CRP COMPREHENSIVE ANGKATAN 2009

Untuk nomor 41 51
Although great efforts have been exerted by the World Health Organization (WHO)
to reduce the public health burden of measles, the disease remains the leading
cause of vaccine-preventable child morbidity and mortality worldwide, particularly
in developing countries where immunization coverage is low and vitamin A
deficiency is common. Globally, more than 20 million measles cases are reported
annually with 345.000 deaths in 2005, which represent 50 60% of the estimated
1.6 million deaths attributed to vaccine-preventable diseases of childhood. Failure to
deliver at least one dose of measles vaccine to all infants remains the main reason
for high measles morbidity and mortality as 95% coverage is required to interrupt
measles transmission. In Indonesia, measles remain an important cause of
morbidity and mortality in children under five years of age. Measles outbreaks,
confirmed by IgM antibody diagnosis, have been recently reported in many parts of
the country. In late 2002 and early 2003, measles epidemic were reported from at
least six provinces of Java and in the first three months of 2003 more than 150
patients with measles were admitted to the pediatric wards of Government Hospital
in Java Island. In order to determine the factors associated with the disease
outbreak and provide information for future disease prevention planning, we
conducted a retrospective case-control study comparing potential risk factors
between children with and without measles who were admitted at Government
Hospital in Java Island.
41. Describe the persons with vaccine-preventable diseases (cases) who were
identified by your surveillance system. Attributes of the case-patients include age
group, sex, and race or ethnicity. It may be appropriate to divide age groups based
on recommended ages for vaccine administration as well as on the age distribution
of persons with reported cases. Please interpret the data below:
Age group
Frequency
%
Cumulative (%)
< 6 month
57
36.1
36.1
6 12 month
41
25.9
62.0
13 18 month
6
3.8
65.8
19 23 month
6
3.8
69.6
2 5 year
18
11.4
81.0
6 9 year
17
10.8
91.8
10 year
12
7.6
99.4
Age unknown
1
0.6
100
Total
158
100
A. measles cases are clustered among infants, with more than 25% of reported
cases among those 12 months of age and younger

B. measles cases are clustered among infants, with more than 60% of reported
cases among those 12 months of age and younger
C. measles cases are clustered among infants, with more than 11% of reported
cases among those 5 years old and younger
D. measles cases are clustered among infants, with more than 80% of reported
cases among those 5 years old and younger
E. measles cases are clustered among infants, with more than 99% of reported
cases among those 10 years old and younger

42. based on disease incidence, this condition might be have a risk to get high
mortality rate, because:
A. The distribution of disease transmission was very high
B. The route of transmission difficult to draw any conclusion
C. The age group can explained how big the effect of disease prevention
D. The occurrence of pertussis among infants younger than 6 months of age is
extremely high
E. The presentation of data in such unequal age groups may obscure important
differences in disease incidence.
43. if you want to test some medical treatment to controlling transmission of
measles outbreak, which one of the following statement that recommended be
expected o increase the statistical power of a clinical trial to test a new medical
treatment?
A. Treating a more clinically heterogenous group of patients
B. Narrowing the trial to allow enrollment of more patients
C. adopting new measures to ensure compliance with therapy
D. Adopting a more stringent standard of evidence to prove the new treatment
works
E. Testing only a subgroup of patients for whom the new drug would be expected to
have the greates advantage

60
50
40
30
Number of Reported Cases

20
10
0

Age Group

44. This data above shows us about:

A. Incidence measles based on age group
B. Prevalence measles based on age group
C. mortality rate of measles by age group
D. case fatality rate of measles by age group
E. Incubation period of measles by age group

350
300
250
200
150
Incidence per 100.000 population

100
50
0

Age Group

45. This data above shows us about:

A. Morbidity of measles
B. Mortality of measles
C. Risk to get the disease
D. Probability children got measles attack
E. Number of children who got new treatment

Untuk nomor 46 47
Sex
Female
Male
Total

Frequency
27
12
39

%
69.3
30.7
100

46. The data above shows us about:

A. Mean of male sex is 30.7
B. Total number of cases are 39 people
C. Incident of male cases is lowest than female cases

Cumulative %
69.3
100

D. Of the 39 cases of measles, only more than 30% are males.

E. Of the 39 cases of measles, more than two-thirds are among females.

47. We can assuming that the female predominance because

A. Possibly due to differences in exposures
B. Possibly due to difference in ages
C. Male has highest proportion at population
D. All of female has lowest immunity than male
E. Susceptibility in population must in the same condition

48. if we assuming the population under surveillance includes approximately equal

numbers of males and females, among cases may reflect a real difference in
disease incidence among female because:
A. Age
B. Sex
C. Genetic
D. Immunity
E. Family History

