Commed Sessional 36
Assalammualaikum and hello everyone, 1st of all, thanks to everyone involve in making this Q&A
commed sessional a great success. Special thanks to Robie for initiating it, Keith , Acap eswan for google
doc, Azmee for compiling with answer and all the other. Sekali lagi, Terima kasih
1) robaayah
2)qis
3) acap
4) danial
5) sasha
6) hisyam
7)aainaa
8)yusrina
9)izrina
10)syidi
11)sandriga
12)ikmal
13) azzu
14)faris
15)farhah
16)angelyn
17)imashi
18)alif
19) Farhana
20) acap ezwan
21)spencer
22) Vinoshvin
23)logenth
24)danison
25) fahmin
26)Khavisha
27)nizam
28)sia ban tiong
29)hanim
30)yana
31)yungsin
32)mahavithya
33)ram
34)sabun
35) shubha
36)gautham
37)Kalai
38) thilaga
39) yagan
40)ming
41) teh lin
42) nandi
43) V
44) azmee
45)syahmi
46) Keith
So yes, thanks to all of them :p, and without futher delay, the question and answer start
next. Terima kasih V(^___^)V. If got thing wrong, please tell
1. The concept of level of prevention aim at
a) eradication of disease
b) preventing epidemic
c) ascertaining prognosis of disease
d) intervening in natural history of disease
e) early diagnosis & treatment
source: K park 20th edition page 39 paragraph 2
2. When a new treatment is develop that delay death but does not produce recovery from
chronic disease, which of the following will occur?
a) prevalence of disease will decrease
b) incidence of disease will increase
c) prevalence of disease will increase (d/t the number of people with disease remain
constant while new cases add therefore prevalence increase)
d) incidence of disease will decrease
e) incidence and prevalence of disease decrease
additional point: 1) Longer duration of disease, increase prevalence 2) short duration of
disease low prevalence 3) treatment that improve condition decrease prevalence of
disease. If you want to remember easily, use formula Prevalance = incidence x duration
(P=ID)
Source: K park 20th edition page 58 paragraph 2
3. Reliability definition
a) frequency of new cases with confirmed diagnosis
b) degree to which result are consistent
c) degree of strength between 2 association
d) degree of which instrutment measure what its supposed to measure
e) ensuring all patient take test under same condition
additional point: 1) accuracy is how close measurement to true value 2) precision is
resemblance in study result to each other ie how close the measurement to each other
source: lecture note
4. All of following statement about maternal mortility rate (MMR) in Malaysia are true
EXPECT (no idea the answer)
a) 35/100,000
b) 98% of delivary by health train worker
c) Antenatal coverage 90%
d) training of nurse, Dr, and provision of obstetric care is important component of MCH
service
e) provision of sex education and family planning service help reduce teen pregnancy
5. Most common encounter problem children born under 28th gestation week is
a) cerebral palsy
b) mental retardation
c) behavioral problem
d) learning disability
e) visual hearing problem
6. All of following about directly observe tx short course (DOTS) are true EXCEPT
a) help reduce TB drug resistance
b) case detection by sputum microscopy should be done before starting regimen
c) patient need to take drug infront of nurse/Dr
d) implemented in endemic area
e) help motivate patient to take drug in for expected duration
7. All of following airborne disease except
a) listeriosis (food poisoning)
b) legionelliosis
c) MERS
d) Meninggococcal meningitis
e) leprosy
8. Number of death people above 65y expressed as percentage of total death across all
health group is
a) expectancy of life at 65y
b) propotional mortality rate (death d/t particular disease/death any cause x1000)
c) crude death rate (n of death/midyear population x 100)
d) specific death rate (death specific to disease/midyear population x 1000)
e) adjusted death rate
9. Quarantine is the limitation of movement of well person or animal exposed to
communicable disease by period of
a) early IP (incubation period)
b) late IP
c) minimal IP
d) maximum IP
e) median IP
source: k park 20th edition page 111
10. Which of the following is an example of host factor in disease occurance?
a) air pollution enchances respiratory infection
b) adolescent and young adult more suspectible to STD
c) bad housing facilitate transmission communicable disease
d) female genital mutilation increase risk of infection
e) measle vaccine reduce mortality rate under 5y
11. Stage characterize by decline death rate while birth rate remain high in demographic
cycle known as
a) declining (stage 5 death rate>birth rate)
b) low stationary (stage 4 low birth,death&growth rate)
c) High stationary (stage 1, high birth rate high death rate, population static)
d) early expanding aka stage 2
e) late expanding (stage 3 decline birth death rate, and population)
source: lecture note population dynamic topic
12. Total population in village of Liberia 2000, 20 case in ebola outbreak, 18 death. Calculate
case fatality rate.
