EOH 353 - Global Perspective of Environmental Health » Spring 2020 » Midterm Exam

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Question #1
Which of the following is one of the agents responsible for many publicized outbreaks of gastrointestinal illness on cruise ships?
A.   Hepatitis A virus
B.   Shigella
C.   Novovirus
D.   Salmonella
E.   None of the above
Question #2
An internal overdose refers to the
A.   quantity of a substance that is administered
B.   amount of a substance that is available to the internal organs of the body.
C.   quantity of a substance that is administered
D.   dose acquired by contact with contaminated environmental sources
E.   portion of a substance that becomes internalized in the body
F.   None of the above
Question #3
Which of the following is not an example of an incidental additive?
A.   Stored DDT in tissues of cattle
B.   Chemicals from food wrappers
C.   Residue from spraying crops
D.   Vitamins to improve nutrition
E.   Insect parts
Question #4
According to Healthy People 2020, which of the following is not an environmental objective for outdoor air quality?
A.   Increasing the production of clean coal as an energy source
B.   Reducing the number of days the AQI exceeds 100, weighted by population and AQI
C.   Reducing the number of days the AQI exceeds 100, weighted by population and AQI; increase the use of alternative modes of transportation for work; and reducing air toxic emissions to decrease the risk of adverse health effects
D.   Increasing use of alternative modes of transportation for work
E.   Reducing air toxic emissions to decrease the risk of adverse health effects
Question #5
Chemical hazards that may be present in food include:
A.   heavy metals
B.   Mushroom toxins
C.   monosodium glutamate
D.   marine toxins
E.   All of the above
Question #6
The existence of a dose-response relationship maybe used to establish which of the following kinds of information
A.   Causal association between a toxin and biological effects
B.   Rate of accumulation of harmful effects
C.   Minimum dosages needed to produce a biological effect
D.   both causal association between a toxin and biological effects and minimum dosages needed to produce a biological effect
E.   All of the above
Question #7
A justification for the hazard analysis of critical control points is that:
A.   food-associated illness is almost exclusively due to Salmonella
B.   poor canning practices cause the greatest number of fod-related intoxications
C.   health hazards can be introduced at any point from harvest to consumption
D.   chemical additives are the most dangerous food associated health hazards at present
E.   None of the above
Question #8
The environment plays a role in human health through associations with which of the following?
A.   Allergic responses
B.   Acute conditions
C.   Chronic disease
D.   Disability
E.   All of the above
Question #9
The poisonous substance in Amanita phalloides ("death cap" mushroom) is an example of a(n)
A.   poison caused by bacterial activity
B.   Toxin
C.   toxicant
D.   anthropogenic form of poison
E.   None of the above
Question #10
What does the abbreviation GRAS stand for?
A.   Greatly Researched Additives that are Safe
B.   Grossly Reported As Sanitary
C.   Gently Resolved as Suitable Chemicals
D.   Generally Recognized as Safe Chemical Additives
E.   None of the above
Question #11
Which of the following is an interpretation of the Delaney Clause
A.   The Food Additives Amendment allows low levels of substances that cause cancer in animals but not in human beings
B.   The primary responsibility for safety of food additives rests with the local boards of health
C.   Carcinogenic chemicals are not permitted in food in any amounts
D.   Toxic chemicals are not permitted in food in any amounts
E.   None of the above
Question #12
When used as a food additive, nitrates, and nitrites
A.   have been demonstrated to have carcinogenic properties by themselves
B.   may react with other substances to form carcinogens
C.   are a significant cause of carboxyhemoglobin
D.   None of the above
E.   All of the above
Question #13
Food additives are used to achieve all of the following except:
A.   keep certain products such as table salt from caking
B.   make the food more attractive
C.   protect the nutritional quality of foods
D.   provide effective protection from microbial growth in storage
E.   keep food free from rodent filth
Question #14
In comparison with the general population, workers may receive exposure to toxic chemicals that are:
A.   confined to a single time episode
B.   more likely to be associated with acute effects than long term effects
C.   at higher concentrations for much longer time periods
D.   at lower levels for shorter time periods
E.   None of the above
Question #15
Reasons for the potential spread of avian influenza include which of the following?
