. Oil fumes B. Dust particles C. Cigarette smoke D. Sulfur oxide E. Heavy metals

138 B.

You will complete the 28-30 day regimen of rabies treatment only when: A. The biting animal showed signs and symptoms of rabies B. Has died but on autopsy was IFAT (-) C. The animal was lost D. The animal died E. None of the above

144 A., C., D. When the animal shows signs and symptoms of rabies, died or lost, it is recommended to complete the 28-30 day regimen.

The primary function of the spleen is A. Filtering of damaged and old erythrocytes from the bloodstream B. Storage of platelets and granulocytes C. Blood pressure and volume regulation D. A and B E. All of the above

156 D. The function of the spleen is to remove old RBC from the blood stream and store platelets and/or granulocytes

What is the denominator for the incidence rate? A. Person-years of observation B. Midyear population C. Total population at that time D. Total population at an interval in time E. None of the above

160 A.

IO came in at your clinic due fever. He told you that he was exposed to his sneezing officemate and the symptoms started as a colds. The time interval between his exposure and the onset of colds is A. Communicable period B. Incubation period C. preinfectious period D. contagious period E. decubation period

161 B. incubation period is the time interval between entry of an infectious agent into a host and the onset of symptoms

It is defined as the capacity of an agent to induce disease which is clinically apparent in an infected host A. Infectivity B. Pathogenicity C. Virulence D. Antigenicity E. Immunogenicity

188 B. Pathogenicity

This herbal medicinal plant is used for ascariasis A. akapulko B. tsaang gubat C. ulasimang bato D. yerba buena E. niyog-niyogan

190 E. Niyog-niyogan

in what phase of clinical trial wherein the drug or test is performed on patients with consent carried out mostly on hospital in patients. It assesses the effectiveness, safety and continued use of the drug/device? A. Phase 1 B. Phase 2 C. Phase 3 D. Phase 4 E. Phase 5

228 C. phase 1 - experimental animals used to establish that the new agent is effective and suitable for human use. Phase 2 -assess the effectiveness of the drug or device , determines the appropriate dose and investigates its safety. Phase 4 - trial in normal field or program setting, reassess effectiveness, safety, acceptability and continued use of the drugs.

which of the following acts as a reservoir for Nocardiosis? A. Soil B. vegetations C. Mosquito D. human E. None of the above

239 A. Nocardia is a saprophyte ubiquitous organism found in soil.

All of the following are considered risk factors for coronary artery disease warranting institution of lipid screening except? A. diabetes B. family history of cardiovascular disease before 50 in males and 60 in females C. hypertension D. tobacco and illicit drug use E. Helicobacter pylori infection

250 E. H. pylori not implicated

All of the following are examples of secondary level of prevention except? A. RPR and VDRL on high risk patients B. HbsAg titers on pregnant mothers C. screening chest xray for recurrence D. annual mamography screening E. annual pap smear

254 C. screening for recurrence of a disease is tertiary level

Exposure of nonsmokers to second hand cigarette smoke may result in all of the following EXCEPT A. increased incidence of osteoporosis B. elevation of blood concentration of carbon monoxide C. increased incidence of infections of lower respiratory tract D. eye irritation, headache, nasal congestion and cough E. exacerbation of COPD

255 A. primary smokers cause more osteoporosis not secondary smoke

from question number 236, what is the crude birth rate? A. 12/1000 B. 13/1000 C. 14/1000 D. 15/1000 E. 16/1000

257 B. 650/50000 x 1000

from question number 236, what is the cause specific mortality rate from cardiovascular diseases? A. 400/1000 B. 500/1000 C. 600/1000 D. 700/1000 E. 800/1000

260 A. 120/300 x 1000 =

A study finds that a screening test helps increase the 5- year survival rate of patients with colon cancer. What type of bias is most likely in this study? A. Misclassification bias B. Differential bias C. Recall bias D. Surveillance bias E. Lead-time bias

263 C.Lead-time bias refers to apparent increase in life expectancy seen in patients who have their disease diagnosed with a screening test

When debating whether providing or withholding medical treatment is ethical, the least important consideration of those listed below is: A. Expected quality of life B. Patient's preference C. Physycian's preference D. Economic factors E. Indications for medical intervention

270 C. The physician's preferences are relatively unimportant in ethical decisions

What is the most important single test in the examination of drinking water? A. Physical B. Chemical C. Biological D. Bacteriological E. Radiological

272 D.

In the same town in the previous question, calculate the crude death rate: A. 22/1000 B. 23/1000 C. 24/1000 D. 25/1000 E. 26/1000

279 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Round off to the nearest whole number. Crude death rate is number of death/midyear population x 1000

Which of the following best characterizes an emphatic response of a physician? A. One which shows the interviewer's feeling to be the same as that of the patient B. One which names the patient's feelings and shows approval that the feeling is the correct one C. One which recognizes the patient's feelings and allows the patient to have the feeling D. One that names the patient's feelings and points out the rationale for the feeling E. All of the above

288 C.

Which of the following is not considered as a possible risk factor for the development of colon cancer? A. Diet high in animal fat B. Obesity and insulin resistance C. Irritable bowel syndrome D. Familial polyposis E. Ulcerative colitis

290 C. Pretest 7th ed 167, modified

A medical student is conducting a study regarding the comparison of blood glucose level before and after ingestion of one pint of ice cream. Which of the following statistical analysis would be most appropriate? A. Fishers exact test B. Analysis of variance C. Linear regression D. Multiple regression E. Paired T test

291 E. the paired t test is approprate for comparing paired (before and after) measurements

Within 4 hours after attending a village banquet, 25 individuals experienced a sudden onset of nausea, vomiting and abdominal cramps. What is the most likely infectious agent responsible for the symptoms? A. Clostridium perfringens B. Enteroinvasive Escherichia coli C. Salmonella typhimurium D. Staphylococcus aureus E. Clostridium botulinum

292 D. Pre test 7th edition 289, modified

Which of the following physical characteristics of water is the most important impediment to disinfection ? A. Color B. Viscosity C. Turbidity D. Temperature E. Density

293 C. Pre test 9th edition 258

Which of the following parameters in the APGAR measures the capability of the family to utilize and share resources? A. Adaptation B. Partnership C. Growth D. Affection E. Resolve

294 A. Partnership - ability to solve problems by communicating, Growth - freedom to grow and change, Affection - intimacy and emotional interaction within the family, Resolve - members satisfaction with the commitment made by the members of the family

The presence of petechiae, sore gums, hematuria, and joint or bone pain is associated with deficiency of what vitamin? A. Vitamin D B. Vitamin C C. Vitamin B1 D. Vitamin E E. Vitamin K

296 B. Scurvy - deficiency of Vitamin C

Drugs not covered by patent protection and which are labeled solely by their international propriety names? A. Complementary drugs B. Generic drugs C. Essential drugs D. Core drugs E. None of the above

308 B. ( SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE)

which of the following medicinal plant is correlated with anticholesterol effect? A. garlic B. ampalaya C. akapulko D. Lagundi E. None of the above

310 A. B-antidiabetes, C-scabies, tinea, ringworm, D- cough, asthma

A country has 8,190,345 male and 7,397,056 females. 40% of which are less than 45 y/o.This year there were 26,525 births, 6,146 mothers died of childbirth, 10,568 died of peumonia, 25,788 died of myocardial infarction, 7,825 died of CVA, 14,638 died of cancer, 2,027 infants less than 1 year old died of sepsis. 1736 children died of MVA. what is the maternal mortality rate ? A. 23.18% B. 23.20% C. 23.16% D. 23.19% E. 23.17%

316 E. # deaths due to childbirth/ total live births.

"I am satisfied with the way my family and I share time together" pertains to which component of the APGAR assessment tool: A. Adaptation B. Partnership C. Growth D. Affection E. Resolve

322 E.

Which statement about obesity is correct? A. Osteoarthritis is less common among obese persons because of decreased activity. B. In a normal person, 300 calories of excess carbohydrate will lead to the same weight gain as 300 calories of excess fat. C. Obese persons are significantly less active than non- obese persons. D. The apparent association between obesity and hypertension is probably due to the use of inappropriately small blood pressure cuffs in the obese subjects. E. none of the above

326 C.

Which of the following diseases is found almost exclusively among persons who have worked with or have been exposed to asbestos? A. bronchogenic carcinoma B. byssinosis C. pleural mesothelioma D. laryngeal carcinoma E. emphysema

330 C.

The newborn with CMV infection at birth most commonly presents with: A. hepatosplenomegaly B. hepatitis C. thrombocytopenia D. cerebral calcifications E. no symptoms

336 E.

The primary objective of health education is to: A. transfer technology to lay personnel B. impart knowledge C. promote health in general D. improve health practices

346 D.

Bacteriological examination of water should be done: A. every 3 months B. every 6 months C. every 12 months D. as often as possible E. only once

368 D. It should be done as often as possible but the interval between testing should not be more than 6 months; other chemical tests should be done every 12 months Topnotch pg 28

Sewer workers are exposed to which hazardous substance in their workplace? A. Silica dust B. Carbon monoxide C. Vinyl acetate D. Hydrogen sulfide E. Asbestos

378 D. #314 Pretest 7th

Statistics of disease frequency in a community are usually or routinely obtained from: A. Reports of disease occurrence only B. Registration of deaths only C. Morbidity/mortality surveys D. Reports of disease occurrence and registration of death E. Census of deaths from the NSO

407 D.

What statistical test is used to check the difference between 2 qualitative variables? A. T- test B. Z-test C. Chi square test D. ANOVA E. Regression Analysis

42 C. Chi square test: quali --> quali; t-test quali --> quanti (<30); z-test quali --> quanti (>30); ANOVA quali --> quanti (3 or more groups); Logistic regression analysis quanti--> quali; Linear regression analysis/correlation coefficient quanti- -> quanti

The following is NOT a side effect of DPT immunization: A. abscess B. seizures C. rashes D. fever E. No exception

420 C.

Randomization is a procedure used for assignment of subjects to treatment and control groups in experimental studies. This ensures: A. That treatment and control groups are similar in all respects except treatment B. That placebo effects are eliminated C. That bias in observations is reduced D. That assignment occurs by chance E. None of the above

421 D. The technique in prev med is repeated SERIOUS and SYSTEMATIC reading of the Prev Med Pretest (at least the 7th ed). Familiarize [if REALLY not memorize] yourself closely to both the questions and answers in the 1st 3 chapters. They would sometimes change some words or shuffle the choices, but they will basically be the same. This is your chance to improve your overall grade so don't miss it!

Dentist: A. Syphilis B. Hepatitis B C. Brucellosis D. Sporotrichosis

440 B. Questions in the exam can be as SIMPLE and as SHORT as this one. This asks for the infection that a dentist could probably contract because of his practice.

Dr. J will conduct a research about the prevalence of vaping and its effects to blood pressure measurements and pulse rates of call center agents in Quezon City. Individuals are initilally assembled according to some order in a group and then individuals are selected according to a constant determinant, every third of the subject. The Sampling that is used by Dr. J is: A. Systematic sampling B. Simple random sampling C. Cluster sampling D. Stratified sampling E. Paired sampling

442 A. Systematic sampling is a process that first requires the arrangement of the group to be sampled in some kind of order. Then individuals are selected systematically throghout the series on the basis of a predetrmined sampling fraction or constant determinant, for example, every 3rd, 4th, 5th in the ordered group.

Many occupational environments contain airborne substances that cause lung disease. Byssinosis is associated to: A. Radar assembly worker B. Arc welder C. Textile worker D. Hay farmer E. Coal worker

458 C. The acute symptoms of byssinosis occur in many workers after years of breathing air that contains dusts, of cotton, flax or hemp and consist of episodic obstruction with chest tightness, cough, and wheezing. Chronic byssinosis is aasociated with irreversible pulmonary damage.

All of the following are advantages of case control studies, as opposed to cohort studies, except: A. They are relatively fast studies B. They can study many possible causes of a disease C. They allow calculation of exposure rates D. They require relatively few study subjects E. They can easily study rare diseases

465 C.

The following tests and procedures have been considered for colorectal cancer screening, except: A. Annual Fecal occult blood testing B. Rigid sigmoidoscopy C. Radiographic barium contrast studies D. Ultrasound

473 D. Harrison's17th ed, 491 also colonoscopy

Possible risk factors for the development of colon cancer includes, except: A. Diet high in animal fat B. Obesity and insulin resistance C. Irritable bowel syndrome D. Familial polyposis

474 C. Pretest 7th ed 167, modified

Who is NOT considered a dependent of members, according to Philhealth? A. Ria's mother who is 55 years old B. Dax's son who is 18 years old C. Jeanry's 25 year old daughter who is mentally retarded D. None of the above

484 A. Dependent of Philhealth members are: parents over 60 years old, children below 21 years old or above 21 years old if child is mentally retarded or incapacitated.

Silica dust: A. Brake mechanic B. Potter C. Sewer D. Arc welder

494 B. Some questions in the board exam consist of one or two-word phrases lifted exactly from Pretest. So be sure to familiarize yourself with the questions and the answers. :)

Which of the following statements about blood pressure is true? A. Isolated systolic hypertension is a risk factor for stroke. B. The prevalence of isolated systolic hypertension increases with age in men but not in women. C. The prevalence of isolated systolic hypertension peaks between ages 60 and 70. D. Isolated systolic hypertension is defined as a systolic bp above 200 mmHg with a normal diastolic blood pressure.

495 A. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE Pretest 7th ed.

Which of the following statements about valvular heart disease is true? A. Most patients with mitral valve prolapse remain asymptomatic for their entire lives. B. Coronary artery disease is the most common cause of aortic stenosis in the US. C. The incidence of rheumatic heart disease in the US has been decreasing for the past 10 years. D. None of the above

496 A. MVP is seen in 7% of women aged 14 to 30, and most of them are asymptomatic. Pretest 7th ed.

Possible risk factors for the development of colon cancer includes, except: A. Diet high in animal fat B. Obesity and insulin resistance C. Irritable bowel syndrome D. Familial polyposis

514 C. Pretest 7th ed 167, modified

The rate of dissemination of an epidemic is measured by A. Pre-patent period B. Prevalance rate C. Decubation period D. Attack rate E. Generation time

52 E.

A program for the primary prevention of coronary artery disease is implemented in a community in the USA. Assuming that diagnostic procedures and detection remain the same, which of the following measures involving the disease is most effective in monitoring the program? A) Case fatality B) Hospitalization C) Incidence D) Mortality

523 C.

A 32-year-old woman who is HIV positive has a CD4+ lymphocyte count of 800/mm3 (Normal ≥ 500). Her health maintenance regimen should include immunization against which of the following pathogens? A) Haemophilus influenzae type b B) Hepatitis A C) Influenza virus D) Neisseria meningitidis

524 C.

First born child is generally A. Persevering B. Rebellious C. Demanding D. Optimisitc E. NOTA

53 A. first born - persevering; middle child - optimisitc; youngest - demanding

In explaining the results of her study to lay persons, the researcher declares that the probability of the screening test that she developed in correctly identifiying non- diseases subjects was 95%. In statistical jargon, this number represents which of the following variables: A. Sensitivity B. Specificity C. Positive predictive value D. Negative predictive value E. Odds ratio

543 B. Specificity is also known as the 'true negative fraction.'

During the SARS outbreak in 2002, 14 cases of SARS was diagnosed in the Philippines; with 2 deaths reported. Thus, the ___ rate for SARS is 14%. A. Crude mortality B. Morbidity rate C. Age-adjusted fatality rate D. Case fatality rate E. Incidence

546 D.

Which of the ff is not an example of primary prevention? A a low fat and low calorie diet B good sanitation C measles vaccine D antibiotics for pneumonia

562 D.

The goal of DOH to improve the general health status of the population requires strategies that will: A. Decrease life expectancy B. Increase total fertility rate C. Increase maternal mortality rate D. Decrease infant mortality rate E. Increase growth rate

102 D. Page 2 of Topnotch Handout. Infant mortality rate is the most sensitive indicator/index of assessing the health status in the community.

What is an experimental study? A. A brief report of a characteristic or outcome of a single clinical subject or event B. Examines the relationship between a disease and a variable of interest C. Describes the natural history of a disease D. Provide the best evidence for testing any hypothesis or investigate a cause and effect relationship E. None of the above

142 D.

In an evacuation center in Tacloban, 5350 children were registered, over a 2 month period, 2500 of them got sick, the top 3 causes of morbidity are as follows: 1. AGE - 550, 2. pneumonia - 250, 3. measles - 150, the top 3 causes of mortality are as follows: 1. pneumonia - 10, 2. measles - 9, 3. AGE - 7. What is the morbidity rate? A. 488 per 1000 population B. 467 per 1000 population C. 590 per 1000 population D. 650 per 1000 population E. 780 per 1000 population

151 B. 2500 total of who got sick/5350 registered children = 0.467289 x 1000 = 467.289 or 467 per 1000 pop.

Same case as #231. What is the cause specific mortality rate for pneumonia? A. 2 per 1000 population B. 3 per 1000 population C. 5 per 1000 population D. 7 per 1000 population E. 10 per 1000 population

153 A. 10/5350 = 0.001869 x 1000 = 1.869 or 2

It is a herbal plant used in lowering serum uric acid levels A. Allium sativum B. Cassia alata C. Mentha cordifelia D. Blumea balsamifera E. Peperonia pellucida

158 E. Common name is ulasimang bato

Bacillus Calmette-Guerin or BCG is prepared using ____________ bacteria that have lost their virulence in human. A. M. tuberculosis B. M. bovis C. M. avium D. M. gordonae E. M. leprae

170 B. they use M bovis that is usually cultured in Middlebrook 7H9. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

The incidence rate of a disease is expressed as: A. Number of cases observed B. Number of new cases observed C. Number of asymptomatic cases D. Person-years of observation E. Persons lost to follow-up

204 D. Person-years of observation simulatenously take into account the number of persons under observation and the duration of observation of each person.

Which hepatitis profile is consistent with a recently vaccinated adult? A. HbsAg-positive, (+) IgM anti-HBcAg, (-) anti-HBsAg B. HbsAg-negative, (-) IgM anti-HBcAg, (+) anti-HbsAg C. HbsAg-positive, (+) IgM anti-HBcAg, (+) anti-HBsAg D. HbsAg-negative, (-) IgM anti-HbcAg, (-) anti-HBsAg E. HbsAg-positive, (+) IgM anti-HBcAg, (-) anti-HBsAg

207 B. After vaccination, only anti-HbsAg antibodies are present.

A 45 year-old male textile worker came in for an annual physical examination. He has no subjective complaints. He has been working in the same factory for 25 years. He is involved in the dye preparation. Which test should you request for this patient? A. Chest x-ray B. Urinalysis C. Brain MRI D. CBC with platelet count E. Thyroid function test

211 B. Dye workers are susceptible to bladder cancer due to exposure to B-naphtylamine and benzidine. Hematuria, gross or microscopic, is the most common presenting symptom.

the health status of the community may be expressed in terms of ? A. Availability of public utilities B. Morbidity and mortality statistics C. Health care services utilization D. Availability of health care services E. All of the above

237 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE last aug 2014.

The basic indicator most often used to reflect the economic health of a country is ? A. Child mortality rate B. Infant mortality rate C. Gross national product D. Population density E. Migration rate

303 B. ( SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE)

what is the crude death rate ? A. 0.42% B. 0.45 % C. 0.44% D. 0.43% E. 0.46%

320 C. total deaths in a year/ total population

This is an essential health service that is available, accessible, affordable and community-based: A. Socialized health care B. Health insurance C. Primary health care D. Personal care

350 C.

What is the incidence rate of Bronchitis/bronchiolitis? A. 2.47 B. 2.67 C. 3.47 D. 3.67

355 A.

The infant mortality rate is a sensitive index of health in the community. The denominator of this rate is the: A. number of live births in the year B. number of live births and fetal deaths 28 weeks or more during the year C. total number of deaths of ages 1-12 D. total number of deaths in the year regardless of age E. the number of deaths under 1 year of age

367 A. Choice B denominator of Perinatal mortality rate; Choice D denominator of Proportionate mortality rate; Choice E numerator of infant mortality rate Topnotch pg 2

Gardners: A. COPD B. Psittacosis C. Sporotrichosis D. Histoplasmosis E. Byssinosis

380 C. #307 Pretest 7th

Which is not included in the Millenium Development Goals A. Improve Maternal Health B. Reduce cardiac mortality C. Combat HIV/AIDS, Malaria and other diseases D. Develop a Global Partnership for Development E. Achieve Universal Primary Education

41 B. Goal 1: Eradicate Extreme Hunger and Poverty Goal 2: Achieve Universal Primary Education Goal 3: Promote Gender Equality and Empower Women Goal 4: Reduce Child Mortality Goal 5: Improve Maternal Health Goal 6: Combat HIV/AIDS, Malaria and other diseases Goal 7: Ensure Environmental Sustainability Goal 8: Develop a Global Partnership for Development

The following are examples of secondary level of prevention,EXCEPT: A. Disease detection B. Disease reporting C. Specific protection D. A and B E. All of the above

412 C.

A Filipino gets benefits from the Philhealth insurance if he has: A. A condition which requires a minor surgical procedure on OPD basis provided that the 45-day allowance for room and board has not been consumed yet. B. He is confined in an accredited hospital for not less than 24 hours due to any condition requiring hospitalization. C. At least 3 monthly contributions within the immediate 6 months prior to the month of hospitalization. D. None of the above E. All of the above

422 E. Philhealth is a must know topic. An OFW can also benefit from Philhealth if he has complied with the required annual contributions.

Characteristic signs or symptoms of kwashiorkor include all the following except: A. Hypoalbuminemia B. Loss of subcuatenous fat C. Edema D. Diarrhea

436 B.

To which of the following hazardous compounds is a brake mechanic most likely exposed? A. Asbestos B. Vinyl chloride C. Hydrogen sulfide D. Silica dust

438 A. Hydrogen sulfide = sewer worker; silica dust = potter, glass manufacturer; carbon monoxide = arc welder.

The major environmental source of lead absorbed in the human blood stream in adults is: A. Air B. Water C. Lead-based paint D. Food E. None of the above

439 A.Although most lead intake in humans is from ingestion of lead-contaminated food - about 0.1 mg of lead is ingested daily - the amount of lead that is absorbed through inhalation of contaminated air is more significant because up to 50% of inhaled lead is absorbed and circulated in the body.

The time interval between entry of an Hepatitis B virus into host and the onset of symptoms is called: A. Preinfectious period B. Window period C. Communicable period D. Incubation period E. Noncontagious period

441 D. The incubation period is the duration of time of time between exposure to an infectious agent and the appearance of the first manifestation of the disease.

In the study about the cause of a disease, the essential difference between an experimental study and an observational study is that the experimental investigation: A. The study is retrospective B. The is study is prospective C. The study and control groups are of equal size D. The study and control groups are selected on the basis of history of exposure to the suspected causal factor E. The investigators determine who is and is not exposed to the suspected causal factor

443 E. In experimental studies, the investigators determine exposure of the study and control groups to a suspected causal factor and measure responses in the two groups. In observational studies, investigators have no control over exposure to a suspected causal factor but can measure responses in those who are and are not exposed.

What is the appropriate epidemiologic term for this statement: The likelihood of finding a lost biochemistry notebook in your apartment is higher in the month of June than in the month of March? A. Type 1 Error B. Lead Time Bias C. Surveillance Bias D. Recall Bias E. Type II Error

444 C. Surveillance bias refers to overdetection of the disease of interest because one of the groups goes to the doctor more often than does another group. Similarly, you are more likely to find something that is lost in June (when you may be moving) than in March, when you are presumably in the middle of the term.

Asthmatic attacks are usually precipitated by several factors. All of the following are clearly associated with acute episodes of Asthma except: A. Emotional stress B. Aspirin C. Caffeinated beverages D. Upper respiratory infections E. Elevated ozone concentrations

448 C. Acute episodes of asthma have been associated with a variety of triggers, including dust, animal dander, respiratory infections, ozone pollution, aspirin and emotional factors. Asthma is characterized by increased responsiveness of airways to these stimule. Caffeine is a methylxanthine related to theophylline and is a low-potency bronchodilator.

Correct statements about obesity include all the following except: A. Genetic factors contribute to obesity B. Obesity is the major risk factor for coronary heart disease C. Sedentariness appears to be the most important cause of obesity in Western populations D. A woman whose body fat is greater than 30% of her total body mass E. None of the above

449 B. Obesity is a major risk factor for NIDDM but it is relatively unimportant as a risk factor for coronary heart disease except at extremes of the weight distribution.

Screening programs is a A. Primordial prevention B. Primary prevention C. Secondary prevention D. Tertiary prevention E. Quarternary prevention

45 C. Secondary prevention aims to diagnose early and give prompt treatment.

All of the following patients are at an increased risk of folate deficiency compared with the general population except: A. 22 year-old woman who is a strict vegetarian B. 22 year-old man with thalassemia C. 55 year-old woman on hemodialysis D. 65 year-old man who drinks a quart of gin daily E. 40 year-old man with tropical sprue

450 A. Folate deficiency can occur because of insufficient intake in the diet, because eof malabsorption, or because of increased needs for the vitamin. Folate is found in green leafy vegetables; strict vegetarians are at increased risk of deficiency of cobalamin which is found in meats.

Tertiary programs includes A. Physical therapy B. Water sanitation C. MMR vaccination D. Annual physical examination E. Immunoglobulin administration

46 A. The goal of tertiary prevention is to limit disability and to rehabilitate from disease.

Dentist: A. Histoplasmosis B. Hepatitis B C. Legionnaires Disease D. Brucellosis E. Sporotrichosis

460 B. Although most occupational diseases are not infectious in origin, it is important to be aware of those that are infectious. Health care workers are at risk of hepatitis B and should be vaccinated.

The association between low birth weight and maternal smoking during pregnancy can be studied by obtaining smoking histories from women at the time of prenatal visit and then subsequently correlating birthweight with smoking histories. What type of study is this? A. Cohort (prospective) B. Clinical trial C. Cross-sectional D. Case control (retrospective) E. None of the above

461 C. Cohort and case control compares 2 groups (group with the exposure/disease vs. group without the exposure/disease). Cross sectional studies collect data from a group of people to assess frequency of disease and related risk factors at a particular point in time. First Aid USMLE 2013, 50.

One good criteria of a good research question is one that it "matters what the answer is." This is termed: A. Researchability B. Significance C. Feasibility D. All of the above E. None of the above

462 B. : 1. Researchability-a problem is researchable if it can be resolved through research. That is, it can be tested empirically, data can be collected to answer the question or resolve the problem. 2. Significance 3. Feasibility-adequate subjects can be gathered for the study, procedures are technically possible, information needed can be collected, resources are available, study can be completed within a reasonable period of time

Which of the following measures is used frequently as a denominator to calculate the incidence rate of a disease? A. Number of cases observed B. Number of new cases observed C. Number of asymptomatic cases D. Persons lost to follow-up E. Person-Years of observation

464 D.

In country X there are 25 new cases of breast cancer per 100,000 adult women per year; in country Y the number is 85 per 100,000. Which of the following is the most likely explanation? A. Women in country X have high caloric intake contributing to enhanced aromatase activities in fatty tissues. B. Most women in country X use oral contraceptives. C. Women in country X are younger. D. Country Y is more technologically developed E. Women in country X are more educated.

468 C. Pretest 7th ed 133, modified

Primordial prevention to prevent cardiovascular diseases includes A. Policies to encourage healthy lifestyles B. Drinking medication conscienctiously C. Exercising regularly D. Both A and B E. AOTA

47 A. The clear distinction between primordial and primary prevention relates to primordial prevention activities lying outside the doctor- patient relationship and the medical model.

Transmission of bacteria involved in nosocomial infections are most often by: A. Airborne matter B. Hospital linen and beddings C. Direct contact via hands D. Unchanged IV lines

471 C. Pretest 7th ed 142, modified

The following are complications of diabetes mellitus, except: A. Loss of vision B. Hearing loss C. Stroke D. Pancreatic cancer E. Heart attack

478 D. 208, modified

The development of neuropathic symptoms is associated with chronic exposure to all the following substances EXCEPT: A. Sulfur dioxide B. arsenic C. lead D. Nitrous oxide

490 A. Exposure to sulfur dioxide mainly causes irritation of the mucous membranes. They got verbatim questions from Pretest 7th edition during our board exam.

It is often iatrogenic: A. osteoarthritis B. Rheumatoid arthritis C. Sarcoid arthritis D. Gout

491 D. Gout is usually caused by diuretic therapy (thiazides) used in the treatment of hypertension or congestive heart failure. Pretest 7th ed.

The varaiance of this set of numbers (1, 2, 3, 4, 5) is A. 1.5 B. 2.0 C. 2.5 D. 3.0 E. 3.5

54 C.

In a screening test for a disease, much value is given to this parameter? A. Sensitivity B. Specificity C. Positive Predictive Value D. Negative Predictive Value E. Prevalence

584 A. In a screening test, the diagnostic test should be more sensitive not specific. The opposite is true for a confirmatory test.