For questions number 49 50

Ethnicity
Sundanese
Javanese
Unknown
Total

Frequency
32
77
49
158

49. The data above shows us about:

A. Almost half were among Javanese
B. Only 30% Chinese has been infected

%
20.35
48.7
31.0
100

Cumulative %
20.3
69.0
100

C. One-fifth occurred among persons of Chinese ethnicity

D. One-third occurred among persons of Javanese ethnicity
E. One-third occurred among persons of Sundanese ethnicity

50. We can assuming that:

A. The data suggest a disproportionate burden of disease in one group
B. Proportion of the population under surveillance is Javanese ethnicity.
C. Proportion of the population under surveillance is Sundanese ethnicity.
D. Proportion of the population under surveillance is Chinese ethnicity.
E. Case investigation was incomplete because almost one-third of cases is unknown

51. If there are any indicating disproportionate burden of disease in one group from
previous reports, that might be caused by:
A. Different levels of reporting
B. High rates of vaccine coverage
C. High reporting practices among providers
D. Appropriate system in access to medical care
E. Decease disease incidence in certain neighborhoods or communities

52. Traditionally epidemiological surveillance was focused on infectious diseases.

However, over time, surveillance within the field of public health has expanded to
also encompass concern with non-infectious conditions such chronic diseases,
injuries, and environmental and occupational exposures, as well as personal
behaviors that promote health and prevent disease. Surveillance data from all of
these areas is essential for:
A. developing policies and programs
B. critical for low budget of management evaluations
C. efficiently bringing clinical problems under control
D. Critical for limited resources such as clinical specialization

E. Evaluating their effectiveness in management of the disease

53. Surveillance data which is analyzed and disseminated on a regular and ongoing
basis helps us know when and how to take public health action. In which condition
surveillance data important to detect and control outbreak of disease?
A. Monitoring changes in health practices and behaviors
B. Monitoring persons within the population at high risk for complications
C. Determine the etiology and natural epidemiological history of diseases,
environmental
D. Detection occupational exposures, and health behaviors, and increases and
decreases in their occurrence over time.
E. Data collection concerning influenza activity every years is disseminated to
health care providers and used to determine when intensified vaccination efforts.

54. In which condition data collection activity useful for monitoring changes in
health practices and behaviors?
A. information concerning life-style habits
B. Information about new drug from drug store
C. Information about new exposures of the disease
D. Information about persons within the population at high risk for complications
E. Information about new etiology and natural epidemiological history of diseases

55. In which condition surveillance data also helps us evaluate the effectiveness
treatment programs at reaching at-risk populations?
A. Increase prevention programs at hospital
B. Develop new policy about regulation of vaccine at school
C. Informs individuals about good habits due to health condition
D. Adoption of policy about management of infectious disease at hospital
E. Make new organizations that responsible for the development new policy

56. Analyses of surveillance data should take place on a regular and ongoing basis
with special analyses added when disease outbreaks or unusual health conditions
occurs. Results from data analyses should be:
A. Reviewed regularly
B. Report after outbreak cases appear
C. Reported to Ministry of Health officer
D. Reviewed originally by Ministry of Health
E. Reported back to local government officer

Maaf pada ga ngumpulin >.< Yang bagian saya juga lupa, maaf
Back Up
1. What is the level of significant?
a. Probability of rejecting Ho when Ho is true
b. Probability of rejecting Ho when Ho is false
c. Probability of accepting Ho when Ho is true
d. Probability of accepting Ho when Ho is false
e. Probability of rejecting Ho when H1 is true
Sisanya ga ada, puntenn
Titipan
For the question number 79-80, refer to the scenario below
A common symptom of otitis media in young children is the prolonged presence of
fluid in the middle ear, as known as middle-ear effusion. The presence of fluid may
result in temporary hearing loss and interfere with normal hearing skills in the first
two years of life. One hypothesis is that babies who are breast-fed for at least 1
month build up some immunity against the effects of the disease and have less
prolonged effusion than do bottle-fed babies. A snakk study of 34 pairs of babies is
set up, where the babies are matched on a one to one basis, according to age, sex,
socioeconomic status, and type of medication taken. One member of the matched
pair is a breast-fed baby and the other is a bottle-fed baby. The outcome variable is
the duration of middle-ear effusion after the first episode of otitis media.
79.What hypotheses are being tested here?