A.   Intensive animal husbandry practices
B.   Demonstrated person to person transmission
C.   Restriction of international travel
D.   Both restriction of international travel and demonstrated person to person transmission
E.   All of the above
Question #16
The advantages of genetically modified foods do not include:
A.   reduction in genetic diversity
B.   increased nutritional value of foods
C.   increased resistance of food animals to disease
D.   development of herbicide resistance
E.   increased crop yields
Question #17
Which of the following abbreviations is used to describe toxic effects of chemicals?
A.   LD50
B.   TLV
C.   VOCs
D.   TFR
E.   AQI
Question #18
Compared with adults, children represent a group that is especially vulnerable to environmental hazards for the following reasons, except:
A.   They may inadvertenly ingest toxic substances
B.   They maybe exposed more often to toxins in the soil
C.   They spend more time indoors
D.   Their immune system are still developing
E.   They maybe exposed more often to toxins in outdoor air
Question #19
With respect to the policy cycle, what problem(s) maybe encountered in the agenda setting stage?
A.   Poorly defined problems
B.   Lack of information on risk; lack of coordination
C.   Lack of governmental support
D.   Inability to coordinate and assess research information
E.   Lack of sound scientific data
Question #20
With respect to the policy cycle, what problem(s) maybe encountered in the assessment/evaluation stage?
A.   Lack of sound scientific data
B.   Lack of information on risk; lack of coordination
C.   Inability to coordinate and assess research information
D.   Lack of government support
E.   Poorly defined problems
Question #21
With respect to the policy cycle, what problem(s) maybe encountered in the problem definition stage?
A.   inability to coordinate and assess research information
B.   Lack of information on risk; lack of coordination
C.   Poorly defined problems
D.   Lack of government support
E.   Lack of sound scientific data
Question #22
What problem(s) maybe encountered in the policy implementation stage?
A.   Lack of sound scientific data
B.   Lack of government support
C.   inability to coordinate and assess research information
D.   Poorly defined problems
E.   Lack of information on risk; lack of coordination
Question #23
What problem(s) maybe encountered in the policy establishment stage?
A.   Poorly defined problems
B.   Lack of sound scientific data
C.   Lack of information on risk; lack of coordination
D.   Lack of government support
E.   inability to coordinate and assess research information
Question #24
How can the built environment encourage healthy lifestyles?
A.   By encouraging people to walk more
B.   By colocating businesses and residences
C.   By causing greater use of private automobiles
D.   By encouraging the use of public transportation
E.   By encouraging the people to walk more, encouraging the use of public transporation, and colocating businesses and residences
Question #25
Which of the following describes the precautionary principles?
A.   all people in society should receive equal treatment with respect to environmental laws and policies
B.   A polluter should bear the expense of carrying out pollution prevention and control measures
C.   Preventive measures should be taken when an activity raises threats of harm to the environment
D.   A strong, just, and wealthy society can be consistent with a clean environment
E.   None of the above
Question #26
Which of the following describes the principle of environmental sustainability?
A.   Preventive measures should be taken when an activity raises threats of harm to the environment
B.   A polluter should bear the expense of carrying out pollution prevention and control measures
C.   A strong, just, and wealthy society can be consistent with a clean environment
D.   all people in society should receive equal treatment with respect to environmental laws and policies
E.   None of the above
Question #27
Which of the following describes the polluter-pays principle?
A.   A polluter should bear the expense of carrying out pollution prevention and control measures
B.   A strong, just, and wealthy society can be consistent with a clean environment
C.   all people in society should receive equal treatment with respect to environmental laws and policies
D.   Preventive measures should be taken when an activity raises threats of harm to the environment
E.   None of the above
Question #28
Which of the following statements about zoonotic diseases is most likely to be true?