What is the most appropriate statistical test to analyze the data in comparing the serum cholesterol before and after eating fired chicken in KFC? A. Linear Regression B. Paired t test C. Student t test D. Analysis of variance E. Chi-square analysis

587 B. Based on no. 70 of Pre test 7th ed.

Cancer of this organ is associated with exposure to Radium: A. Lung B. Head and Neck C. Bone D. Liver E. Hematopoietic System

596 C. Based on no. 305 of Pre-test 9th ed

Which vitamin defieciency is marked by edema, neuropathy, and myocardial failure? A. Thiamine deficiency B. Vitamin A deficiency C. Riboflavin deficiency D. Vitamin C deficiency E. Niacin deficiency

598 A. Based on no. 379 of Pre-test 7th ed.

A 72-year old man with controlled hypertension complains of gradual impairment of vision. He has type 2 DM, well controlled. He is a farmer. Diagnosis? A. Cataract B. Glaucoma C. Macular degeneration D. Diabetic retinopathy E. Xerophthalmia

599 A. Based on no. 394 of Pre test 9th ed

This is an example of a sampling design wherein every kth element of the population is chosen. A. Simple random sampling B. Systematic sampling C. Cluster sampling D. Multistage sampling E. Stratified sampling

6 B. Simple random sampling â€" each individual has an equal chance of being selected Cluster sampling â€" population is first divided into sampling units called clusters and each element found in the chosen clusters is included in the study Stratified sampling â€" individuals are divided into subgroups on the basis of specified characteristics and then random samples are selected from each subgroup Source: Topnotch handout on preventive medicine

A 34-year old man is brought to the paramedics from a running marathon, which started at 11am in a very sunny weather. He started to note headache, nausea, vomiting (1 epsiode, nonprojectile) and headache after an hour of running. He is hyperventilating, with moist skin and core o body temperature is 38.6 C. He is most likely suffering from: A. Sunstroke B. Heat cramps C. Heat exhaustion D. Heat stroke E. Heat syncope

601 C. Heat stroke is charcetrized by presence of mental status changes and core body temp of more than 39C. Heat cramps are characterized by painful muscle cramps along with some nausea and vomiting. Heat syncope is a sudden loss of consiousness due to vasodilation due to heat.

Which of the following is the most common site of hospital-acquired infection? A. Surgical wound B. GIT C. Blood D. Genito-urinary tract E. Heart

620 D. UTI > Surgical site infection > Respiratory tract infection > Septicemia. UTI accounts for 35% of all nosocomial infections. 70-80% of UTIs are related to catheters and urinary tract manipulation.

The development of neuropathic symptoms is associated with chronic exposure to all of the following substances EXCEPT: A. Mercury B. Lead C. Arsenic D. Sulfur dioxide E. Nitrous oxide

635 D.

This characteristic of data collection refers to the consistency and reproducibility of a test? A. Validity B. Sensitivity C. Specifciity D. Accuracy E. Precision

71 E. Precision also refers to the absence of random variation in a test and is synonymous with reliability

2. From the above scenario, what is the standard error? a. 9.92 b. 10.2 c. 8.6 d. 11.5 e. none of the above

82 A.

4. Which of the following is the first step in calculating for F - ratio? a. calculate the degrees of freedom b. calculate the variance between samples and within samples c. calculate the sample means within groups d. calculate the sum of squares between samples and within samples e. divide the mean square between groups and mean square within groups

84 C.

5. Which of the following is the MOST common indoor pollutant? a. tobacco smoke b. Radon c. nitric oxide d. dust e. none of the above

85 B. American lung association

6. HS, a 32 year old male with multiple sexual partners both male and female, comes to you for pretest counselling for HIV. After a series of discussions, HS finally submits himself for testing. The next day, the results came back positive and HS is asking for his result. Which of the following is your most approriate first response? a. "Im afraid I have some bad news for you." b. "Do you really want to know your results?" c. "You are HIV positive." d. "We need more tests."

86 A.

19. Lola Sepa is the administrator of an autosupply and lumber center in Pangasinan. She is loved by the people in the town however she comes to you for complaints of difficulty in sleeping. Which of the following changes in the elderly would be expected from Lola Sepa except? a. increased in REM b. decrease in slow wave sleep c. increased sleep onset latency d. increased early awakenings e. none of the above

99 A. there is decreased REM USMLE first AID 2015

Mang Jose lost his vision because of bilateral retinal detachment. Fortunately, his building’s elevator has Braille on the elevator keys so he has no problem getting around. Mang Jose has: A. Impairment B. Disability C. Handicap D. A and B E. All of the above

1 D. Impairment â€" loss of psychological, physiologic or anatomic function Disability â€" lack of ability to perform certain activities which is considered normally possible for a human being Handicap â€" inability to perform a role in the context of society Mang Jose’s impairment is blindness. His disability in this context is reading the elevator keys. However, he is not handicapped because despite this disability he is able to use the elevator. If the elevator did not have Braille on it, he would have been handicapped. Handicap is a relative term that can be adjusted via modifications in the environment that allows people with disabilities to be able to perform equal functions or roles as those who do not.

An epidemiologist wishes to determine how fast people are added to the population through births. Which formula should be used? A. Number of live births in a year/population during July 1 B. Number of live births in a year/population during August 1 C. Number of live births during July 1/population during July 1 D. Number of live births during August 1/population during August 1 E. Number of live births in a year/population during the end of the year

10 A. Crude birth rate = number of registered live births in a year/midyear population Source: Topnotch handout on preventive medicine

How many decibels is permissible for an 8 hour work day: A. 85-90 B. 90-95 C. 95-100 D. 100-105 E. 105-110

119 A. Page 35 of Topnotch Handout. In an 8 hour work day the permissible decibels is 85-90.

The ability of microorganism causing a common cold in a 5-year old child to invade and multiply in approximately 6 out of 10 household contact is: A. Pathogenicity B. Virulence C. Antigenicity D. Incubation E. Infectivity

139 E. Infectivity or contagiousness refers to ability of a microbe to spread in a population of exposed susceptible person.

You are implementing a health teaching program in a community, you want to check the level of understanding of the community of your health teachings, in what phase would you do this? A. Planning B. Organizing C. Implementation D. Evaluation E. None of the above

146 D. Evaluation is used to check how well your participants understood the concepts that you wanted to impart to them.

This stage of the family life cycle wherein there is increasing flexibility to boundaries to include children and independence. There is refocus on midlife, marital and career issues as well as beginning shift towards concern for older generations. A. Unattached young adult B. Newly married couple C. Family with adolescents D. Launching family E. Family in later life

15 C. Source: Topnotch handout on preventive medicine

It describes the ability of the microbe to spread in a population of exposed susceptible persons A. immunogenicity B. pathogenicity C. virulence D. contagiousness E. None of the above

165 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

which of the following vaccines have both live and killed preparations? A. rabies B. tetanus C. measles D. polio E. Varicella

171 D. Salk and Sabin. Salk is the killed preparation while Sabin is live preparation. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

In a normal distribution of 100 samples, how many of the samples fall within 1 standard deviation of the mean? A. 43% B. 55% C. 68% D. 95% E. 99.7%

175 E.68% fall within 1 standard deviation of the mean… 95% fall within 2 SD of the mean…. 99.7% of observation fall within 3 SD

As for post exposure prophylaxis for rabies, which of the following should be given to Leo in addition to wound cleaning? A. None. Wound cleaning is the only necessary measure B. Active vacccine C. Passive vaccine IM route D. Active and passive vaccines E. passive vaccine on the wound

178 B. no need for passive vacccine for category II

As for post exposure prophylaxis for rabies, which of the following should be given to Antonio in addition to wound cleaning? A. None. Wound cleaning is the only necessary measure B. Active vacccine C. Passive vaccine IM route D. Active and passive vaccine E. passive vaccine on the wound

180 D. active and passive vaccines are given for category III. The passive vaccine is given as wound infiltration and if there are still few left after in the computed amount of passive vaccine after completed wound infiltration, the remaining must be given through deep IM.

A 10 year old boy with sickle cell disease presents with headache, anorexia and fever. He complains of pain in the right tibia and local inflammation is noted. Osteomyelitis is diagnosed. The most likely etiologic agent is A. Listeria B. Shigella C. Salmonella D. Cryptosporidium E. Campylobacter

199 C. Persons with sickle cell disease have functional asplenism due to infarction. This results in impaired immune response to polysaccharide antigens.They are more susceptible to invasive Salmonella infection. Pre-test#176, 9th ed.

Which of the following is the millennium development goal aimed at combating HIV/AIDs, malaria, and other diseases? A. MDG4 B. MDG5 C. MDG6 D. MDG7 E. MDG8

20 C. MDG1 -To kill extreme poverty and hunger MDG2 - To achieve universal primary education MDG3 - To promote gender equality MDG4 - To reduce child mortality MDG5 - To improve maternal health MDG6 - To combat HIV/AIDS, malaria, and other diseases MDG7 - To ensure environmental sustainability MDG8 - To develop a global partnership for development I'm not sure if this is gonna be asked again in the next exams since the MDG target is by 2015 so not sure if this will still be relevant. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE.

Under republic act 7610 also known as Child Protection Law, the definition of a child is? A. Person who reach the age of emancipation of 18 years old B. Person below 15 y/o C. Person regardless of age whom by physical or mental condition unable to protect themselves D. only A and C E. only B and C

238 C. A child is defined by law as a person below 18 years old or whom by virtue mental or physical condition are unable to protect themselves regardless of age.

Which of the following tools can be utilized by the practitioner to evaluate the capacity of the family to participate in the provision of health care to their sick family member or to cope with crisis? A. family APGAR B. SCREEM C. family genogram D. family map E. family circle

243 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, review the functions of the various tools as it was asked in this format answer was SCREEM in our boards, APGAR mainly assess dysfunction or satisfaction of each family member with regards the family

Which of the following statements about blood pressure is true? A. Isolated systolic hypertension is a risk factor for stroke B. Diastolic BP is a more important predictor of incidence of coronary heart disease than is systolic BP C. The prevalence of isolated systolic hypertension peaks between ages 60 and 70 D. The prevalence of isolated systolic hypertension increases with age in men but not in women E. Isolated systolic hypertension is defined as a systolic BP above 200mmHg with normal diastolic BP

267 A. Systolic hypertension is a strong risk factor for cardiovascular disease. ISH is BP greater than 160mmHg with a normal DBP. Prevalence increases with age in both men and women

What refers to the ability of an infectious agent to produce serious illness and is measured in terms of fatality? A. Infectivity B. Virulence C. Pathogenicity D. Antigenicity E. Susceptibility

271 B. Infectivity ability to invade and multiply; pathogenicity - capacity to induce clinically apparent disease; antigenicity - ability to induce immunity

In the same town in question number 238, calculate the case fatality rate for heart disease: A. 4% B. 5% C. 6% D. 7% E. 8%

280 C. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Round off to the nearest whole number.

what is the case fatality rate of CVA? A. 11.39 B. 11.40 C. 11.41 D. 11.42 E. 11.43

319 A. total deaths due to CVA/total deaths in a year

Which is the most appropriate statistical test to analyze the date of a study that compares the serum cholesterol before and after ingestion of hamburgers in a sample of fast-food patrons? A. Chi-square test B. analysis of variance C. linear regression D. student t test E. paired t test

331 E.

Epidemiology can be defined as the study of: A. the etiology of disease in humans B. the frequency of causes of death in humans C. the determination of causes of death in humans D. the distribution and determinants of frequency of disease in humans E. the patterns of organization and financing of health care

334 D.

The newborn with CMV infection at birth most commonly presents with: A. Hepatosplenomegaly B. Hepatitis C. Cerebral calcifications D. No symptoms

342 D. Reference: PrevMed Pre-test, 7th ed.

Measles, shigellosis, scabies A. Bacterial infections B. Zoonoses C. Person-to-person spread D. Viral infections E. Arthropod-borne infections

375 C. #284 Pretest 7th

According to our local rules and regulations, the birth certificate should be filed at the local registrar within how main hours/days from birth? A. 24 hours B. 48 hours C. 7 days D. 14 days E. 30 days

382 E.

The death certificate should be filed at the local registrar within how many days from death? A. 24 hours B. 48 hours C. 5 days D. 7 days E. 14 days

383 B. In cases of epidemics, the death certificate may be filed within 5 days.

Screening for hypertension is an example of which level of prevention? A. Primary B. Secondary C. Tertiary D. Primary and Secondary E. Primary and Tertiary

4 D. Primary â€" before disease occurs Secondary â€" before symptoms occur but already with disease Tertiary â€" symptoms and disease already occurred HPN screening is secondary because BP already high but no s/s. Primary because there is no stroke yet.

Which is a water-washed disease? A. Schistosomiasis B. Leptospirosis C. Dengue D. Scabies E. Malaria

40 D. Water-washed diseases: caused by poor personal hygiene and skin or eye contact with contaminated water. Waterborne diseases: caused by the ingestion of water contaminated by human or animal faeces or urine containing pathogenic bacteria or viruses. Water-based diseases: caused by parasites found in intermediate organisms living in contaminated water. Water-related diseases: caused by insect vectors, especially mosquitoes, that breed in water.

In the 2013 census of Barangay Berde, it was reported to have a total population of 2,500, with 150 live births and 75 deaths. Among those who died, 15 were infants below 1 year of age. What is the infant mortality rate for this barangay in 2013? A. 0.6% B. 10% C. 20% D. 3.0% E. 6.0%

400 B. Infant mortality rate = deaths under 1 year of age / number of live births for the same year

In the Philippine Health Picture,this is shown as the leading cause of mortality: A. Vehicular accidents B. Neoplastic Diseases C. Malnutrition D. Communicable diseases E. Cardiovascular diseases

401 E.

In the Philippines, the agency tasked to coordinate all nutrition related activities of the government and private sectors is the: A. National Nutrition Council B. DOH's Nutrition Service C. Nutrition Center of the Philippines D. Department of Science and Technology E. Food and Drug Administration

402 A.

The most appropriate strategy for teaching the signs and symptoms of dehydration to Community Health Workers: A. Typewritten handouts on the sign and symptoms of dehydration B. Simulation or field observation C. Lectures D. Examination E. Demonstration-return demonstration

404 E.

What is the most common site of nosocomial infections? A. Urinary tract B. Surgical wound C. Respiratory tract D. Blood stream

434 A. Infections of the surgical wounds are the second most common nosocomial infection, followed by infections of the lower respiratory tract and blood stream.

The occurrence of a disease that are generally or constantly found among people in a particular area is called: A. hyperendemic B. epidemic C. endemic D. enzootic E. Pandemic

466 C.

The following are true of rubeola, except: A. Humans are the only natural host. B. 99% of adults had serologic evidence of previous rubeola infection. C. The disease is brought under control through 3 doses of vaccine. D. Mortality rates are highest among children less than 2 years and among adults. E. Patients are contagious from 1-2 days before symptom onset until 4 days after the rash appears.

480 C. 2 doses, Harrison's 17th ed, 1214

Intestinal autoinfection may lead to increasing worm burden and dissemination: A. Necator B. Ascaris C. Strongyloides D. Taenia

497 C. Autoinfection is a characteristic of strongyloides infection. Pretest 7th ed.

Guilt is the primary emotion at this stage according of Kubler Ross Stages of Death and Dying A. Denial B. Anger C. Bargaining D. Depression E. Acceptance

50 C.

The association between low birth weight and maternal smoking during pregnancy can be studied by obtaining smoking histories from women at the time of prenatal visit and then subsequently correlating birthweight with smoking histories. What type of study is this? A. Cohort (prospective) B. Clinical trial C. Cross-sectional D. Case control (retrospective) E. None of the above

501 C. Cohort and case control compares 2 groups (group with the exposure/disease vs. group without the exposure/disease). Cross sectional studies collect data from a group of people to assess frequency of disease and related risk factors at a particular point in time. First Aid USMLE 2013, 50.

The following are true of rubeola, except: A. Humans are the only natural host. B. 99% of adults had serologic evidence of previous rubeola infection. C. The disease is brought under control through 3 doses of vaccine. D. Mortality rates are highest among children less than 2 years and among adults. E. Patients are contagious from 1-2 days before symptom onset until 4 days after the rash appears.

520 C. 2 doses, Harrison's 17th ed, 1214

If a family physician wanted to assess the capacity of families to participate in provision of health care and to determine resources that may be available to the family to help in maintaining their health, which family tool would be most appropriate? A. Family genogram B. APGAR C. SCREEM D. FACES E. Draw a Family Test

556 C.

Patients with renal cell CA were matched with controls by age, sex, place of residence and social class. Two groups were noted according to the frequency of cigarette smoking. This is what type of study? A. Case cohort B. Historical cohort C. Clinical trial D. Prospective cohort E. None of the above

600 A. Based on no. 29 of Pre-test 7th ed.

A study shows that elevated bilirubin levels in neonates are associated with brain damage only in babies who also have infections or severe hemolytic disease. Which of the following epidemiologic phenomenon made in arriving at such conclusion? A. Confounding B. Effect modification C. Differential misclassification D. Lead-time bias E. Selection bias

602 B. Effect modification occurs when one factor modifies the effect on outcome of another.

Which of the following is an alternate to the PIE chart? A. Bar graph B. Component bar diagram C. Frequency polygon D. Histogram E. Line graph

622 D.

As an epidemiologist, you are asked to recommend the type of study appropriate to the needs of researchers who would like to study the causes of a rare form of sarcoma. They have discovered a registry of this form of cancer and have access to a large data base of patients, which unfortunately is only a few years old. What type of study design would you recommend? A. Cohort prospective B. Historical cohort C. Cross sectional D. Experimental E. Case-control retrospective

628 E. case control for rare disordees with multipl potential causes

Passive immunization is the major means of prevention of which of the following diseases? A. Influenza B. German measles C. Mumps D. Roseola infantum E. Viral hepatitis A

639 E.

The association between low birthweight and maternal smoking during pregnancy ca n be studied by obtaining histories from women at the time of prenatal visit and then subsequenty correlating birthweight with smoking histories. What type of study is this? A. Clinical trial B. Cross-sectional C. Cohort D. Case-control E. None

643 C.

Which is the most common site of nosocomial infections? A. Surgical wound B. Respiratory tract C. Blood stream D. Urinary tract E. GI tract

653 D.

This population pyramid is described as having a base that is narrower than the middle of the pyramid usually as a result of recent rapid decline in fertility? A. Constructive B. Stationary C. Expansive D. Inverted E. Platypelloid

66 A. Pls refer to your Prevmed Topnotch handouts

This level of prevention aims to avoid the emergence and establishment of the social, economic and cultural patterns of living that are known to contribute to disease risk? A. Primordial B. Primary C. Secondary D. Tertiary E. Quarternary

665 A. Examples of Primordial prevention includes implementation of public health policies and health promotion

Ability of bacteria and viruses to produce clinically apparent illness in an infected population? A. Immunogenicity B. Pathogenicity C. Virulence D. Toxigenicity E. Resistance

666 B. An example of highly pathogenic virus - measles

The probability of commiting type I error in computing your sample size is called? A. power of the study B. effect size C. level of significance D. standard deviation E. variance

78 C. Pls refer to your Prevmed Topnotch handouts

3. APT, a novice researcher wants to know the statistical test she would use for her undergraduate study. She asks you for help and tells you that she is trying to compare the mean blood pressure between members of 3 different Filipino ethnic groups of Mindanao. Which of the following is the appropriate test? a. chi square b. student t - test c. paired t- test d. ANOVA e. Mann Whitney test

83 D. USMLE first aid

11. In the above situation, which of the following is a requirement for referral to hospice care? a. has a DNR order b. has a diagnosis of Breast Cancer Stage IV c. has prognosis of 5 months to live d. has good decision making ability e. has ambulatory capacity

91 C. hospice model: focus on quality of life, symptom control, interdisciplinary team, services provided at home, assisted living facility; requires prognosis of <= 6 months

from question number 236, what is the maternal mortality rate? A. 46.2/1000 B. 47.2/1000 C. 48.8/1000 D. 49.9/1000 E. 50.0/1000

258 A. 30/650 x 1000 =

What is the crude death rate? A. 5.33 B. 5.93 C. 6.33 D. 6.93

353 C. Crude death rate = # of deaths / Total population x 1000

Primary Health Care team is composed of: A. Interdisciplinary Composition of Community B. Office of Secretary of Health C. Provincial Health Officer and Staff D. Municipal Health Officer and Staff E. Local Government Officials

411 A.

A familial aggregation pattern exists for cancer of all the following organs EXCEPT: A. breast B. retina C. colon D. larynx E. Skin

633 E.

Composition of standard ORS, except? A. Glucose 120 mmol/L B. Na 90 C. Cl 80 D. K 20 E. Citrate 10

677 A.

The prevalence rate can affect the: A. Positive predictive value B. Negative predictive value C. Sensitivity D. Specificity E. Only A and B

109 A. Page 4 of pearls. Predictive values are dependent on the prevalence of a disease.The higher the prevalence of a disease, the higher the positive predictive value.

Which of the following is a sensitive indicator of the standard of health care by analyzing the number of deaths over 50 years old? A. Child mortality rate B. Age specific proportionate mortality C. Maternal mortality rate D. Dependency ratio E. Swaroop’s index

11 E. Swaroop’s index = number of deaths among >50yrs old/total deaths in a year Higher value = better Swaroop’s index tends to be higher in developed countries than developing ones. Source: Topnotch handout on preventive medicine

A screening test should have a high: A. Positive predictive value B. Negative predictive value C. Sensitivity D. Specificity E. Only A and B

110 C. Page 3 of pearls. A high sensitivity is desirable for a screening test to rule out. SNOUT= sensitivity rules out. A high specificity is desirable for a confirmatory test to rule in.

A 65 y/o male, smoker is hypertensive with a fasting blood sugar of 220 mg/dl and has a family history of colon cancer. Which of the following recommendations are correct: A. Colonoscopy every 2 years B. ECG annually C. Ultrasonography for abdominal aortic aneurysm every 3 years D. Total cholesterol and HDL levels initially and monitor accordingly E. DRE twice a year

116 D. Page 27 of Topnotch Handout.

Which of the following diseases employ passive immunization as a major means of prevention : A. Influenza B. Rubella C. Rubeola D. Hepatitis A E. Mumps

117 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. HAV infection can be prevented by administration of immune serum globulin.

Which of the following is an effect of Zinc deficiency: A. Osteoporosis, poor mineralization of bones and teeth B. Nausea, diarrhea, muscle cramps, dehydration C. Scorbutic rosary, poor wound healing D. Tendency to dental caries E. Dwarfism, Hepatosplenomegaly, poor wound healing

118 E. Page 9 of pearls. A-calcium, B-Sodium, C-Vitamin C, D-Flourine.

The following are live attenuated vaccine except: A. Rabies vaccine B. BCG C. Varicella Vaccine D. Measles Vaccine E. OPV

121 A. Rabies vaccine is an inactivated/killed vaccine. Other inactivated/killed vaccines include Polio (Salk), Influenza, Typhoid, cholera, and Pertussis vaccine. Live attenuated vaccines: BCG, OPV, Measles, Rotavirus, Yellow fever, Varicella. Source: CDC. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT (3-4 questions regarding vaccine/type of vaccine)

A 5 month-old infant brought to the barangay health clinic had no previous immunization. The following vaccines should be given except: A. Measles B. DPT C. BCG D. Hepatitis B vaccine E. No exception

122 A. Measles vaccine should be given at 9 months

The most practical way of eradicating rabies in the community is: A. Impounding all stray dogs B. Vaccination of all children with rabies vaccine C. Mass vaccination of all dogs against rabies D. Keeping the community clean and free of garbage E. None of the above

123 C.

What is the antidote for benzodiazepine toxicity? A. EDTA B. Flumazenil C. Naloxone D. Atropine E. Pralidoxime

124 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT

In a study of how different doses of a drug affect the severity of symptoms, a researcher could compare the frequency and intensity of symptoms when different doses are administered. The dose of the drug is the A. Dependent variable B. Independent variable C. Confounding variable D. Extraneoous variable E. None of the above

125 B. Independent variable that is varied or manipulated by the researcher, and the dependent variable is the response that is measured.

Dr. X has developed a new diagnostic test for dengue. He performs the test on 100 patients known to have Disease Y and 100 patients known not to have Disease Y with the following results. (+) test (-) test Disease Y 90 10 No Disease Y 11 89 What is the sensitivity and positive predictable value of the new diagnostic test? A. 90% ; 89% B. 89% ; 90% C. 89%; 89% D. 50%; 89% E. 11% ; 52%

127 A. Sensitivity = true positives divided by number all people with disease; (90/90+10) x 100 = 90% PPV = number of positives divided by number of peope who tested positive for the disease; 90/90+11 = 89% I purposely interchange the arrangement of the columns (+) test and (-) test and rows -- presence and absenceof Disease Y,.. (Kaya siguro naconfuse kayo) But based on the formula of sensitivity = true positives divided by the number of all people with disease, that is 90/(90+10)= 90/100= 90%. Sensitivity is 90% PPV = true positives divided by the number of people tested positive for the disease, that is, 90/(90+11) = 90/111 =89%

A report of a clinical trial of a new drug versus a placebo noted that the new drug has a higher proportion of success than did the placebo. The report ended with statement: chi square=4.2. p=0.5. In light of this information, we may conclude: A. If the drug were ineffective, the probability of the reported finding is less than 0 B. If the drug were effective, the probability of the reported finding is less than 1 C. Fewer than one in 20 will fail to benefit from the drug D. Chance that an individual patient will fail to benefit is less than 0.05. E. None of the above

134 D.

The method of sampling where every nth unit (such as every fifth or 10th member) is selected from a population which is arranged in some definite way is called: A. Simple random sampling B. Cluster sampling C. Purposive sampling D. Multi-stage sampling E. Systematic sampling

135 E.

Chemotherapeutic agents are applied to the eyes of the newborn to prevent: A. Juvenile cataract B. Gonorrhea C. Syphilis D. Trachoma E. Tetanus

136 B.

Among the following interventions for malnutrition, which of the following is least effective in changing the behavior of the community? A. Teaching them how to utilize their local resources B. Teaching them about the possible diseases of Vitamin and mineral deficiency C. Teaching effective and economical cooking practices D. Teaching them how to plan their meals E. None of the above

147 B. This measure is the least helpful as it will do nothing about the situation of malnutrition, the rest of the options are helpful in combatting malnutrition

A family has a family member dying of cancer, at what level of prevention is the patient in? A. Primary B. Secondary C. Tertiary D. Quaternary E. None of the above

150 C. The patient is at the tertiary level as he/she has already the complications of the disease and the goal of medical management is giving the patient a good quality of life.

The capacity of a microbe to cause a symptomatic illness in an infected host is ______. A. immunogenicity B. virulence C. pathogenicity D. contagiousness E. Infective ability

163 C. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

Which among the following causes of death is written on the Death Certificate and the one counted in mortality rate? A. Underlying B. Antecedent C. Immediate D. Incidental E. None of the above

169 A.

This measure is the number of true positives divided by number of people who tested positive for the disease. This is usually interpreted as the probability of having a condition given a positive test. A. sensitivity B. specificity C. positive predictive value D. negative predictive value E. reliability

173 C. sensitivity is labeling positive those who really have the disease. Specificity is labeling negative those who do not have the disease. NPV is the probability of not having the condition given a negative test.

Antonio's rabies exposure falls under what category? A. I B. II C. III D. IV E. V

179 C. abrasions and scratches with no spontaneous bleeding and including those induced are classified as category II except if it is located on the head or neck which is categorized as III.

In a study of the cause of lung cancer, patients who had the disease were matched with controls by age, sex, place of residence and social class. The frequency of cigarette smoking was then compared in the two groups. What type of study was this? A. Cohort (prospective) B. Historical cohort C. Clinical trial D. Case control E. None of the above

181 D. pretest #29 7th ed

Exposure to benzene has been associated with all of the following diseases except A. Bronchogenic carcinoma B. Aplastic anemia C. Acute nonlymphocytic leukemia D. Testicular atrophy E. Chronic myelogenous leukemia

185 A. Although benzene is absorbed via the lungs, it is not associated with an increased incidence of lung cancer. Pretest #214 7th ed

Which of the following is true if the distribution curve is negatively skewed? A. Median is greater than the mode B. Mean is greater than the mode C. Mode is greater than the mean D. Mean is greater than the median E. Mean, median, mode are equal

187 C. Negatively skewed means that the distribution curve is shifted to the left. Mode>median>mean.

At what age is it recommended to start screening for diabetes in an asymptomatic patient with no risk factors? A. >45 B. >35 C. >40 D. >55 E. >25

189 A. All patients >45 y.o and those with BMI of 25kg/m2 with no known risk factors (1st deg relative w/ DM, GDM, delivered macrosomic baby, hypertensive, HDL <35, TAG>250, hx of vascular disease) should be screened for DM

Screening for hypertension is what level of prevention? A. primary B. secondary C. tertiary D. A and B E. B and C

193 D. Screening for hypertension in asymptomatic person is both a secondary measure and a primary measure as it also prevents the occurence of strokes

What is the cause of death rate of accidents in number 234? A. 100 B. 200 C. 300 D. 400 E. 500

195 A. cause of death rate= number of deaths from a certain cause in a year/midyear population x 100000

What is the case fatality rate of cardiovascular diseases in number 234? A. 13 B. 12 C. 11 D. 10 E. 9

196 D. case fatality rate= number of deaths from a specified cause/ number of cases of the same disease x 100

Frank and Jel are married for 2 years. They are living in their new home in Manila. Jel is now 5 months pregnant. They are now in what stage of family life cycle? A. Newly married couple B. Unattached young adult C. Family with young children D. Family with adolescents E. Launching family

200 C. Family with young children starts with pregnancy for the first child to the emergence of adolescents.

You wanted to investigate if a new drug can prevent hemorrhagic strokes in hypertensive patients. The most appropriate study to perform is: A. Clinical trial B. Cross-sectional C. Prospective cohort D. Case-control E. Retrospective cohort

201 A. Clinical trials are prospective studies in which an intervention is applied.

A causative agent's virulence is described as: A. Development of neutralizing antibodies after an attack B. Development of disease in infected persons C. Death among cases D. Infection among contacts of infected persons E. Period of time from infection to appearance of signs and symptoms

208 C. Virulence refers to the severity of illness produced by a microbe and is measureed by the percentage of severe or fatal cases.