Death d/t the disease (18)/number of case of disease (20) x 100 = 90%
13. Define epidemiology:
a) study of distribution and determinant of health related state in specific population
b) study of human relationship and human behavior
c) study of physical social and culture of human
d) scientific study human population
e) study of health, health behavior and medical institution
Additional point: more specific, add and the application of this study to the control of
health problem, source: K Park 20th edition page 49
14. All of following criteria selecting health problem for surveillance EXCEPT
a) incidence of problem
b) resource needed to conduct surveillance
c) presence previous research
d) socioeconomic impact
e) outbreak impact
note: rationale: data collection avaibality,public health action possible, cost effective of
program, public health importance. Objective:monitor disease trend, estimate size of
health problem, detect outbreaks, monitor progress, evaluate intervention and
prevention program, identify research need
15. Which one of following is principle use in USA to control and prevention of Zika
a) make host unsuspectible to agent by immunization
b) eradicate all source of infection
c) kill virus by antivirus
d) kill adult and larva
e)make host unsuspectible to disease by chemoprophylaxis
16. Regarding control and prevention of rabies, weakest point in chain of transmission
a) agent
b) host
c) mode of exit
d) source of infection
e) portal of entry
17. In waste management hierarchy, which of following most preffered method?
a) source reduction and reduce
b) recycling material (2nd most preferred with composting)
c) composting garbage (same as above)
d) energy recovery from palm tree (3rd most preferred)
e) treatment solid waste (4th most preferred)
Source: lecture note
18. Total fertility rate (TFR) of each country. Mlaysia 2.55, Philippines 3.55, south korea
1.05, Singapore 0.81
P/S d/t too long all the choice answer plus is there in previous batch note, give away
straight the answer – population Singapore south korea shrinking, other expanding
19. All of following primary level of prevention EXCEPT
a) balanced diet
b) prophylactic INH to infant of sputum positive mother on ATT
c) vaccination
d) colonoscopy on community to screen colon cancer (word screen indicate 2ry)
e) regular exercise
note: 1) primordial before anything start so health education etc,2) primary prevention
before disease happen by remove agent (fogging etc) improve host defence (vaccine,
chemoprophylaxis etc) improve environment and prevent contact 3) 2ry preventive
measure lead to early diagnosis and treatment thus limit disability like screening, case
finding program 4) tertiary after the disease to reduce its impact like medication
chemotherapy surgery dialysis etc
20. Shortly after party, most student get acute diarrhea and vomitting. Which of following
epidemic occur?
a) propagated (infectious origin transmitted person-to-person, epidemic show gradual
rise, more likely to occur when when large number of suspectible aggregated or regulr
supply of suspectible host like migrants)
b) point source (this is case of food poisoning, characterized by brief silmultaneos
exposure and all develop disease within one IP)
c) common source continuous exposure (eg, one prostitute with one STD continuously
over period of time transmit the disease)
d) cyclic trend (some disease occur in cycle over short period of time like measle
prevaccine era and automobile accident when balik raya (help your foreigner friend by
translating this word for me, thank you)
e) sessional (rain, winter session more etc)
source: K Park 20th edition page 60 61
21. RMT provide free food for children, long term complication
again like no18, stigma label to school children from poor families
22. Web of causation apply to
a) Hepatitis A
b) cholera
c) Rabies
d) diabetes mellitus
e) leptospirosis
23. No plastic bag movement at shopping facilities
a) reduce usage plastic bags
b) reuse of shopping bags
c)recycling
d) proper waste management
e) reduction of waste
24. 3 month old child come to klinik kesihatan (KK) for nutritional counselling of babies.
Mother not aware of timeframe needed to see Dr. which of following scheme is the
necessary for her child at this time.
a) every month
b) every 2 month
c) every 3 month
d) every 6 month
e) every year
25. 28y man complain of red spot on shaft of penis, painless 4 weeks of sexual intercourse
with sexual partner, diagnos syphilis. Talking about contact tracing, which one of
following for the contact tracing?
a) sexual contact during precededing 6 month
b) sexual contact within 3month prior to onset of symptom (d/t this one primary)
c) sexual contact previous 1 year
d) previous 2 month tracing of partner
e) previous one month with all family
additional point: 1) congenital syphilis ask all family member, 2) secondary contact
during preeceeding 6 month, 3) early latent: previous 1 year, 4) latent:marital partner
and children of infected mother source lecture note
26. Which one of following is true regarding perinatal death
a) include early and late neonatal death (for neonatal death)
b) include still birth and early neonatal birth
c) include stillbirth and late neonatal period
d) include early neonatal death and post neonatal death (if here early & late & post
neonatal = infant mortality)