A.   An animal infected with zoonotic agentmaybe free from symptoms
B.   Children younger than 5 maybe at reduced risk for morbidity from zoonotic diseases
C.   Immunocompromised persons maybe at reduced risk for morbidity from zoonotic diseases
D.   A zoonotic disease is always associated with transmission by a vector
E.   None of the above
Question #29
Methods for transmissin of zoonotic pathogens include?
A.   ingestion of contaminated foods
B.   direct inhalation
C.   bite or scratch of an animal
D.   contact with the skin
E.   All of the above
Question #30
Examples of disease vectors are:
A.   rats and mice
B.   sand flies
C.   mosquitoes
D.   ticks
E.   All of the above
Question #31
Which of the following is an example of a vector-borne disease?
A.   Measles
B.   Q-fever
C.   The "black death"
D.   Trichinellosis
E.   None of the above
Question #32
The most deadly form of malaria is caused by
A.   P. ovale
B.   P. vivax
C.   P.falciparum
D.   P. malariae
E.   None of the above
Question #33
Resurgence of malaria has been attributed to :
A.   evidence of increased person - to - person transmission
B.   discontinuance of DDT spraying
C.   mosquitoes' development of resistance
D.   discontinuance of DDT spraying, mosquitoes' development of resistance, and evidence of increased person to person transmission
E.   both discontinuance of DDT spraying and Mosquitoes' development of resistance
Question #34
The causative agent for malaria is a type of
A.   prion
B.   rickettsial agent
C.   virus
D.   bacterium
E.   protozoa
Question #35
The causative agent for leishmaniasis is a type of
A.   protozoa
B.   prion
C.   rickettsial agent
D.   virus
E.   bacterium
Question #36
Minimata disease was associated with ingestion of seafood tainted with which of the following
A.   Lead
B.   Mercury
C.   Arsenic
D.   Cadmium
E.   None of the above
Question #37
Itai-itai disease was a form of poisoning associated with ingestion of which of the following?
A.   Mercury
B.   Cadmium
C.   Arsenic
D.   Lead
E.   None of the above
Question #38
Which of the following metal is not classified as a major toxic metal with multiple effects?
A.   Chromium
B.   Silver
C.   Arsenic
D.   Berylium
E.   Mercury
Question #39
Possible methods for exposure to metals include which of the following?
A.   Inhalatin of dusts
B.   Ingestion
C.   Inhalation of metal fumes
D.   Skin contact with dusts
E.   All of the above
Question #40
Which of the following statements about heavy metal is true?
A.   All of them are toxic even at trace levels
B.   Their specific gravity exceeds that of water by five or more times
C.   None of them is necessary to sustain life
D.   None of the above
E.   All of the above
Question #41
Bioaccumulation (biomagnification) of heavy metal is a particular hazard associated with which of the following?