Paragonimiasis is transmitted by ingestion of infected: A. Swine B. Fish C. Cattle D. Crab E. Snail

210 D. The larval stages of Paragonimus wetsermanii, also known as the lung fluke, develop in freshwater crabs and other crustacea.

Which metal may cause Fanconi syndrome if exposure has been chronic? A. Arsenic B. Lead C. Mercury D. Cadmium E. Zinc

213 D.

this type of nonverbal communication connotes that the physician wants to establish a sense of personal relationship with the patient? A. Eye contact B. posture C. Handshake D. Tone of voice E. mannerism

223 C. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Additional notes - eye contact infers sincerity. Mannerism - distracts patient. Tone of voice should be modulated to avoid threatening the patient.

in what phase in the family life cycle wherein there is development of adult to adult relationship between grown up children and their parents? A. Launching family B. Family with adolescents C. Family in later life D. Unattached young adult E. none of the above

224 A. launching family - this stage begins when the first child leaves home. During this stagem the parents must develop adult type relationships between the grown up children and themselves.

which of the following factors can increase the prevalence rate of a cetain disease? A. shorter duration of disease B. Improved diagnostic facilities C. Out migration of cases D. Improved cure rate of the disease E. All of the above

232 B. the following factors that can increase the prevalence rate of a certain disease are the following: Longer duration of disease, prolongation of patients life,increase in incidence,in migration of cases, out migration of healthy people,improved diagnostic facilities, in migration of susceptible people.

which of the following is true about the recommending screening parameters for colorectal cancer? A. Annual FOBT starting at age 50 y/o offers negligible mortality rate reductions B. 10-year interval for colonoscopy based on the natural history of adenomatous polyps. C. Digital rectal examination (DRE) is recommended as an adequate screening strategy D. every 10 years for double contrast barium enema. E. none of the above

235 B. A - Annual FOBT screening is proven to provide greater mortality reduction because of early case finding and subsequent prompt intervention. C- Neither DRE or stool sampling from DRE is recommended for screening. D- double contrast barium enema and flexibe sigmoidoscopy should be done every 5 years because of its lesser sensitivity.

What is the treatment regimen for latent PTB among adults? A. Rifampicin 20mg/kg once daily for 4 months B. INH 5mg/kg once daily for 9 months C. INH 15mg/kg once a day for 9 months D. Rifampicin 15mg/kg once daily for 4 months E. none of the above

241 B. similar question from our boards, INH for 9 months, 5mkd, children 10-20mkday or rifampicin 10mg/kg once a day for 4 months - from CDC

Referring to the question above, this is an example of which type of prevention? A. primary prevention B. secondary prevention C. tertiary prevention D. all of the above E. only A and B

246 B. screening is secondary prevention, a lot of examples for each level of prevention came out during our boards

from question number 236, what is the under 5 mortality rate? A. 22.6/1000 B. 23.6/1000 C. 24.6/1000 D. 25.6/1000 E. 26.6/1000

259 C. 16/650 x 1000 =

In comparing the difference between two means, the value of p is found to be 0.60. The correct interpretation of this result is? A. The difference is statistically significant B. The difference occurred by chance C. The null hypothesis is rejected D. Sampling variation is an unlikely explanation of the difference E. The difference is compatible with the null hypothesis

273 E. A value of p of 0.05 is the conventional upper limit of significance.

Which of the following clinical manifestations is not associated with congenital rubella syndrome? A. Cataracts B. Hutchinson's teeth C. Sensorineural deafness D. Microcephaly E. Pulmonic stenosis

285 B. Hutchinson's teeth is seen in congenital syphilis

Which of the following is an effective means of preventing trichinosis in humans? A. Skin testing of hogs with Trichinella antigen prior to slaughter B. Attention to proper disposal of hog feces C. Cooking pork to ensure that all parts reach a temperature of at least 40 degree celsius D. Prohibiting the marketing of garbage fed hogs E. All of the above

297 D. Pre test 7th edition 354

Improving maternal health pertains to Millenium Development goal number: A. 2 B. 3 C. 4 D. 5 E. 6

30 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE.

which of the following health promotion strategy is based on organizational approach? A. Development of support groups by nonprofit organizations and facilities that provide services to people with special needs B. Regulations aimed at reducing youth access to tobacco products and alcohol C. Organization and training of out of school youth to reduce vulnerability to sex or drug crimes D. Stress management classes for middle-management employees in the workplace E. all of the above

311 A. B-Legislative approach, C -societal approach D- educational approach. ( refer to topnotch handout for the complete examples). SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

what is the infant mortality rate? A. 7.64% B. 7.60% C. 7.62% D. 7.58% E. 7.66%

317 A. number of deaths (less than 1 year old)/ total live births. Always bring calculator. Lesson learn during my previous board exam.

what is the case fatality rate of MI ? A. 37.50% B. 37.52% C. 37.55% D. 37.53% E. 37.51%

318 B. total deaths due to MI/total deaths in a year

Which of the following statements about emphysema is true? A. There is a definitive clinical diagnosis of the disease. B. The majority of persons with emphysema are symptomatic. C. Flow rates on pulmonary function tests resemble those seen in chronic bronchitis. D. It is equally prevalent in light and heavy smokers. E. It is associated with the chronic inhalation of coal dust.

325 C. Choice E refers to pneumoniconiosis.

The parameter that can be used to obtain the best estimate of the prevalence of dental caries is: A. the calculus index B. the malocclusion index C. the decayed, missing, or filled rate D. the oral hygiene index E. none of the above

327 C.

Randomization is a procedure used for assignment or allocation of subjects to treatment and control groups in experimental studies. Randomization ensures: A. that assignment occurs by chance B. that treatment and control groups are alike in all aspects except treatment C. that bias in observations is eliminated D. that placebo effects are eliminated E. none of the above

328 A.

Radiologic findings specific for exposure to asbestos include: A. bilateral pulmonary fibrosis B. pulmonary nodules C. pleural effusion D. pleural calcification E. none of the above

339 D.

If you wanted to know whether board exam scores of students who enrolled in Topnotch are significantly higher than those who enrolled in another review school, which statistical test would be most appropriate? A. Pearson correlation B. Chi-square test C. One way ANOVA D. Student's t-test E. Matched pairs t-test

36 D.

The following are measures of location in distribution curves EXCEPT? A. Median B. Mode C. Mean D. Standard deviation E. No exception

376 D. SD is a measure of DISPERSION

Which of the following statements about emphysema is correct? A. There is a definitive clinical diagnosis of the disease B. The majority of persons with emphysema are asymptomatic. C. Flow rates on pulmonary function tests resemble those seen in bronchitis D. It is equally prevalent in light and heavy smokers E. It is associated with chronic inhalation of coal dust

390 C. Prev Med 7th ed. #172

Reasons to treat gonorrhea with oral tetracycle 500 mg qid for 7 days--rather than with oral ampicillin 3.5 g plus oral probenicid 1 g taken at one time--include: A. Lower frequency of side effects B. Better coverage fo Chlamydia trachomatis C. Greater safety in case of pregnancy D. Enhanced compliance E. None of the above

393 B. Prev Med 7th ed. #345

Clinical findings of dwarfism, hepatosplenomegaly and poor wound healing are associated with deficiency in which of the following minerals? A. Fluorine B. Copper C. Zinc D. Sodium E. Calcium

395 C. Prev Med 7th ed. #396

The occurrence of a group of illnesses of similar nature at a rate above the expected number is called: A. Hyperendemic B. Epidemic C. Endemic D. Enzootic E. Pandemic

396 B. Prev Med 7th ed. #50

A group that is least vulnerable to anemia: A. Pre-schooler B. Lactating woman C. Normal neonates up to 3 months D. Pregnant woman E. Elderly

413 C.

Passive immunization is the major means of prevention of which of the following diseases? A. Influenza B. German measles C. Mumps D. Hepatitis A

427 D. Passive immunization is the provision of antibodies that are pre-formed rather than of antigens, which are used for active immunization (to activate the body to make its own antibodies).

What vitamin is probably deficient in a patient suffering from sore gums, petechiae, hematuria and bone or joint pains? A. Thiamine B. Riboflavin C. Vitamin C D. Vitamin D

429 C. Scurvy due to vitamin C deficiency is characterized by pain and tenderness of the extremities, irritability, and hemorrhagic phenomena, all the result of defective formation of collagen.

Malaria prophylaxis is a A. Primordial prevention B. Primary prevention C. Secondary prevention D. Tertiary prevention E. Quarternary prevention

44 B. Primary prevention includes health education, specific protective measures, and environmental modification and sanitation.

Prevention and control of infection in a hospital setting include all the following except: A. Retrospective surveillance of nosocomial infections of patients B. Employment of practitioners of infection control C. Investigation of epidemic and endemic infections D. Isolation of patients with communicable disease E. A physician who serves as a hospital epidemiologist

455 A. Prospective surveillance programs are much more valuable in determining if nosocomial infections have occurred than retrospective surveillance.

Which of the following prenatal screening tests is recommended for all pregnant women? A. Hemoglobin electrophoresis B. HIV antibody C. Ultrasound D. Hepatitis B surface antigen E. None of the above

456 D. Universal screening for Hepatitis B surface antigen (HBsAg) in pregnant women is based on evidence that early treatment of the newborn with Hepatitis B immune globulin and subsequent vaccination is 85-95% effective in preventing development of the chronic carrier state in infants born to HBsAg- positive mothers.

Influenza vaccine is generally recommended for which of the following groups? A. Pregnant women B. All persons above 55 y/o C. School-age children D. All persons with severe pulmonary disorders regardless of age E. All of the above

457 D. Influenza vaccine is not recommended for routine use in the entire population because current vaccines produce immunity lasting only from 1 to 2 years and are only 60-70% effective.

Which of the following parameters is evaluated in SCREEM? A. environment B. mental C. religion D. sexual

486 C. SCREEM stands for Social, Cultural, Religion, Education, Economic, Medical.

Occurrence of number of cases of a disease in excess of normal occurrence or expectancy derived from a common or propagated source A. Hyperendemic B. Epidemic C. Endemic D. Pandemic E. Absnce of disease

49 B.

Deficiency in sodium manifests as: A. osteoporosis B. dehydration C. Tendency to dental caries D. Dwarfism

492 B. Lack of sodium causes nausea, diarrhea, muscle cramps and dehydration (because sodium maintains osmotic pressure). Pretest 7th ed.

Which of the following measures is used frequently as a denominator to calculate the incidence rate of a disease? A. Number of cases observed B. Number of new cases observed C. Number of asymptomatic cases D. Persons lost to follow-up E. Person-Years of observation

504 D.

Which of the following is not true of acute appendicitis? A. Misdiagnosis is significantly higher among men than in women. B. It is most frequently seen in the 2nd through 4th decades of life. C. Appendectomy for appendicitis is the most commonly performed emergency operation in the world. D. Perforation rates are highest in children <5 years and in patients > 65 years

509 A. Pretest 7th ed 134, modified Misdiagnosis is higher in women-Schwartz ,1075

The National Health Insurance Act of 1995 is A. RA 7875 B. RA 7610 C. RA 2382 D. RA 7767 E. RA 7234

51 A. RA 2382 - Medical Act of 1959

The following tests and procedures have been considered for colorectal cancer screening, except: A. Annual Fecal occult blood testing B. Rigid sigmoidoscopy C. Radiographic barium contrast studies D. Ultrasound

513 D. Harrison's17th ed, 491 also colonoscopy

A familial aggregation pattern exists for cancer of all the following organs except? A. Breast B. Ovary C. Colon D. Uterus E. Larynx

516 E. Laryngeal CA is related to smoking and alcohol use

A 5-year-old girl is brought to the physician 30 minutes after being bitten on the forearm by her cat. Examination shows a small puncture wound covered with dried blood. She is at increased risk of infection for which of the following reasons? A) Arm wounds are more susceptible to infection B) Salivary enzymes in cats augment infection C) It is difficult to cleanse pathogens from this wound D) Young children are less able to resist infection than adults

528C.

"The absence of valvular calcification in an adult suggests that severe valvular aortic stenosis is not present" . This statement means that: A) Valvular calcification is a sensitive test for severe valvular aortic stenosis B) Valvular calcification is an insensitive test for severe valvular aortic stenosis C) Valvular calcification is a nonspecific test for severe valvular aortic stenosis D) Valvular calcification is a specific test for severe valvular aortic stenosis

539 A.

The Framingham Heart Study was started in 1948 to "identify factors or characteristics that contribute to CVD by following its development over a long period of time in a large group of participants who had not yet developed overt symptoms of CVD or suffered a heart attack or stroke." It is an example of a: A. Ecologic study B. Cross-sectional study C. Case-control study D. Cohort study E. Community trial

544 D.

A screening test was developed and seemed to improve survival. However, on closer inspection, it seemed that if one compares the survival time from point of diagnosis, subjects whose disease was identified through screening appears to survive longer only because their disease was identified earlier. This describes which type of bias: A. Self-selection bias B. Length time bias C. Lead time bias D. Surveillance bias E. Spectrum bias

545 C.

The following are advantages of a cross-sectional study except: A. It can be conducted quickly. B. It is generally lest costly. C. It is insensitive to observation bias. D. It can identify stage of disease before it becomes apparent clinically. E. None of the above

547 C.

The major environmental source of lead absorbed in the human blood stream in adults is: A. Air B. Water C. Lead-based paint D. Food E. Soil

549 A.

Knowledge of teratogenic chemicals and environmental factors is paramount to prevent women giving birth to infants with congenital malformations. Which of the following is non-teratogenic? A. Ethanol B. Phenytoin C. Iodine deficiency D. X-ray E. None of the above

552 E.

Pulmonary Tuberculosis is transmitted primarily through what route? A. Ingestion of food B. Kissing C. Droplet D. Air borne

564 D.

In order to determine a causality of a rare disease, the most appropriate type of research to implement is: A case control B prospective cohort C RCTs D case report

566 A.

The association between low birth weight and maternal smoking can be studied by obtaining smoking histories from mothers at the time of the prenatal visit and then subsequently correlating birth weight with smoking histories. What type of study is this? A clinical trial B cohort prospective C cross sectional D none of the above

567 B.

Most common presentation of newborns with CMV infection: A organomegaly B thrombocytoenia C cerebral calcifications D asymptomatic E fever

568 D.

Which is the second most common site of nosocomial infections? A surgical wound B respiratory tract C blood stream D urinary tract

571 A.

A good screening test should be cheap, accessible and has: A high sensitivity B high sensitivity and specificity C be able to screen rare and life threatening diseases D high specificity is enough

572 A.

Dwarfism, hypogonadism, hepatosplenomegaly and poor wound healing are manifestations of those with deficiency in: A. Fluorine B. Copper C. Zinc D. Sodium E. Calcium

605 C. Deficiency in calcium will lead to poor bone mineralization, which may present as osteoporosis. Defiecnsy in sodium causes nasuea, diarrhea, cramps and dehydration. Increased tendency for caries characetrizes fluorine deficiency.

Family history is a well-documented risk factor for the following, EXCEPT: A. Breast CA B. Ovarian CA C. Colon CA D. Lung CA E. No exception

606 D. there is no sufficient data that links family history as a significant risk factor for lung cancer.

The following does NOT describe depressive disorders, EXCEPT: A. They are associated with more frequent visits for physical symptoms B. They mostly affect young married men C. They are rarely encountered in ambulatory care D. They can result in suicide in over 50% of cases E. They rarely present with physical complaints

610 A. Depression is more common in persons who are young, female, divorced, single, separated, seriously ill or have a prior history or family history of depression. Suicide occurs in 15% of untreated major depressive disorder. Depressed patients frequently present with a variety pf physical complaints.

An investigator wanted to determine if there is significant difference in the mean systolic blood pressure of 10 women before and after oral contraceptive use for 3 months. The appropriate statistical test for the significance of the study is: A. Analysis of variance B. Chi square test C. Student t test D. Paired t test E. All of the above

623 D. Paired t test

The primary objective of health education is to: A. improve health practice B. Transfer technology to lay personnel C. Promote health in general D. Impart knowledge E. All of the above

624 A.

The minimum distance of a pit privy from a well in a sandy soil is: A. 10 meters B. 15 meters C. 20 meters D. 25 meters E. 30 meters

625 D. 25 meters

The association between low birth weight and maternal smoking during pregnancy can be studied by obtaining smoking histories from women at the time of the prenatal visit and then subsequently correlating birthweight with smoking histories. What type of study is this? A. Clinical trial B. Cross sectional C. Cohort prospective D. Case control (retrospective) E. Case analysis

626 C.

The newborn with cytomegalovirus infection at birth most commonly presents with: A. hepatosplenomegaly B. hepatitis C. thrombocytopenia D. Cerebral calcifications E. None of the above

632 E. for every 1 with classic symptoms, 20 infants are asymptomatic

Approximately 9 people die each year in barrio Walang- Gana for every 1000 estimated to be alive. This describes the barrio's A. Case fatality rate B. Crude mortality rate C. Crude morbidity rate D. Secondary attack rate E. Specific Morbidity rate

649 B.

Heavy metals are known toxic materials from factories and mining companies. This heavy metal is primarily obtained from ore cinnabar A. Mercury B. Lead C. Cadmium D. Nickel E. Copper

660 A. MCU Prevmed notes, FCM 3rd edition, page 90

Which of the following is the ultimate goal of an epidemiologic investigation? A. To request for international assistance B. To institute curative, preventive and control measures to avoid more cases C. To identify administrative and operational problems of a health agency D. To determine discrepancies in policy implementation

686 B.

Among these statistical analysis, which is the most appropriate for comparing blood glucose levels of male & female rats using three different drugs? A. Student T-test B. Paired T-test C. Chi square analysis D. Analysis of variance E. Linear regression

695 D. Student T-test: independent samples Pair T-test: before/after samples Chi square : prevalence ANOVA: >2 groups

People who drink coffee tend to smoke more and for this reason coffee drinkers have a higher risk of lung cancer is a statement which displays which epidemiologic term? A. Confounding B. Effect modification C. Misclassification bias D. Lead-time bias

696 A. Confounding- asso. Between 2 variables is distorted by the fact that both are asso. w/ a third. Effect modification â€" one factor modifies the effect of another on outcome Lead-time bias - distortion of apparent efficacy of a screening program

A sampling design wherein every kth element of the population is chosen ie: every 6th person of a sampel size of 60 is chosen is what kind of sampling method? A. Purposive sampling B. Simple random sampling C. Systematic sampling D. Cluster sampling E. Multistage sampling

75 C. Pls refer to your Prevmed Topnotch handouts

A researcher is ointerested in performing a study regardign Budd-Chiarri syndorme and factors that could have led to this condition? What study method is best for this disease entitiy? A. Cross sectional B. Prospective cohort C. Retrospective cohort D. Case control E. Case report

79 D. Case control studies provides opportunity to investigate rare diseases (ex: Budd chiarri syndorme occuring in 1 per 1 million population) as well as disease with long periods of latency

9. AT, a gastroenterologist, was caring for a Muslim hypertensive patient from Dubai. During the course of treatment, the patient was noncompliant with all his medications. Which of the following is the most approriate response of AT? a. refer the patient to a Muslim doctor who would understand their culture b. counsel and emphasize on the consequences of noncompliance which would lead to mortality c. counsel and emphasize on the good effects of compliance with treatment d. read about Muslim culture and ask for advise e. none of the above

89 B. Kaplan USMLE REview

12. A 65 year old female came in for complaints of knee pain. Her medical problems include hypertension, gouty arthritis, and dyslipidemia. She has seen several doctors already for consult of her knee pain but doesn’t seem to go away with medications and physical therapy. She says, “ Pagod na pagod na ako. Walang nakakatulong sa akin. Walang gamot din tumatalab sa sakit ng tuhod ko. Hindi na nga ako nakakapaglinis ng bahay at nakakapaglaba. Mas mabuti magfile na ako ng PWD card.†Which of the following is the most appropriate response? a. better consult with a pain specialist b. you may have untreated depression c. I will assist you in filling up your PWD card d. I understand your frustration. It is difficult to help when you are convinced nothing will work e. I understand that lack of improvement has been frustrating

92 E. Best approach is to empathize with patient’s frustrations and disappointment with past treatment failures.

18. Which of the following are exceptions to informed consent? a. therapeutic privilege b. emergency cases c. capacity d. both A and B e. both B and C

98 D. A - withholding information when disclosure would severely harm the patient or undermine informed decision making capacity. B - implied consent in an emergency. Other exceptions are patient lacks decision makinng capacity or is legally incompetent and patient explicitly waives the right of informed consent USMLE first AID 2015

20. Understanding of the evaluation of diagnostic tests is essential in the practice of ORK. Which of the following is true? a. negative predictive value varies directly with prevalence or pretest probability b. positive predictive value varies inversely with prevalence or pretest probablity c. High sensitivity test is used for screening in diseases with high prevalence d. high specificity test is used for confirmation after a positive screening test e. none of the above

100 D.

This is an essential health service that is available, accessible, affordable and community-based: A. Primary health care B. Managed care C. Socialized health care D. Health insurance based care E. Personal care

101 A. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Page 45 of Topnotch Handout. PHC is essential healthcare, made universally accessible to individuals and families in the community by means acceptable to them through their full participation and of cost affordable by the community and country.

A duly licensed, DOH, and Philhealth accredited health care provider devoted primarily to the maintenance and operation of facilities for the promotion, prevention, diagnosis, treatment, and care of individuals which under the law should comply with the 20% discounted fees for identified services to senior citizens is termed: A. Health care professional B. Health care institution C. Health maintenance organization D. Community based organization E. Primary health care provider

103 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE.

How will public health professionals help in promoting the employment of people with disabilities as dictated in the Philippine Disability Act? A. Talk with the employers and tell them to prioritise last the psychosocial impact of disabilities on patients B. Refuse employment of a disabled on the basis of absence of facilities for the disabled C. Educate the employers on the work abilities of the disabled D. Consider the idea that disabled individuals cannot work well E. None of the above

104 C. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE.

An investigation in which assignment of patients to study groups is by random allocation : A. Cohort study B. Experimental study C. Case-control study D. Cross-sectional study E. All of the above

105 B.

Which of the following non-verbal form of communication shows sincerity: A. Handshake B. Eye contact C. Nodding D. Social distance E. None of the above

106 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Page 25 of Topnotch Handout. Eye contact indicates sincerity.

Aling Maria a 55 y/o laundry woman complains of knee pain. Which of the following herbal plants would you advise her to use? A. Sambong B. Akapulko C. Ampalaya D. Niyog-niyogan E. Yerba buena

107 E. Page 49 of Topnotch Handout. Yerba buena (Mentha cordifolia) is used for gaseous distention and rheumatism.

A family meeting should be done in the following situation: A. 4 y/o boy with acute nasopharyngitis B. 20 y/o female on her 2nd pregnancy C. 12 y/o male with acne vulgaris D. 65 y/o female who suffered a stroke E. 30 y/o male for annual physical exam

108 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. A family meeting is done when a family is expected to experience a new debilitating illness or circumstance that will alter the whole family structure and interaction.

A study was done to determine the doctor's ability to diagnose streptococcal throat infection in 149 patients coming to the clinic. Doctor's clinical impressions were compared to results of throat cultures for Group A Streptococcus. 37 patients had positive throat cultures, 27 were diagnosed by doctors as having strep throat. 112 patients had negative cultures, and doctors diagnosed 35 of these as having strep throat. What is the sensitivity of the doctor's clinical impression in this study? A. 44% B. 89% C. 73% D. 69% E. 42%

111 A. Page 3 of pearls. Sensitivity is the number of true positives divided by the number of all people with disease. Number of true positives is 27. True negative is 77. positive but not diagnosed as having strep throat=10, iagnosed with disease but negative culture is 35. Hence, SN=27/62=0.435x100= 43.5 or 44%

Which one of the following choices is more useful to a physician in ruling in the disease if the diagnostic test result turns out positive? A. Positive predictive value B. Negative predictive value C. Sensitivity D. Specificity E. Only A and B

113 D. Page 3 of pearls. Specificity rules in.

Which of the following is false: A. A relative risk reduction of <25% is considered not clinically significant B. The 95% confidence interval is another approach of determining whether a not statistically significant result in a study is clinically significant C. The determination of risk reduction rate is a quick and useful measure in deciding whether a statisically significant study is clinically significant D. None, all are true E. All of the above

114 D. Page 17 of Topnotch Handout. All are true.

A child was playing with his pet dog. When his mother came home she saw that the child sustained abrasions on the legs and a small gaping wound. What immunization would you give the child: A. None, Just wash it with soap and water B. Give Rabies vaccine only C. Give Rabies vaccine and Ig D. Give Ig only E. None, Just apply garlic on the wound

115 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE This is a category II exposure only. Vaccine is the management.

This phase of communicable illness occurs in the environment. It is the preliminary interaction of potential agent, host and environmental factors in disease production. A. Incubation period B. Generation period C. Prepathogenic phase D. Pathogenic phase E. Resolution phase

12 C. Incubation period â€" infection to signs and symptoms Generation time â€" infection to maximal communicability of that host Pathogenic phase â€" course of disorder in man Source: Topnotch handout on preventive medicine Incubation period, generation period, latency period are relatively same in duration (and sometimes used interchangeably?)SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE.

This refers to the ability of an agent to produce serious illness and is measured in terms of fatality: A. Antigenicity B. Virulence C. Pathogenicity D. Invasiveness E. Infectivity

120 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Page 29 of Topnotch Handout. Virulence is the ability of an agent to produce serious illness and is measured in terms of fatality.

People who drink coffee tend to smoke more, and for this reason coffee drinkers have a higher risk of lung cancer. This is an example of: A. Effect modification B. Selection bias C. Confounding D. Non-differential misclassification E. Lead-time bias

128 C. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT

Which of the following ways and means is not utilized by the Primary Health Care program in the achievement of their goals? A. Medical information in promoting health B. Prevention of disease and health promotion C. Intersectoral cooperation and participation D. Basic health infrastructure and facilities within the reach of every Filipino E. No exception

129 D.

The resistance of a group to invasion and spread of an infectious agent based on the immunity of a high proportion of individual members of the group, believed to be an important factor underlying the dynamics of propagated epidemic and periodicity of a disease is: A. Environment B. Antigenicity C. Herd immunity D. Virulence E. Pathogenicity

13 C. Source: Topnotch handout on preventive medicine

Community planning should start with A. Formation of objectives B. Determination of resources C. Educational analysis D. Identification of roles and their relationship E. Working with people

130 A.

The initial step in planning for the provision of health and medical services for a community is to: A. Set the objectives B. Define the health problems C. Decide on what services to provide D. Establish the system of delivery E. Determine the projected budget

131 B.

Which of the following is not a characteristic of a community-based health program? A. Community organizing is used as a means of changing people's attitudes thus leading to their full cooperation B. People become partners in health care C. Active participation of the community in decision making D. It is democratic in nature. E. No exception.

132 A.

The Republic Act 7875 is also known as the National Health Insurance Act of 1995. This program covers health insurance for: A. All government employees only B. All public and private employees C. Unemployed citizens D. Indigent patients E. All Filipino citizens

133 E. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT

Tetanus toxoid immunization is effective in protection against infection. After adequate primary immunization, booster doses should be given every: A. 3 years B. 15 years C. 10 years D. 5 years E. 2 years

137 C. Source: CDC. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT

Which of the following family assessment tools is used to assess the capacity of the family to participate in provision of health care or to cope with crisis? A. Triangulation B. APGAR C. SCREEM D. Functional chart E. Family Genogram

14 C. Screem (Social, Cultural, Religious, Economic, Educational, Medical) - Source of help - Relationship of health behavior, practices and utilization of health services SCREEM = Resources (this is a must know!) Source: Topnotch handout on preventive medicine

The first step in epidemic investigation is: A. Formulation of hypothesis B. Orientation as to time, person, and place C. Testing of hypothesis D. Preliminary investigation E. Case finding

140 D. Steps in epidemic investigation: 1. Preliminary investigation, 2. Orient the epidemic as to time, person and place (Case finding,institution of investigation forms, analysis of lab specimen, formation of spot map, epidemic curve, host characteristics, envt factors, attack rate); 3. Formulation of hypothesis; 4. Testing hypothesis; 5. Conclusion and recommendation.

