February 2009 Physicians’ Licensure Examination

Preventive and Community Medicine

Concepts of Health and Disease

1.  Considered most dangerous with regards to possible disease spread:

A.  clinical carrier / C. non-immunized
B.  clinical stage patient / D. terminally ill patient

2.  Factors affecting community reaction:

A. Previous exposure / C. Virulence of agent
B. Chance contact / D. Volume of agent

3. An individual who has contact with or who manifests the risk factor prior to

becoming ill:

A. Exposed C. Infected

B. Inflicted D. Well

Levels of Prevention

4. For asymptomatic and normotensive elderly, blood pressure monitoring should be:

A.  Every month C. Every year

B.  Every 6 months D. Whenever convenient

Nutrition

5. Which of the following anthropometric measurements is the best indicator of current or recent malnutrition?

A. weight for age C. weight for height for age

B. height for age D. body mass index

6. Median urinary iodine level that indicates mild IDD

A. < 20 ug/L C. 50-99 ug/L

B. 20-49 ug/L D. > 100 ug/L

7. The group most vulnerable to nutritional deficiencies:

A. Pregnant women C. Adolescents

B. Working group D. Non-lactating mothers

Immunization

8. Which of the following is the real primary target of National Immunization Day?

A. Poliomyelitis C. Measles

B. Tuberculosis D. Diptheria, pertussis, tetanus

9. If a pregnant woman received 3 doses of Tetanus Toxoid she will have immunity

against tetanus for how many years?

A.  3 years C. 10 years

B.  5 years D. 15 years

Food Sanitation

10. Which of the following is the primary objective of food sanitation?

A. to ensure the consumption of safe and wholesome food

B. to prevent the sale of food which is inferior in value and quality

C. to cut down spoilage and wastage of food

D. none of the above

11. The bacterial limit for pasteurized milk and milk products is:

A. 100, 000/ml C. 20,000/ml

B. 10,000/ml D. 1gm/ml

Water Sanitation

12. The most important parameter of drinking water quality is:

A. Bacteriological C. Physical

B. Chemical D. Organic constituents

13. Formation of sticky precipitates of soap with water indicates that the water is:

A. Polluted C. Contaminated

B. Hard D. Soft

14. Hardness of water is primarily due to:

A. calcium and magnesium C. iron content

B. nitrogen content D. sulphur content

15. The primary disinfectant in water treatment:

A. Fluorine C. Aluminum sulfate

B. Chlorine D. Ferric sulfate

16. The most important test for potability of water:

A. taste and odor C. algae, microorganism

B. chemicals D. strep coliforms

Waste Management

17. The recommended refuse disposal method for hospital is:

A. Dumping C. Recycling

B. Incineration D. Composting

18. The cheapest and most frequently used refuse disposal in the community but can

result to water and air pollution is:

A.  Dumping C. Incineration

B.  Sanitary landfill D. Reduction and salvage

19. Excreta disposal is considered to be sanitary if

A. there is minimal fecal handling

B. it prevents soil and water contamination

C. it is accessible and acceptable contamination

D. it prevents both soil water contamination and there is minimum fecal handling

20. The most critical step in waste reduction and recycling is:

A. waste segregation C. collection of solid waste

B. incineration D. transfer and transport

Vector and Rodent Control

·  Most effective method to get rid of rodents

Housing Sanitation

22. Adequate emergency exit is a provision of:

A. fundamental physiologic needs C. protection against contagion

B. fundamental psychologic needs D. protection against accidents

Occupational Health

23. The most exposed industry to ergonomic problems:

A. Manufacturing / C. Fishing
B. Mining / D. Agriculture

24. One of the following cancers is NOT associated with occupational exposures:

A. Breast CA C. Lung CA

B. Bladder CA D. Liver CA

25. One of the responsibilities of the Occupational Medicine Practitioner is to

administer:

A.  Periodic examination exclusively done for high risk groups

B.  Pre placement examination exclusively done for high risk groups

C.  Special examination exclusively done for high risk groups

D.  Efficient record keeping exclusively done for high risk groups

·  Example/Scenario of occupational medicine

Environmental Toxicology

27. Substitute/s causing neurological problems:

A. Mercury / C. Asbestos
B. Silica / D. Bagasse

Statistics

28. The branch of science that counts, measures and numerically states fact is:

A. Demography C. Statistics

B. Medical statistics D. Health statistics

Data Collection

29. The probability that a person has the disease given a positive test result is:

A.  Negative predictive value of the test

B.  Sensitivity of the test

C. Specificity of the test

D. Positive predictive value of the test

30. The ability of a diagnostic test to produce results closest to the true value of the

measurement is called:

A. sensitivity C. validity

B. predictability D. precision

31. The probability that a test will declare positive those who have the disease is:

A.  sensitivity C. positive predictive value

B.  specificity D. positive likelihood ratio

32. A newly developed test for diabetes produced positive results in 138 of 150 known

diabetics and in 24 of 150 persons known not to have diabetes.

What is the sensitivity of the test?

A.  84% C. 88%

B.  85.2% D. 92%

Measures of Central Tendency

33. In a frequency distribution, the value that divides the observed values into two parts is

the

A.  median and mode C. median

B.  mean D. mode

Statistical Analysis

34. You have conducted a clinical trial in which you measured blood pressure in the same

patients during a control period and after 2 weeks of treatment with an experimental

antihypertensive medication. Systolic blood pressure was the characteristic you

measured. You now want to determine whether there was a significant difference in

the average (mean) systolic blood pressure between the control and treatment periods.

Which of the following is the most appropriate statistical procedure for this

determination?

A. Paired t test / C. two sample t test
B. Chi-square / D. correlation coefficient

35. An investigator wanted to determine if there is a significant difference in the mean

systolic blood pressure 10 women before and after oral contraceptive use for 3

months. The appropriate statistical test for significance for this study is:

A. Analysis of variance C. Student t-test

B. Chi-square analysis D. Paired t-test

Data Presentation

36. The part which tells the reader what the different parts of the diagram stand for is

called:

A.  Source C. Legend

B.  Title D. Footnote

37. Which of the following is an alternative to the pie chart?

A.  Bar graph C. Frequency Polygon

B. Component bar diagram D. Histogram

Statistical Indices of Health and Disease

38. The basic indicator most often used to reflect the economic health of a country is:

A. infant mortality rate / C. migration rate

B. infant mortality rate

/ D. population density

39. Health status evaluation includes the following, except

A.  Infant mortality rate

B.  Hospital services utilization

C. All of the above

D. None of the above

40. Which among the following measures fertility:

A.  Sex ratio C. Maternal mortality rate

B.  Crude birth rate D. Life expectancy

41. Incidence of a disease in a particular population over a specified time period:

A. Morbidity rate C. Attack rate

B. Mortality rate D. Crude rate

Civil Registration

42. If death occurred within the jurisdiction of the Philippines but the exact place of its

occurrence cannot be determined, the death shall be registered in the office of the

local civil registrar of

A. place of burial upon the presentation of a certificate

B. victim’s last known address upon the presentation of a certificate

C. birthplace of the victim upon the presentation of a certificate

D. none of the above

Epidemiology – Cross-sectional Studies

3.  Which of the following statements is true regarding cross-sectional studies?

A.  They assess exposure and disease status simultaneously.

B.  They can yield information regarding disease incidence.

C.  They are more time-consuming to perform than case-control or cohort studies.

D.  They are an effective design to determine casual relationships.

E.  They are not an appropriate methodology to draw conclusions from chart databases or census data.

Cohort Study

·  Type of study (duration of breastfeeding and development of infections)

RCTs

4.  In double-blind randomized clinical trials:

A.  The distribution of characteristics between the exposure and nonexposure groups is determined by chance.

B.  The investigator is aware of who is and who is not getting the exposure.

C.  The subjects are not aware that they are taking part in a research protocol.

D.  The subjects are permitted to choose whether they want to be in the exposure or nonexposure group.

97.  Randomization is a procedure used for assignments or allocation of subjects to treatment and control groups is experimental studies. Randomization ensures

a.  That assignments occurs by chance

b.  That treatment and control groups are alike in all respects expect treatment

c.  Bias in observation is eliminated

d.  The placebo effects are eliminated

Community Trial

89. Which of the following trial should be use to determine the effectiveness of a health program?

A. Community trial C. Therapeutic trial

B. Clinical trial D. Prophylactic trial

Epidemiology – Time

69. If the line graph of mortality of a particular disease showed an abrupt dip or

decrease, this would most likely be due to:

A. an increase in herd resistance of the population

B. an improvement in diagnostic procedures

C. an improvement in treatment modalities

D. altered procedures in assigning causes of death

Family Medicine

5.  The most difficult stage of the Family Illness Trajectory for the patient:

A. Accuracy of diagnosis
B. Adjustment to permanency of outcome
C. Major therapeutic efforts
D. Early adjustment to possible outcome

6.  The “therapeutic Triangle” in Medicine refers to which of the following?

A. Patient/family/health care team
B. Patient/family, health care institution, health care team
C. Patient/family, friends/extended family, health care team
D. Patient, health care team, community

7.  A family meeting should be done in the following situation:

A. 16 y/o old female, first pregnancy
B. 12 y/o female with acne
C. 4 y/o old boy with acute nasopharyngitis
D. 30 y/o old male for annual employment physical

31 Family, as a group of people, is defined in various ways. Which among the following

description runs common among the various definitions?

A.  Related by blood or marriage

B.  Related by strong affection

C.  Comprises a permanent household

D.  Changes through time

37 Mrs. D began having difficulty remembering things, missing at time of work, and

appearing in public in an untidy state at age of 64 years. Mrs. D was brought to a

doctor for consult and was diagnosed to have Alzheimer’s disease. Because

Mrs. D’s condition seemed to progress rapidly, the attending physician did a home

visit. When he arrived, she found Mrs. D unkempt, bedridden and has lost weight.

The daughter who lives with her complained of exhaustion and of getting very little

help from her siblings. In assessing the condition of the index patient and the family,

the doctor made use of several tools. Which among the following tools and their

corresponding indication for use is NOT correct?

A.  APGAR – assess familial resources

B.  Genogram – identify alternate caregivers

C.  SCREEM – assess capacity of family to participate in health care

D.  Family map – describe family dynamics

4. Present day Filipino families have accepted this family phenomenon:

A.  Husband no longer monopolizes as the bread winner

B.  Institutionalization of the aged member

C.  Parenting is restrictive

D.  Authoritative parents

5. Family Life Cycle provides the physicians the most important information

regarding:

A. sequence of stressful events with family’s readjustments to maintain health

and viability

B. weak points are identified for the physician to strengthen

C.  bad practices for the physician to correct

D.  the dominant person in the family is identified for the physician to solely rely on him/her

9 . The most important aspect of health promotion among adolescents

A.  Screening

B.  Immunization

C.  Health education

D.  Counseling

This is a branch of medicine that deals with provision of comprehensive health care to people regardless of age or sex:

A.  Public Health

B.  Community Medicine

C.  Preventive Medicine

D.  Family Medicine

Public Health

8.  Criteria that justifies doing screening test:

A. Can identify patients likely to have the disease at pre-symptomatic stage
B. Can identify patients who have the disease at symptomatic stage
C. Can identify patients who will not benefit from treatment
D. Can identify patients who will not benefit from rehabilitation

9.  Which of the following statements about chemoprophylaxis is true?

A. Low dose aspirin for men 65 years old and above prevents heart disease
B. Estrogen with progestin increases the risk of endometrial cancer
C. Estrogen replacement therapy decrease the risk of osteoporosis when started in women 40 years old and below
D. Chemoprophylaxis is warranted only in younger patients

Primary Health Care

44. Primary Health Care Concept is:

A.  meant for people to attain health by being responsible for it

B.  the provision of all health care services at affordable prices

C.  meant to give accessible, affordable and available primary, secondary and tertiary care

D.  a level of care

1.  Primary health care as defined in Alma Ata is referred to as:

A.  first contact between a physician and the patient

B.  strategy utilizing participatory approach in the provision of basic health services to the people.

C.  training program on first aid for the people in the communities

D.  a program of health activities carried out by health professionals

11.  This is an essential health service that is available, accessible and affordable by the community:

A.  social care

B.  preventive medicine

C.  medical care

D.  primary health care

National Health Programs

Food and water-borne Diseases