A.   Iron
B.   Mercury
C.   Manganese
D.   Copper
E.   None of the above
Question #42
The symptoms of long-term exposure to lower levels of toxic metals include which of the following
A.   Chronic illness effects
B.   Sudden onset of headaches
C.   convulsions
D.   Vomiting and stomach pain
E.   All of the above
Question #43
For fetuses, infants, and children, the hazards of heavy meatls include:
A.   damage to internal organs
B.   impairment of physical and mental development
C.   brain damage
D.   All of these are correct
E.   some forms of cancer
Question #44
On Airs, Waters, and Places was significant because it:
A.   identified an environmental cause of cancer
B.   emphasized the role of the environment in people's health
C.   described the unsafe and hazardous working environment
D.   described the toxic properties of sulfur and zinc
E.   None of the above
Question #45
Lemuel Shattuck's proposals set forth in the Report of the Sanitary Conditions of Massachusetts
A.   were extremely innovative for their time
B.   described how environmental sanitation affected heatlh
C.   ultimately were adopted by public health departments and are now in use
D.   argued for the creation of state health departments
E.   All of the above
Question #46
Affluent Romans may have suffered from chronic lead poisoning from lead pipes used to carry the water supply
A.   TRUE
B.   FALSE
Question #47
Cholera outbreaks occurred in New York City during the mid 1800s
A.   TRUE
B.   FALSE
Question #48
In The Jungle (1904) Upton Sinclair described the deplorable conditions in the meat processing industry
A.   FALSE
B.   TRUE
Question #49
Rachel Carson published Silent Spring to highlight the dangers of pesticide
A.   TRUE
B.   FALSE
Question #50
A contemporary environmental issue is the release of greenhouse gases and their possible contribution to global warming
A.   FALSE
B.   TRUE
Question #51
Van Leeuwenhoek identified the yellow fever virus during the early 1900s
A.   FALSE
B.   TRUE
Question #52
The fatal 1930 incident in Muese Valley, Belgium was associated with leakage of toxic chemicals from a former dump site
A.   TRUE
B.   FALSE
Question #53
The legal profession has virtually no relevance to the environmental health field
A.   TRUE
B.   FALSE
Question #54
Which of the following is an example of in vitro testing for toxicology
A.   Experiments with cells derived from human sources
B.   Dose-response assessments in human populations
C.   Studies of animals exposed to toxins
D.   Experiments with normal volunteers
E.   Experiments with volunteers who have had unintentional exposures
Question #55
All of the following statements about thalidomide are true, except:
A.   it was used to treat morning sickness during pregnancy
B.   it was developed before the advent of rigorous clnical trials
C.   it was associated with heart problems among adults
D.   it was a potent teratogen
Question #56
Which term indicates that the combined effect of exposures to two or more chemicals that is greater that the sum of heir individual effects?
A.   Antagonistic
B.   Synergistic
C.   Coalitve
D.   Additive
Question #57
When several agents that have no known toxic effects interact to produce a toxic effect, it is characteristic of what type of interaction?
A.   Potentiation
B.   Coalitive
C.   Antagonism
D.   Synergistic
Question #58
Which of the following refers to toxic substances that are man-made or resultfrom human (anthropogenic) activity?
A.   Toxin
B.   Poison
C.   Teratogen
D.   Toxicant
Question #59
Normally, which of the following refers to a beneficial effect of a substance, such as relief of pain or may stand for a harmful effect, such as paralysis?
A.   Internal dose
B.   Effective dose
C.   Exposure dose
D.   Absorbed dose
Question #60
Which of the following is the measurement of the relationship between the amount of exposure and the occurrence of the unwanted health effects?
A.   Dose-response assessment
B.   Risk assessment
C.   Hazard assessment
D.   Exposure assessment
Question #61
The quality of data from what type of assessment determines the accuracy of risk assessments and therefore is a limiting factor in the risk assessment process?
A.   Ecologic assessment
B.   Exposure assessment
C.   Hazard assessment
D.   Dose-response assessment
Question #62
In the "real world" of environment exposures, most exposures are due to muliple chemicals rather than to a single chemical.
A.   TRUE
B.   FALSE
Question #63
When highly controlled and standardized conditions are desired, human subjects are used in toxicologic testing.
A.   FALSE
B.   TRUE
Question #64
In the United States, what agency is responsible for protecting human health and safeguarding the natural environment, including air, land and water?
A.   Environmental Protection Aency (EPA)
B.   National Institute for Occupational Safety and Health (NIOSH)
C.   National Institute of Environmental Health Sciences (NIEHS)
D.   Agency for Toxic Substances and Disease Registry (ATSDR)
Question #65
What piece of legislation gave the Environmental Protection Agency (EPA) the power to seek out those parties responsible for any release and assure their cooperation in the cleanup?