What is a confounding variable? A. Occurs when the methods of measurement are dissimilar among groups of patients B. Occurs when 2 factors are associated and the effect of one is confused with or distorted by the other C. Comparisons are made between groups of patients that differ in determinants of outcome other than the one under the study D. The clinician knows that a patient possesses a prognostic factor of presumed importance may carry out more frequent or more detailed searches for relevant prognostic outcomes E. None of the above

141 C. Confounding variables are variables that wrongly associate the effects of an independent variable to the outcome (dependent variable).

A patient was brought to your clinic due to a dog bite, you educate the family that the first thing to do after a dog bite is: A. Wash with soap and water for 10 minutes B. Apply alcohol to the bite site C. Apply garlic or toothpaste to the bite area D. Induce the wound to bleed E. None of the above

143 A. Washing the bite site with soap and water for 10 minutes is the first step then promptly bringing the patient to a doctor to assess for any complications

You are on duty at the ER when a child came in due to being hit by a fallen roof of their house, the wound on his head was a lacerated wound with some debris on it, you asked his tetanus immunization and said that the child received 3 doses of tetanus vaccine, the last was 3 years ago, what would you give? A. Toxoid only B. Antitoxin and toxoid C. Antitoxin only D. Give nothing E. Prescribe antibiotics

145 E. Prescribe antibiotics for protection against infection. You may opt to give no tetanus vaccination as the protection by the toxoid is still effective in this patient. You may give a booster dose of toxoid if the last vaccine was more than 5 years from the onset of the injury.

A patient with diabetes mellitus had a below the knee amputation, at what stage of the illness is she? A. Pre-clinical B. Susceptibility C. Disease outcome D. Clinical E. None of the above

148 C. The patient is at the disease outcome stage as she has already the outcome of the complication of her disease which was vasculopathy leading to limb ischemia and subsequent amputation.

A 3 year old child was living with her grandmother being treated for tuberculosis for 6 months, at what stage is the child? A. Pre-clinical B. Susceptibility C. Disease outcome D. Clinical E. None of the above

149 A. The patient is already exposed to the causative agent but still has not developed any signs of the disease detectable clinically, thus this child is at the pre-clinical stage.

Same case as #231, what is the incidence of gastroenteritis? A. 10 per 100 population B. 11 per 100 population C. 12 per 100 population D. 13 per 100 population E. 14 per 100 population

152 A. 550/5350 = 0.1028 x 100 = 10.28 or 10

If a drug that extends the life of a patient but it doesn’t cure or prevent the disease, what happens to the indices A. Incidence increases B. Incidence decreases C. Prevalence increases D. Prevalence decreases E. None of the above

154 C. Because the drug neither cures nor prevents the disease, the prevalence would go up as the drug prolongs the life of those with a particular disease

Mycobacterium bovis is a weakened, non-pathogenic form of the bacterium that causes tuberculosis. Upon injection, macrophages engulf and destroy them and use the resulting debris to prime the acquired immune system. The macrophages would display the pieces of digested bacteria on their: A. MHC I proteins B. MHC II proteins C. MHC III proteins D. Antigen receptors E. Cell membrane

155 B.

Diseases like cholera, typhoid fever and bacillary dysentery are examples of A. Water washed diseases B. Water based diseases C. Water borne diseases D. Water related vector diseases E. None of the above

157 C. Water washed diseases are diseases caused by lack of water (e.g. Scabies, lice), water based diseases are diseases where the offending agent uses water as a medium of infecting man (e.g. schistosomiasis, threadworm), water borne diseases are diseases transmitted by water (e.g. cholera, typhoid fever, dysentery), water related vector diseases are diseases in which the vectors have a part of their life cycle in water (e.g. Mosquito borne diseases like malaria, Dengue, Yellow fever, Filariasis)

Which of the following is involved in natural passive immunity A. Injection of human antibodies into an individual B. Vaccination C. Injection of horse antibodies into an individual D. Excretion of antibodies into breast milk E. Producing memory cells in response to infection with a live virus

159 D. Choice A and C are artificial passive immunity, B and E are acquired immunity

Which of the following is not a feature of Primary Health Care? A. Goal is development of preventive health care B. Focus of care is the well and early sick C. Decision making is from top to down D. Acceptance of indigenous practitioners E. Self reliance of the community

16 C. Source: Topnotch handout on preventive medicine

A vaccine was able to induce production of specific antibodies as protection for a certain disease. This property is called: A. immunogenicity B. pathogenicity C. virulence D. contagiousness E. Efficience

162 A. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

This is usually measured by the number of severe or fatal cases over the number total number of people who had the disease. A. immunogenicity B. Pathogenicity C. Congiousness D. Fatality factor E. Virulence

164 E. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

Which of the following herbal medicinal plants has an anithelmintic property? A. Akapulko B. Ampalaya C. Tsaang gubat D. bayabas E. Niyog-niyogan

166 E. akapulko is usually for fungal infections and scabies. Ampalaya is for diabetes. Tsaang gubat is for abdominal pain. Bayabas has many uses like in dizziness, infections and inflammatory conditions.

In a barrio where you are practicing, a teenager consulted your for enlarging slightly raised hypopigmented lesions on his back associated with itching. Since you are in a far barrio and your patient cannot afford to go town and buy an ointment, which of the following can you give as a treatment aside from educating him for proper hygiene? A. ampalaya B. bawang C. akapulko D. yerba buena E. lagundi

167 C. the patient is suffering from a cutaneuos fungal infection so you can give akapulko because it has an antifungal property.

The National Health Insurance Act of 1995 or the Act instituting a national health insurance program for all Filipinos and establishing the Philipping Health Insurance Corporation for the pupose was approved by Pres Fidel Ramos last February 14, 1995. This Act is also known as: A. RA 7432 B. RA 7305 C. RA 7875 D. RA 6675 E. RA 9257

168 C. RA 7432 is the senior citizen act of 1992. RA 7305 is the Magna Carta of Public Health Workers. RA 6675 is the generics act of 1988. RA 9257 is the expanded senior citizens act of 2003.

Which of the following Philippine Herbal Medicinal Plants is recommended for Diabetes? A. Lagundi B. Niyognyogan C. Sambong D. Ampalaya E. Bawang

17 D. Lagundi â€" Cough, asthma Niyognyogan - ascariasis Sambong - urolithiasis Ampalaya â€" Antidiabetes Bawang â€" lowers cholesterol, athletes foot Source: Topnotch handout on preventive medicine

A painter came in to your clinic for consult. His symptoms were consistent of Plumbism or lead poisoning. Which of the following can you give as treatment. A. dimercaprol B. NAC C. penicillamine D. Calcium gluconate E. EDTA

172 E. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

Dr LFD, was tasked to do a probability sampling. He listed all the names of the members of the population and arranged it alphabetically. He then picked every 6th name on the list and made them the sample of the study. The sampling design is called: A. Simple random sampling B. systematic sampling C. cluster sampling D. multistage sampling E. none of the above

174 B. systematic sampling design is choosing every kth element of the population

A resident has a research comparing the samples who receive and did not receive a rotavirus vaccine as to the severity of their diarrhea. Which statistical test will be most appropriate for him use? A. Chi square B. T test C. Z test D. ANOVA E. regression analysis

176 A. chi square is used for testing the relationship between two qualitative data.if you use 1-100 to describe the severity, the values will be in ordinal. T test can only be used if your values are either interval or ratio

Leo and Antonio consulted you for dog bite. They were bitten by their pet dog who just given birth to 3 puppies. According to them, their dog is yearly vaccinated with rabies vaccination. Leo suffered from a tiny abrassion on his left arm but did not bleed spontaneously so he just induced bleeding by pressing it. On the other hand, Antonio suffered from minor scratches at the back of his neck but no spontaneous bleeding and induction of bleeding was not done. Leo's rabies exposure falls under what category? A. I B. II C. III D. IV E. V

177 B. abrasions and scratches with no spontaneous bleeding and including those induced are classified as category II except if it is located on the head or neck which is categorized as III.

A 4 year old female patient comes to you because the pet dog licked her hand. PE revealed no break in the skin. What is the appropriate management? A. Wash exposed skin with soap and water B. Vaccine C. RIG D. A + B E. All of the above

18 A. Cat 1 â€" intact skin â€" no vaccine or RIG needed Cat 2 â€" break in skin but no bleeding â€" vaccine Cat 3 â€" bleeding or wound located in head and neck â€" vaccine Source: Topnotch handout on preventive medicine

As an epidemiological investigation officer for CDC, you are contacted by a local health department. They inform you that a large number of people have acquired mild symptoms of influenza despite being vaccinated for the appropriate strain being cultured. You find that the cultured strain is the same as that incorporated into the trivalent vaccine administered throughout the world. You also note that the strain had a high case fatality rate in previous epidemics in China, where most new strains are isolated and identified for vaccine preparations. The most likely explanation for the outbreak noted by the local health department is A. vaccine failure B. antigenic drift C. antigenic shift D. herd immunity E. incomplete immunity from previous rhinovirus infections

182 B. pretest 7th ed

Reasons to treat gonorrhea with tetracycline rather with other susceptible drugs include A. Lower frequency of side effects B. Better coverage of Chlamydia trachomatis C. Greater safety in case of pregnancy D. Enhanced compliance E. All of the above

183 B.

About 1 % of boys are born with undescended testes. To determine whether prenatal exposure to tobacco smoke is a cause of undescended testes in newborns, the mothers of 100 newborns with undescended testes and 100 newborns whose testes had descended were questioned about smoking habits during pregnancy. The study revealed an odds ratio of 2.6 associated with exposure to smoke, with 95% confidence intervals from 1.1 to 5.3. Which of the following statements is true? A. The results provide no evidence that maternal cigarette smoking is associated with undescended testes in offspring B. If the study results are accurate, they suggest that a baby boy whose mother smoked is about 2.6 times as likely to be born with testes undescended as a baby boy whose mother did not smoke C. The fact that the confidence interval excludes 1.0 indicates that p>0.05 D. The 90% confidence interval for these results would probably include 1.0 E. None of the above

184 B. Pretest #19 7th ed

In a health officer's point of view, what are the implications of a low Infant Mortality Rate? A. Adequate immunization program B. Satisfactory pre and post-natal services C. Young population D. All of the above E. A and B

186 E. Implications of low IMR in a Health Officer's point of view: adequate immunization program, sound infant and maternal nutrition, satisfactory pre and post-natal services, good disease control program, strict laws governing the administration of health programs. High IMR signifies: high incidence of communicable disease, poor state of sanitation, inadequate health facilities, shorter life expectancy and young population.

Which of the following is an example of specific protection? A. Immunization against poliomyelitis B. Ear protecting devices in loud working environments C. Hold an education program on nutrition for children for mothers in a community with children aged 1-5 y/o D. A and B E. All of the above

19 D. Specific prevention is a form of primary prevention targeted at a specific disease or type of injury. Examples include immunization against specific disease, use of seatbelts to prevent injuries in automobile accidents, treatment of hypertension to prevent end organ damage. NOTE: Concept of specific prevention is a must know concept in prev med!! Source: Jekel's Epidemiology, Biostatistics, Preventive Medicine, and Public Health By David L. Katz, Joann G.. Elmore, Dorothe

This type of infection is classified as a water-based disease? A. Cholera B. scabies C. Malaria D. Heavy metal poisoning E. Leptospirosis

191 E. Water-borne: infections that cause gastroenteritis (cholera, giardia, etc), heavy metals, nitrates, dental fluorosis. Water-washed: scabies, typhus, lice. Water-based: schistosomiasis, leptospirosis. Water-related: dengue, malaria, filaria

In comparing difference between two means, p-value is found to be 0.60. The correct interpretation of this result is A. The null hypothesis is rejected B. The difference is compatible with the null hypothesis C. The difference occured by chance D. The difference is statistically significant E. Sampling variation is an unlikely explanation of the difference

192 B. pretest #28 7th ed

The population of Sin City is 60 000 last July 2014. In the same year, there were 800 births and 580 deaths. Of the 580 deaths, 280 were due to cardiovascular diseases, 150 were caused by cancer, 90 from infectious diseases and the others are caused by accidents. There were 2700 people diagnosed with cardiovascular disease. What is the crude birth rate? A. 13/1000 B. 14/1000 C. 15/1000 D. 16/1000 E. 17/1000

194 A. crude birth rate= number of registered live births in a year/midyear population x 1000

Patient came in with chief complaint of fever of 3 days associated with myalgia, vomiting and headache. CBC revealed leukopenia and thrombocytopenia. NS1 antigen test is postive. Patient cannot tolerate oral fluids, hence admitted. What IV fluid is appropriate for this case? A. PLR B. D5W C. 0.45 NaCl D. D5 0.9 NaCl E. PNSS

197 D. D5LRS, acetated ringer's, D5NSS or D5 0.9NaCl are appropriate for dengue patients without warning signs who are admitted but without shock (this is based on Dengue Clinical Management Guidelines

What is the recommended post-exposure prophylaxis for leptospirosis in individuals with high risk exposure? A. Doxycycline 200mg single dose within 24-72 hours from exposure B. Doxycycline 200mg once weekly until the end of exposure C. Doxycycline 200mg once daily for 3-5 days to be started immediately within 24-72 hours from exposure D. Doxycycline 200mg once daily until the end of exposure E. Doxycycline 100mg once daily for 3-5 days to be started immediately within 24-72 hours from exposure

198 B. High risk exposure is defined as those individuals with continuous exposure (those having more than a single exposure or several days such as those residing in flooded areas, rescuers and relief workers). Recommended post-exposure prophylaxis for this is Doxycycline 200mg once weekly until the end of exposure. A is for low risk exposure. C is for moderate risk exposure.

Patient undergoes a screening test and a tumor was discovered. The screening advanced the time of diagnosis but no true prolongation of life occurs because there are no effective treatments available. What form of bias is this? A. Length bias B. Lead time bias C. Information bias D. Recall bias E. Selection bias

2 B. Length bias â€" window period between the time the cancer can be detected and the time it will become clinically apparent is short. Screening tests are more effective in slowly growing tumors. Lead-time bias â€" screening advances time of diagnosis but no true prolongation of life occurs because survival for persons who are screened and those who are not is the same Information bias â€" systemic difference in the way data are collected from exposure or the outcome Recall bias â€" one form of information bias and refers to what one may remember from exposure Selection bias â€" inclusion of a subject in a study group is linked to the exposure of interest Source: Topnotch handout on Preventive Medicine

Which correctly describes infant mortality? A. Number of deaths in the first 28 days of life per 1000 live births in 1 year B. Number of fetal deaths plus deaths in the first week of life per 1000 total births in 1 year C. Number of deaths under the age of 1 year per 1000 live births in 1 year D. Number of deaths between the ages of 28 days and 11 months per 1000 live births in 1 year E. Number of deaths within 72 hours of life per 1000 live births in 1 year

202 C.

A new test for Salmonella infetion is introduced. Half of the patients who are tested have a positive test. Compared with blood cultures, 60% of those with a positive test are infected with Salmonella, and 80% of those who tested negative are free of the infection. What is the sensitivity of the new test? A. 40% B. 60% C. 67% D. 75% E. 80%

203 D. Specificity: 67%. PPV: 60%. NPV: 80%. Prevalence of Salmonella: 40%

A randomized study of breast conservation surgery to prevent recurrence in patients with stage I breast cancer fails to find a significant difference between BCS and control groups after ten years (N = 500 per group; p = 0.20). Which of the following might best explain this? A. Misclassification bias B. Type I error C. Type II error D. Selection bias E. Ecologic fallacy

205 C. A typr II error occurs when a study fails to reject the null hypothesis (of no effect) when it is, in fact, false.

Which patient is most likely to become a chronic carrier following an acute episode of hepatitis B? A. A newborn B. A 20 year-old female following vaginal sexual transmission C. A 50 year-old male following rectal sexual transmission with a partner positive for HBeAg D. A 30 year-old health care worker following a percutaneous injury E. A 40 year-old HIV-infected male with a CD4 count of 200

206 A. Up to 90% of infants born to HbsAg-positibve mothers will become carriers.

Campylobacter jejuni is associated with which of the following conditions? A. Guillain-Barre syndrome B. Hemolytic anemia C. Febrile seizures D. Intussusception E. Neutropenia

209 A. 20-30% of all cases occuring in North America, Europe, and Australia are preceded by infection or reinfection with C. jejuni.

You are reading a study that compares cholesterol levels in children whose fathers died from a myocardial infarction with cholesterol levels in children whose fathers died from other causes. The p value obtained in the test was <0.001. What does this value indicate? a. There was no difference in cholesterol levels between the two groups b. The difference in the cholesterol levels was less than 0.1% c. There is a less than 0.1% probability that the results obtained in this study were incorrect d. There is a less than 0.1% probability that the results obtained in this study occurred because of a sampling error e. If the null hypothesis is true, there is a less than 0.1% probability of obtaining a test statistic equal to or more extreme than the one obtained

21 C. The p value for any hypothesis test is the level at which we would be indifferent between accepting orrejecting the null hypothesis given the sample data at hand. It can also be thought of as the probability of obtaining a test statistic as extreme or more extreme than the actual test statistic obtained, given that the null hypothesis is true. It does not reflect the absolute difference in the data between groups, and does not reflect the correctness of the data in the sample.

A patient with silicosis is most susceptible to have: A. Lung cancer B. Pneumonia C. Asbestosis D. Mesothelioma E. Tuberculosis

212 E. It is postulated that silicosis results in a depression of cell-mediated immunity, and crystalline silica may inhibit the ability of pulmonary macrophages to kill phagocytosed mycobacteria.

The antidote to parathion poisoning is: A. EDTA B. Pralidoxime C. Dimercaprol D. Acetylcysteine E. Flumazenil

214 B. Parathion is an organophosphate pesticide.

The Ames test is applied in: A. HIV testing B. Mutagenicity screening C. Diagnosis of bacterial vaginosis D. Statistical analysis in clinical trials E. Peripheral vision testing

215 B. The Ames test is a bacterial mutation assay that is most commonly used in the rapid screening test for mutagenesis and carcinogenesis. It is very sensitive to DNA damage.

A patient with pulmonary tuberculosis has just finished 2 months of intensive therapy. He complains of numbness of both hands. This would have been prevented by co- administration of which vitamin? A. Thiamin B. Riboflavin C. Ascorbic acid D. Pyridoxine E. Folic acid

216 D. Isoniazid causes peripheral neuropathy. Vitamin B6 is given to prevent this adverse drug effect.

The use of oral contraceptives will have the most impact on gynecological mortality by reducing the risks for which of the following cancers? A. Ovarian B. Breast C. Cervical D. Uterine E. Vulvar

217 A. OCPs decrease the risk of ovarian cancer by up to 80%. They can also reduce the risk of uterine cancer.

Screening for hypertension constitues: A. Primary prevention B. Secondary prevention C. Tertiary prevention D. A and B E. B and C

218 D. Screening for hypertension in asymptomatic persons is both a secondary measure and a primary measure as it also prevents the occurrence of strokes.

To obtain informed consent, which of the following is NOT required? A. Disclosure of the nature and purpose of the proposed therapy B. Disclosure of the risks and benefits of the proposed therapy C. Alternatives to the proposed therapy D. Consequences if the proposed therapy is not given E. Signature of the patient on the written consent form

219 E. Consent may be obtained verbally.

Stage in the Family life cycle which begins with the birth of the couples first child? A. The Unattached Young Adult B. Newly Married Couple C. Family with Young Children D. Launching Family E. Family in Later Life

22 C.

In the case of Tarasoff v. Regents of the University of California (1976), a person was murdered after a therapist failed to inform the victim of a patient's intentions to kill that person. This exemplifies: A. Malpractice B. Duty to warn C. Confidentiality D. Respect for autonomy E. Nonmaleficence

220 B. The court held that the patient's right to privacy did not obviate the therapist's duty to warn possible victims in cases in whhich a therapist can reasonably determine that another person is at foreseeable risk.

this type of family includes step parents, and or step children brought about by annulmentm with separation and remarriage? A. Nuclear B. Communal C. Extended D. Blended E. None of the above

221 D. Nuclear - married man and women with their children, extended - linked together by virtue of kinship bond between parents and children and or between siblings . It ncludes three generations. Communal - composed of group of individual who are formed for specific ideological or societal purposes.

In a five star physician model, which aspect refers to a physician referring a patient to other specialist, or to agencies and institution and coodinates function in the clinic, hospital or community center? A. Social mobilizer B. Health care provider C. Manager D. Counselor E. Researcher

222 C. social mobilizer - emprovers and motivates patient, family and even the community to be partners in health care. Counselor- promotes healthy lifestyle by empathic explanation and encouraging individuals and groups to enhance and protect their health. health care provider- considers patient as an integral part of a family and the community and provides high standard clinical care and personalizes preventive care within a long term trusting relationship.Researcher - selects appropriate medicine,test or ancillary procedures based on evidenced based practice.

In the family illness trajectory, what stage refers to the second crisis which points to the family's adjustment to the effect of illness? A. Major therapeutic effect B. Reaction to diagnosis C. Adjustment to the permanency of the outcome D. early adjustment to outcome E. onset of illness

225 D.

In family APGAR, this refers to the capabillity of the family to utilize and share inherent resources A. Adaptation B. partnership C. Growth D. Affection E. Resolve

226 A. Partnership - sharing in decision making. Measure the satisfaction attained in solving problems by communicating. Growth - refers to both physical and emotional growth. This measures the satisfaction of the available freedom of change. Affection - measures the members satisfaction with the intimacy and emotional interaction that exist in the family. Resolve - refers to how time, space, and money are shared. measures the members satisfaction with the commitment made by other members of the family.

In McCubbins family typology, this type of regenerative family has a high value in family coherence but low in terms of family hardiness? A. Vulnerable type B. Durable type C. Secure type D. Regenerative type E. None of the above

227 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Vulnerable - low family hardiness, low family coherence. ( more complacent , less likely to try new and exciting things, tending to do the same things over and over, and are less likely to encourage each other to be active and to learn new things. secure -high family hardiness, low family coherence. active, in control, but when faced with difficulties are also less supportive of each other, less caring and loyal. and less tolerant of hardships. regenerative type - high in family hardiness and coherence. cope by working together to solve problems.

which of the following is a criteria for instituting a screening program? A. There should be a short period between first signs and overt disease B. Diagnostic test must be sensitive and specific C. Low prevalence during the preclinical stage of the disease D. all of the above E. none of the above

229 B. criteria for instituting a screening program: the disease must have the following characteristics: serious or high risk for mortality or morbidity, high prevalence of preclinical stage, well understood natural history, long interval between first signs and overt disease. Diagnostic test: must be sensitive and specific, safe and acceptable, reliable. Treatment: facilities are adequate, effective ,acceptable , and safe treatment available.

You are caring for a 24-year-old generally healthy woman. She is sexually active and currently in a monogamous relationship, using oral contraceptives. You recently completed her annual examination. Her Pap smear reports “atypical squamous cells of undetermined significance.†Human papillomavirus testing was positive. Which of the following is the most appropriate next step? A. Repeat the Pap smear immediately B. Repeat the Pap smear in 4â€"6 months C. Repeat the Pap smear in 1 year D. Perform colposcopy E. Treat the patient with imiquimod and repeat the Pap smear after the treatment is complete.

23 D. When the results of a Pap smear are reported as ASCUS, and HPV testing on the sample is positive, the physician should proceed to colposcopy. Colposcopy involves cervical examination under stereoscopic magnification and includes biopsy of abnormal appearing areas, and is the definitive test for assessing Pap smear abnormalities. Imiquimod is an immune modulator and can treat warts, but is not indicated in this case.

what type of epidemiologic study is useful for investigating exposures that are fixed characteristics of individuals, such as ethnicity, socioeconomic status and blood groups, or chronic disease or stable condition? A. Prevalence studies B. Case control studies C. prospective cohort studies D. RCT E. Ecological studies

230 A. prevalence or cross sectional studies provides measurement of exposure and effects that are made at the same time. It is useful for investigating exposures that are fixed characteristics of an individual. It is the most convenient initial step in causality investigation during sudden outbreak of a disease. its disadvantages are the following: rare disease, diseases with very high case fatality rate are often not detected, provide no direct estimate of risk and prone to bias from selective survival.

which of the following best describes the double burden of the disease in the Philippines? A. Pneumonia is the leading communicable cause of mortality and morbidity B. The leading cause of mortality is cardiovascular disease C. hypertension is the 5th leading cause of morbidity in this country D. all of the above E. none of the above

231 D. the double burden of disease in the Philippines indicate that the leading causes of morbidity are communicable disease while the leading cause of mortality are the noncommunicable ones. In terms of ranking, pneumonia is the leading cause of morbidity followed by diarrheal illness. mortality shows that heart disease remain the no 1 cause of death of filipinos. along the least, the most common communicable disease that causes mortality is pneumonia.

which of the following is true statement regarding a validity test? A. A specific test is most helpful to a clinician especially if the test result is negative. B. Highly sensitive test is needed when false positive result can induce potential harm to the patient C. the positive predictive value of a test increases the prevalence of a disease D. Sensitivity and specificity are affected by the prevalence of the disease or condition E. all of the above

233 C. A - a highly sensitive test is most helpful to rule out a disease. B- a specific test is needed to confirm a positive result since a false positive can induce potential harm to a patient. Sensitivity and specificity is unaffected by the disease prevalence. Since sensitivity depends only on those with the disease or condition and specificity only on those without the disease or condition.

this medicinal plant can be use as anti-helminthic for patients with ascariasis in terms of eradication of its ova through routine fecalysis? A. Niyog niyogan B. Ulasimang bato C. Yerba buena D. Sambong E. None of the above

234 A. Ulasimang bato - anti-inflammatory agent for patients with arthritis & gout.Yerba Buena - anti- spasmodic agent for patients with irritable bowel syndrome. Sambong - anti-uricosuric for patients with kidney stones in terms of reducing the size of kidney stone & or completely dissolving the kidney stone.

Which of the following best describes the double burden of the disease in the Philippines? A. Pneumonia is the leading communicable cause of mortality and morbidity B. The leading cause of mortality is cardiovascular disease C. hypertension is the 5th leading cause of morbidity in this country D. all of the above E. none of the above

301 D. the double burden of disease in the Philippines indicate that the leading causes of morbidity are communicable disease while the leading cause of mortality are the noncommunicable ones. In terms of ranking, pneumonia is the leading cause of morbidity followed by diarrheal illness. mortality shows that heart disease remain the no 1 cause of death of filipinos. along the least, the most common communicable disease that causes mortality is pneumonia.

A 74 year old retired professor consulted you for a general check up. He read from a health magazine that vitamin supplementation can prevent cardiovascular disease and even cancer and started taking it daily. You were asked if there is truth to this recommendation. which of the following statement will you tell to your patient? A. mega doses of vitamin C shortens the duration of illness and increases the immunity against that of the disease. B. beta carotene supplementation helps reduce oxygen radicals and are recommended in patients at risk for cardiovascular disease. C. taking Vitamins A, C and E combination for the prevention of cancer or cardiovascular disease D. recommended daily allowance particularly in elderly even if achieved in the diet is still not enough because of decreased absoprtion efficiency. E. none of the above

236 E. AAFP encourages adherence to recommended daily allowance Recommends against the use of beta-carotene supplements for the prevention of CV disease and cancer.Evidence is insufficient to recommend for or against use of supplements of Vitamin A, C, and E for CV disease and cancer prevention

In family APGAR, this refers to the capabillity of the family to utilize and share inherent resources A. Adaptation B. partnership C. Growth D. Affection E. Resolve

302 A. Partnership - sharing in decision making. Measure the satisfaction attained in solving problems by communicating. Growth - refers to both physical and emotional growth. This measures the satisfaction of the available freedom of change. Affection - measures the members satisfaction with the intimacy and emotional interaction that exist in the family. Resolve - refers to how time, space, and money are shared. measures the members satisfaction with the commitment made by other members of the family.

which type of parenting style will yield a child that is rebellious, impulsive and low achieving? A. rejecting B. Permissive C. authoritarian D. Uninvolved E. None of the above

304 B. A-immature, psychologically troubled child, c- conflicting, unfriendly irritable child, D- lonely and withdrawn child.

Which type of verbal communication indicates sincerity ? A. Eye contact B. handshake C. Posture D. mannerism E. Touch

305 A. ( SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE)

The most challenging and rewarding stage for the physician in the Family Illness Trajectory? A. Onset of illness to diagnosis B. Reaction to diagnosis C. Major therapeutic effort D. Early adjustment to outcome E. None of the above

306 C. (SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE)

29 year old HIV positive male was recently diagnosed with TB meningitis now exhibit stuporous state, ophthalmoplegia, dysphagia, and meningeal signs. In what stage is the patient most likely at ? A. Stage I B. Stage II C. Stage III D. Stage IV E. stage V

307 B. Stages of TB Meningitis • Stage I nonspecific symptoms especially gastrointestinal, irritable, listless , fever • Stage II progressive stupor cranial nerve palsies, and long tract signs, kernig and Brudzinski • Stage III Coma, irregular respirations, fixed pupils and clonic spasms of the extremities.

