CDC 4E051

Public Health Journeyman

Volume 2. Disease Recognition and

Control
Unit Review Exercises
Note to Student: Consider all choices carefully, select the best answer to each question, and circle
the corresponding letter. When you have completed all unit review exercises, transfer your answers to
ECI (AFIADL) Form 34, Field Scoring Answer Sheet.

1. (201) A primary or definitive host is a host in which a disease organism

a. attains its maturity and goes through its sexual or reproductive stage.
b. becomes most easily identified by laboratory tests.
c. has not yet invaded an intermediate host.
d. enters the larval stage.

2. (201) The ability of an agent to produce clinical disease in a host is its

a. virulence.
b. infectivity.
c. penetrability.
d. pathogenicity.

3. (202) Rabies is spread by

a. direct contact.
b. airborne contact.
c. vectorborne contact.
d. vehicleborne contact.

4. (202) Giving hepatitis A vaccine and malaria prophylaxis to deploying troops controls what link in
the chain of infection?
a. Source.
b. Vehicle.
c. Susceptible person.
d. Means of transmission.
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5. (203) In countries where pork is eaten, individuals may be at risk of trichinosis infection when the
pork is undercooked. This is an example what intrinsic factor in the occurrence of disease?
a. Diet.
b. Personal hygiene.
c. Physiological state.
d. Preexisting disease.

6. (203) Using night soil as a fertilizer allows the transmission of such diseases as typhoid, dysentery,
amebiasis, and hepatitis. Preventing transmission of these diseases involves educating people on
a. proper disposal of human wastes.
b. good household hygiene.
c. good personal hygiene.
d. occupational hazards.

7. (204) The environmental factor that has the greatest effect on hay fever sufferers is
a. social.
b. climate.
c. geography.
d. physiological.
8. (204) What environmental factor relates to the fact that quinine, used to treat malaria, comes from
tree bark?
a. Social.
b. Climate.
c. Biological.
d. Geography.

9. (205) Numeric facts or data that have been assembled, classified, and tabulated to present
significant information about a given subject are called
a. statistics.
b. the mode.
c. the mean.
d. the median.

10. (205) What number is most commonly used as a measurement of central tendency?
a. Rate.
b. Mean.
c. Mode.
d. Median.

11. (205) The mode for the numbers 6, 18, 26, 14, 12, 19, 20, and 26 is
a. 17.625.
b. 18.500.
c. 19.250.
d. 26.000.

12. (205) The median of the numbers 3, 3, 5, 7, 8, 9, and 12 is

a. 3.00.
b. 6.71.
c. 7.00.
d. 8.21.

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13. (206) Public health workers use attack rates when investigating foodborne illness outbreaks to
determine the
a. time the food was consumed.
b. gender of the average patient.
c. food or foods most likely responsible for the outbreak.
d. average number of items consumed by the ill population.

14. (206) If 30 out of 90 people who ate at a base picnic became ill, the attack rate per 100 persons is
a. 3.33.
b. 33.30.
c. 333.00.
d. 333.30.
15. (207) A method that is used to study two similar groups by administering a vaccine, special diet,
or some other factor to one group while withholding it from the other group is called
a. prospective.
b. experimental.
c. retrospective.
d. observational.

16. (207) A method that is used to study different groups under natural conditions is called the
a. prospective.
b. experimental.
c. retrospective.
d. observational.

17. (207) Which study method traces the source of a food poisoning outbreak, or examines STD
incidence and prevalence?
a. Controlled method.
b. Experimental method.
c. Prospective observation.
d. Uncontrolled observation.

18. (208) In an outbreak investigation, what step do you take after confirming the existence of an
outbreak?
a. Define and identify cases.
b. Communicate your findings.
c. Establish or verify the diagnosis.
d. Perform descriptive epidemiology.

19. (208) In what step of an outbreak investigation do you construct an epidemic curve or graph of
cases that is plotted according to time of onset?
a. Step 2 (establish existence of an outbreak).
b. Step 3 (take steps to establish or verify the diagnosis).
c. Step 4 (define and identify cases).
d. Step 5 (perform descriptive epidemiology).

20. (209) What form of meningitis occurs most often in children under 5 years old?
a. Rheumatic fever.
b. Kidney infection.
c. Neisseria meningitis.
d. Haemophilus meningitis.