A.   Resource Conservation and Recovery Act
B.   National Environmental Policy Act
C.   Comprehensive Environmental Response, Compensation, and Liability Act
D.   Toxic Substances Control Act
Question #66
The term cap and trade is used to describe a method for reducing greenhouse gas emissions from facilities such as electric generating plants.
A.   TRUE
B.   FALSE
Question #67
When the nature of the risks associated with an environmental hazard or toxin is uncertain, planners are left in quandary about what aspects of the exposure require policy interventions.
A.   FALSE
B.   TRUE
Question #68
Despite medical advances, infectious diseases are taking an increasing toll in the developed world.
A.   TRUE
B.   FALSE
Question #69
Which toxic heavy metal is associated with melanosis, a dermatologic condition that can cause the darkening of the skin of the entire body?
A.   Beryllium
B.   Mercury
C.   Cadmium
D.   Arsenic
Question #70
Itai-itai disease, which began occurring in the Jinzu River basin in japan as early as 1912, is one of the conditions attributed to which toxic metal?
A.   Mercury
B.   Cadmium
C.   Arsenic
D.   Beryllium
Question #71
What metal is believed to play a role in reducing the occurrence of common infection and is theorized to be necessary for children's growth and for maintaining the health of pregnant women?
A.   Iron
B.   Zinc
C.   Nickel
D.   Copper
Question #72
Contact with high concentrations of toxic metals is most likely to occur in an occupational setting.
A.   FALSE
B.   TRUE
Question #73
Less developed countries increasingly are being selected as the dumping grounds for electronic waste, which is scavenged by unwitting individuals who are not aware of the hazardous naure of this waste.
A.   FALSE
B.   TRUE
Question #74
The term abortive human rabies refers to a case that:
A.   also experienced comorbidity with monkeypox
B.   was caused by Francisella tularensis
C.   required an abortion in oder to survive
D.   recovered without receiving intensive care
E.   None of these is correct.
Question #75
In what sense is influenza a zoonotic diseaase?
A.   None of these is correct.
B.   The main reservoir is wild carnivores
C.   It is transmitted by "stealth" arthropods
D.   It is transmitted frequently by contact with wool
E.   It has animal reservoirs,especially birds and swine
Question #76
Methods for the conrol of mosquito-borne diseases Include:
A.   All of these are correct
B.   wearing long clothing
C.   monitoring the presence of viruses in sentinel chickens and birds
D.   use of mosquito-eating fish
E.   removing standing water around the home
Question #77
Which of the following is true about rabies?
A.   Postexposure prophylaxis has prevented human rabies successfully.
B.   Outside the United States, the most common vector is Gambian rats.
C.   The disease has a low medium fatality rate.
Question #78
During the sporegenic cycle, the malaria parasite is transferred to the human host when the mosquito takes a blood meal.
A.   FALSE
B.   TRUE
Question #79
Amastigotes are an extracellular form of the organism that has flagella, whereas promastigotes are nonflagellated intracellular forms.
A.   TRUE
B.   FALSE
Question #80
Which of he following indicates he ocurrence of a similar illness among the two or more people that an investigation linked o consumption of a common meal or food items?
A.   Foodborne intoxication
B.   Foodborne disease
C.   Foodborne infection
D.   Foodborne outbreak
Question #81
Just one case of what foodborne illness is considered an outbreak?
A.   Salmonellosis
B.   Listeriosis
C.   Trichinellosis
D.   Botulism
Question #82
What organism can thrive in an environment that has a heavy concentration of salt or sugar, an environment in which most other bacteria are unable to tolerate?
A.   Staphylococcus aureus
B.   Clostridium botulinum
C.   Salmonella typhi
D.   Escherichia coli
Question #83
Foodborne intoxications are included by infectious agents, such as some bacteria,that cause foodborne illness directly.
A.   FALSE
B.   TRUE
Question #84
The development of antimicrobial-resistant Salmonella has been tied to the administration of antibiotics to animals consumed for food.