In which of the following situations can a patient avail of the philhealth benefit? a.) The patient has applied for philhealth a month ago, and he is now confined in the hospital for an appendectomy b.) Patient was admitted last month for 2 months due to sepsis due to CAP-HR, and she is now admitted in the hospital for another episode of CAP-HR c.) Patient is admitted for a case of UTI, but was discharged on the same day d.) Patient underwent excision of breast mass as OPD e.) All of the above

309 D. One can avail philhealth if 1.) There is at least 3 monthly contributions within the immediate 6 month period prior to the month of confinement 2.) Confinement in any accredited hospitals for not less than 24 hours due to an illness or injury requiring hospitalization. 3.) Minor surgical procedures and chemotherapy, radiotherapy, hemodialysis and cataract extraction even on OPD basis provided that the 45 days allowance for room and board has not been consumed yet.

You and your friends have just measured the heights of your dogs. You came up with the following measurements: 600mm, 470mm, 170mm, 430mm and 300mm. What is the standard error? A. 164 B. 27,130 C. 394 D. 73.66 E. 32.8

24 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. The actual stem question was a clinical case that asked for the standard mean, variance and standard deviation in 3 separate questions. We were allowed to use a scientific calculator, so familiarize yourself on how to use it if you forget the formula. FORMULA FOR STANDARD ERROR: Standard deviation/square root of sample size. LONG METHOD OF CALCULATING STANDARD ERROR - Step 1: Calculate the mean (Total of all samples divided by the number of samples). Step 2: Calculate each measurement's deviation from the mean (Mean minus the individual measurement). Step 3: Square each deviation from mean. Squared negatives become positive. Step 4: Sum the squared deviations (Add up the numbers from step 3). Step 5: Divide that sum from step 4 by one less than the sample size (n-1, that is, the number of measurements minus one) Step 6: Take the square root of the number in step 5. That gives you the "standard deviation (S.D.)." Step 7: Divide the standard deviation by the square root of the sample size (n). That gives you the “standard errorâ€.

In the course of investigating a 24-year-old HIV-infected male, the HBsAg is positive. He is currently asymptomatic, his physical examination is essentially normal, and his CD4 cell count is 800. Which of the following tests is most helpful in determining whether the patient is in the acute phase of viral hepatitis? A. HbeAg B. HbsAg C. ALT levels D. IgM anti Hbc E. IgG anti Hbc

240 D. Currently available laboratory tests for hepatitis B include HBsAg (hepatitis B surface antigen), anti- HBs (antibody to hepatitis B surface antigen), IgM anti-HBc, IgG anti-HBc (antibodies to the core antigen), HBeAg, and anti-HBe. Because HBcAg is sequestered within an HBsAg coat, HBcAg is not routinely detected in patients with hepatitis B. IgM anti-HBc appears soon after the onset of infection and the detection of HBsAg, and precedes by many weeks detectable levels of anti-HBsAg. It generally disappears after 6 to 8 months. The presence of IgM is a marker for acute (less than 6 months) hepatitis B. IgG anti-HBc appears somewhat later than the IgM and may persist for years. Elevated ALT may be present both in the early and chronic phases of the disease. HBeAg may persist for years in patients with chronic disease and is associated with high infectivity. HBsAg remains detectable beyond 6 months in chronic hepatitis B.

Juan and Juana are married for 15 years, their eldest child Rita is currently second year high school, the family is currently balancing increasing the flexibility of their boundaries to balance their child's independence and guidance, their concerns as parents as verbalized were regarding information regarding injury prevention, drug abuse, STD and early pregnancy issues as their child increasingly becomes moody and intolerant what stage of family life cycle they are currently in? A. unattached young adults B. newly married couple C. family with young children D. family with adolescents E. launching family

242 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

The Philippines currently suffers from a double burden of disease, which among the following statements correctly refers to this? A. the leading cause of mortality in the Philippines is from infectious or communicable diseases B. the leading cause of morbidity in the Philippines is from non communicable diseases C. the Philippines has to address infectious or communicable diseases only first D. there are different leading causes of mortality and morbidity in the Philippines which must be addressed separately E. all of the above

244 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, very similar in format, leading mortality include noncommunicable, morbidity infectious, both need to be addressed by separate programs hence double burden

A 30 year old male patient with cough of 3 weeks was asked to provide 3 sputum specimens for screening for tuberculosis, only 1 smear came in positive what is the next best step of action? A. request another 3 sputum specimens B. request for chest xray C. request for sputum culture D. refer to TBDC E. all of the above

245 A. know the steps in TB diagnosis and treatment, collect a new set of 3 sputum specimens is the next step

Once a physician is accredited by Philhealth when will he renew his Philhealth accreditation? A. 1 year from date of issuance of Philhealth ID B. 2 years from date of issuance of Philhealth ID C. 3 years from date of issuance of Philhealth ID D. 4 years from date of issuance of Philhealth ID E. 5 years from date of issuance of Philhealth ID

247 C. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE., possibly the only philhealth related question that came out then

Which of the following actions are proven to decrease mortality and morbidity from measles infection? A. zinc supplementation B. Vitamin D supplementation C. Vitamin C supplementation D. Vitamin A supplementation E. Iron supplementation

248 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE., vitamin A

All of the following vaccines are live attenuated vaccines EXCEPT? A. measles B. influenza C. rotavirus D. varicella E. HPV

249 E. HPV vaccine is made using parts of microorganism similar to hep B vaccine

An infant born to a Hepatitis B infected mother should get HBIG (hepatitis B immune globulin) and vaccine within how many hours after birth? A. 12 B. 24 C. 36 D. 48 E. 72

25 A.

What is the indicator that can be used to reflect or infer regarding a country's economic status? A. infant mortality rate B. swaroop's index C. population density D. inmigration and outmigration rate E. cause specific mortality rate

251 A. infant and maternal mortality may reflect country's economic status, swaroops index reflect those over 50 years of age and reflect more the country's health system

Of the goals and components of primary health care concept which among these is the most important? A. accessible B. acceptable C. affordable D. community participation E. none of the above

252 D. community participation is considered most important for sustainability

What is the appropriate term to describe an infection wherein antibody develops in almost majority of the people affected by the disease? A. immunogenicity B. pathogenicity C. contagiousness D. virulence E. none of the above

253 A. similar question from our boards, initially on the past board exams a LOT of questions came from pretest, but in our boards only about less than 10 were from pretest review book…

In Barangay San Isidro, July 2013 population of 50,000 individuals, for the year 2013, there were 300 documented deaths, of the 300 deaths, 120 were due to cardiovascular diseases, 80 were due to malignancy, 50 due to accidents and injury, 30 from childbirth, 20 were from infectious disease, of the 20, 16 were aged below 5 yrs old died from diarrheal an other infectious diseases, 4 adults died from other infectious dieases. There were 650 total births during that year as well. What is the crude death rate? A. 3/1000 B. 4/1000 C. 5/1000 D. 6/1000 E. none of the above

256 D. exact style of questioning during our boards, compute manually no calculators, with numbers ranging from hundreds of thousands and not easy to compute because not much 0s all solid numbers from 1-9

The Family APGAR assesses the following aspects except? A. Adaptation B. Partnership C. Growth D. Affection E. Resilience

26 E. R should be Resolve

Which of the following measures is used frequently as a denominator to calculate the incidence rate of a disease? A. Number of asymptomatic cases B. Person-years of observation C. Number of cases observed D. Number if new cases observed E. Persons lost to follow-up

261 B. Person-years of observation are frequently used in the denominator of incidence rates and provide a method of dealing with variable follow-up periods

Which of the following is true regarding the family life cycle? A. The key principle in the process of transition in The family with young children is commitment to the new system B. The family with adolescents is the longest stage in the Philippines C. First-order changes refer to changes that involve change in the main structure of the family D. Second-order changes refer to changes in the role and identity of family members E. None of the above

262 D. Review topnotch notes on family life cycle

In country A there are 35 new cases of breast cancer per 100,000 adult women per year; in country B the number is 90 per 100,000. Which of the following is the most likely explanation? A. Women in country A receive more frequent preventive care such as mammography B. Treatment is much more successful in country A C. Women in country A have a much higher rate of nursing their infants D. Women in country A are younger E. Women in country A are less likely to smoke cigarettes

264 D. The most important risk factor for breast Ca is age. If crude incidence rates are compared, one country may have much larger numbers of women in the peak age group so some type of age of adjustment is essential.

If the prevalence of a disease in a population decreases, how will a test for that disease be affected? A. There will be no effect on sensitivity and specificity B. There will be an increase in positive predictive value C. There will be a decrease in negative predictive value D. Positive and negative predictive values will not be affected E. A, B, and C are correct

265 A. A lower prevalence will decrease PPV and increase NPV but it will have no effect on both sensitivity and specificity.

Which of the following family assessment tools is used to assess the capacity to participate in provision of health care or cope with crisis? A. Family genogram B. Family APGAR C. SCREEM D. Family Environmental Scale E. FACES

266 C. Genogram - tool in learning family structure; APGAR - measures one's level of satisfaction with family relationships; FACES - rates family on 30 items on a 1-5 scale; FES - compares health care results with family variable

Which of the following is true in a positively skewed distribution? A. The distribution is skewed to the left B. The outlying variables are small C. Mean is larger than the median D. A and B E. All of the above

268 C. A postively skewed distribution is skewed to the right, has large outlying variable and the mean is larger than the median. The opposite is true for negatively skewed distribution

A worker who develops aplastic anemia will most likely have been exposed to which of the following toxic substances? A. Arsenic B. Organic mercury C. Asbestos D. Benzene E. Chromium

269 D. Benzene is a potent myelotoxic agent.

You are determining whether or not to use a rapid streptococcal antigen test to screen for streptococcal pharyngitis. You find that that 2% of people with strep throat actually test negative using this test. Of the following, which statement best describes this situation? A. The sensitivity of the test is 2% B. The specificity of the test is 98% C. The test has a 2% false negative rate D. The test has a 2% false positive rate E. The test has a positive predictive value of 98%

27 C. A false negative is defined as a person who tests negative, but who is actually positive. In the above example, 2% of the positive people test negative. Therefore, the false negative rate is 2% in this case. Sensitivity is defined as the probability that the test would be positive, given that the person has strep throat. The specificity is the probability that the test would be negative if the person does not have strep. The false positive rate is defined as the percent of people who test positive, but are actually negative. The positive predictive value is the probability that a person has an illness, given that the test is positive.

This type of disease exemplified by leptospirosis is caused by agents spread by contact with or ingestion of water? A. Water-based disease B. Water-borne disease C. Water-washed disease D. Water-related disease E. None of the above

274 A. Water-borne is transmitted by contaminated drinking water such as cholera; Water-washed is transmitted from person to person due to inadequate water supply for personal hygiene such as scabies; Water-related is transmitted by insects harboring in water such as dengue fever

Which of the following is true regarding Primary health care? A. Comprised of curative services and deals with more complex problems B. Must be community based with full participation and involvement of the people C. Promotion of mental health is not an essential element D. B and C E. All of the above

275 B.

The family illness trajectory is a normal course of the psychological aspects of disease for the patient and the family. In which stage does the physician explore the explanatory model and fear that the patient bring's to the clinical set-up? A. Onset of illness to Diagnosis B. Reaction to Diagnosis C. Major Therapeutic Efforts D. Early Adjustment to Outcome E. Adjustment to Permanency of Outcome

276 A. Review Family illness trajectory

You are attempting to conduct a study that will look into the association between consumption of coffee and peptic ulcer disease. You obtain the history of coffee drinking of selected patients and then subsequently follow them up in the next five years to correlate PUD diagnosis with coffee drinking. What type of study will you use? A. Cross-sectional B. Clinical trial C. Case-control D. Cohort E. Experimental

277 D. Cohort study categorizes the subjects on the basis of exposure or lack of exposure to a risk factor and then following them up to determine if a particular outcome resulted.

Demographic data and vital statistics rates were obtained from a small town with a population of 235,697. During the same year, the total number of deaths was 5,453 and the total number of live births was 9,873. Heart disease was the leading cause of morbidity with 15,758 diagnosed cases followed by pneumonia with 13,234 diagnosed cases. Heart disease was also the leading cause of mortality with a total of 998 deaths in the same year. Infants who died before 1 year of age numbered 192. Calculate the infant mortality rate. A. 18/1000 live births B. 19/1000 live births C. 20/1000 live births D. 21/1000 live births E. 22/1000 live births

278 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Round off to the nearest whole number. Crude death rate is number of death/midyear population. IMR is number of death less than 1 year old/number of live births X 1000

You are caring for an 18-year-old man with asthma. He smokes, and reports needing to use his short-acting bronchodilator daily. He gets flares of asthma at least twice a week, and while some days are relatively symptom free, some exacerbations may last several days. He wakes up at least once a week with symptoms. Which of the following classifications best characterizes his asthma? A. Mild intermittent B. Moderate intermittent C. Mild persistent D. Moderate persistent E. Severe persistent

28 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. The patient described in this question fits the “moderate persistent†classification, characterized by daily symptoms and use of short-acting inhaler, with exacerbations that affect activity and may last for days. Nighttime symptoms occur at least weekly.

John and Anna have been having marital disputes which they refuse to confront and instead they overly express concern for their adolescent daughter's defiant behavior. What family process is described in this sitaution ? A. Enmeshment B. Triangulation C. Disengagement D. Rigidity E. None of the above

281 B. Triangulation - detouring conflict between 2 people by involving a third person thereby stabilizing the relationship betweem the original pair

Which of the following diseases is found exclusively among persons who have worked with or have been exposed to asbestos? A. Bronchogenic carcinoma B. Angiosarcoma C. Laryngeal carcinoma D. Pleural mesothelioma E. Multiple myeloma

282 D. Chronic exposure to asbestos predisposes one to develo pleural mesothelioma. Overall, bronchogenic carcinoma is the malignancy most commonly associated with asbestos exposure

You are conducting a study that will examine the relationship between the gender and nutritional status of a certain population. What statistical test would be most appropriate ? A. Chi square test B. Regression analysis C. Student T test D. Multiple regression E. Analysis of variance (ANOVA)

283 A. Two qualitative variables are being studied and compared to hence a chi square test would be most appropriate

Which of the following herbal medicines is recommended by the DOH for its use to lower blood uric acid levels? A. Akapulko B. Bayabas C. Yerba buena D. Ulasimang bato E. Niyog-niyogan

284 D. Akapulko for fungal infections; bayabas as an antiseptic (wound and vaginal wash); ulasimang bato to lower uric acid levels; yerba buena for rheumatism, niyog-niyogan as anti helminthic

Patients with pancreatic cancer were matched with controls by age, sex, place of residence and social class. Two groups were noted according to the frequency of cigarette smoking. This is what type of study? A. Prospective cohort B. Case report C. Clinical trial D. Cross sectional E. Case control

286 E. Based on no. 29 of Pre-test 7th ed.

Which of the following refers to the constant presence of a very high incidence of disease or infection in a given geographical area? A. Hyperendemic B. Endemic C. Epidemic D. Pandemic E. None of the above

287 A. Endemic - refers to the constant presence or usual prevalence of a disease or infectious agent in a given geographic area. Epidemic refers to the occurrence of disease w/in a community clearly in excess of what is to be normally expected. Pandemic refers to widespread disease throughout a continent or across a very large geographic areas

Which of the following health indices serves as a sensitive index of health in the community? A. Maternal Mortality Rate B. Infant Mortality Rate C. Specific Mortality Rate D. Crude Death Rate E. Crude Birth Rate

289 B. Infant mortality rate is a sensitive index of health status in the community. A high IMR means low level of health standards w/c may be secondary to poor maternal and child health care, malnutrition, poor environment sanitation or deficient health care service

The following is true of the tip of the iceberg phenomenon of disease except: A. The submerged portion of the iceberg represents carriers and undiagnosed cases. B. The floating tip represents what the physician sees in his practice/chamber/hospital. C. The floating tip includes deaths, clinical cases, symptomatic patients and subclinical cases. D. The unseen part of an iceberg is much larger than the part that is visible above the water. E. The pattern of disease encountered in a hospital is quite different from that in a community.

29 C. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. The floating tip does not include subclinical cases (which belongs to the submerged portion of the iceberg).

In order to obtain a sample population, a researcher assembled individuals to some order and are then selected according to a constant determinant (every 7th subject is selected). What sampling procedure was done by the researcher? A. Paired sampling B. Cluster sampling C. Symple sampling D. Stratified sampling E. Systematic sampling

295 E. Systematic sampling - every kth element of the population is chosen

The Dangerous Drug Act of 2002 is otherwise known as which of the following? A. RA 9288 B. RA 9165 C. RA 7875 D. RA 9257 E. None of the above

298 B. RA 9288 Newborn screening, RA 7875 National Health insurance act of 1995, RA 9257 Expanded senior citizens act of 2003

An infant born to a Hepatitis B infected mother should receive a hepatitis B immune globulin within how many hours after birth? A. 24 hours B. 96 hours C. 12 hours D. 48 hours E. 6 hours

299 C. Infants born to HBsAg-positive women should receive vaccine at birth, 1â€"2 mo, and 6 mo of age, with the first dose accompanied with HBIG, to be given within 12 hours of birth.

The country of birth is an example of what measurement scale? A. Dichotomous B. Nominal C. Ordinal D. Interval E. Ratio

3 B. Dichotomous â€" only 2 possible values (male/female, dead/alive, cured/not cured) Nominal variable â€" more than 2 possible values but no intrinsic ordering Ordinal variable â€" intrinsically ordered but not in a quantitative way (good-better-best, always- sometimes-never) Interval â€" real numerical units but without a clear zero point (temperature, year of birth) Ratio â€" measurements in relation to a clear zero point (age, metric system) Source: Topnotch handout on Preventive Medicine

Dwarfism, hepatosplenomegaly and poor wound healing may indicate deficieny of which of the following minerals? A. Zinc B. Copper C. Fluorine D. Manganese E. Sodium

300 A. Pre test 7th edition 396

You are caring for a 35-year-old man in the hospital, admitted with pneumonia. On day 2 of his hospitalization, he becomes diaphoretic, restless, and irritable. Within hours, he is complaining of severe pain, abdominal cramps, and diarrhea. Which of the following would likely be present in his urine toxicology screen? a. Cocaine b. Marijuana c. Opiates d. 3,4-Methylenedioxymethampheatmine (MDMA or ecstasy) e. Benzodiazepines

31 C. Opiate withdrawal is well-characterized, and although not life-threatening in otherwise healthy adults, can cause severe discomfort. Symptoms from a short-acting drug like heroin can occur within just a few hours. Withdrawal from longer acting opiates may not cause symptoms for days. Early symptoms include lacrimation, rhinorrhea, yawning, and diaphoresis. Restlessness and irritability occur later, with bone pain, nausea, diarrhea, abdominal cramping, and mood lability occurring even later. Cocaine withdrawal does not produce a significant physiologic withdrawal. Intoxication with cocaine does produce elevated heart rate and blood pressure. The most common problem produced by cocaine withdrawal is known as a “crash.†The crash is characterized by extreme fatigue and significant depression. Relapse is common during the crash because return to use provides quick and reliable relief. Marijuana withdrawal syndrome is also not physiologically significant. Ecstasy can be considered a hallucinogen or a stimulant, and withdrawal is often associated with depression, but not the symptoms described above. Benzodiazepine withdrawal mimics alcohol withdrawal, and is associated with hypertension, tachycardia, and possibly seizures.

An 18-year-old sexually active college student presents with complaints of lower abdominal pain and irregular bleeding for five days. She has no fever. She uses oral contraceptives as method of birth control. Upon examination, the cervix is friable, there is cervical motion tenderness and adnexal tenderness. The pregnancy test is negative. Which is the most likely etiologic agent responsible for these findings?? A. Neisseria gonorrhoeae B. Chlamydia trachomatis C. Treponema pallidum D. Herpes simplex virus type 2 E. Mycoplasma hominis

312 B. Chlamydia trachomatis is the most frequently reported bacterial sexually transmitted disease (STD) in the United States. Infections of the cervix may present as a friable cervix, but are most often without signs or symptoms.

In nine families surveyed, the numbers of children per family were 4, 6, 2, 2, 4, 3, 2, 1, and 7. The mean, median, and mode numbers of children per family are, respectively: A. 3.4, 2, 3 B. 3, 3.4, 2 C. 3, 3, 2 D. 2, 3.5, 3 E. 3.4, 3, 2

313 E. The correct values for mean, median and mode are 3.4, 3, and 2. The mean is the average: the sum of the observations divided by the number of observations. In this case, the mean is 31/9 = 3.4. The median is the middle observation in a series of ordered observations, that is, the 50th percentile. In this case, there is an uneven number (9) of observations. When the observations are orderedâ€" 1, 2, 2, 2, 3, 4, 4, 6, 7â€"the median is 3. If the number of observations is even, it is midway between the two middle observations. For example, if we were to have only 8 observations such as : 1, 2, 2, 2, 3, 4, 6, 7, then the median would be equal to the average of the fourth and fifth largest observations: 2 + 3/2 = 2.5. The mode is the observation that occurs with greatest frequency; in this case it is 2, which occurs three times.

which of the following is a criteria for instituting a screening program? A. There should be a short period between first signs and overt disease B. Diagnostic test must be sensitive and specific C. Low prevalence during the preclinical stage of the disease D. all of the above E. none of the above

314 B. criteria for instituting a screening program: the disease must have the following characteristics: serious or high risk for mortality or morbidity, high prevalence of preclinical stage, well understood natural history, long interval between first signs and overt disease. Diagnostic test: must be sensitive and specific, safe and acceptable, reliable. Treatment: facilities are adequate, effective ,acceptable , and safe treatment available.

David and Lorie has been having marital disputes which they refuse to confront and instead they express over concern for their adolescent daughter’s defiant behavior to house rules. What family process is described? A. Disengagement B Triangulation C. Coalition D. Enmeshment E. scape goating

315 B. Triangulation - Detouring conflict between 2 people by involving a third person, thereby stabilizing the relationship between the original pair.• Enmeshment â€"over involvement of family members with each other. Disengagement â€" members are isolated from each other or have little emotional response to each other. Coalition- one family member is siding with another family member.Scape-goating - family member (often child) who is the object of displaced conflict/criticism.

You are reading a medical journal and come across an article about diabetes. The study followed 10,000 patients over 3 years. At the start of the study, 2000 people had diabetes. At the end of the study, 1000 additional people developed diabetes. What was the incidence of diabetes during the study? a. 10% b. 12.5% c. 20% d. 30% e. 50%

32 B. The incidence of a disease is the probability that a person with no prior disease will develop a new case of the disease over a specific time period. In this case, 1000 people eveloped diabetes. In the study, only 8000 people began with no prior disease. Therefore, the incidence is 1000/8000 or 12.5%. The prevalence is the probability of having a disease at a specific point in time, and is obtained by dividing the number of people with the disease by the number of people in the study.

True of the family genogram as a graphic representation of a family tree, except: A. consists of 3 or more generations B. Each generation is identified by arabic numbers. C. The first-born of each generation is farthest to the left. D. The family name is placed above each major family unit. E. Given names and ages are placed below each symbol.

321 B. Each generation is identified by roman numerals.

The Family APGAR is needed in which situation? A. when the family will be directly involved in caring for the patient B. when treating a new patient in order to get information to serve as general view of family function C. when treating a patient whose family is in crisis D. when a patient's behavior makes you suspect a psychosocial problem possibly due to family dysfunction E. all of the above

323 E.

All of the following statements about the relationship between marital status and cancer are true, except: A. The risk of cancer of the cervix is higher in married women compared with single women. B. The risk of cancer of the cervix is lower in women who marry late in life than in women who marry earlier. C. The risk of breast cancer is higher in single than in married women. D. The risk of ovarian cancer is not related to marital status. E. The risk of cancer of the testes is higher in married than in single men.

324 E.

The association between low birth weight and maternal smoking during pregnancy can be studied by obtaining smoking histories from women at the time of the prenatal visit and then subsequently correlating birth weight with smoking histories. What type of study is this? A. clinical trial B. cross-sectional C. cohort (prospective) D. case-control (retrospective) E. none of the above

329 C.

Treatment outcome for PTB patients characterized as a smear positive patient who has underwent 6 months of DOTS but without proof of cure? A. Cured B. Relapse C. Treatment completed D. Failure of treatment E. Default

33 C.

Studies in medicine are designed to identify causes of disease. The ultimate goal of such studies is to alter the frequency or severity of these diseases. All of the following are considerations in the determination of causality, except: A. temporal sequence - causative agents must precede their consequences B. biological gradient - dose-response curve C. concurrency - cause and effect are found at the same time D. strength of association E. consistency - repeated observations of the same associations

332 C.

In nine families surveyed, the numbers of children per family were 4, 6, 2, 2, 4, 3, 2, 1, and 7. The mean, median, and mode numbers of children per family are, respectively: A. 3.4, 2, 3 B. 3, 3.4, 2 C. 3, 3, 2 D. 2, 3.5, 3 E. none of the above

333 E. 3.4, 3, 2

As a new public health officer, you are tasked with developing criteria for a disease surveillance system. All the following are important purposes for a public health surveillance system, except: A. detection of epidermics B. detection of rare but fatal condition, such as Alzheimer's disease C. description of trends and the natural history of a health condition D. evaluation of hypotheses about the occurrence of a disease E. evaluation of control and prevention measures

335 B.

A familial aggregation pattern exists for cancer of all the following organs, except: A. breast B. retina C. colon D. larynx E. skin

337 D.

True statements above osteoarthritis include: A. It is more than twice as common among women as men of the same age B. The pattern of joint involvement is essentially identical in all races among persons of the same age C. Osteoarthritis is the leading cause of disability in the elderly. D. Hereditary factors are important in Heberden's nodes. E. none of the above

338 D.

Selective Primary Health Care was introduced as a strategy: A. Bellagio Conference B. Alma Ata Declaration C. Brahimi Report D. Clinton Accord E. Millenium Summit

34 A. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE.

Which of the following statements about the statistics of suicide is correct? A. Compared with other sex-race groups, the mortality from suicide is highest in black males of all ages. B. The incidence of suicide attempts is highers in males than in females. C. The risk of suicide increases for several months following divorce, separation, or death of the spouse. D. Suicide rates do not correlate with socioeconomic status E. None of the above

340 C.

Which of the following statements about aortic dissection is true? A. Almost all patients with aortic dissection have elevated serum cholesterol levels (>240 mg/dL) B. Aortic dissection is the major cause of mortality in Marfan’s syndrome C. There is increased incidence of aortic dissection in patients with Gaucher’s disease D. Acute aortic dissection is usually asymptomatic

341 B. Reference: PrevMed Pre-test, 7th ed.

Epidemiologic investigation of testicular cancer have shown that: A. the peak incidence occurs within 1 to 2 years of puberty B. there is an increased incidence in males with cryptorchidism C. there is an increased risk in males with a history of venereal disease D. there is no increased risk in males with a history of mumps orchitis

343 B. Reference: PrevMed Pre-test, 7th ed.

Reasons to treat gonorrhoea with oral tetracycline 500 mg qid for 7 days â€" rather than with oral ampicillin 3.5 g plus oral probenecid 1 g taken at one time â€" include: A. lower frequency of side effects B. better coverage of Chlamydia trachomatis C. greater safety in case of pregnancy D. none of the above

344 B. Reference: PrevMed Pre-test, 7th ed.

“The absence of valvular calcification in an adult suggests that severe valvular aortic stenosis is not present.†This statement means that: A. valvular calcification is a sensitive test for severe valvular aortic stenosis B. valvular calcification is an insensitive test for severe valvular aortic stenosis C. valvular calcification is a specific test for severe valvular aortic stenosis D. valvular calcification is a nonspecific test for severe valvular aortic stenosis

345 A. Reference: PrevMed Pre-test, 7th ed.

The initial step in planning for the provision of primary health care services for a community is to: A. Set the objectives B. Determine the projected budget C. Define the health problems D. Decide on what services to provide

347 C.

Which of the following active listening skills explores the previous statement of a participant? A. Direct leading B. Probing C. Confrontation D. Perception checking

348 B.

Strengths and weaknesses in situational analysis pertain to: A. Factors external to the organization B. Factors internal to the organisation C. Objectives of the organisation D. Vision and mission statements

349 B. SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis Strengths and weaknesses - internal factors Opportunities and threats - external factors

What do you call the time interval between entry of an infectious agent into a host and the onset of symptoms? A. Incubation period B. Communicable period C. Preinfectious period D. Noncontagious period E. Decubation period

35 A.

At which stage of the family life cycle is there increasing flexibility of boundaries to include children’s independence? A. Family with young children B. Family with adolescent C. Launching family D. Family in later years