21. (209) What form of meningitis, which is more common and less severe than bacterial meningitis,
is normally called “aseptic meningitis”?
a. Viral meningitis.
b. Spinal meningitis.
c. Streptococcus pyogenes.
d. Haemophilus meningitis.
22. (209) What is the most common type of streptococcal infection?
a. Sore throat.
b. Scarlet fever.
c. Rheumatic fever.
d. Kidney infection.

23. (209) The Air Force instituted the Influenza Surveillance Program to identify new strains of
influenza viruses. This program is also known as
a. Project Gargle.
b. Project Influenza.
c. the Disease Surveillance Program.
d. the Influenza Vaccination Program.

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24. (210) During what stage of tuberculosis do bacilli encapsulate and remain in the alveoli of the
lung until conditions favor growth?
a. Active.
b. Infection.
c. Dormant.
d. Incubation.

25. (210) What tuberculin skin test is used by the Air Force to screen people for tuberculosis?
a. Mantoux test.
b. Sputum culture.
c. Tuberculin tine test.
d. BCG.

26. (210) How long after receiving a BCG vaccination will most people revert to a negative
tuberculin skin test?
a. 4 years.
b. 6 years.
c. 8 years.
d. 10 years.

27. (210) To confirm a diagnosis of tuberculosis, it is essential to perform a

a. chest x-ray.
b. tine skin test.
c. sputum culture.
d. Mantoux PPD skin test.

28. (210) Where is the original AF Form 2453, Tuberculosis Detection and Control Data, filed?
a. County health office.
b. Patient’s outpatient medical record.
c. Public Health patient filing system.
d. It is not necessary to file the original.
29. (211) During what period of development is syphilis first detectable through laboratory testing?
a. Initial.
b. Latent stage.
c. Primary stage.
d. Incubation period.

30. (211) Which laboratory test measures antibodies to the causative organism of syphilis?
a. Darkfield microscopy.
b. Lightfield microscopy.
c. Nontreponemal testing.
d. Treponemal testing.

31. (211) What are you looking at if you see a raised, table-top or mushroom-like papule with a pale,
white soggy appearance on the genitals or rectum?
a. Adenitis.
b. Alopecia.
c. Mucous patch.
d. Condylomata lata.

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32. (212) Gonococcal epididymitis is an example of which type of gonorrhea?

a. Complicated genital infection.
b. Uncomplicated genital infection.
c. Complicated nongenital infection.
d. Uncomplicated nongenital infection.

33. (212) What is the most common complication of female gonorrhea infections?
a. Sterility.
b. Salpingitis.
c. Genital lesions.
d. Pelvic inflammatory disease.

34. (212) When a patient indicates difficulty in taking multidose medications, a healthcare provider
may select a single-dose injection. This is an example of which consideration for treatment of
gonorrhea?
a. Reliability.
b. Antibiotic side effects.
c. Antibiotic effectiveness.
d. Compromised immune system.

35. (213) What is a chronic infectious disease of the conjunctiva and cornea that produces
photophobia, pain, and excessive tearing?
a. NGU.
b. Trachoma.
c. Occularitis.
d. Infant conjunctivitis.
36. (213) What is considered to be the standard test for identifying chlamydia in genital infections?
a. Cytology.
b. Skin scraping.
c. Serological testing.
d. Tissue culture.

37. (213) Which diagnostic method is the quickest for identifying chlamydia infections?
a. Skin scraping.
b. Serological testing.
c. Tissue culture.
d. Antigen-antibody tests.

38. (214) Which diagnostic method is the most specific and sensitive to confirm herpes?
a. Antigen-antibody testing.
b. Serological testing.
c. Tissue culture.
d. Skin scraping.

39. (214) What disease starts with a pimple-like sore and, if left untreated, forms a bubo in most
patients?
a. HSV1.
b. HSV2.
c. Lymphogranuloma venereum.
d. NGU.

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40. (215) Which symptom does not assist healthcare providers in diagnosing AIDS?
a. Kaposi sarcoma.
b. CMV.
c. Acute HSV1 infection.
d. Candida in the mouth and esophagus.

41. (215) Which diagnostic method is the most specific for identifying individuals within high-risk
groups who are positive for HIV?
a. Tissue culture.
b. Skin scraping.
c. Western blot.
d. ELISA test.

