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.
Salmonella
C.
Novovirus
D.
Shigella
E.
None of the above
Question #2
An internal overdose refers to the
A.
quantity of a substance that is administered
B.
portion of a substance that becomes internalized in the body
C.
amount of a substance that is available to the internal organs of the body.
D.
quantity of a substance that is administered
E.
dose acquired by contact with contaminated environmental sources
F.
None of the above
Question #3
Which of the following is not an example of an incidental additive?
A.
Vitamins to improve nutrition
B.
Chemicals from food wrappers
C.
Insect parts
D.
Stored DDT in tissues of cattle
E.
Residue from spraying crops
Question #4
According to Healthy People 2020, which of the following is not an environmental objective for outdoor air quality?
A.
Reducing the number of days the AQI exceeds 100, weighted by population and AQI
B.
Increasing the production of clean coal as an energy source
C.
Reducing air toxic emissions to decrease the risk of adverse health effects
D.
Increasing use of alternative modes of transportation for work
E.
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
Question #5
Chemical hazards that may be present in food include:
A.
Mushroom toxins
B.
heavy metals
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.
Minimum dosages needed to produce a biological effect
B.
Rate of accumulation of harmful effects
C.
Causal association between a toxin and biological effects
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.
poor canning practices cause the greatest number of fod-related intoxications
B.
health hazards can be introduced at any point from harvest to consumption
C.
chemical additives are the most dangerous food associated health hazards at present
D.
food-associated illness is almost exclusively due to Salmonella
E.
None of the above
Question #8
The environment plays a role in human health through associations with which of the following?
A.
Disability
B.
Chronic disease
C.
Acute conditions
D.
Allergic responses
E.
All of the above
Question #9
The poisonous substance in Amanita phalloides ("death cap" mushroom) is an example of a(n)
A.
anthropogenic form of poison
B.
poison caused by bacterial activity
C.
Toxin
D.
toxicant
E.
None of the above
Question #10
What does the abbreviation GRAS stand for?
A.
Greatly Researched Additives that are Safe
B.
Generally Recognized as Safe Chemical Additives
C.
Gently Resolved as Suitable Chemicals
D.
Grossly Reported As Sanitary
E.
None of the above
Question #11
Which of the following is an interpretation of the Delaney Clause
A.
Toxic chemicals are not permitted in food in any amounts
B.
The Food Additives Amendment allows low levels of substances that cause cancer in animals but not in human beings
C.
Carcinogenic chemicals are not permitted in food in any amounts
D.
The primary responsibility for safety of food additives rests with the local boards of health
E.
None of the above
Question #12
When used as a food additive, nitrates, and nitrites
A.
may react with other substances to form carcinogens
B.
have been demonstrated to have carcinogenic properties by themselves
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.
protect the nutritional quality of foods
B.
make the food more attractive
C.
keep food free from rodent filth
D.
provide effective protection from microbial growth in storage
E.
keep certain products such as table salt from caking
Question #14
In comparison with the general population, workers may receive exposure to toxic chemicals that are:
A.
at higher concentrations for much longer time periods
B.
confined to a single time episode
C.
at lower levels for shorter time periods
D.
more likely to be associated with acute effects than long term effects
E.
None of the above
Question #15
Reasons for the potential spread of avian influenza include which of the following?
A.
Restriction of international travel
B.
Intensive animal husbandry practices
C.
Both restriction of international travel and demonstrated person to person transmission
D.
Demonstrated person to person transmission
E.
All of the above
Question #16
The advantages of genetically modified foods do not include:
A.
increased nutritional value of foods
B.
increased resistance of food animals to disease
C.
increased crop yields
D.
development of herbicide resistance
E.
reduction in genetic diversity
Question #17
Which of the following abbreviations is used to describe toxic effects of chemicals?
A.
TLV
B.
VOCs
C.
AQI
D.
TFR
E.
LD50
Question #18
Compared with adults, children represent a group that is especially vulnerable to environmental hazards for the following reasons, except:
A.
They spend more time indoors
B.
Their immune system are still developing
C.
They maybe exposed more often to toxins in the soil
D.
They may inadvertenly ingest toxic substances
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.
Lack of sound scientific data
B.
Lack of governmental support
C.
Poorly defined problems
D.
Lack of information on risk; lack of coordination
E.
Inability to coordinate and assess research information
Question #20
With respect to the policy cycle, what problem(s) maybe encountered in the assessment/evaluation stage?
A.
Lack of government support
B.
Inability to coordinate and assess research information
C.
Poorly defined problems
D.
Lack of sound scientific data
E.
Lack of information on risk; lack of coordination
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 government support
C.
Lack of information on risk; lack of coordination
D.
Poorly defined problems
E.
Lack of sound scientific data
Question #22
What problem(s) maybe encountered in the policy implementation stage?
A.
Lack of government support
B.
Poorly defined problems
C.
Lack of sound scientific data
D.
Lack of information on risk; lack of coordination
E.
inability to coordinate and assess research information
Question #23
What problem(s) maybe encountered in the policy establishment stage?