351 B.

Refer to the given date below for items 232-235: Based on the Philippine Health Statistics in 2009, the total population living in the national capital region was 11,855,975. The number of live births in the same region for that year was 211,517, and the number of deaths was 75,019. The top 5 leading causes of morbidity were as follows: 1) Acute respiratory infection - 104,930; 2) Acute lower respiratory tract infection and pneumonia - 48,848; 3) Bronchitis/bronchiolitis - 29,260; 4) Hypertension - 28,784; and 5) Acute watery diarrhoea - 27,212. What is the crude birth rate? A. 17.84 B. 17.34 C. 16.84 D. 16.34

352 A. Crude birth rate = # of births / Total population x 1000

What is the incidence rate of acute lower respiratory tract infection? A. 7.25 B. 7.85 C. 8.25 D. 8.85

354 D. Incidence rate = # of new cases of a disease / population at risk x 1000

A 65 year old male is having his session for physical therapy due to hemiparesis after a cerebrovascular accident. At which stage of the natural history of disease is he in? A. Stage of susceptibility B. Stage of preclinical disease C. Stage of clinical disease D. Stage of disease outcome

356 D.

What role is a physician fulfilling when he sees and examines a patient in his clinic, orders lab tests and prescribes medications? A. Health care provider B. Educator and counsellor C. Social mobilizer D. Manager

357 A.

The case fatality rate of cholera is currently less than 1 percent. Major factors responsible for this include: A. treatment with tetracycline or other antibiotics B. mass immunisation in endemic regions C. widespread use of intravenous hydration D. chlorination of water supplies in endemic regions

358 A. Reference: PrevMed Pre-test, 7th ed.

Chickenpox is associated with: A. Congenital malformations in 10% of offspring of infected mothers B. A high reinfection rate C. A long prodromal period D. Reye syndrome

359 D. Reference: PrevMed Pre-test, 7th ed.

Prolonged exposure to polyvinyl chlorides in production is associated with each of the following except: A. Raynaud syndrome B. Lung disease C. Angiosarcoma of the liver D. Scleroderma like skin changes

360 B. Reference: PrevMed Pre-test, 7th ed.

The following are considered dependents and are included in the principal's PhilHealth coverage? A. Chesca's adopted 18 year old son B. Faye's 55 year old father who suffered from severe stroke 2 years ago who still has residuals C. Monchi's 5 year old illegitimate child D. A and B E. All of the above

361 E. All are dependents according to PhilHealth: Legitimate spouse who is not a member; Unmarried and unemployed legitimate, legitimated, acknowledged, illegitimate children and legally adopted or stepchildren below twenty- one (21) years of age; Children who are twenty- one (21) years old or above but suffering from congenital disability, either physical or mental, or any disability acquired that renders them totally dependent on the member for support, as determined by the Corporation; Foster child as defined in Republic Act 10165 otherwise known as the Foster Care Act of 2012 ; Parents who are sixty (60) years old or above, not otherwise an enrolled member, whose monthly income is below an amount to be determined by the Corporation in accordance with the guiding principles set forth in the Act; and Parents with permanent disability regardless of age as determined by the Corporation, that renders them totally dependent on the member for subsistence. Dr Banzuela's PhilHealth Primer 2014

The following is/are included in the PhilHealth benefits package? A. Optometric services B. Out-patient psychotherapy and counseling C. Rehabilitation services D. B and C E. None of the above

362 D. The following are NOT included in the benefit package: non-prescription drugs and devices, drug/alcohol abuse or dependency treatment, cosmetic surgery, optometric services, fifth and subsequent normal obstetrical delivery, cost ineffective procedures which shall be defined by PhilHealth. RA 9241 which amended RA 7875 now includes normal obstetrical deliveries, out-patient psychotherapy and counseling for mental disorders and home & rehabilitation services in the benefit package Dr Banzuela's PhilHealth Primer 2014

APGAR is an important tool in evaluating a family member’s perception of family functioning by measuring the following parameters EXCEPT? A. Adaptability B. Partnership C.Generosity D. Affection E. Resolve

363 C. Growth

The simplest excreta disposal method is: A. Cat-hole latrine B. Pit privy C. Bored-hole latrine D. Pail system E. Water sealed laterine

364 A. Cat-hole: small hole excavated then feces covered when done; done on emergency cases only; Pit privy: pit dug to a depth of 4-6 ft, riser is provided with seat and self closing lid; Bored-hole: deep holes bored into earth using mechanical or manual earth boring equipment with cover on top, sometimes footrests are provided to facilitate squatting Topnotch

What herbal medicinal plant can be used to lower uric acid levels? A. Tsaang gubat B. Bawang C. Niyog-niyogan D. Ulasimang bato E. Sambong

365 D. Tsaang gubat used for abdominal pain; Bawang lowers cholesterol levels; Sambong used for urolithiasis; Niyog niyogan used for ascariasis Topnotch

Which is the most important greenhouse gas? A. Carbon dioxide B. Methane C. Water vapor D. Nitrous oxide E. Ozone

366 C. Water vapor most important greenhouse gas, any increase in global temperature will increase its concentration Topnotch pg 27

In a class of 500 topnotch students, there will likely be a few who can answer this question correctly without understanding the material: A. Lead-time bias B. Surveillance bias C. Recall bias D. Type 1 error E. Power

369 D. type 1 error: FRIENDZONED (akala mo meron pero wala) #81 Pretest 7th

Wokers with occupational exposure to lead include the following EXCEPT A. battery makers B. prodicers of crystal glass C. coal miners D. solderers E. gasoline station attendants

370 C. #231 Pretest 7th

As an epidemiologist you are asked to recommend the type of study appropriate to the needs of the researchers who would like to study the causes of a rare form of glycogen storage disease. They have discovered a registry of the disease and have access to a large database of patients, which unfortunately is only a few years old. They have funding for only 1 year from the National Institutes of Health and the budget will be limited What type of study design will you recommend? A. Cohort (prospective) B. Historical cohort C. Cross-sectional D. Experimental E. Case-control (retrospective)

371 E. #21 Pretest 7th

In a previously well 35-year-old man with 3 h of severe, crushing, substernal pain and 5 mm of acute ST elevation in leads V2 to V4 application of Bayesian reasoning would indicate that A. He is likely to have a non-atherosclerotic form of coronary heart disease B. He is likely to have a serum cholesterol above 9 mmol/L (326 mg/dl) C. He is likely to be having an acute myocardial infarction. D. An elevated level of creatine kinase MB isozyme is likely to be a false positive E. Measurement of creatine kinase MB enzymes would not be a vey sensitive test

372 C. #63 Pretest 7th

What statistical analysis will you use for the comparison of systolic blood pressures in independent samples of diabetics and non-diabetics A. Chi-square analysis B. Student t test C. Paired t test D. Analysis of variance E. Linear regression

373 B. #67 Pretest 7th

Correct statements concerning upper respiratory infections include which of the following? A. Summertime outbreaks of illness characterized by fever, pharyngitis, and conjunctivitis have most frequently been associated with paramyxovirus infection B. Treatment with penicillin hastens recovery in children with streptococcal pharyngitis C. Patients with viral upper respiratory infections are generally most infectious the day before their symptoms begin D. The most common identifiable cause of pharyngitis is adenovirus E. None of the above

374 B. #151 Pretest 7th

During a drinking session, you and your friends decided to taste test ten foreign beers and rank them from most to least flavorful. What type of measurement scale is being described? A. Dichotomous scale B. Nominal scale C. Ordinal scale D. Interval scale E. Ratio scale

377 C. Nominal - no intrinsic order; Ordinal - ordered but not quantitatively; Interval - ordered quantitatively but cannot be divided to each other since there is no intrinsic zero to the scale; Ratio - clear zero point, can be divided

PhilHealth derives its funds from which of the following? A. Premiums B. Sin taxes C. Investment earnings D. A and B E. All of the above

379 E. Philhealth has the following sources of funds: Premiums, grants and donations, investment earnings and sin taxes Dr Banzuela's PhilHealth Primer 2014

Bysinnosis will have which of the following as a risk factor? A. Hay farmer B. Radar assembly worker C. Arc welder D. Coal worker E. Textile worker

38 E. Byssinosis is a rare lung disease. It is caused by inhaling hemp, flax, and cotton particles. It is sometimes referred to as brown lung disease. It is a form of occupational asthma. In the United States, byssinosis occurs almost exclusively in people who work with unprocessed cotton.

Which parameter in the family APGAR is used to assess the satisfaction of a member with the time spent by other members with him/her? A. Adaptation B. Partnership C. Growth D. Affection E. Resolve

381 E. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE.

Which of the following family assessment tools is used to assess the relationships between family members, including the rigidity or flexibility of the boundaries between them? A. Family genogram B. Family map C. SCREEM analysis D. FACES scale E. APGAR scoring

384 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

Which of the following family assessment tools is used to identify resources that may aid in the holistic management of the diseased member in the family? A. Family map B. Family lifeline C. SCREEM analysis D. FACES scale E. APGAR scoring

385 C. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

Which of the following industries is most exposed to ergonomic problems? A. Manufacturing B. Agriculture C. Transportation D. Mining E. Academe

386 A.

When constructing emergency sanitary pits, they must made at least how many meters away from sources of clean water? A. 10 m B. 20 m C. 25 m D. 50 m E. 100 m

387 C.

Who among the following is not considered dependents of an individually-paying member of PhilHealth? A. His legal spouse B. His 19-year old daughter C. His 62-year old father D. His 55-year old mother suffering from cataract E. His 24-year old son with Down syndrome

388 D. Dependents of PhilHealth: Legitimate spouse, children below 21 years old, children above 21 years old with disability, parents above 60 years old, parents below 60 years old with permanent disability

Medical students enrolled in a first-year anatomy class are more likely to remain at their same addresses for the next 2 years than medical students enrolled in fourth-year clerkship. This exemplifies which type of bias? A. Lead-time bias B. Surveillance bias C. Recall bias D. Type I error E. Power

389 A. Prev Med 7th ed. #83

A study shows that people who drink coffee tend to smoke more, and for this reason, coffee drinkers have a higher risk of lung cancer. Which of the following occurred in this study? A. Lead-time bias B. Effect modification C. Differential misclassification D. Confounding E. Selection bias

39 D.

Epidemiologic investigations of testicular cancer have shown that: A. The peak incidence occurs within 1-2 years of puberty B. There is an increased incidence in males with cryptoorchidism C. There is an increased risk in males with a history of venereal disease D. There is an increased incidence in males with a family history of breast cancer E. All of the above are true

391 B. Prev Med 7th ed. #209

Preventive treatment with isoniazid is recommended for all the following groups except: A. Young adults in whom a positive tuberculin test is demonstrated B. Children under age 3 in whom a positive tuberculin test is demonstrated C. All members of a household in which one member has an active case of tuberculosis D. Children with atypical mycobacterial infection E. Nursing mothers with positive tuberculin skin tests

392 D. Prev Med 7th ed. #343. Preventive treatment is recommended for children and young adults whose tuberculin tests are positive, for those who have had contact with persons who have recently converted to tuberculin positivity, and for immunosuppressed persons whose tuberculin tests are positive. It is only used for people with inactive TB--that is, TB without evidence of disease.

Use of postmenopausal estrogens has been consistenly associated with: A. An increased risk of endometrial cancer B. A decreased risk of breast cancer C. An increased risk of osteoporotic fractures D. An increased risk of coronary heart disease E. An increased incidence of liver cancer

394 A. Prev Med 7th ed. #363

Decision analyses often include a patient's utilities in the determination of best decision. These utilities measure: A. Whether a patient facors one decision over another B. Whether a physician facors one decision over another C. The difference between a patient's decision and the physician's decision D. The relative value a patient places on a particular outcome E. The relative likelihood of a particular outcome

397 D. Prev Med 7th ed. #64

Which of the following best describes a sampling strategy used to achieve comparability of the groups being studied? A. Matching B. Stratification C. Age adjustment D. Multivariate analysis E. Survival analysis

398 A. Prev Med 7th ed. #89

In Barangay Bughaw, there was a reported total of 28 cases of dengue for the year 2013. Among these, 7 died. The total population of the barangay for 2013 was 1,000. What is the case fatality rate for dengue for this barangay in the year 2013? A. 25% B. 0.7% C. 2.8% D. 15% E. 28%

399 A. Case fatality rate = number of deaths from a specified cause / number of cases of the same disease

Living bodies that harbor,sustain and maintain the growth and multiplication of the infectious agent are: A. Chain of transmission B. Etiologic agents C. Reservoir of infection D. Causative agents E. None of the above

403 C.

Most permanent method for the control of rodent: A. Fumigation B. Natural enemies C. Poisons D. Rehabilitation E. Mechanical Traps

405 D. Rehabilitation of the environment means non- chemical means of control like sanitation, mechanical blocks & sealing/exclusion of holes

If the infant mortality of a community is 53/1,000 live births,this means: A. 53 out of 1,000 persons in the community were infant deaths B. 53 babies die before reaching their first birthday C. 53 out of 1,000 babies born alive died during infancy D. 53% of all deaths are infants E. 53% die of a specific disease before reaching 28 days

406 C.

The objectives of family planning education is difficult to achieve because of the following,EXCEPT: A. It has to contend with one of the strongest human urges B. Only negative effects can be demonstrated C. The subject is generally very private to Filipinos D. Many cultural obstacle E. All of the above

408 B.

One of the cheapest and most useful chemical disinfectant for human excreta is: A. DDT B. Lime C. Bichloride D. Phenol E. Chlorine

409 B.

The development of neuropathic symptoms is associated with chronic exposure to all of the following substances,EXCEPT: A. Mercury B. Lead C. Arsenic D. Sulfur dioxide E. Cadmium

410 D. Associate mercury poisoning (choice D) with (depending upon the route of exposure) GI disturbance, pneumonitis, renal failure, and CNS involvement. Sulfur dioxide - due to combustion of fossil fuels. Forms sulfurous acid on contact with moist mucous membranes - conj and bronchial irritation, epistaxis, delayed pulmo edeme. no neuropathy

Factors to consider in choosing the method of data collection include the following,EXCEPT: A. Probability of good coverage B. Availability of time and facilities C. Acceptability of the procedure/method to the subjects D. Need for personal skill E. Financial capability

414 C.

Because of his inherent weakness, this method is not utilized in the collection of scientific data: A. Census B. Questionnaire method C. Registration method D. Case record method E. All of the above

415 C. Registration data( e.g. voters, drivers, etc) are subject to inaccuracy of certain details about persons. Disease registers however are accurate data.

Niyog-niyogan is a plant whose seeds are used for the treatment of: A. Diarrhea B. Ascariasis C. Intestinal colic D. Fever E. Wound infection

416 B. herba buena - fever, niyog-niyogan - ascaris, bayabas - antibacterial, bawang - hpn, -ampalaya - diabetes, sambong - diuretic, lagundi - cough, tsaang gubat - diarrhea, akapulko - skin diseases, ulasimang bato - gout

If 300 mothers die during the time when there is a total of 1,000,000 pregnancies,the maternal mortality rate is : A. 3/1000 B. 30/1000 C. 0.3/1000 D. 0.1% E. 30%

418 C.

Which of the following statements describing the risk of death from simultaneous smoking and the use of oral contraceptives is true: A. A 39-year old non-smoker taking oral contraceptives is at greater risk than a 30-years old smoker taking the same contraceptives. B. Smoking increases the risk of death of all women of any age who are using contraceptives C. Smoking does not increase the risk of death in a women taking oral contraceptives unless than years of age D. Women under age 20 years and those over age 40 years who smoke and take oral contraceptives are the two groups at the greatest risk E. All of the above

419 A. contraindicated in those >35 and smoking, 180/110 BP, >20 years diabetic,

A characteristic demographic feature of rheumatoid arthritis is an incidence ratio of 1:3 that applies to: A. Male:female B. Blacks:whites C. Rural:urban dwellers D. Rich:poor

423 A.

Which of the following 60-year old patients is most likely to have a stroke within a year? A. A male smoker B. A man with hypertension C. A man with an asymptomatic carotid bruit D. A woman with a recent TIA

424 B. Hypertension is the major risk factor for stroke, and treatment of high BP is the most effective way of preventing it. Other risks include smoking, vascular disease, TIAs, and DM.

Which herbal medicinal plant is used to treat ascariasis? A. Akapulko B. Niyog-niyogan C. Ulasimang bato D. Yerba buena

425 B. Akapulko is effective against scabies, tinea, athlete's foot, and ringworm. Ulasimang bato is used to improve hyperuricemia, whereas yerba buena is for rheumatism.

The management principle which aims to strengthen the sense of unity and cohesion among the people in the organization is: A. Unity of command B. Unity of direction C. Scalar chain D. Esprit de corps

426 D. At least 2 questions were about management principles. Unity of command means that a person should receive orders from only one superior and that he is accountable only to that superior. Unity of direction, meanwhile, means there should be a single plan of action for a group of activities having the same objective and that there is one manager to supervise them.

All of the following techniques are considered useful in screening for screening in asymptomatic persons except for: A. Mammography in a 45-year old woman B. Breast examination is a 45-year old woman C. Pap smear in a 55-year old female smoker D. Chest radiography in a 55-year old male smoker

428 D. The objective of cancer screening is to detect the disease while the patient is still asymptomatic. This is helpful only if early intervention is more effective than late treatment. Detection of lung CA with radiography in asymptomatic smokers does not meet this requirement.

The Goal 4 in the MDG is A Improve Maternal Health B. Reduce Child mortality C. Ensure Environmental Sustainability D. Develop a Global Partnership for Development E. Promote Gender Equality and Empower Women

43 B. Goal 1: Eradicate Extreme Hunger and Poverty Goal 2: Achieve Universal Primary Education Goal 3: Promote Gender Equality and Empower Women Goal 4: Reduce Child Mortality Goal 5: Improve Maternal Health Goal 6: Combat HIV/AIDS, Malaria and other diseases Goal 7: Ensure Environmental Sustainability Goal 8: Develop a Global Partnership for Development

This is a sampling procedure ensuring that each individual of the total group has an equal chance of being selected: A. Systematic sampling B. Paired sampling C. Simple random sampling D. Cluster sampling

430 C. *READ EVEN THE MATCHING TYPE SECTIONS OF ALL 1st 3 CHAPTERS (PreTest). Simple random sampling is a process in which individuals are sampled independently, and each individual of the population has an equal probability of being selected.

All of the following statement about meta-analysis are true except: A. It is a study in which the units of analysis are populations or groups of people, rather than individuals. B. It is used to enhance the statistical power of research findings where numbers in available studies are too small. C. It combines results from different studies to obtain a numerical estimate of an overall effect D. It is meant to be more objective and quantitative than a narrative review. E.

431 A.

The most important single test to determine if water is potentially dangerous is: A. Physical test B. Chemical test C. Radiation test D. Bacteriologic test

432 D. Bacteriological water test is ideally routinely done and aims to detect presence of coliforms or potentially harmful microorganisms that are supposedly not present in water for consumption. Radiologic test is only done when there is suspicion of contamination.

Chickenpox is associated with: A. Congenital malformations in 10% of offspring of infected mothers B. A high reinfection rate C. A long prodromal period D. Reye syndrome

433 D. Reye syndrome is a major cause of morbidity in children if they are given aspirin in the course of infection. There is no reinfection (life-long immunity), but reactivation in the form of shingles (zoster). Malformations from gestational chickenpox exposure are very rare. The incubation period is long, lasting up to 3 weeks, but the prodromal period is short.

Among patients with intermittent claudication, all the following statements are true except: A. About 50% eventually require amputation if they do not undergo vascular reconstruction. B. The leading cause of death is coronary heardt disease. C. About 50% have significant coronary artery disease at the time of presentation. D. Cigarette smoking is the most powerful risk factor.

435 A.

Which of the following arthritides is often iatrogenic? A. Osteoarthritis B. Rheumatoid arthritis C. Gout D. Sarcoid arthritis E. None of the above

437 C. Gout is caused by deposition of rate crystals in joint. It is always associated with hyperuricemia, which is commonly caused by diuretic therapy used in the treatment of hypertension or heart failure. It can also be idiopathic (caused by either overproduction or underexcretion of uric acid) or associated with underlying malignancy or renal disease.

A study of patterns of contraceptive use finds that countries with the highest per capita use of condoms also have the highest pregnancy rates and concludes that condoms are ineffective as ocntraceptives. It is best described as: A. Ecologic fallacy B. Type I Error C. Type II Error D. Selection Bias E. Misclassification bias

445 A. The ecologic fallacy occurs when associations among groups of subjects are mistakenly assumed to hold for individuals. Thus, although among communities high rates of condom use may be associated with higher fertility rates among those who use the condoms, the fertility rate could be in fact be zero.

Which of the following measures is used frequently as a denominator to calculate the incidence rate of a disease? A. Persons lost to folow-up B. Person-years of observation C. Number of cases observed D. Number of new cases observed E. Number of asymptomatic cases

446 B. Person-years of observation are frequently used in the denominator of incidence rates and provide a method of dealing with variable follow-up periods. Person-years of observation simultaneously taken into account the number of persons into account the number of persons under observation and the duration of observation of each person.

In nosocomial infections, pathogenic microorganisms are most oftenly transmitted by: A. Airborne matter B. Exposure to common source C. Direct contact by hands D. Indwelling catheters E. Fomites

447 C. Transmission of bacteria from patient to patient most often occurs by hands of hospital personnel. Fomites, indwelling catheters, airborne transmission, common-source exposure do occur but much less important than direct spread.

All of the following are true statements about tuberculosis except: A. The causative agents of human tuberculosis include Mycobacterium bovis B. The primary infection is often asymptomatic C. Humans are the only reservoir of Mycobacterium tuberculosis D. HIV infection is an independent risk factor for the development of active tuberculosis E. The time from infection to the development of a positive tuberculin skin test averages 6 months

451 E. The time from development of a positive skin test is not 6 months but it is between 2 and 8 weeks.

The most common asbestos-related tumor in humans is: A. Bronchogenic carcinoma B. Carcinoma of the colon C. Laryngeal carcinoma D. Pleural mesothelioma E. Peritoneal mesothelioma

452 A. Mesotheliomas of the pleural and peritoneal surfaces are the classic asbestos-related tumors because they are rarely seen in persons never esposed to asbestos. It is important to realize that in persons with asbestosis, however, the principal cause of death is bronchogenic carcinoma.

Diseases that are transmitted chiefly from person-to- person include: A. St. Louis encephalitis B. Lymphocytic choriomeningitis C. California encephalitis D. Meningococcal meningitis E. None of the above

453 D. Meningococcal disease is transmitted by direct contact with droplets and discharges from infected cases and, more often, carriers. The others are diseases in which the causative virus is mosquito- transmitted.

Which of the following statements about the use of nicotine-containing chewing gum to help cigarette smokers quit smoking is true? A. Its success is unrelated to the degree of nicotine addiction B. It is most successful in persons with high levels of addiction to nicotine C. It is most successful in persons who are not addicted to nicotine D. It is most successful in persons with low levels of addiction to nicotine E. It is most successful in persons with moderate levels of addiction to nicotine

454 B. Nicotine-containing chewing gum is a useful adjunct in helping smokers to quit. It is most successful in smokers who report high levels of addiction.

Hypothesis that assumes that association does not exist such that a sample is not different from a population: A. Null hypothesis B. Alternative hypothesis C. Positive hypothesis D. Two-tailed or non-directional alternative hypothesis E. None of the above

463 A. Null hypothesis- there is no difference; Alternative/Positive hypothesis-assumes that an association exists; Two-tailed or non-directional alternative hypothesis- doen't indicate direction of the association; One-tailed or directional alternative hypothesis- gives the direction of the relationship, or states which is greater when 2 samples are being compared

The occurrence of a group of illnesses of a similar nature at a rate above the expected number is called: A. hyperendemic B. epidemic C. endemic D. enzootic E. Pandemic

467 B.

Which of the following is not true of acute appendicitis? A. Misdiagnosis is significantly higher among men than in women. B. It is most frequently seen in the 2nd through 4th decades of life. C. Appendectomy for appendicitis is the most commonly performed emergency operation in the world. D. Perforation rates are highest in children <5 years and in patients > 65 years

469 A. Pretest 7th ed 134, modified Misdiagnosis is higher in women-Schwartz ,1075

The most common symptom presented by a newborn with cytomegalovirus infection at birth is: A. No symptoms B. Blueberry muffin-like rash C. Low platelet count D. Intracranial calcifications E. Low birth weight

470 A. Pretest 7th ed 139, modified Symptomatic congenital CMV infection was originally termed cytomegalic inclusion disease. Only 5% of all congenitally infected infants have severe cytomegalic inclusion disease, another 5% have mild involvement, and 90% are born with subCliniCal, but still chronic, CMV infection. - Nelson 19th ed, 1116

Which of the following statements is true of breast feeding? A. Breast-feeding is contraindicated in mothers diagnosed with pulmonary tuberculosis until completion of 4 weeks of maternal therapy. B. Smoking is a contraindication to breast-feeding. C. Breast milk provides significant quantities of immunoglobulins. D. Breast-feeding promotes poor bonding between mother and child

472 C. Pretest 7th ed 154, modified Breast-feeding is contraindicated in mothers diagnosed with pulmonary tuberculosis until completion of 2 weeks of maternal therapy.Nelson 19th ed, 161 Discourage cigarette smoking, but smoking is not a contraindication to breast-feeding. Nelson 19th ed, 161.

Which of the following is true of Asthma? A. Childhood asthma seems more prevalent in rural areas of developing countries. B. Combination of environmental exposures and inherent biologic and genetic vulnerabilities are implicated in the causation of childhood asthma. C. Childhood asthma in more affluent nations seems more severe. D. Girls are more likely to have asthma. E. None of the above

475 B. Nelson 19th ed, 781 A. Childhood asthma seems more prevalent in modern metropolitan locales. B. Combination of environmental exposures and inherent biologic and genetic vulnerabilities are implicated in the causation of childhood asthma. C. Childhood asthma in less affluent nations seems more severe. D. Boys are more likely to have asthma.

The following are true of leptospirosis, except: A. Rats are the most important reservoir of this disease. B. The causative microorganism of leptospirosis establish a symbiotic relationship with their host and can persist in the muscles for years. C. This infection occurs most commonly in the tropics. D. Transmission of leptospires to humans may follow direct contact with blood or tissue from an infected animal. E. Transmission of leptospires to humans may follow direct contact with urine from an infected animal.

479 B. …can persist in the renal tubules not muscles… Harrison's 17th ed, 1049

Which does NOT characterize the current state of the Philippine health situation? A. Highly centralized health care system B. Double burden of disease C. Health status improving but at a slower rate compared to neighboring Asian countries D. large variations in health status across population and socioeconomic groups

481 A. Very obvious answer. :)

When are Philhealth benefits NOT applicable? A. Patient died within the first 24 hours. B. Patient was discharged within the first 24 hours of confinement by an accredited hospital. C. Patient sustained a vehicular accident and was confined in a non-accredited hospital. D. patient was transferred to a better equipped hospital before the first 24 hours of confinement.

482 B. Several PhilHealth questions were asked during our exam. If patient is admitted for less than 24 hours then Philhealth benefits is not applicable (should be more than 24 hours). For vehicular crash patients admitted in an accredited or non- accredited hospital, PhilHealth benefits can be claimed.

Which of the following is in line with the principles of Primary Health Care? A. Doctors make decisions in a community health program. B. Free clinics are held. C. A barangay health council is established to plan, implement and evaluate community program. D. traditional birth attendances are not allowed to attend to deliveries.

483 C. The concept of Primary Health Care is health for the people, by the people. The people attain health by being responsible for it. Community participation is essential.

The first contact of the community to the health chain as defined by the Primary Health Care system is? A. Barangay captain B. Midwife C. Hospital personnel D. Village health workers

487 D. Village health workers are also known as barangay health workers.

What is the first step in hypothesis testing? A. State the null hypothesis B. State the level of significance C. Specify the test statistic to be used D. State the alternative hypothesis

489 A.

Radiologic findings specific for exposure to asbestos include: A. Bilateral pulmonary fibrosis B. Pleural calcification C. Pulmonary nodules D. Pleural effusion

493 B. Calcification of the pleura and diaphragm is a common finding in people who have been exposed chronically to asbestos. Pretest 7th ed.

The likelihood of finding a lost biochemistry notebook in your apartment is higher in the month of June than in the month of March. This is due to: A. Lead time bias B. Surveillance bias C. Recall bias D. Type 1 error

498 B. Surveillance bias refers to overdetection of the disease of interest because one of the groups goes to the doctor (or has a diagnostic test) more often than does another group. Pretest 7th ed.

A sampling strategy used to achieve comparability of the groups being studied: A. Stratification B. Age adjustment C. Randomization D. Matching

499 D. Matching is a way of selecting subjects that are comparable with respect to specific variables. Contrast this to stratification in which subjects are divided into separate, relatively homogeneous strata and the comparison between groups can occur within each stratum. Randomization ensures that assignement of each subject occurs by chance.