42. (216) There are two keys to conducting a successful interview concerning STD. The first key is
the interviewer must be knowledgeable. What is the second?
a. The patient must control the conversation.
b. The interviewer must control the conversation.
c. Interviewer ensures that all contacts are treated and followed up.
d. Interviewer ensures that pictures, tissues, and telephone are available.
43. (216) What method of preventing STD among sexually active people is most effective?
a. Using condoms properly.
b. Checking partners for signs of disease.
c. Decreasing the number of sexual partners.
d. Maintaining personal hygiene after sexual contact.

44. (217) Which form of hepatitis is most commonly found in child development centers?
a. A.
b. B.
c. C.
d. D.

45. (217) Which form of hepatitis has an average incubation period of 60 to 90 days?
a. A.
b. B.
c. C.
d. D.

46. (217) What must be present for the delta virus to infect and cause illness?
a. Hepatitis A.
b. Hepatitis B.
c. Hepatitis C.
d. Hepatitis D.

47. (218) In order for IG to be effective, how soon must it be given after exposure to hepatitis?
a. Within 2 weeks.
b. Within 2 months.
c. Immediately after exposure.
d. Never. It is not effective against hepatitis.

48. (218) Who is at highest risk of hepatitis B infection?

a. Child development center worker.
b. Water treatment worker.
c. Food service worker.
d. Dentist.

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49. (218) What is the key to effectively controlling and preventing the spread of viral hepatitis?
a. Isolate all patients with hepatitis.
b. Vaccinate all personnel for hepatitis.
c. Provide education and sanitary controls.
d. Administer immune globulin to high-risk employees.

50. (219) What is an acute disease that has sudden onset of profuse watery stools, occasional
vomiting, rapid dehydration, and circulatory collapse?
a. Shigellosis.
b. Giardiasis.
c. Amebiasis.
d. Cholera.
51. (220) How does a healthcare provider notify PH of a suspected communicable disease?
a. Use e-mail.
b. Complete AF Form 422, Physical Profile.
c. Complete AF Form 570, Notification of Patient’s Medical Status.
d. Fax the Standard Form 600, Chronological Record of Patient Care.

52. (221) What is one source of endogenous infection for a patient in a hospital?
a. Contaminated medical equipment.
b. Inadequate air-conditioning systems.
c. Poor personal hygiene of the patient.
d. Improper handling of patients by medical employees.

53. (221) Which method is the most effective way to avoid transmission of infection from hospital
employee to patient?
a. Educating patients prior to working on them.
b. Cleaning and sanitizing the patient’s skin or wound.
c. Sterilizing all medical equipment for use on or by patients.
d. Frequent and thorough handwashing, especially prior to working on patients.

54. (221) Which office is responsible for maintaining proper disinfection and sterilization of hospital
supplies?
a. Public Health.
b. Central Supply.
c. Infection Control.
d. Bioenvironmental Engineering.

55. (222) Which foodborne illness has an average incubation time of 18 hours, and symptoms varying
from nausea to severe headache, chills, fever, violent retching, colic, and diarrhea?
a. Salmonellosis.
b. Campylobacter jejuni.
c. Streptococcal infections.
d. Staphylococcal intoxications.

56. (222) Which food is susceptible to contamination by streptococcal organisms if improperly

handled?
a. Potato chips.
b. Potato salad.
c. Loaf of bread.
d. Fruit cocktail.

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57. (222) Which disease is more common than both salmonellosis and shigellosis?
a. Botulism.
b. Clostridialenteritis.
c. Campylobacter enteritis.
d. Listeria monocytogenes.
58. (222) Which source is the most common cause of foodborne intoxication?
a. Bacteria.
b. Poisonous plants.
c. Poisonous animals.
d. Chemicals used mistakenly.

59. (223) Who should give training on foodborne illness investigation to medical personnel who have
initial patient contact?
a. Public Health Services.
b. Chief, Aeromedical Services.
c. Local Public Health Department.
d. Director, Base Medical Services.

60. (223) AF Form 431, Food Poisoning Outbreak—Individual Case History, is completed to
a. list all foods served at a food facility.
b. show distribution of the disease over a period of time.
c. report the cause of disease and proper control measures.
d. list the foods consumed for 72 hours and record symptoms with onsets and duration.

61. (224) Immunizations for rabies after exposure to the disease must be given prior to the onset of
encephalitis, which is in which stage of rabies?
a. Stage 1. Incubation period.
b. Stage 2. Prodrone phase.
c. Stage 3. Acute neurological phase.
d. Stage 4. Coma leading to death or recovery.

