Epidemiology – MCQ

1. The World Health Organisation define the maternal mortality ratio as

A. Maternal deaths per 10,000 live births & still births
B. Maternal deaths per 100,000 live births & still births
C. Maternal deaths per 10,000 live births
D. Maternal deaths per 100,000 live births
E. Ratio of maternal deaths to live births

2. Regarding uterine fibroids (leiomyoma) which of the following statements is TRUE regarding their prevalence?

A. The prevalence is highest amongst asian women
B. The prevalence is highest amongst black women
C. The prevalence is highest amongst european women
D. The prevalence is highest amongst white women
E. There is no statistical difference in fibroid prevalence between ethnic groups

3. The World Health Organisation (WHO) define maternal death as

A. The death of a woman whilst pregnant or within 48 hours of termination of pregnancy
B. The death of a woman whilst pregnant or within 7 days of termination of pregnancy
C. The death of a women whilst pregnant or within 14 days of termination of pregnancy
D. The death of a women whilst pregnant or within 42 days of termination of pregnancy
E. The death of a women whilst pregnant or during labour

4. Following a single episode of reduced fetal movements what percentage of pregnancies will be uncomplicated?

A. 98%
B. 90%
C. 70%
D. 50%
E. 25%

5. A study looks at the average systolic blood pressure of patients in antenatal clinic. Out of 200 women the average SBP was 110mmHg and the standard error of the mean was 8mmHg. What is the 95% confidence interval

A. 104.5 to 115.5
B. 94.3 to 125.6
C. 102 to 118
D. 100 to 120
E. None of the above

6. Which of the following reduces the risk of fibroids?

A. Black ethnicity
B. Obesity
C. Taking the Combined Oral Contraceptive Pill
D. Early Puberty
E. Pregnancy

7. Sensitivity is calculated by

A. A/A+B
B. A/A+C
C. B/A+B
D. B/B+D
E. D/B+D

8. A new test for Group B strep has been designed and the results are shown above. Which of the below is the Sensitivity?

A. 0.86
B. 0.93
C. 0.95
D. 0.97
E. 18.6

9. Which of the following tests require the population to be of normal distribution

A. Chi‐squared
B. Mann Whitney U
C. Analysis of Variance
D. Kruskal Wallis
E. Spearman Correlation

10. A 34 year old patient sustains a 3b perineal tear following delivery of her 3rd child. What is the UK incidence of OASIS (obstetric anal sphincter injury) in multiparous women?

A. 1.7%
B. 2.9%
C. 6.1%
D. 11.3%
E. 15.5%

11. Which of the following studies is most appropriate to assess the efficacy of a new medication to reduce pain caused by endometriosis?

A. Randomised Control Trial
B. Longitudinal Study
C. Cohort Study
D. Cross Sectional Analysis
E. Cross Sectional Study

12. Regarding Pulmonary Embolism in Pregnancy which of the following statements is true?

A. PE is the most common cause of maternal death in the UK
B. PE accounts for approximately 25% of maternal deaths in the UK
C. PE mortality is 0.79/100,000 pregnancies in the UK
D. Being overweight (BMI 25‐30) does not increase VTE risk
E. Age >30 is a positive risk factor for VTE when considering thromboprophylaxis

13. A study looked at 40,000 women at a maternity unit in an area with a population of 520,000. The number of identified VTE episodes was 60 with a standard deviation of 20. Using the figures what is the standard error of the mean (SEM)?

A. 0.23
B. 0.076
C. 4.6
D. 0.1
E. 3

14. Regarding Venous Thomboembolism (VTE) in pregnancy which of the following statements is TRUE?

A. Relative risk of VTE in pregnancy is 4 to 6 fold
B. Relative risk of VTE in pregnancy is 2 to 3 fold
C. Incidence of antenatal PE in the UK is 10/10,000 maternities
D. Incidence of antenatal PE in the UK is 3/10,000 maternities
E. Absolute risk of VTE in pregnancy and puerperium is 4‐5/1000

15. Which of the following is the least common cause of maternal mortality

A. VTE
B. Eclampsia
C. Pre‐eclampsia
D. Sepsis
E. Haemorrhage

16. A patient arrives on labour ward she is 37 weeks pregnant. Her last pregnancy ended with delivery via uncomplicated lower segment C‐Section 4 years ago. Contractions are 5 minutes apart and on examination and the cervix is 5cm dilated. She wants to know the risk to the baby of proceeding with vaginal delivery. What is the risk of the infant developing hypoxic ischaemic encephalopathy with VBAC?

A. 2 in 10,000
B. 8 in 10,000
C. 2 in 1,000
D. 8 in 1,000
E. 28 in 10,000

17. A new test for Group B strep has been designed and the results are shown above. Which of the below is the Negative Predictive Value?

A. 0.87
B. 0.93
C. 0.95
D. 0.97
E. 18.6

18. Specificity is calculated by

A. A/ A+C
B. A/ A+B
C. B/ A+B
D. B/ B+D
E. D/ B+D

19. A 26 year old patient sustains a 3b perineal tear following delivery of her 1st baby. What is the UK incidence of OASIS (obstetric anal sphincter injury) in primiparous women?

A. 0.5%
B. 1.7&
C. 2.9%
D. 6.1%
E. 11.%

20. Regarding the table above which of the below formulas would you use to calculate the positive likelihood ratio?

A. A ÷ (A+C)
B. D ÷ (B+D)
C. (A/A+C) ÷ (1 ‐ (D/B+D))
D. (1 ‐ (A/A+C)) ÷ (D/B+D)
E. A ÷ (A+B)