A researcher is conducting a study on the effects of exposure to arsenic and the development of skin cancer. He takes a group of patients with disease and compares them with case matched patients without the disease. The frequency of arsenic exposure is compared between the 2. Which of the following type of study is this? A. Ecologic study B. Cross sectional study C. Case control study D. Prospective Cohort E. Retrospective Cohort

5 C. Case control â€" Subjects are initially divided according to presence or absence of disease. Outcome is analyzed first, then from there exposure is determined. Cohort â€" Subjects are initially divided according to presence or absence of exposure. Exposure is analyzed first, then from there outcome is determined. There are 2 types: If the outcome has not yet occurred, it’s a prospective cohort (but exposure definitely has occurred already cause remember that’s how you are gonna group the patients). If the outcome and exposure both have already occurred, then it’s a retrospective cohort. Source: Topnotch handout on preventive medicine

In nine families surveyed, the numbers of children per family were 4, 6, 2, 2, 4, 3, 2, 1 and 7. The mean, median and mode numbers of children per family, respectively, are: A. 3.4, 2, 3 B. 3, 3.4, 2 C. 3, 3, 2 D. None of the above

500 D. The mean is the average: 3.4. The median is the middle observation in a series: 3. The mode is the observation that occurs with greatest frequency: 2. This concept is a must-know.

One good criteria of a good research question is one that it "matters what the answer is." This is termed: A. Researchability B. Significance C. Feasibility D. All of the above E. None of the above

502 B. : 1. Researchability-a problem is researchable if it can be resolved through research. That is, it can be tested empirically, data can be collected to answer the question or resolve the problem. 2. Significance 3. Feasibility-adequate subjects can be gathered for the study, procedures are technically possible, information needed can be collected, resources are available, study can be completed within a reasonable period of time

Hypothesis that assumes that association does not exist such that a sample is not different from a population: A. Null hypothesis B. Alternative hypothesis C. Positive hypothesis D. Two-tailed or non-directional alternative hypothesis E. None of the above

503 A. Null hypothesis- there is no difference; Alternative/Positive hypothesis-assumes that an association exists; Two-tailed or non-directional alternative hypothesis- doen't indicate direction of the association; One-tailed or directional alternative hypothesis- gives the direction of the relationship, or states which is greater when 2 samples are being compared

All of the following are advantages of case control studies, as opposed to cohort studies, except: A. They are relatively fast studies B. They can study many possible causes of a disease C. They allow calculation of exposure rates D. They require relatively few study subjects E. They can easily study rare diseases

505 C.

The occurrence of a disease that are generally or constantly found among people in a particular area is called: A. hyperendemic B. epidemic C. endemic D. enzootic E. Pandemic

506 C.

The occurrence of a group of illnesses of a similar nature at a rate above the expected number is called: A. hyperendemic B. epidemic C. endemic D. enzootic E. Pandemic

507 B.

In country X there are 25 new cases of breast cancer per 100,000 adult women per year; in country Y the number is 85 per 100,000. Which of the following is the most likely explanation? A. Women in country X have high caloric intake contributing to enhanced aromatase activities in fatty tissues. B. Most women in country X use oral contraceptives. C. Women in country X are younger. D. Country Y is more technologically developed E. Women in country X are more educated.

508 C. Pretest 7th ed 133, modified

The most common symptom presented by a newborn with cytomegalovirus infection at birth is: A. No symptoms B. Blueberry muffin-like rash C. Low platelet count D. Intracranial calcifications E. Low birth weight

510 A. Pretest 7th ed 139, modified Symptomatic congenital CMV infection was originally termed cytomegalic inclusion disease. Only 5% of all congenitally infected infants have severe cytomegalic inclusion disease, another 5% have mild involvement, and 90% are born with subCliniCal, but still chronic, CMV infection. - Nelson 19th ed, 1116

Transmission of bacteria involved in nosocomial infections are most often by: A. Airborne matter B. Hospital linen and beddings C. Direct contact via hands D. Unchanged IV lines

511 C. Pretest 7th ed 142, modified

Which of the following statements is true of breast feeding? A. Breast-feeding is contraindicated in mothers diagnosed with pulmonary tuberculosis until completion of 4 weeks of maternal therapy. B. Smoking is a contraindication to breast-feeding. C. Breast milk provides significant quantities of immunoglobulins. D. Breast-feeding promotes poor bonding between mother and child

512 C. Pretest 7th ed 154, modified Breast-feeding is contraindicated in mothers diagnosed with pulmonary tuberculosis until completion of 2 weeks of maternal therapy.Nelson 19th ed, 161 Discourage cigarette smoking, but smoking is not a contraindication to breast-feeding. Nelson 19th ed, 161.

Which of the following is true of Asthma? A. Childhood asthma seems more prevalent in rural areas of developing countries. B. Combination of environmental exposures and inherent biologic and genetic vulnerabilities are implicated in the causation of childhood asthma. C. Childhood asthma in more affluent nations seems more severe. D. Girls are more likely to have asthma. E. None of the above

515 B. Nelson 19th ed, 781 A. Childhood asthma seems more prevalent in modern metropolitan locales. B. Combination of environmental exposures and inherent biologic and genetic vulnerabilities are implicated in the causation of childhood asthma. C. Childhood asthma in less affluent nations seems more severe. D. Boys are more likely to have asthma.

The most common site of cancer in persons from developing countries is: A. lungs B. pancreas C. cervix and uterus D. liver E. Colon

517 A. Pretest 7th ed 195, modified

The following are complications of diabetes mellitus, except: A. Loss of vision B. Hearing loss C. Stroke D. Pancreatic cancer E. Heart attack

518 D. 208, modified

The following are true of leptospirosis, except: A. Rats are the most important reservoir of this disease. B. The causative microorganism of leptospirosis establish a symbiotic relationship with their host and can persist in the muscles for years. C. This infection occurs most commonly in the tropics. D. Transmission of leptospires to humans may follow direct contact with blood or tissue from an infected animal. E. Transmission of leptospires to humans may follow direct contact with urine from an infected animal.

519 B. …can persist in the renal tubules not muscles… Harrison's 17th ed, 1049

A cohort study is conducted to assess the relationship between oral contraceptive use and the risk of breast cancer. Participants were chosen from a closed-panel HMO and includes 530 women between 30 and 40 years of age with no gynecologic disease. Each participant is asked to complete a questionnaire about her use of an oral contraceptive. Twenty years later, 40% of the paricipants are enrolled in the same HMO. Of the 100 women who remained with the HMO and continued to use an oral contraceptive, 12 patients developed histologically confirmed breast cancer compared with 4 patients among the women who did not use an oral contraceptive. Which of the following features of this study is most likely to affect its validity? A) Differential follow-up B) Lead time bias C) Recall bias D) Misclassification of outcome

521 A.

A 67-year-old woman comes for a routine health maintenance examination. She exercises regularly. She is not sexually active. At her last visit 1 year ago, her serum cholesterol level was 180 mg/dL, and fasting serum glucose level was 80 mg/dL; a Pap smear and mammography showed normal findings. Two years ago, flexible sigmoidoscopy showed no abnormalities. Today, she weighs 63 kg (140 lb) and is 165 cm (65 in) tall. Her blood pressure is 120/80 mm Hg. Examination shows no abnormalities. Which of the following is the most appropriate screening test for this patient? A) Pap smear B) Measurement of serum cholesterol level C) Measurement of serum glucose level D) Mammography

522 D. pap-smear is only done up till age 65, mammography up till 70

A healthy 18-year-old woman comes for a routine health maintenance examination. Menses occur at regular 28-day intervals. Her last menstrual period was 2 weeks ago. She is sexually active with one partner, and she and her partner use condoms inconsistently for contraception. Her maternal grandmother was diagnosed with breast cancer at the age of 65 years, her paternal grandfather was diagnosed with colon cancer at the age of 72 years, and her maternal grandfather died of a myocardial infarction at the age of 66 years. Examination shows no abnormalities. Which of the following is the most appropriate screening test for this patient? A) Complete blood count B) Fasting serum lipid studies C) Test of the stool for occult blood D) Testing for Neisseria gonorrhoeae and Chlamydia trachomatis

525 D. inconsistent condom use >> screen for STDs

A 1-year study of a new drug to treat hypertension is conducted. One hundred patients with hypertension are enrolled; 50 patients are given the new drug and another 50 patients are given hydrochlorothiazide. All patients completed the trial. One noted unexpected effect is increased growth of scalp hair which occurred in those taking the new drug, a nonstatistically significant difference (p>0.10). This effect has also been reported in studies of other similar drugs in the new therapeutic class. The investigators of the study concluded that the new drug did not cause hair growth. Which of the following features of this study is most likely to affect the validity of this conclusion? A) Differential follow-up B) Lead time bias C) Length of the study D) Sample size

526 D.

The genetic disease institute at a university hospital has developed a rapid screening test for a serious but treatable inherited metabolic disorder. Although this disorder is predominantly found in a particular ethnic group, it is also found sporadically throughout the entire population. The screening test has a sensitivity of 95% and a specificity of 90%. When used in an ethnically prescreened population where the prevalence of this disorder is 30%, the positive predictive value is 80% and the negative predictive value is 96%. The institute proposes to use this screening test on the general population where the prevalence of this disease is 0.1%. Which of the following is the most likely result of this screening program? A) Negative predictive value decreases B) Positive predictive value decreases C) Sensitivity decreases D) Specificity decreases

527 B.

A healthy 42-year-old man comes to the physician for a life insurance evaluation. He smoked one-half pack of cigarettes daily for 20 years but quit 10 years ago. His father died of a myocardial infarction at the age of 65 years. The patient weighs 93 kg (205lb) and is 178 cm (70 in) tall. His blood pressure is 160/110 mm Hg, pulse is 96/min, and respirations are 16/min. Physical examination, ECG, and an x-ray film of the chest show no abnormalities. Laboratory studies are within normal limits except for a serum cholesterol level of 206 mg/dL. Which of the following is the greatest risk factor for cerebral infarction in this patient? A) Genetic profile B) History of smoking C) Hypercholesterolemia D) Hypertension

529 D.

A 52-year-old woman, gravida 3, para 3, comes to the physician because of irregular vaginal bleeding over the past 2 months. She has hypertension treated with enalapril and type 2 diabetes mellitus well controlled with diet. Menopause occurred 2 years ago.Her maternal aunt had breast cancer at the age of 70 years. The patient weighs 88 kg (195 lb) and is 160 cm (63 in) tall. Examination shows no other abnormalities. An endometrial biopsy specimen shows adenocarcinoma. Which of the following is the most significant predisposing factor for this patient's endometrial cancer? A) Heredity B) Hypertension C) Parity D) Weight

530 D. obesity >> increased estrogen

During a routine examination, a 32-year-old man has a blood pressure of 120/80 mm Hg. He is concerned because his father, grandfather, and two uncles have hypertension. He works as a systems programmer for a large computer company and frequently has to meet tight deadlines. He has smoked one pack of cigarettes daily for 10years. He is 4.5 kg (10 lb) overweight and drinks three cups of coffee daily. Which of the following measures is most likely to reduce this patient's risk for hypertension over the next 5 years? A) Increase intake of dietary fiber B) Weight loss C) Stress management D) Restrict caffeine

531 B.

A study is conducted to assess the effectiveness of a new blood test for early detection of prostate cancer. Ten thousand healthy men over the age of 50 years are randomly assigned to receive either annual rectal examination or annual screening with the new blood test. After 5 years, results show that of the 50 men in the blood test group that were diagnosed with prostate cancer, 40 were living 2years after the diagnosis was made. In comparison, only 15 out of 45men in the rectal examination group survived 2 years after being diagnosed with prostate cancer. Researchers conclude that the blood test increases survival compared with rectal examination. Which of the following potential flaws is most likely to invalidate this conclusion? A) Age of the patients B) Diagnostic bias C) Lead time bias D) Recall bias

532 C.

37-year-old man comes to the physician 6 months prior to traveling to sub-Saharan Africa for 1 year. He has no history of hepatitis and has no high-risk behavior for hepatitis B. Which of the following is the most appropriate recommendation to prevent hepatitis during and after his trip? A) Immune globulin B) Hepatitis B immune globulin (HBIG) only C) Hepatitis B vaccine series only D) Hepatitis B vaccine series and hepatitis A vaccine

533 D.

A healthy 27-year-old woman comes to the physician for an annual examination. She is concerned about her risk for an abnormal Pap smear in the future. A history of use of which of the following would increase her risk for cervical cancer? A) Alcohol B) Cervical cap C) Cigarettes D) Tamoxifen

534 C.

A case-control study is conducted to assess the risk for intussusception in infants under the age of 1 year who receive the rotavirus vaccine. The medical records of all those who received the vaccine and those who did not receive the vaccine over a 6-month period are reviewed. Results show 125 cases per 100,000 infant-years for infants who received the vaccine compared to 45 cases per 100,000 infant-years for infants who did not receive the vaccine. The investigators conclude that the relative risk for intussusception is 1.9 times greater in infants who receive the rotavirus vaccine (95% confidence interval of 0.5â€"7.7 and p=0.39). Which of the following is the most accurate interpretation of these results? A) The results do not show an association between rotavirus vaccine and intussusception, but they may be related B) The results show sufficient statistical power to identify an association between rotavirus vaccine and intussusception C) Rotavirus vaccine is associated with a 39% risk for intussusception D) Rotavirus vaccine causes intussusception in 1.9% of infants

535 A. RR shows a relationship but p value is statistically insignificant

On routine annual screening, an asymptomatic 27-year-old man has a positive PPD skin test. One year ago, a PPD skin test was negative. He works as a nurse. Three years ago, he was diagnosed with hepatitis A after a trip to South America. Examination shows no abnormalities. His serum aspartate aminotransferase (AST, GOT) activity is 10 U/L, and serum alanine aminotransferase (ALT, GPT) activity is 14 U/L. An x-ray film of the chest shows no abnormalities. Which of the following is the most appropriate chemoprophylaxis? A) Isoniazid and folic acid supplementation B) Isoniazid and rifampin C) Isoniazid and vitamin B1 (thiamine) supplementation D) Isoniazid and vitamin B6 supplementation

536 D.

As an epidemiologist, you are asked to recommend the type of study appropriate to the needs of researchers who would like to study the causes of a rare form of sarcoma. They have discovered a registry of this form of cancer and have access to a large data base of patients, which unfortunately is only a few years old. What type of study design would you recommend? A) Cohort prospective B) Case-control retrospective C) Cross sectional D) Experimental

537 B.

Randomization is a process used for assignment or allotment of subjects to treatment and control groups in experimental studies. Randomization ensures: A) That assignment occurs by chance B) That treatment and control groups are alike in all respects except treatment C) That bias in observation is eliminated D) That placebo effects are eliminated

538 A.

In a review of 3000 patients in whom adult onset diabetes mellitus was diagnosed, 2000 of these patients were obese at the time of diagnosis. The investigator concluded that there is an association between diabetes and obesity. What made this conclusion misleading or false? A) Lack of control group B) Lack of proper follow up C) Lack of adjustment for age D) Lack of denominators

540 A.

In a survey on the sexual behaviors of High School students, the researches selected classes at random; every person in the selected sections were then included in the sample. The researchers employed which sampling procedure. A. Simple random sampling B. Stratified sampling C. Cluster sampling D. Systematic sampling E. Paired sampling

541 C.

If you wanted to know whether board exam scores of patients who enrolled in Topnotch Review School are significantly higher than those who enrolled in another review school, which statistical test would be most appropriate? A. Pearson correlation B. Chi-square test C. One way ANOVA D. Student's t-test E. Matched pairs t-test

542 C. You are relating a nominal variable (Topnotch or non-Topnotch students) with an interval variable (actual test scores). A one-way ANOVA is most appropriate. REMEMBER: To correlate two interval variables, use Pearson correlation; to correlate two nominal variables, use Chi square.

Which of the following is the most common and useful measure of dispersion because it is the average distance of each score from the mean? A. Range B. Variance C. Standard deviation D. Coefficient of variation E. Mode

548 C.

This family assessment tool is used to determine the capacity to participate in provision of health care A. Family Tree B. APGAR C. SCREEM D. FACES E. FES

55 C. SCREEM (Social, Cultural, Religious, Economic, Educational, Medical)

The intensity of noise is measured in decibles. The threshold for pain is set at: A. 100 dB B. 120 dB C. 200 dB D. 240 dB E. 300 dB

550 B.

A 20/M was standing in the heat for 2 hours doing ROTC drills when he suddenly fainted. He subsequently regained consciousness and was brought to the ER. What is the likely diagnosis? A. Heat stroke B. Heat exhaustion C. Heat syncope D. Heat cramps

551 C.

Jose and Josie Reyes have three children. Their eldest son, an engineer, just got married this year and has moved out of the house. The couple is still supporting their two other children, aged 22 and 18. Jose's family is in which stage of the family life cycle: A. Newly married couple B. Family with young couple C. Family with adolescents D. Launching family E. Family in later life

553 D. Begins when first child leaves and ends when last child leaves

Which of the following is NOT a characteristic principle of the primary health care approach? A. Health is multifactorial. B. Interventions to improving the health of the community must be multisectoral. C. Health is a human right that must be upheld by governments. D. The health sector is the principal and sole agent involved in defining health issues and organizing resources for the community. E. Interventions make use of technology that is scientifically sound and suitable to the community.

554 D.

Which of the following herbal medicines recommended by the DOH is an antihelminthic agent? A. Akapulko B. Bayabas C. Yerba buena D. Olasimang bato E. Niyog-niyogan

555 E. Akapulko for fungal infections; bayabas as an antiseptic (wound and vaginal wash); ulasimang bato to lower uric acid levels; yerba buena for rheumatism

A 50/M, textile worker, presents to your office for his periodic health examination. He has no complaints. Review of history reveals that he has been working for over 25 years at the same company. His work consists of preparing dyes. Which of the following tests would be appropriate in this setting? A. Chest X ray B. Cranial CT scan C. Liver function tests D. Complete blood count E. Urinalysis

557 E. Aniline dyes a risk factor for bladder cancer which commonly presents as painless hematuria.

According to the PSMID Guidelines on Immunization, which of the following is NOT true regarding the HPV vaccine? A. It is safe for breastfeeding patients. B. It amy be administered to patients with equivocal or abnormal Pap smear. C. There are no serious adverse reactions reported. D. Both quadrivalent and bivalent HPV vaccines are routinely given to adolescent males and females 10 years to less than 19 years. E. None of the above

558 E.

Which of the following is NOT true about meningococcal disease? A. Humans are the only natural reservoir. B. Asymptomatic colonization of the upper respiratory tract provides the source for spread of the organism. C. Case fatality rate is 9 - 12% in all age groups D. In the Philippines, serogroups A, B, C and W-135 have been implicated. E. Invasive disease is highest in adolescence.

559 E. Invasive disease is highest in infancy with second peak in adolescence. Source: PSMID 2009 Guidelines on Immunization of Filipinos

This component of APGAR describes the ability to share in decision making A. Adaptation B. Partnership C. Growth D. Affection E. Resolve

56 B.

Which of the following is NOT a contraindication to administration of the rabies vaccine? A. Presence of moderate and severe acute illnesses B. Allergy to any vaccine component C. Pregnancy D. Immediate anaphylactic reaction to a previous dose of rabies vaccine E. None of the above

560 C. Pregnancy is NOT a contraindication.

In the egg poultry industry, cracked eggs are also called: A checked B rotten C unqualified D waived

561 A.

The most common lung disease among coal miners is : A siliconiosis B pneumocconosis C bronchogenic CA D pneumonia

563 C.

The following strategy is not part of the national TB program: A early treatment of infective patients B primary prophylaxis of the uninfected C BCG vaccination D health education

569 B.

Most common type of leukemia among pediatric population: A acute lymphoblastic B chronic myelogenous C acute myelogenous D chronic lymphoblastic

570 A.

What is NOT true about cystic fibrosis? A diagnosis demonstrates an absence of chloride in the sweat B it is an autosomal recessive disorder C the median survival rate is around 20 years D 1 in 20 americans are heterogeneous for the gene

573 A.

Which of the following has the strongest association with development of stroke within a year? A hypertension B old age% C smoking D diabetes mellitus

574 A.

true of systemic lupus erythematosus: A it is approximately 10 times more commonly found in women B more common in white americans than african americans C diagnosis requires a positive ANA result D most common cause of arthritis in the elderly

575 A.

Cigarette smoking increases the risk of having malignancy of the following organs except: A pancreas B kidney C larynx D liver E bladder

576 D.

The leading cause of end stage renal disease is: A urinary tract infection B glomerulonephritis C SLE D hypertension E diabetes mellitus

577 E.

mental disorders seen to be more prevalent in the male gender includes : A schizophrenia B nymphomania C affective disorders D alcoholism and drug abuse E all of the above

578 D.

An arc welder is most likely prone to develop this disease based on occupational exposure: A. Hypersensitivity pneumonitis B. Byssinosis C. Caplan’s disease D. Siderosis

579 D.

This is the amount of chemical that is allowable for only a short duration A. Time weighted average B. Short term exposure limit C. Ceiling D. Both A and B E. AOTA

58 B.

the major environmental source of lead absorbed in the human bloods stream in adults is from: A water B lead-based C food D furnitures E air

580 E.

Which statement describes health promotion? A. Process of translating knowledge into action and promoting behavior change B. Process of making decisions, plans, and actions that are undertaken to achieve specific health care goals within a society C. Process of enabling people to increase control over their health and its determinants D. Process of addressing a specific risk and known cause of a disease E. Process of education the public about health

581 C. A. is Health Empowerment B is Health Policy C is Health Promotion D is Health Prevention E is Health Education

What is the minimum distance of a satisfactory excreta disposal facility from an underground water source? A. 10 meters B. 15 meters C. 25 meters D. 35 meters E. 50 meters

582 C. 25 meters is the minimum safe distance.

In a normal Gaussian distribution, how many percent of values is found between one and two standard deviations from the mean? A. 27% B. 34% C. 68% D. 95% E. 99.7%

583 A. 1 SD from the mean is 68% of values. 2 SD is 95% So values between 1 and 2 standard deviations is 95-68= 27%.

What stage in the family life cycle wherein the first child leaves home? A. Unattached Young Adult B. Launching Family C. Extended Family D. Family with Young Adults E. Family in Later Years

585 B. Launching Family begins when the first child leaves home and ends when the last child leaves home.

A study demonstrates that aspirin intake reduces the risk of cardiovascular disease among physicians. The question "can the result of this study can be applied to the population at large" is describing what epidemiologic term? A. Precision B. Clinical significance C. Statistical significance D. External validity E. Internal validity

586 D. Based on no. 68 of Pre test 9th Edition. Please buy the original book, preferably both the 9th and 7th edition. Remember to study all questions and explanations. I will simply write the test no. and edition and you are tasked to read the explanation yourselves.

What do you call the time interval between entry of an infectious agent into a host and the onset of symptoms? A. The incubation period B. The communicable period C. The preinfectious period D. The noncontagious period E. The decubation period

588 A. Based on no. 169 of Pre test 9th ed

Correct statements about infant mortality include all the following EXCEPT? A. The denominator is the number of births in a year. B. The numerator is the number of infants who die before their first birhday for a given year. C. IMR is an important marker of the health situation in a country. D. The rate is expressed per 1000 births. E. None of the above

589 A. Based on no. 135 of Pre test 7th ed

The size of particles in micrometer that is deposited in the alveolar sacs A. 0.1-0.5 B. 0.5-0.9 C. 1-2 D. >2 E. >10

59 C. 1-2 deposted in alveolar sacs; >2 to <10 deposited in the tracheobronchial tree; >10 filtered by nose and pharynx

Which of the following statements about bronchiectasis is TRUE? A. It is manifested by cough B. . It is uncommon in childhood. C. It is rarely accompanied by fever. D. It is usually a primary disorder. E. It is usually a self-limited problem.

590 A. Based on no. 175 of Pre-test 7th ed

Bysinnosis will have which of the following as a risk factor? A. Hay farmer B. Radar assembly worker C. Arc welder D. Textile worker E. Coal worker

591 D. Based on no. 303 of Pre-test 7th ed

As a city health officer, following multiple reports of cases of Cryptosporidium parvum diagnosed by private physicians, you conducted an epidemic investigation.You found out that the city drinking water supply is contaminated. What public health advisory measure would you announce to prevent ingestion of contaminated water? A. Freeze and use thawed water B. Use faucet filters capable of removing particles of 2.0 microns C. Disinfect with chlorination D. Boil water for 1 minute E. Drink bottled water only

593 D. Based on no. 192 of Pre-test 9th ed.

In the geriatric population, which of the following mental disorders has its highest incidence? A. Anxiety disorder B. Involutional depression C. Schizophrenia D. Obsessive-compulsive disorder E. None of the above

594 B. Based on no. 257 of Pre-test 7th ed

All of the following are ways for Prevention and control of infection in a hospital setting EXCEPT? A. Isolation of patients with communicable disease B. Retrospective surveillance of nosocomial infections of patients C. Investigation of epidemic and endemic infections D. Employment of practitioners of infection control E. a physician who serves as hospital epidemiologist

595 B. Based on no. 337 of Pre-test 7th ed

Plasma lipid levels are determined by the following in the diet EXCEPT? A. Cholesterol B. Total calories C. Alcohol D. Vitamin E E. Saturated Fat

597 D. Based on no. 362 of Pre-test 7th ed.

The recommended ORS osmlarity (mmol/L) for fluid replacement amongst children with diarrhea A. 200 B. 245 C. 290 D. 335 E. 380

60 B. Glucose, Na, Cl, K, HCO3 (75, 75, 65, 20, 10, a total of 245)

A study shows that people who drink coffee tend to smoke more, and for this reason, coffee drinkers have a higher risk of lung cancer. Which of the following occurred in this study? A. Confounding B. Effect modification C. Differential misclassification D. Lead-time bias E. Selection bias

603 A. Confounding occurs when the association between two variables is distorted by the fact that both are associated with a third.

In a cohort study of hypertensive men, the proportions of subjects with high and low renin levels who lived for another 5 years are compared separately according to age: among those aged 40 to 49, 50 to 59 and 60 to 69. Which of the following epidemiologic method was done? A. Matching B. Age adjustment C. Stratification D. Survival analysis E. Multivariate analysis

604 C. Stratification is a way of dividing subjects into separate, relatively homogenous strata and the comaprison between groups can occur with each stratum.

Hormone replacement therapy for post-menopausal women increases the risk for developing: A. Hypertension B. Thrombosis C. Alzheimer's disease D. Gallbladder disease E. Endometrial cancer

607 E. Unopposed estrogen therapy increases the risk for endometrial cancer. Adding progesterone to the regimen significantly reduces this risk, but does not eliminate it.

Some substances have been found to be neurotoxic to the fetus and may affect pregnancy outcomes. The fetus is most susceptible to these substances during what age in utero: A. 3 to 16 weeks B. 6 to 9 weeks C. 4 to 8 weeks D. 3 to 6 weeks E. 7 to 9 weeks

608 A. 3 to 6 weeks is the period of greatest susceptibility for agents that affect cardiac development, while 7 to 9 weeks is the perios of highest susceptibility to those that may affect the external genitalia.

The following factors should be considered for implementation of a screening test, EXCEPT: A. Burden of suffering B. Cost of screening test C. Physician's familiarity with the disease D. Potential adverse effect of the screening test E. Efficacy of treatment

609 C. These are the factors that have to be considered before instituting any preventive health measure, including a screening test. The burden of suffering inlcudes both the sevrity and prevalence of the disease.

Counselling on safe drug use to prevent hepatitis C virus (HCV) transmission and counselling on safer sex is classified as what level of prevention? A. Primordial B. Primary C. Secondary D. Tertiary E. Both primary and tertiary

61 B. There were a lot of questions regarding levels of prevention. Additionally, primordial level was included as an offshoot of primary level of prevention. Understand each of them by heart. Primary prevention is defined as the avoidance of disease. It seeks to prevent the onset of specific diseases via risk reduction: by altering behaviours or exposures that can lead to disease, or by enhancing resistance to the effects of exposure to a disease agent.

Which of the following patients is at highest risk of adverse effect from iron deficiency anemia? A. Postmeonpausal woman B. Elderly widow living alone C. Breastfed 1-month old D. 10-month old with a diet of cow's milk E. 14-year old with heavy periods

611 D. Infants on cow's milk are at highest risk for IDA, which can be associated with abnormal growth and development.

The following values are obtained in a study determining the number of children among 10 households in a barangay: 2, 4,7, 3, 3, 5, 7, 8, 4, 6. Determine the median number of children among these households: A. 3.5 B. 4 C. 4.5 D. 5 E. 5.5

612 C. The median is computed by arranging the values in order of increasing values. The 5th and 6th values have to be averaged (in this case, 4 and 5) since the total number of values given is even (10). If the number of values is odd, the middlemost value is taken as the median value.

A group of researchers wanted to study the causes of a rare form of CNS tumor. They found a complete registry of this disease and have access to a large database of patients. They have funding for only 1 year from the PCHRD. Which study design is most appropriate? A. Case series B. Cross-sectional C. Case-control D. Cohort E. Experimental

613 C. Case control is most appropriate in assessing many risk factors for a disease. It is retrospective and can help determine causal relationships. It is very useful in studying conditions with very low incidence or prevalence rates.

