1.Table ade kat ebm in practice diagnostic table 1(page 1865)
This type of table is commonly found in the following study design
A. cohort study
B. interventional study
C. cross sectional study
D. case control study
E. case reports
2. Which of the following is true?
A. female patient are prone to CAD
B. incidence of CAD can be calculated
C. mean of age not precise because the gap is wide
D. more subject include in 1st attack of CAD
E. CAD is inheritable disease
3. Select the correct conclusions u can draw from abstract above
A. this is an interventional study
B. the aim of this study is to assess test performance
C. there is no blinding in this study
D. patients has to be assessed more than once by MRA
E. MRA is better than xray angiography
5. Jadual dln practice in ebm diagnostic page 2nd last table 3 tapi data lain skit
Select the correct statement below for results on left main coronary artery
A. 2 subjects are detected +ve among healthy subjects
B. 85 subjects are detected correctly among subjects of CAD
C. 11 subjects of all are falsely detected
D. LR-ve is better than LR+ve
E. 30 subjects are detected +ve correctly
6. Which of the following is the correct statement for Anterior Descending Artery based on the table?
A) Accuracy is used to estimate disease probability in subject
B) Negative result is for exclusion
C) Highly recommended for definite diagnosis
D) More subjects have negative result
E) Inter observer bias is merit
7. NADRAH!!!
For questions 8-10:
Points to consider on natural time course of atrial fibrillation.
Atrial fibrillation tends to progress to permanent atrial fibrillation~10%.
In the first year after symptomatic manifestation 5% per annum thereafter.
Structural heart disease and age may promote this progression.
Paroxysmal atrial fibrillation occurences follow chaotic patterns that are not random.
Recurrence of persistent atrial fibrillation can be classified as immediate, early and late
Presence of atrial fibrillation approximately doubles mortality with a likely higher impact on cardiovascular mortality.
8. Based on the passage above, the indirect primary outcome of therapeutical trials in atrial fibrillation can be selected from one of the following stement
A. Rate control
B. Rhythm control
C. Atrial fibrillation recurrency
D. Presence of stroke
E. Pain control
9. In order to define a reasonable set of outcome parameters for AF trials,it's necessary to recall natural time course of arrthmia & consequences
Considering the natural time course of AF which factors are important in setting inclusion criteria in any therapeutical trial of AF
A. disease prevalence
B. frequency of previous AF
C. absence of valvular disease
D. ECG pattern
E. previous antithrombotic treatment
10. Calc needed of treatment which is most good outcome
A. rate of control
B. sinus control
C. abnormal ecg
D. side effect drug
E. reduction mortality
11. SHIKIN!!!
12. BASYI!!!
13. IZRA!!!
14. ZILA!!!
15. Which of the following is correct about data on table 1?
A) more cardiac event in dobutamine group should have been avoided with management during the first
B) for better result,subject should be matched n cardiac event would be much lower
C) patients with cardiac event were more likely to have abnormal ECG,older age, n less likely to undergo exercise test