A.
inability to coordinate and assess research information
B.
Lack of government support
C.
Poorly defined problems
D.
Lack of sound scientific data
E.
Lack of information on risk; lack of coordination
Question #24
How can the built environment encourage healthy lifestyles?
A.
By encouraging the people to walk more, encouraging the use of public transporation, and colocating businesses and residences
B.
By encouraging the use of public transportation
C.
By colocating businesses and residences
D.
By causing greater use of private automobiles
E.
By encouraging people to walk more
Question #25
Which of the following describes the precautionary principles?
A.
Preventive measures should be taken when an activity raises threats of harm to the environment
B.
all people in society should receive equal treatment with respect to environmental laws and policies
C.
A polluter should bear the expense of carrying out pollution prevention and control measures
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.
all people in society should receive equal treatment with respect to environmental laws and policies
B.
A strong, just, and wealthy society can be consistent with a clean environment
C.
Preventive measures should be taken when an activity raises threats of harm to the environment
D.
A polluter should bear the expense of carrying out pollution prevention and control measures
E.
None of the above
Question #27
Which of the following describes the polluter-pays principle?
A.
Preventive measures should be taken when an activity raises threats of harm to the environment
B.
all people in society should receive equal treatment with respect to environmental laws and policies
C.
A strong, just, and wealthy society can be consistent with a clean environment
D.
A polluter should bear the expense of carrying out pollution prevention and control measures
E.
None of the above
Question #28
Which of the following statements about zoonotic diseases is most likely to be true?
A.
Immunocompromised persons maybe at reduced risk for morbidity from zoonotic diseases
B.
A zoonotic disease is always associated with transmission by a vector
C.
An animal infected with zoonotic agentmaybe free from symptoms
D.
Children younger than 5 maybe at reduced risk for morbidity from zoonotic diseases
E.
None of the above
Question #29
Methods for transmissin of zoonotic pathogens include?
A.
ingestion of contaminated foods
B.
bite or scratch of an animal
C.
direct inhalation
D.
contact with the skin
E.
All of the above
Question #30
Examples of disease vectors are:
A.
rats and mice
B.
ticks
C.
sand flies
D.
mosquitoes
E.
All of the above
Question #31
Which of the following is an example of a vector-borne disease?
A.
The "black death"
B.
Trichinellosis
C.
Q-fever
D.
Measles
E.
None of the above
Question #32
The most deadly form of malaria is caused by
A.
P. ovale
B.
P. vivax
C.
P. malariae
D.
P.falciparum
E.
None of the above
Question #33
Resurgence of malaria has been attributed to :
A.
discontinuance of DDT spraying
B.
mosquitoes' development of resistance
C.
evidence of increased person - to - person transmission
D.
both discontinuance of DDT spraying and Mosquitoes' development of resistance
E.
discontinuance of DDT spraying, mosquitoes' development of resistance, and evidence of increased person to person transmission
Question #34
The causative agent for malaria is a type of
A.
bacterium
B.
rickettsial agent
C.
virus
D.
protozoa
E.
prion
Question #35
The causative agent for leishmaniasis is a type of
A.
prion
B.
protozoa
C.
virus
D.
bacterium
E.
rickettsial agent
Question #36
Minimata disease was associated with ingestion of seafood tainted with which of the following
A.
Mercury
B.
Lead
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.
Lead
C.
Cadmium
D.
Arsenic
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.
Mercury
E.
Berylium
Question #39
Possible methods for exposure to metals include which of the following?
A.
Ingestion
B.
Inhalatin of dusts
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.
None of them is necessary to sustain life
B.
All of them are toxic even at trace levels
C.
Their specific gravity exceeds that of water by five or more times
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.
Copper
B.
Iron
C.
Mercury
D.
Manganese
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.
convulsions
C.
Vomiting and stomach pain
D.
Sudden onset of headaches
E.
All of the above
Question #43
For fetuses, infants, and children, the hazards of heavy meatls include:
A.
damage to internal organs
B.
All of these are correct
C.
brain damage
D.
some forms of cancer
E.
impairment of physical and mental development
Question #44
On Airs, Waters, and Places was significant because it:
A.
described the unsafe and hazardous working environment
B.
emphasized the role of the environment in people's health
C.
identified an environmental cause of cancer
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.
argued for the creation of state health departments
C.
described how environmental sanitation affected heatlh
D.
ultimately were adopted by public health departments and are now in use
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.
Dose-response assessments in human populations
B.
Experiments with normal volunteers
C.
Experiments with cells derived from human sources
D.
Studies of animals exposed to toxins
E.
Experiments with volunteers who have had unintentional exposures
Question #55
All of the following statements about thalidomide are true, except:
A.
it was associated with heart problems among adults
B.
it was used to treat morning sickness during pregnancy
C.
it was a potent teratogen
D.
it was developed before the advent of rigorous clnical trials
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.
Synergistic
D.
Antagonism
Question #58
Which of the following refers to toxic substances that are man-made or resultfrom human (anthropogenic) activity?
A.
Poison
B.