62. (224) What is the primary reservoir of rabies in most foreign countries?
a. Bats.
b. Dogs.
c. Foxes.
d. Raccoons.

63. (225) When an animal is suspected in a bite case on base, who has the responsibility for
determining if the animal has rabies?
a. Public Health.
b. Army veterinarian.
c. Healthcare provider.
d. Chief, Rabies Advisory Committee.

64. (225) Which immunization is given to treat personnel exposed to rabies?

a. Immune globulin.
b. Duck embryo vaccine.
c. Human diploid cell vaccine.
d. Animal rabies virus vaccine.

65. (226) Who has the ultimate responsibility for ensuring personnel are protected from vectorborne
disease?
a. Base commander.
b. Base civil engineer.
c. Chief, Military Public Health.
d. Director, Base Medical Services.
66. (226) Who establishes the frequency for surveying disease vectors on base?
a. Director, Base Medical Services.
b. Chief, Military Public Health.
c. Aerospace Medicine Council.
d. Centers for Disease Control.

67. (226) Who determines the need for aerial spraying of pesticides to control vectors or medically
important pests?
a. Bioenvironmental Engineering.
b. Aerospace Medicine Council.
c. Base Civil Engineering.
d. Public Health.

68. (226) Who provides vector identification for bases in the CONUS?
a. Public Health at each base.
b. Base Civil Engineering at each base.
c. USAF Headquarters Entomology Support Division.
d. Air Force Institute for Operational Health.

69. (227) What is the first classification or grouping within the animal or plant kingdom?
a. Family.
b. Phylum.
c. Class.
d. Order.

70. (227) In most cases, what is the lowest major division in the classification system of insects?
a. Order.
b. Class.
c. Species.
d. Phylum.

71. (227) Which animal has an endoskeletal structure?

a. Tick.
b. Mite.
c. Human.
d. Scorpion.

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72. (227) Which type of metamorphosis is a growth cycle that includes four stages: egg, larva, pupa,
and adult?
a. Complete metamorphosis.
b. Incomplete metamorphosis.
c. Gradual metamorphosis.
d. No metamorphosis.
73. (227) Flies, mosquitoes, midges, and punkies belong to which order of insects?
a. Diptera.
b. Coleoptera.
c. Siphonaptera.
d. Hymenoptera.

74. (228) Which mosquito genus deposits its eggs so they are attached together to form rafts that float
on the water?
a. Aedes.
b. Culex.
c. Anopheles.
d. Mansonia.

75. (228) During which stage do mosquitoes abstain from feeding?

a. Egg.
b. Larval.
c. Pupal.
d. Adult.

76. (229) Which disease is sometimes called “breakbone fever”?

a. Western equine encephalitis.
b. Yellow fever.
c. Dengue fever.
d. Malaria.

77. (229) Which mosquitoes are vectors for dengue fever?

a. Aedes.
b. Culex.
c. Mansonia.
d. Anopheles.

78. (229) Which mosquitoes transmit all four forms of malaria?

a. Aedes.
b. Culex.
c. Mansonia.
d. Anopheles.

79. (229) Where do most complications develop when a human is infected with malaria?
a. Liver.
b. Heart.
c. Brain.
d. Spleen.

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80. (230) How far above the ground should New Jersey traps be located to attract the most
mosquitoes?
a. 2 feet.
b. 4 feet.
c. 6 feet.
d. 8 feet.

81. (230) What type of surveillance method uses a paper-towel-wrapped tongue depressor emerged in
a one-pint, black jar that has been half-filled with water?
a. Larva collection site.
b. Ovitrap for mosquito eggs.
c. Artificial resting site for adult mosquitoes.
d. Collection device for mosquitoes in the pupal stage.

82. (231) Which is an example of an environmental control for mosquitoes?

a. Filling in the low-lying areas with dirt.
b. Placing Gambusia minnows in the base pond.
c. Spraying the base with low doses of malathion.
d. Depositing larvacide in the stagnate water areas.

83. (231) Whose responsibility is it to recommend that low-lying areas be filled with dirt to control
mosquitoes?
a. Civil engineer.
b. Base commander.
c. Base medical service.
d. Local mosquito control.

84. (231) Replacing the weather stripping on a door and patching screens are two examples of which
type of mosquito control?
a. Environmental.
b. Biological.
c. Chemical.
d. Cultural.