A.   TRUE
B.   FALSE
Question #85
In a case-control sudy, cases are those wo have the outcome of interest and the conrols are those who do not.
A.   TRUE
B.   FALSE
Question #86
According to Hill's Criteria of Causality,what criterion suggests that the cause and effect interpretation of our data should not seriously conflict with the generally known facts of the natural history and biology of disease?
A.   Coherence
B.   Plausibility
C.   Temporality
D.   Specificity
Question #87
The use of what measure as a study endpoint has several advantages, including the fact that it may be relevant to agents that have a subtle effect over a long time period?
A.   Mortality
B.   Incidence
C.   Prevalence
D.   Morbidity
Question #88
What term is normally used to describe the aggregation of relatively uncommon events or diseases?
A.   Grouping
B.   Randomizing
C.   Sampling
D.   Clustering
Question #89
Which of the following is a study in which the units of analysis are populations or groups of people rather than individuals?
A.   Ecologic studies
B.   Case-conrol studies
C.   Cross-sectional studies
D.   Case series study
Question #90
What type of study design classifies subjecs according to their exposure to a factor of interest and then observes them over time to document the accurence of new cases or other health events?
A.   Case series study
B.   Cross-sectional study
C.   Case-conrol study
D.   Cohort study
Question #91
An ecologic study is one that examines a group as the unit of analysis.
A.   TRUE
B.   FALSE
Question #92
Used in cohort sudies, the relative risk is a measure of the strength os association between a possible risk factor and a disease.
A.   FALSE
B.   TRUE
Question #93
The Texas Sharpshooter Effect illustrates:
A.   a description of disease according to etiologic factors
B.   one cause of spurious or chance clustering
C.   a new insect pest that is invading the southwest.
D.   None of these is correct.
E.   a description of disease according to person variables
Question #94
Which of the following activities characterizes the epidemiologic approach (as opposed to the clinical approach)?
A.   None of these is correct.
B.   Description of a single individual's symptoms
C.   Study of cancer occurrence in populations
D.   Diagnosis of a disease in a sinlge individual
E.   Treatment of a patient with lung cancer
Question #95
A national survey of asthma conducted on May 1, 2012, obtained the following results for the state of Oklahoma: X = The number of residents with asthma. Y=The population of the state on June 30, 2012. and all members of the population were considered at risk. Z=The number of new cases of asthma diagnosed during 2012. The incidence rate of asthma during 2012 (per 100,000) would be expressed as:
A.   (X/Y) x 100,000
B.   (X/Z) x 100,000
C.   None of these is correct.
D.   (Z/X) x 100,000
E.   (Z/Y) x 100,000
Question #96
The risk of acquiring a given disease during a time period is best determined by which of the following?
A.   The number of deaths due to that disease during a given year
B.   A spot map that records all cases of the disease in the past year
C.   The incidence rate for that disease in a given period of time
D.   The prevalence for that disease during the past year
E.   The case fatality rate (CFR) from that disease in the 0 to 4 age group
Question #97
Which of the following historical figures was among the first to expound on the role of environmental factors in causing diseases?
A.   K.J. Rothman
B.   Socrates
C.   Sir Percival Pott
D.   John Snow
E.   Hippocrates
Question #98
Prevalence measures aid in:
A.   assessing variations in disease occurrence, the development of hypothesses, and describing the scope of health problems
B.   describing the scope of health problems
C.   assessing variations in disease occurrence
D.   determining the risk of disease
E.   the development of hypothesses
Question #99
Which of the following is the most deadly type of malaria that may produce kidney failure, seizures, mental confusion, coma, and ultimately death?
A.   Plasmodium malariae
B.   Plasmodium falciparum
C.   Plasmodium vivax
D.   Plasmodium ovale
Question #100
The exposé written by what man was instrumental in the passage of the first Food and Drug Act that was instituted in the United States in 1906?
A.   Upton Sinclair
B.   Walter Reed
C.   John Snow
D.   Henry David Thoreau

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