Teratogen
C.
Toxicant
D.
Toxin
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.
Effective dose
B.
Internal 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.
Dose-response assessment
D.
Hazard assessment
Question #62
In the "real world" of environment exposures, most exposures are due to muliple chemicals rather than to a single chemical.
A.
FALSE
B.
TRUE
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.
Agency for Toxic Substances and Disease Registry (ATSDR)
B.
National Institute of Environmental Health Sciences (NIEHS)
C.
Environmental Protection Aency (EPA)
D.
National Institute for Occupational Safety and Health (NIOSH)
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.
Toxic Substances Control Act
B.
Resource Conservation and Recovery Act
C.
Comprehensive Environmental Response, Compensation, and Liability Act
D.
National Environmental Policy 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.
TRUE
B.
FALSE
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.
Cadmium
B.
Beryllium
C.
Mercury
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.
Cadmium
B.
Mercury
C.
Beryllium
D.
Arsenic
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.
Zinc
B.
Iron
C.
Copper
D.
Nickel
Question #72
Contact with high concentrations of toxic metals is most likely to occur in an occupational setting.
A.
TRUE
B.
FALSE
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.
None of these is correct.
B.
also experienced comorbidity with monkeypox
C.
was caused by Francisella tularensis
D.
recovered without receiving intensive care
E.
required an abortion in oder to survive
Question #75
In what sense is influenza a zoonotic diseaase?
A.
It is transmitted frequently by contact with wool
B.
It is transmitted by "stealth" arthropods
C.
None of these is correct.
D.
The main reservoir is wild carnivores
E.
It has animal reservoirs,especially birds and swine
Question #76
Methods for the conrol of mosquito-borne diseases Include:
A.
wearing long clothing
B.
use of mosquito-eating fish
C.
monitoring the presence of viruses in sentinel chickens and birds
D.
All of these are correct
E.
removing standing water around the home
Question #77
Which of the following is true about rabies?
A.
The disease has a low medium fatality rate.
B.
Outside the United States, the most common vector is Gambian rats.
C.
Postexposure prophylaxis has prevented human rabies successfully.
Question #78
During the sporegenic cycle, the malaria parasite is transferred to the human host when the mosquito takes a blood meal.
A.
TRUE
B.
FALSE
Question #79
Amastigotes are an extracellular form of the organism that has flagella, whereas promastigotes are nonflagellated intracellular forms.
A.
FALSE
B.
TRUE
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 infection
B.
Foodborne intoxication
C.
Foodborne disease
D.
Foodborne outbreak
Question #81
Just one case of what foodborne illness is considered an outbreak?
A.
Trichinellosis
B.
Salmonellosis
C.
Listeriosis
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.
Escherichia coli
B.
Salmonella typhi
C.
Clostridium botulinum
D.
Staphylococcus aureus
Question #83
Foodborne intoxications are included by infectious agents, such as some bacteria,that cause foodborne illness directly.
A.
TRUE
B.
FALSE
Question #84
The development of antimicrobial-resistant Salmonella has been tied to the administration of antibiotics to animals consumed for food.
A.
FALSE
B.
TRUE
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.
Temporality
B.
Plausibility
C.
Coherence
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.
Prevalence
B.
Morbidity
C.
Incidence
D.
Mortality
Question #88
What term is normally used to describe the aggregation of relatively uncommon events or diseases?
A.
Sampling
B.
Grouping
C.
Randomizing
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.
Case series study
B.
Case-conrol studies
C.
Cross-sectional studies
D.
Ecologic studies
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-conrol study
B.
Cross-sectional study
C.
Cohort study
D.
Case series study
Question #91
An ecologic study is one that examines a group as the unit of analysis.
A.
FALSE
B.
TRUE
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.
TRUE
B.
FALSE
Question #93
The Texas Sharpshooter Effect illustrates:
A.
a description of disease according to etiologic factors
B.
a description of disease according to person variables
C.
one cause of spurious or chance clustering
D.
None of these is correct.
E.
a new insect pest that is invading the southwest.
Question #94
Which of the following activities characterizes the epidemiologic approach (as opposed to the clinical approach)?
A.
Description of a single individual's symptoms
B.
Study of cancer occurrence in populations
C.
Treatment of a patient with lung cancer
D.
Diagnosis of a disease in a sinlge individual
E.
None of these is correct.
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.
(Z/X) x 100,000
B.
(X/Z) x 100,000
C.
None of these is correct.
D.
(X/Y) 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 incidence rate for that disease in a given period of time
B.
The case fatality rate (CFR) from that disease in the 0 to 4 age group
C.
The prevalence for that disease during the past year
D.
A spot map that records all cases of the disease in the past year
E.
The number of deaths due to that disease during a given year
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.
determining the risk of disease
C.
describing the scope of health problems
D.
assessing variations in disease occurrence
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 falciparum
B.
Plasmodium ovale
C.
Plasmodium malariae
D.
Plasmodium vivax
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.
John Snow
B.
Upton Sinclair
C.
Walter Reed
D.
Henry David Thoreau
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