D) biases are very well controlled in study methods
E) both group were treated equally except the case of b blocker
16. Look at the table below,select the correct statement
A) age of more important risk than % max HR of CAD
B) peak WMSI showed inconsistent association with CAD
C) multivariate analysis support peak WMSI as of important risk factor
D) ejection fraction indices showed more significant impact than peak WMSI
E) the data showed above is inconclusive for risk
17. Choose the correct statement about the figure below
A) cardiac event rate tell the prevalence by calculation of mean
B) WMSI < 0.1 is important index to predict CAD
C) ejection fraction is more better to diagnose CAD compare to peak WMSI
D) EF< 45% associated with higher cardiac event rate
E) EF> 45% associated with higher cardiac event rate
18. AZNA!!!
19) EER
A) 3/297 x 100%
B) 6/297 x 100%
C) 12/300 x 100%
D) 6/300 x 100%
20. Subject: 600,divide sama byk between LRCS n SRCS
loss to follow up: 3 LRCS n 3 SRCS
death LRCS=2, SRCS= 4
pacemaker LRCS= 1, SRCS= 5
what is the correct figure for ARR
A) -6
B) +6
C) +0.04
D) -0.02
E) (12-3)/297
21. Number need to treat LRCS
A. 0.02/(2/100)
B. 0.04/(2/100)
C. 1/(2/100)
D. 2/(2/100)
E. 4/(4/100)
22. Correct formula to correlate impact of treatment toward risk chase is?
A. (0.04-0.03)/0.02
B. (0.02-0.04)/0.04
C. (0.04-0.02)/0.04
D. (12-6)/6
E. (12-6)/300
23. Which is the suitable study design?
24. Further info to assess the important of study
A. Method of random
B. Difference in drug administration
C. Impact loss of follow up
D. Binding of physician in charge
E. Time interval to primary end point
25. Cardiac medical therapy in patient after undergoing coronary artery bypass graft surgery. A review of Randomized Clinical Trial, Karen Robert Platt Louise Piloto
A. Level 1a
B. Level 1b
C. Level 1c
D. Level 2a
E. Level 2b
She posses the question in her child with asthma, does her child can get persistent and relapse asthma in adulthood? You have to look for articles on NJEM on that condition. The articles are:
The longitudinal, population based, cohort study of childhood asthma followed to adulthood.
ABSTRACT. Background: The outcome of childhood asthma in adult has been described in high risked cohort, but few population based studies have reported the risk factors for persistent and relapse.
Method: We assessed children born from April 1972 through March 1973 in Dunedin , New Zealand
Result: By the age of 26 years, 51.4% of 613 study members with complete respiratory data had reported wheezing at more than 1 assessment. 89 study members with complete wheezing that persisted from childhood to 26 years of age, whereas 168 (27.4%) had remission, but 76 (12.4%) subsequently relapsed by age of 26. Sensitization to house dust mite predicted the persistent of wheezing (OR 2.41,P=0.001) and relapse (OR 2.18,P=0.001) as did the airway hyperresponsiveness ( 0R for persistent 3.00 P<0.001, OR for relapse 3.03 P<0.001). Female sex predicted the persistent of wheezing (OR 1.71,P=0.03) as did smoking at age of 21 years (OR 1.84,P=0.01). The earlier the age of onset, the greater the risk of relapse (OR 0.89 per year of increase in the age of onset, P<0.001). Pulmonary function was consistently lower in those with persistent wheezing than in those without.
Conclusion: In an unselected birth cohort, more than 1 in 4 children had wheezing that persisted from childhood to adulthood or that relapse after remission. The factors predicting persistence or relapse were sensitization to dust mites, airway hyperresponsiveness, female sex, smoking and early age of onset. These findings, together with persistently low lung function, suggest that outcomes in adult asthma may be determined primarily in childhood
26. what is the study design?
A. Case control
B. Case control and cohort
C. Clinical trial
D. Cross sectional
E. Experimental study and design
27. Was info about representative sample of patient assembled common point in course from abstract is enough?
A.Yes, definitely
B. No. number of total children is needed
C. No. many information of characteristic of childhood
D. No. there was no info on maternal implement
E. No. sample size was too small
28. Were patient followed up sufficiently long and complete? *article about asthma
A. Yes, certainly
B. Long enough but not complete
C. Too short to assess asthma condition
D. Neither long nor complete
E. Need to read full paper answer
29. What was supposed to be objective outcome criteria of this study?
A. Born from April 1972-march 1973
B. Have high risk factors for persistence and relapse
C. 9-26 years of age
D. Hyper responsiveness
E. Wheezing
30. Was the outcome of objective applied in a blinded fashion?
A. Yes, definitely
B. No, parents know the symptoms
C. No, doctor knows the condition of the child
D. No, in cohort design the exposure must be known
E. No, need full article
31. IZZA!!!
32. How likely was asthma relapse to outcome?
A. 1.71
B. 1.84
C. 2.18
D. 2.41
E. 3.00
B. 1.84
C. 2.18
D. 2.41
E. 3.00
33. How likely was smoking in adult to occur?
A. Not clinically significant
B. Not statistically significant
C. In clinically sign
D. Statistically and clinically significant
E. Statistically and clinically aren’t significant
34. What measure should be further evaluated to access the precision of prognostic estimates?
A. Proportion
B. Probability
C. Odd ratio
D. P value
E. Confidence Interval
B. Probability
C. Odd ratio
D. P value
E. Confidence Interval
36. Will this evidence make important impact to you?
A. Yes, asthma relapse is high
B. Yes, patient is in stable condition
C. No, there is no complete info on future outcome after 3 years of age
D. No, patient will be upset with the result
E. No, the fact is just a probability not real fact
Question 37-38:
You have a patient, 11 years old boy, brought by his mom with chief complaint vomiting and difficulty in breathing. According to his mum, he suffered DM Type 1 since he was 8 years old, and has been taking self insulin injection 3 times daily. During the last 2 days he has bad cold with high fever, therefore he omitted insulin injection. His mom wants to know what is the risk of future is her son refuse insulin?