85. (231) Using young dragonflies to control mosquitoes is an example of which type of pest control?
a. Environmental.
b. Biological.
c. Chemical.
d. Cultural.

86. (232) Approximately how many times per day do body lice feed?
a. One.
b. Three.
c. Five.
d. Seven.
87. (232) What is the best control method for body lice?
a. Chemical.
b. Biological.
c. Personal cleanliness.
d. Regular clothes washing.

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88. (233) Which type of fly is the most common?

a. Sand fly.
b. Black fly.
c. Flesh fly.
d. House fly.

89. (233) The term “maggot” refers to which stage of fly development?
a. Egg.
b. Larval.
c. Pupal.
d. Adult.

90. (234) Which disease is transmitted by fleas?

a. Dengue fever.
b. Leishmaniasis.
c. Malaria.
d. Plague.

91. (234) How is endemic typhus (murine typhus) transmitted?

a. Bite of a flea.
b. Flea eggs laid in an open wound.
c. Feces of a flea rubbed into a wound.
d. Flea vomitus rubbed into an open wound.

92. (235) Which is an example of a hard tick?

a. South coast tick.
b. Balkan deer tick.
c. American dog tick.
d. Rocky Mountain pine ticks.

93. (235) Which disease is a bacterial disease spread by ticks?

a. Tularemia.
b. Spotted fever.
c. Relapsing fever.
d. Colorado tick fever.
94. (235) What do you call the transmission of rickettsial pathogens from adult ticks through the egg
to subsequent larval, nymphal, and adult stages?
a. Chemical transmission.
b. Mechanical transmission.
c. Transovarial transmission.
d. Infection through interrupted feeding.

95. (236) How many legs do larval mites have?

a. Two.
b. Four.
c. Six.
d. Eight.

96. (236) Which type of mite transmits a disease called “Tsutsugamushi disease” or “scrub typhus”?
a. Straw-itch mites.
b. Follicle mites.
c. Rat mites.
d. Chiggers.

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97. (237) What is the most abundant cockroach species in the United States?
a. Oriental cockroach.
b. German cockroach.
c. American cockroach.
d. Brownbanded cockroach.

98. (237) What is the most effective method of controlling cockroaches?

a. Using insecticides.
b. Using roach traps/motels.
c. Practicing good housekeeping.
d. Denying access to food or moisture.

99. (238) What is the vector for Chagas disease?

a. Snakes.
b. Spiders.
c. Scorpions.
d. Kissing bugs.

100. (238) Which type of venom produces raised areas on the skin that may itch or be intensely
painful?
a. Hemorrhagic toxin.
b. Hemolytic toxin.
c. Urticating toxin.
d. Neurotoxin.

101. (239) Which is the largest and most common domestic rat?
a. Roof rat.
b. House rat.
c. Norway rat.
d. Scandinavian rat.
102. (239) Which is the best method of controlling rodents?
a. Cultural.
b. Chemical.
c. Biological.
d. Sanitation and physical.

103. (240) Bubonic plague primarily affects the

a. lungs.
b. heart.
c. lymph nodes.
d. blood stream.

104. (240) Which disease results from either direct or indirect contact with the urine of infected
rodents or other animals?
a. Leptospirosis.
b. Scrub typhus.
c. Tularemia.
d. Plague.

105. (241) What is the most positive proof of a rodent infestation?

a. Sighting a live rodent.
b. Rodent damage to foods.
c. Rodent feces on the floor.
d. Rodent rub marks on a wall.

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106. (241) Swing marks made along a beam under floor joists generally indicate the presence of
which type of rodent?
a. House mouse.
b. Norway rat.
c. Fruit rat.
d. Roof rat.

107. (241) If you powder a floor to survey for tracks, the hind feet prints of a rodent will show
a. three toes.
b. four toes.
c. five toes.
d. six toes.

108. (242) Who conducts the overall entomology program within the Air Force?
a. MTF commander.
b. Civilian contractors.
c. Public Health, with assistance from Bioenvironmental Engineering.
d. Base civil engineer pest management function, with assistance from Public Health.
109. (242) Which type of pest control consists of using predators, pathogens, or genetic engineering
to control arthropods?
a. Biological.
b. Chemical.
c. Cultural.
d. Sanitation and physical.

110. (243) The barrier zone around aircraft returning from overseas must be what size to prevent
insects and rodents from boarding?
a. 10 feet.
b. 25 feet.
c. 50 feet.
d. 100 feet.