What is the most important risk factor for breast cancer? A. Family history B. Age C. Gravidity D. Trauma E. Smoking

614 B. Age is the most important risk factor for the devt of breast CA. Nursing may be a protective factor. Cigarette smoke is not a major risk factor, along with history of breast trauma.

A new screening method is being studied. The following data is obtained on applying the new screening tool on 200 people: With Disease w/o Disease Positive 90 60 Negative 10 40 Total 100 100 Using this data, compute for the specificity of the test. A. 90% B. 10% C. 60% D. 40% E. 33%

615 D. Specificity is the true negative. It is computed by dividing the number of true negatives (40) by the number of people without the disease (100).

An infant born to a Hepatitis B infected mother should get HBIG (hepatitis B immune globulin) and vaccine within how many hours after birth? A. 12 B. 24 C. 36 D. 48 E. 72

616 A. Infants born to HBsAg-positive women should receive vaccine at birth, 1â€"2 mo, and 6 mo of age, with the first dose accompanied with HBIG, to be given within 12 hours of birth. (Nelson's 11th ed)

The following are the benefits of active PhilHealth members, EXCEPT: A. Coverage for dialysis or chemotherapy B. Subsidy for room and board, drugs and laboratories, operating room and professional fees for confinements of not less than 24 hours C. Coverage up to the fourth normal delivery D. None of the above

617 C.Philhealth covers maternal claims for up to the 3rd pregnancy only.

Which of the following is NOT included in the ELEMENTS of primary health care? A. Improvement of the health status of mother and their children B. Resolution of neuropsychological health issues in the community C. Ensuring the presence and delivery of safe drinking water D. Prevention of local and endemic diseases E. None of the above

618 B. Elements of primary health care include: Education, Local/endemic diseases, EPI, Maternal and child health, Essential drugs, Nutrition, Technology transfer, Sanitation

Prevalence is a measure of: A. Old cases only B. New cases only C. Cases occurring within an interval D. Old and new cases in the community E. New cases plus expected cases for a given period

619 D. Prevalence is the total number (old and new) of cases in a population in a given time

In a colorectal cancer patient. Follow-up exams to identify recurrence or metastatic disease: physical examination, liver enzyme tests and chest x-rays is classified as what level of prevention? A. Primordial B. Primary C. Secondary D. Tertiary E. Both primary and tertiary .

62 D. Tertiary prevention is defined as the avoidance of negative sequelae of a disease process, once the disease has been diagnosed and treated. It seeks to soften the impact caused by the disease on the patient’s function, longevity, and quality of life.

The infant mortality rate of a country in a gicen year is 45.1 per year per 1000 live birth means: A. 45.1 infants died before reaching their first birthday B. 45.1 % of all deaths occurred in infants below one year C. 45.1 infants died before reaching their first birthday per 1000 live births D. 45.1 infants per 1000 of the population died E. None of the above

621 C.

All of the following are steps necessary to plan and conduct a case-control study, EXCEPT; A. Developing and testing research instruments B. Defining the disease and exposure of interest C. Selecting cases and defining a control group D. Planning the analysis E. Determining the duration of the observational study period

627 E.

Randomization is a process used for assignment or allotment of subjects to treatment and control groups in experimental studies. Randomization ensures: A. That assignment occurs by chance B. That treatment and control groups are alike in all respects except treatment C. That bias in observation is eliminated D. That placebo effects are eliminated E. None of the above

629 A.

In a community you decided to perform organized colonoscopy screening programs. This is classified as what level of prevention? A. Primordial B. Primary C. Secondary D. Tertiary E. Both primary and tertiary

63 C. Secondary prevention is defined as the interruption of any disease process before the emergence of recognized symptoms or diagnostic findings of the disorder. This includes procedures that detect and treat pre-clinical pathological changes and thereby control disease progression

"The absence of valvular calcification in an adult suggests that severe valvular aortic stenosis is not present" . This statement means that: A. Valvular calcification is a sensitive test for severe valvular aortic stenosis B. Valvular calcification is an insensitive test for severe valvular aortic stenosis C. Valvular calcification is a nonspecific test for severe valvular aortic stenosis D. valvular calcification is a specific test for severe valvular aortic stenosis E. None of the above

630 A.

In a review of 3000 patients in whome adult onset diabetes was diagnosed, 2000 of these patients were obses at the time of diagnosis. The investigator concluded that there is an association between diabetes and obesity. What made this conclusion misleading or false? A. Lack of control group B. Lack of proper follow up C. Lack of adjustment for age D. Lack of denominators E. Lack of adjustment for race

631 A.

The use of estrogen-containing oral contraceptive pills increases the risk of: A. Breast cancer B. Vaginal cancer C. Osteoporosis D. Thromboembolism E. None of the above

634 D.

The most prevalent mental health disorder in young children is: A. autism B. Mental retardation C. Behavioral problems D. Schizophrenia E. Depression

636 C.

Asbestos constitutes hazard to health especially to what kind of worker? A. Brake mechanic B. Potter C. Glass manufacturer D. Sewer E. Arc welder

638 A. Asbestos is asscoiated to brake mechanic

Promoting a healthy lifestyle in childhood for example, through prenatal nutrition programs and supporting early childhood development programmes is classified as what level of prevention? A. Primordial B. Primary C. Secondary D. Tertiary E. Both primary and tertiary

64 A. Primordial prevention acts early in the causal chain, to alter general social or economic circumstances that give rise to risk factors. It consists of actions to minimize future hazards to health and hence inhibit the establishment factors (environmental, economic, social, behavioural, cultural) known to increase the risk of disease. It addresses broad health determinants rather than preventing personal exposure to risk factors, which is the goal of primary prevention

The laws governing occupational health and safety in the workplace are? A. Sanitation code of the Philippines PD 856 B. Labor Code of the Philippines C. Presidential Decree 442 D. A and B only E. All of the above

641 E. MCU Prevmed notes, FCM 3rd edition, page 82

According to Permanent-partial disability (Art.193), the complete and permanent loss of the use of both ears should entitle the employee to receive payment with the equivalent compensation of? A. 10 months B. 12 months C. 18 months D. 20 months E. 24 months

642 D. 10 months per ear

In 2009, the crude birth rate of Tra-La-La was 17 per 1000 popunlation; the death rate was 10 per 1000; and the net in-migration rate was 2 per 1000. What was the net growth rate per 1000? A. 5 B. 7 C. 9 D. 15 E. 25

644 C.

Randomization is a procedure used for assignment or allocation of subjects to treatment and control groups in experimental studies. It ensures A. That assignment occurs by chance B. That treatment and control groups are alike in all aspects except treatment C. that bias in observation is eliminated D. that placebo effects are eliminated E. none of the above

645 A.

In comparing the difference between two means, the value of p is found to be 0.06. The correct interpretation of this result is? A. The null hypothesis is rejected B. The difference is compatible with the null hypothesis C. The difference occurred by chance D. the difference is statistically significant E. sampling variation is an unlikely expalanation of the difference

646 B.

A research team wishes to investigate a possible association between Vape (a tobacco substitute) and oral lesions among professional basketball players. At the training camp, they ask each player about current and past use of Vape, real cigarettes, and alcohol, then a dentist notes the type and extent of the lesions in their mouth. What type of study is this? A. Case-control B. Cross-sectional C. Cohort D. Clinical trial E. None of the above

647 B.

In a cohort study of hypertensive men, the proportions of the subjects with high and low renin levels who survived for 5 years are compared separately among those aged 40 to 49, those aged 50 to 59, and those aged 60 to 69 at time of entry. This process is called? A. Matching B. Stratification C. Age adjustment D. Survival analysis E. Multivariate statiztical analysis

648 B.

The Pap smear test detects cervical cancer in women at an early stage of the disease when there are no symptoms and the disease is not evident on visual examination. Which of the following level of prevention applies to a woman with no history of cervical cancer who undergoes a Pap smear? ? A. Primordial B. Primary C. Secondary D. Tertiary E. Both primary and tertiary

65 C. Secondary prevention is defined as the interruption of any disease process before the emergence of recognized symptoms or diagnostic findings of the disorder. This includes procedures that detect and treat pre-clinical pathological changes and thereby control disease progression

In a study, six different risk ratios are calculated: one for each sex at each of three social class levels. The process involved is A. Matching B. Stratification C. Age adjustment D. Survival analysis E. Multivariate statiztical analysis

650 B.

Which of the following statements is true regarding epidemiology of Aortic Dissection? A. Almost all patients with aortic dissection have elevated serum cholesterol levels (>240mg/dL) B. Aortic dissection is the major cause of mortality in patients with Marfan's Syndrome C. There is an increased incidence of Aortic dissection in patients with Gaucher's disease D. Acute Aortic dissection is usually asymptomatic E. There is approximately a 10 percent operative mortality from emergency surgery for dissection of the ascending aorta

651 B.

Studies in the epidemiology of appendicitis have shown that A. It affects girls 3x as frequent as boys B. Its incidence is highest in the 6th and 7th decades of life C. Its incidence is decreasing in the Western World D. Its mortality is increasing in the Western World E. It affects 1:1000 pregnancies

652 E.

Larval form of this worm infects man and is called Cysticercosis. A. Necator americanus B. Ascaris lumbricoides C. Strongyloides stercoralis D. Taenia solium E. Hymenolepis nana

654 D.

Deficiency of this mineral causes dwarfism, hepatosplenomegaly and poor wound healing. A. Fluorine B. Copper C. Sodium D. Zinc E. Molybdenum

655 D.

Paragonimiasis, or the lung fluke disease can be acquired from A. Snail B. Swine C. Fish D. Crab E. Dog

656 D.

Among the entries for causes of death in the death certificate, the most useful data and should be filled when there is only one line provided is the : A. immediate cause B. antecedent cause C. underlying cause D. other causes contributing to death

657 C. the underlying cause is the most important because if it was prevented or controlled, death should have not occurred.

Imhoff tank is composed of two-storey tank usually made of concrete into which raw sewage is led for primary treatment. Which among the following statements is/are true regarding the Imhoff tank? A. The lower tank provides storage space for the sludge and allows anaerobic decomposition B. Secondary treatment is still needed C. More efficient than septic tank and can handle larger sewage volumes D. A and C only E. All of the above

658 E. MCU Prevmed notes, FCM 3rd edition, page 43

Also known as the National Health Insurance Act of 1995 A. R.A. 9241 B. R.A. 7875 C. R.A 6111 D. R.A. 7924 E. R.A. 9610

661 B. B - NHIA, A - act amending R.A. 9241, c - Philippine medical care act, d - Act creating the MMDA, e - special protection of Children against abuse and discrimination act

Stage in the Family life cycle which begins when the first child leaves home? A. The Unattached Young Adult B. Newly Married Couple C. Family with Young Children D. Launching Family E. Family in Later Life

663 D. This stage starts when the first child leaves home. The key principle is the acceptance of a multitude of entries and exits into the family system.

The Family APGAR assess the following aspects except? A. Adaptation B. Partnership C. Growth D. Affection E. Resilience

664 E. Components of the family apgar includes adaptation, partnership, growth, affection and resolve.

Results from failure of thermoregulatory center and suppression of sweating? A. Heat exhaustion B. Heat cramps C. Heat syncope D. Heat stroke E. None

667 D. Heat stroke is a form of hyperthermia, an abnormally elevated body temperature with accompanying physical symptoms including changes in the nervous system function. Unlike heat cramps and heat exhaustion, two other forms of hyperthermia that are less severe, heat stroke is a true medical emergency that is often fatal if not properly and promptly treated. Heat stroke is also sometimes referred to as heatstroke or sun stroke. Severe hyperthermia is defined as a body temperature of 104 F (40 C) or higher.

Arsenic poisoning can cause the following symptoms, except? A. delirium B. coma C. hematuria D. vomiting E. Cherry red color of the blood

668 E. Symptoms of arsenic poisoning begin with headaches, confusion, severe diarrhea, and drowsiness. When the poisoning becomes acute, symptoms may include diarrhea, vomiting, blood in the urine, cramping muscles, hair loss, stomach pain, and more convulsions. The organs of the body that are usually affected by arsenic poisoning are the lungs, skin, kidneys, and liver.The final result of arsenic poisoning is coma to death. CO poisoning manifests with cherry red coloration.

Coalworkers pneumoconioses, except? A. Black lung disease B. Coal miners C. anthracosis D. Carbon dust E. Crystalline silica dust

669 E. Coal workers' pneumoconiosis (CWP), colloquially referred to as black lung disease, is caused by long exposure to coal dust. It is a common affliction of coal miners and others who work with coal, similar to both silicosis from inhaling silica dust, and to the long-term effects of tobacco smoking.

It is the most sensitive index of assessing the health status in the community? A. General fertility rate B. Perinatal mortality rate C. Neonatal mortality rate D. Child mortality rate E. Infant mortality rate

67 E. Pls refer to your Prevmed Topnotch handouts

Greenhouse gases, except? A. Water vapor B. Carbon dioxide C. Methane D. Nitrogen E. Ozone

671 D. Greenhouse gases includes the above plus nitrous oxide and CFC's. These gases block the escape of heat from the atmosphere which causes global warming.

Water washed disease? A. Schistosomiasis B. Leptospirosis C. Scabies D. Dengue E. Malaria

672 C. Water washed diseases are transmitted from person to person due to inadequate water supply for personal hygeine/ domestic use. Includes scabies, lice, typhus, trachoma.

Characteristic of water which serves as an index of pollution degree of the water source? A. turbidity B. Biological C. Color D. pH E. Taste

673 B. Coliform bacteria are a commonly used bacterial indicator of water pollution, although not an actual cause of disease

Type of sanitation facility with a built-in pit or septic tank , water sealed and requires water throughout the year? A. Pit latrine B. Pour flush Toilet C. Flush TOilet D. Cat hole latrine E. Pail system

674 B. Just like a traditional Flush Toilet, there is a water seal that prevents odours and flies from coming back up the pipe. Water is poured into the bowl to flush the toilet of excreta; approximately 2 to 3L is usually sufficient. The quantity of water and the force of the water (pouring from a height often helps) must be sufficient to move the excreta up and over the curved water seal.

Characteristics of a normal distribution curve, except? A. Bell shaped B. Mean = median = mode C. Total area under the curve is 1 D. Long tapering ends which touches the x axis E. None

675 D. tails of a normal distribution curve does not touch the x axis

IMCI case process includes the following except? A. Assess B. Classify C. Identify D. Admit E. Follow-up care

678 D. IMCI process: assess--> classify --> identify --> provide practical treatment instructions --> counsel --> follow-up care

Prophylactic of choice for meningococcemia? A. Cotrimoxazole B. Cefuroxime C. Rifampicin D. Penicillin E. Doxycycline

680 C. Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis (also termed meningococcus). It carries a high mortality rate if untreated. nder certain circumstances if unvaccinated health-care personnel cannot get vaccinated and who have intensive contact with oropharyngeal secretions of infected patients and who do not use proper precautions should receive anti-infective prophylaxis against meningococcal infection (i.e., 2-day regimen of oral rifampin or a single dose of IM ceftriaxone or a single dose of oral ciprofloxacin).

In the Philippines, the following agents can be safely used in water treatment to make it potable for human consumption, except: A. Iodine B. Thiomersal C. Chlorox D. Fluorine

681 B. Thiomersal otherwise known as thimerosal (Merthiolate) is a mercury-containing compound used to prevent bacterial and fungal growth in some vaccines during storage. *SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

As part of an effort to reduce length of hospital stay, renal transplant patients were placed on a clinical pathway. All of the first seven patients placed on the pathway did well except for the last patient, in whom pancreatitis developed and necessitated a month in the ICU. The lengths of stay for these patients were 4, 3, 5, 7, 4, 6 and 41 days. What are the mean, median, and mode of the length-of-stay data? A. Mean = 10, median = 5, mode = 4 B. Mean = 5, median = 10, mode = 5 C. Mean = 10, median = 4, mode = 1 D. Mean = 10, median = 5, mode = 41 E. Mean = 5, median = 5, mode = 1

682 A. • Mean, median and mode are measures of central tendency. • Mean = sum of all observations divided by number of observations. • Median = arrange the data points in rank order. It is the data value in which one half of the data points fall above it and one half below it. • Mode = is the most frequently occurring value in the data set.

An investigator selected a sample of 100 women attending a social hygiene clinic to determine if there is any relationship between OCP use and Chlamydia infection. He then measured the predictor and outcome variables by taking a history of OCP use and sending a cervical swab to a lab for Chlamydia culture. What is the design utilized in this study? A. Experimental Study B. Case-Control C. Cohort Study D. Cross-sectional

683 D. A cross-sectional study is a descriptive study in which disease and exposure status are measured simultaneously in a given population.

Mrs. Yolly Yanin, 64 yo, began having difficulty remembering things, missing time of work and appearing in public in an untidy state. She was brought into a Family Physician for consult and was diagnosed to have Alzheimer’s disease. Because her condition seemed to progress rapidly, the AP did a home visit. Upon arrival, he found Mrs. Yanin unkempt, bedridden and has lost weight. The daughter who lives with her complained of exhaustion and getting very little support from her siblings. The Family Physician makes use of several tools to assess the condition of the index patient and her family. Which of the following tools and its corresponding indication for use is incorrect? A. APGAR â€" assess familial resources B. Genogram â€" identify alternate caregivers C. SCREEM â€" assess capacity of family to participate in health care D. Family map â€" describe family dynamics

685 A.

Which of the following statistical tests would be most appropriate for assessing whether there are significant differences in 1-minute Apgar scores between infants born by emergency cesarean section and those born by vaginal delivery? A. Student’s t-test B. ANOVA C. Correlation coefficient D. X2 test

687 A. The question relates to assessing the statistic validity of differences in a continuous variable, which in this question are Apgar scores between two groups: babies born vaginally and those born by caesarean delivery. Statistical comparison of continuous variable data between two groups can best be assessed by Student’s t-test (named Dr. Student).

The Sanitation Code of the Philippines prescribes the following, except: A. Bacteriologic examination of drinking water sources should be done as often as possible but interval between examinations must not be more than 6 months B. Examination of drinking water sources for radioactive contamination should be done yearly. C. General chemical examination of drinking water sources should be done quarterly D. There is no exception.

688 C. http://www.doh.gov.ph/sites/default/files/code_ on_sanitation_phils.pdf

Global warming is the gradual increase of temperature of the Earth’s lower atmosphere as a result of the increase in greenhouse gases. What will increase in concentration if there is any increase in global temperature that’s why it is considered as the most important greenhouse gas? A. Water vapor B. Carbon dioxide C. CFC D. Ozone

689 A. Water vapor (Preventive Medicine, Topnotch Handouts)

Which among these factors will decrease the prevalence rate of a disease? A. Longer duration of disease B. Prolongation of px's lives without cure C. In-migration of healthy people D. Improved diagnostic facilities E. None of the above

69 C. In-migration of healthy people will decrease the prevalence rate of a disease. All the other choices will icnrease prevalence rate.

Ms. Tan was brought to the ED due to fatigue, with clammy & moist skin after staying on the beach during a summer vacation. Upon your PE, patient was found to be hyperthermic, with weak pulses and low BP. Based on the history and PE, you suspect that this patient is suffering from a general systemic heat disorder resulting from deficiency of water or salt leading to circulatory insufficiency. Your initial impression is most probably A. Heat Stroke B. Heat Cramps C. Heat Exhaustion D. Heat Syncope

690 C. Heat exhaustion is a condition whose symptoms may include heavy sweating and a rapid pulse, a result of body overheating. It's one of three heat- related syndromes, with heat cramps being the mildest and heatstroke being the most severe. Causes of heat exhaustion include exposure to high temperatures, particularly when combined with high humidity, and strenuous physical activity.

Which statement is correct regarding obesity? A. The association between obesity and hypertension is probably due to inappropriate size of BP cuffs in obese subjects. B. Osteoarthritis is less common among obese because of decreased activity. C. Obese persons are significantly less active than non- obese persons. D. In a normal person, 300 cal of excess carbohydrates will lead to the same weight gain as 300 cal of excess fat.

691 C. Asso. between obesity & arthritis is real & not due to small cuff size. Arthritis due to mechanical stresses. Not only number of calories but composition affects weight gain.

Chance of finding effect in your study if it truly exists in the population is described by which epidemiologic term? A. Lead-time bias B. Surveillance bias C. Type 1 error D. Power

692 D. Power refers to chance of finding effect in your study if it truly exists in the population.

Effective means of preventing trichinosis in humans include: A. Cooking pork and pork products to ensure that all parts of the meat reach a temperature of at least 400 C. B. Attention to proper disposal of hog feces C. Prohibiting the marketing of garbage-fed hogs D. Skin testing of hogs with Trichinella antigen prior to slaughter E. None of these

693 C. Prohibition of marketing of garbage-fed hogs is easier to enforce than inspection to ensure that all garbage is properly cooked.

The time from the disappearance of symptoms until recovery is called A. Communicable period B. Incubation period C. Non-contagious period D. Decubation period E. Preinfectious period

694 D. Incubation period â€" duration of time between exposure to an infectious agent and appearance of 1st manifestation of disease. Communicable period â€" time when infected person can transmit infectious agent.

In the study of the cause of a disease, the essential difference between an experimental study and an observational study is that the experimental investigation A. The study is prospective B. The study is retrospective C. The study and control groups are of equal size D. The study and control groups are selected on the basis of history of exposure to causal factor E. The investigators determine who is and who is not exposed to the suspected causal factor

697 A. Observational â€" no control over exposure but can measure response in those who are and are not exposed.

Dr. Jenny Yous developed a new diagnostic test for syphilis. When the agent is added to blood, the organism develop a characteristic ring around them (she fondly calls it ring-around the syphilis/RAS test). She performs the test on 100 patients known to have syphilis and 100 patients known not to have syphilis, w/ the ff.results: (+) syphilis (-) syphilis RAS test + 91 12 RAS test - 9 88 All of the following are correct about the RAS test, except: A. Sensitivity of RAS test = 91% B. Specificity of test = 12% C. False negative rate = 9% D. False positive rate = 12 %

698 B. TP = 91 FP=12 TN= 88 FN= 9 Sensitivity = TP/ TP + FN Specificity = TN/TN + FP

In comparing the difference between two means, the value of p if found to be 0.70. You interpret this as: A. The null hypothesis is rejected B. The difference is compatible with the null hypothesis C. The difference occurred by chance D. The difference occurred is statistically significant E. Sampling variation is an unlikely explanation of the difference.

699 B. p should be , 0.05 to reject null hypothesis so it is not statistically significant

Which of the following is the appropriate statistical test to analyze data comparing the prevalence of malnutrition between exclusively breastfed and nonbreastfed infants? A. Chi square test B. Student T test C. Z test D. Paired T test E. ANOVA

7 A. Quali â€" quali: chi square test Quali â€" quanti: - T-test (<30 population) - Z-test (>30 population) - ANOVA (3 or more groups are being compared) Paired t test- for comparing paired nonindependent measurements Source: Topnotch handout on preventive medicine

You did a community survery to determine the year of birth of each of the sample population. The results fo the survery will fall under what category of data? A. Nominal B. Ordinal C. Interval D. Ratio E. Dichotomous

70 C. Interval scales are ordered but wit hreal numerical units; they can be subtracted from each other but not divided bec there is no intrinsic zero scale.

The development of neuropathic symptoms is associated with chronic exposure to all of the following substances except: A. Mercury B. Lead C. Arsenic D. Sulphur dioxide

700 D. Organic Hg- intention tremor Lead poisoning â€" peripheral neuropathy & ataxia Nitrous oxide- same as neuropathy seen in pernicious anemia Sulphur dioxide â€" irritation to mucous membrane

A study was done to determine the ability of new;y discovered cardiac enzyme, serum marker XY, to diagnose an acute myocardial infarction compared to the gold standard test of Troponins. 56 patients had positive Trop I in which 35 of those patients had a negative cardiac enzyme XY test. On the other hand 138 patients had negative Trop I in which 75 of those patients had a positive cardiac enzyme XY test. What is the sensitivity and the specificity of the novel test, respectively? A. 48.5 and 55.7% B. 25.5 and 56.8% C. 56.8 and 25.5% D. 37.5 and 45.7% E. 45.7 and 37.5%

72 D. In a two way contigency table: TP= 21 FP=75 FN=35 TN=63 Sensitivity is TP/(TP+FN)= 37.5% and specificity is TN/(TN + FP)= 45.7%

In any study where a sample is utilzied, the error or finding an association in the sample when none truly exist in the population is called? A. Type I error B. Type II error C Type III error D. Type IV error E. Type V error

77 A. Type I or alpha error is rejectign the null hypotehsis when it is really true "You saw a difference when it does not exist"

An indigent patient came to the rural heatlh center complained of shooting pains in the flank radiating to the groin assoc with hematuria during urination. He doesn ot have any money for medications. Being knowledgeable with the uses of herbal medications what could you give to the patient? A. Akapulko B. Sambong C. Tsaang gubat D. Yerba buena E. Ulasimang bato

80 B. Pls refer to your Prevmed Topnotch handouts table on Herbal medications.

1. ACT, a brilliant researcher, wants to determine if the paleontologic diet would decrease serum cholesterol among his patients aged 40 - 50 years old and male without other co-morbid conditions. The following are the results of his study: Patient A: 210 ---------- 208 Patient B: 189 ---------- 172 Patient C: 175 ---------- 170 Patient D: 204 ---------- 180 Patient E: 224 ---------- 227 Patient F: 243 ---------- 238 What is the standard deviation? a. 12.9 b. 22.17 c. 24.29 d. 13.8 e. none of the above

81 C. M = mean X = value n = population

7. In the PRECEDE - PROCEED planning model, which of the following is NOT part of the proceed phases? a. implementation b. diagnosis c. process evaluation d. impact evaluation e. outcome evaluation

87 B.Precede phases: 1. social diagnosis; 2. epidemiological, behavioral and environmental diagnosis; 3. educational and ecological diagnosis; 4. administrative and policy diagnosis proceed phases: 1. implementation; 2. process evaluation; 3. impact evaluation; 4. outcome evaluation

8. BAT, a busy dermatologist, arrived an hour late at her clinic in Alabang. The patient walked in her clinic angrily. What should be the most appropriate response? a. immediately apologize and move on with the consultation b. "You seem upset. What seems to be bothering you?" c. apologize and explain why she was late (e.g. stuck in traffic) d. "I can understand why you are upset, and I appreciate your waiting for me." e. none of the above

88 D. How to manage difficult patient encounters (AAFP) - Sharon Hull and Karen Broquet

A researcher wishes to test his new rapid test kit to diagnose malaria. He performs this test on 100 patients known to have malaria, 91 of which test positive. He then performs this test on 100 patients known not to have malaria, 12 of whom tests positive. What is the ability of the test to label negative those who do not have the disease? A. 12% B. 88% C. 90% D. 91% E. 98%

9 B. Sensitivity â€" ability of a test to label positive those who really have the disease A/A+C Specificity â€" ability of the test to label negative those who do not hae the disease D/B+D Positive predictive value â€" probability of having the condition given a positive result A/A+B Negative predictive value â€" probability of having the condition given a negative result D/C+D Source: Topnotch handout on preventive medicine

10. A 65 year old female came in for complaints of breast mass for 2 years. On workup, patient had multiple liver nodes, 1cm temporal lobe mass with multiple bone metastasis. During her visit, patient says, “I know I can survive this. I will do what I can to be with my grandchildren.†Which of the following is the most appropriate response? a. There is no cure as your cancer has metastasized. b. You should be preparing your grandchildren for your death. c. Let us hope for the best and focus on your remaining time left. d. I think you are in denial that your cancer has spread. e. You are going through the normal stages of grief.

90 C. The best approach to a patient in denial is first determine whether denial is interfering with medical care or significant relationships. If not, do not confront the denial. You should validate patient’s hope and encourage to focus on short - term plans to maximize participation in areas that give meaning to her life (grandchildren).

13. A 49 year old math teacher RC comes to you with complains of sore throat, mild cough productive of scant yellow sputum, clear watery nasal discharges, and low grade fever. PE reveals clear breath sounds and low grade fever. RC insists that you prescribe him with antibiotics as his previous doctor always gave antibiotics for these kinds of ailments. What should you do? a. give him the antibiotics because its the patient’s wishes b. give him a placebo as doctor patient relationship is important c. dont prescribe the antibiotics d. refer the patient to another doctor e. none of the above

93 C. don’t prescribe antibiotics becuase of potential risks such as antibiotic resistance.

14. Doctor JMK sees Ms Bea Alonzo for complains of acne vulgaris. Ms Bea asks JMK if he would go out for a candle light dinner with her. Dr JMK finds Bea very attractive and wants to date her also. Which of the following statements is true? a. Dr JMK should accept the invitation for the dinner date b. Dating a patient is unethical c. physician patient relationship must be terminated prior to a date d. it is inappropriate for a beautiful patient to ask for a date e. none of the above

94 B. romantic and sexual relationships with current patients are always unethical due to potential exploitation or interference with objective clinical judgement