a. Ho : duration of middle-ear effusion in breastfed baby = duration of middleear effusion in bottlefed baby. H1 : duration of middle-ear effusion in
breastfed baby duration of middle-ear effusion in bottlefed baby
b. Ho : duration of middle-ear effusion in breastfed baby duration of otitis
media in bottlefed baby. H1 : duration of middle-ear effusion in breastfed
baby > duration of middle-ear effusion in bottlefed baby
c. Ho : duration of middle-ear effusion in breastfed baby = duration of middleear effusion in bottlefed baby. H1 : duration of middle-ear effusion in
breastfed baby < duration of middle-ear effusion in bottlefed baby
d. Ho : duration of middle-ear effusion in breastfed baby duration of middleear effusion in bottlefed baby. H1 : duration of middle-ear effusion in
breastfed baby < duration of middle-ear effusion in bottlefed baby
e. Ho : duration of middle-ear effusion in breastfed baby = duration of middleear effusion in bottlefed baby. H1 : duration of middle-ear effusion in
breastfed baby > duration of middle-ear effusion in bottlefed baby
80.Which non-parametric test should be use here?
a. Friedman
b. Chi-square
c. Kruskal-wallis
d. Mann-whitney-U
e. Wilcoxon-signed-rank
For questions number 81-82, refer to the scenario below:
A pilot study is planned to test the efficacy of vitamin E supplementation as a
possible preventive agent for Alzheimers disease. Twenty subjects age 65+ are
randomized to either a supplement of vitamin E 400 UI/day (group 1, n=20), or
placebo (group 2, n = 20). It is important to establish that the vitamin E intake (from
food and supplements) of the two groups is comparable at baseline.
81.What hypotheses are being tested here?
a. Ho : total vitamin E intake in group 1 = total vitamin E intake in group
H1 : total vitamin E intake in group 1 total vitamin E intake in group 2
b. Ho : total vitamin E intake in group 1 total vitamin E intake in group
H1 : total vitamin E intake in group 1 > total vitamin E intake in group 2
c. Ho : total vitamin E intake in group 1 total vitamin E intake in group
H1 : total vitamin E intake in group 1 < total vitamin E intake in group 2
d. Ho : total vitamin E intake in group 1 = total vitamin E intake in group
H1 : total vitamin E intake in group 1 > total vitamin E intake in group 2
e. Ho : total vitamin E intake in group 1 = total vitamin E intake in group
H1 : total vitamin E intake in group 1 < total vitamin E intake in group 2
82.Which non-parametric test should be use here?
a. Friedman

2.
2.
2.
2.
2.

b.
c.
d.
e.

Chi-square
Kruskal-Wallis
Mann-Whitney-U
Wilcoxon-signed-rank

For the question number 83-84, refer to scenario below:

Suppose we have data on vitamin E intake (UI/day), from both diet and vitamin
supplements, at baseline in four treatment groups in a clinical trial of nutritional
supplements. It is important to establish that the vitamin E intake of the four
treatment groups is comparable at baseline.
83.What hypotheses are being tested here?
a. Ho : vitamin E intake group 1 = vitamin E intake group 2 = vitamin E intake
group 3 = vitamin E intake group 4. H1 : all groups have a different vitamin
E intake
b. Ho : vitamin E intake group 1 vitamin E intake group 2 vitamin E intake
group 3 vitamin E intake group 4. H1 : vitamin E intake group 1 <
vitamin E intake group 2 < vitamin E intake group 3 < vitamin E intake
group 4
c. Ho : vitamin E intake group 1 = vitamin E intake group 2 = vitamin E intake
group 3 = vitamin E intake group 4. H1 : three groups have a different
vitamin E intake
d. Ho : vitamin E intake group 1 vitamin E intake group 2 vitamin E intake
group 3 vitamin E intake group 4. H1 : vitamin E intake group 1 >
vitamin E intake group 2 > vitamin E intake group 3 > vitamin E intake
group 4
e. Ho : vitamin E intake group 1 = vitamin E intake group 2 = vitamin E intake
group 3 = vitamin E intake group 4. H1 : at least two groups have a
different vitamin E intake
84.Which non-parametric test should be use here?
a. Friedman
b. Chi-square
c. Kruskal-Wallis
d. Mann-Whitney-U
e. Wilcoxon-signed-rank
85.Suppose we have 40 ovarian-cancer cases and 80 control, all of whom are age
50 54. Ten of the ovarian-cancer cases and 12 of the controls had an age of
menarche <11 years. One hypothesis is that early age of menarche is associated
with ovarian cancer (one-sided). Which non-parametric test should be use here?
a. McNemar
b. Chi-square
c. Kruskal-Wallis

d. Mann-Whitney-U
e. Wilcoxon-signed-rank
86.One medical student wants to test a hypothesis that birthweight of an infant is
associated with smoking status of the mother during first semester of pregnancy.
She records birthweights of infants (grams) and smoking status of the mother
and divides the smoking status into four groups: non-smoker, ex-smoker, current
smoker and smokes less than 1 pack per day, and current smoker and smokes 1
pack per day or more. If assumptions for parametric test are not met, which of
the following is the CORRECT alternative test?
a. Friedman
b. Kruskal-Wallis
c. Wilcoxon-sum-rank
d. Wilcoxon-signed-rank
e. Kolgomorov Smirnov