e) early neonatal death only
source lecture note
27. According to WHO expert committee, the health information system should be
a) Hospital based and include patient record
b) problem oriented and population based
c) based on census and vital registration record
d) based on epidemiological surveillance
e) include all detail with raw data
28. Regarding cholera, which statement is true?
a) V Cholerae 0139 usually cause epidemic
b) convalescent carrier carry cholera for 6 month
c) mortality usually occur at stage of evacuation
d) timely and adequate rehydration therapy can reduce mortality
e) mass drug therapy can prevent outbreak (not advised)
source: K Park 20th edition page 206-212
29. Correct indicator for Aedes Aegypti vector surveillance
a) Breteau index = number of positive container per 100 household inspect
b) container index = total number of water holding container infested with larvae or
pupae per 1000 household inspected (number of container positive/number container
inspected x 100)
c) aedes aegypti index = number of house infected with larvae per 1000 house inspected
d) House index = total number of house infested with larvae (number of house positive
aedes/number of house inspected x 100)
e) larvae index = percentage of house infested with larvae or pupae
Source: the great google
30. Anti-bullying campaign at primary school
a) ensure safe physical environment for children
b) ensure psychological development of child
c) promote behavioral change of children
d) promote awareness of this issue by community
e) promote awareness of this issue by school children
31. Which of Following statement are true about polio vaccine
a) SALK live attenuated vaccine
b) live attenuated vaccine given 2,3,5,18 month
c) SALK vaccine given IM
d) SABIN is inactivated vaccine
e) Live attenuated vaccine administered IM
32. Mode of transmission in which disease change in form and number
a) mechanical transmission (vector transport organism)
b) propagative transmission (increase in number no change form)
c) cyclical transmission
d) cyclo-developmental transmission (disease agent undergo development only, eg
microfiliria)
e) cyclo-propagative transmission
33. Malaysia has project to generate energy from palm tree remnant. Project known as
a) Three R project
b) The most preferred solid disposal project
c) the least preferred solid disposal project
d) Two R project
e) The second most preffered project
34. In lymphatic filariasis, asymptomatic microfilariaemia
a) only occur in burgia malayi
b) usually develop 10-15 year after infection (chronic obstructive lesion)
c) caused by immune hyperresponsiveness
d) means microfilariae detectable in blood, patient asymptomatic
e) stage where microfilariae best detected at daytime
Additional points: 1) asymptomatic amicrofilariae no mf no symptom 2)asymptomatic
microfilaraemia source of infection, blood taken at night 3) stage of acute manifestation
filarial fever lymphagitis lympadenitis lyphadema epididymoorchitis in male 4) stage of
chronic obstruction d/t fibrosis and obstruction of of lymphatic vessel causing
permennat structural changes
source: K Park 20th edition page 246
35. Which of the following concept is the basic of environmental health
a) germ theories of agent and health
b) multidimension perspective of health
c) biomedical model of health
d) psychosocial model of health
e) health belief model of working place
36. Ms Helen an American citizen is going to Thailand for 6 month. Leaving in 2 weeks time,
never receive vaccine or Immunoglobulin (Ig). Best choice to prevent her from getting
infection
a) A dose of hepatitis A vaccine
b) A dose of hepatitis A Ig
c) A dose of hepatitis A vaccine and Ig
d) 1st dose Hepatitis A vaccine today, booster before she leave
e) 1st dose today and booster 6 month after (usually done in advanced)
additional point: 1) Ig given also to close contact, outbreak control at institute
source K Park pg 191 last paragraph
37. A surveillance system that collect and maintain structured record on the new cases of
specific disease (Eg: TB) for a specific time and population is known as
a) portable health record
b) Disease Register
c) Record linkage
d) sample registration system
e) Hospital record
38. According to Malaysian statistic, dependency ratio 2015 44.4%, 2010 it was 47.81%. Best
interpretation
a) Malaysia has more elderly in 2015 than 2010
b) Malaysia has more infant in 2015 than 2010
c) Malaysia has more working people in 2015 than 2010
d) Approximately 3 less dependent person per 100 working age people in 2015 compare
to 2010 in Malaysia
e) Approximately 3 more dependent person per 100 working age people in 2015
compare to 2010 in Malaysia
39. On examination 24y AIDS patient for visual disturbance, found perivascular
haemorrhage and white fluffy exudate. Most likely cause
a) cotton wool exudate
b) Herpes virus
c) Cytomegalovirus
d) cataract
e) Toxoplasmosis
40. XRay/Gamma used in all diagnostic tool except
a) mammography
b) MRI
c) Positron Emission tomography
d) CT scan
e) Fluoroscopy
41. All of the following should be included in case definition for surveillance except
a) sign of disease
b) laboratory criteria for diagnosis
c) case classification
d) case symptom
e) place distribution of disease
42. Destruction of disease bearing insect act 1975
a) Medical officer or inspector may have the power to enter and examine premise any
given time (need 24 hour prior notice)
b) Owner of premise can refuse to provide necessary information
c) If breeding ground found on premise, inspector can issue fine to owner
d) the person suspected of infection may denied isolation (Need isolate)
e) The medical office can do post mortem examination of suspected infection after
receiving permission from family (no need permission)
43. 31st may 2014 10 HIV case in 100 population, from 1st june to 1st august 9 new cases.
Incidence of HIV is how much
a) 0.1 per 1000
b) 0.19 per 1000
c) 90 per 1000
d) 100 per 1000
e) 190 per 1000
incidence = number of new case given time /population at risk x 1000
44. Difference in incident rate of disease between exposed group and non-exposed group is
a) Attributable fraction
b) Relative risk (RATIO in incident rate of disease between exposed group and non-
exposed group is)
c) Attributable risk
d) prevalence rate
e) Odds ratio (measure of strength of association of risk factor and outcome)
45. Period of pathogenesis is
a) period of incubatory process only
b) begin with entry of disease causing agent
c) period of subclinical manifestation
d) period of preliminary to the onset of disease
e) period before entry of disease causing agent