37. You develop a clinical question:
A. What is the metabolic outcome for childhood DM Type 1?
B. What will be the prognostic factor of childhood DM Type 1?
C. Will respiratory infection influence future metabolic outcome?
D. In childhood DM Type 1, what is the risk of future condition if we use alternative therapy?
E. In adult DM Type 1, what is the risk of future condition if we use alternative therapy?
38. VALI!!!
Aunt Harriet’s cousin’s, sister’s, brother in law’s daughter Maude who live in New York
39. What was the hypothesis will be tested in this study?
A. Susceptibility to infection especially TB in RA treatment
B. Hands hurt, swollen as manifestation of serious side effects or previous treatment
C. Serious side effects of DMARD’s can cause another problem in RA treatment
D. Early treatment with DMARD produce better outcome in patient with RA compared to delayed treatment
40. What was the study design is appropriate for the hypothesis?
A. Cohort
B. Cross sectional
C. Case control
D. Ecological study
E. Experimental study
41. What was the exposure?
A. Early treatment
B. Effect
C. Side effect
D. Susceptibility to infection
E. Early detection of RA
42. What was the outcome?
A. No effects of previous treatment
B. Joint damage and disease activity
C. Minimal symptoms of RA
D. DMARD treatment
E. Mortality of RA
43. AJ!!!
44. What is a confounder?
A. A factor, characteristic or variable associated with exposure and outcome that is in the causal pathway
B. A factor, characteristic or variable associated with exposure and outcome that is not in the causal pathway
C. Another variable that cam manipulate the probability of difference
D. It can happen if no difference between 2 group
45. What is potential confounder factor?
A. Age
B. Seasonal pattern
C. Maternal education
D. Function of relapse
E. Malignancy
46. TAPA!!!
47. Strategies dealing with confounders?
A. Design phase randomization, analysis phase restriction
B. Design phase randomization, analysis phase multivariate
C. Design phase matching, analysis phase randomization
D. Design phase stratification, analysis phase multivariate
E. Design phase restriction, analysis phase matching
Question 48-50:
A recent trial of PTH in presentation of vertebral fractures randomly assigned. 444 post menopausal women receive 20mg of PTH and 448 post menopausal women received placebo. At follow up, 22 of 444 women in treatment group had experienced a new vertebral fractures, compared to 64 of 448 in placebo control group
48. What is the ARR?
49. What is the RRR?
50. The number needed to treat (NNT) to prevent 1 new vertebral fracture is?
A. 1
B. 1.5
C. 2
D. 10
E. 11
Question 51-56
To evaluate the use of male condom in decreasing the risk of male to female transmission of HPV infection. Longitudinal study explicitly designed to evaluate the temporal relationship between condom use and HPV infection .........We observed 82 female university students who reported their first intercourse with male partner either during study period or within 2 weeks before enrollment. Cervical and vulvovaginal sample for HPV DNA testing and Papanicolaou Test.
51. What is appropiate study design for this?
A. Cross sectional
B. Clinical trial
C. Cohort
D. Case control
E. Case review
52. What is population study in this article?
A. Lecturer
B. Clinician
C. Social worker
D. Student
53. Similarity of treatment group with respect to baseline characteristics most likely occurred because of
A. Placebo effect
B. Use informed consent
C. Use of detection bias
D. Use of blinding
E. Use of randomization
54. Other confounding factor not influence outcome ?
A. Maternal education
B. Partnership
C. Race
D. Multiplicity
55. JANANI!!!
57. RUBINY!!!
Question 57-60
In pilot study, 20 women with breast cancer and 20 women without breast cancer is contacted to ask whether exposed to passive smoker. Breast cancer patient match by age, weight and parity.
58. What is appropiate study design?
A. Cross sectional
B. Clinical trial
C. Cohort
D. Case control
E. Case review
60. What the population studied for the article?
A. Lecturer
B. Clinician
C. Nutrition
D. Students
E. General public
0 comments:
Post a Comment