5th Evaluation

Topics:
 Community Diagnosis 2 (Dr. Marlene R. Checa)
 Community Diagnosis 3 (Dr. Djhoanna Pedro)
 Community Diagnosis 4 (Dr. Jeriel De Silos)
 Community Diagnosis 5 (Dr. Jeriel De Silos)
 Acute Respiratory Infection (ISP)

QUESTIONS RATIONALIZATION

CDX 2: MEASURE OF HEALTH AND DISEASES IN A POPULATION (Dr. Marlene R. Checa)

Projected Population 2020 2025 2030

Total 109,949 117,959 125,337

Male 55,461 59,494 63,201

Female 54,487 58,465 62,135

Live Births 5,650 6,302 5,908

0 – 4 years old 11,476 11,361 11,043

0 – 14 years old 33,311 33,909 33,630

15 – 64 years old 70,572 76,379 82,147

65 years and over 9,509 11,717 14,246

Female 15 – 49 years old 28,267 30,253 32,142

1. The General Fertility Rate (GFR) for the ANSWER: C

projected year 2020 is:

A. 15%
B. 17%
C. 20%
(5,650/28267)(1000) = 20%
D. 23%

2. The General Fertility Rate (GFR) for the ANSWER: D

projected year 2030 is:
(5908/32142)(1000)= 18%
A. 10%
B. 13%
C. 16%
D. 18%

3. The General Fertility Rate (GFR) for the ANSWER: A

projected year 2025, as compared to the projected
year 2030 is_____. 20% > 18%

A. Higher
B. Lower
C. The same
D. Cannot be determined

4. The Crude Birth Rate (CBR) for the projected ANSWER: A

year 2025 is:
(6302/117959)x1000 =5%
A. 5%
B. 8%
C. 10%
D. 12%

5.The Crude Birth Rate (CBR) for the projected ANSWER: B

year 2030 is:
(5908/125337) x 1000= 5%
A. 3%
B. 5%
C. 7%
D. 10%

6. Which of the following factors does NOT ANSWER: B

contribute to population aging?
Keyword: Population ageing = pagtanda
A. Increase in life expectancy
B. Increase in mortality A. Increase life expectancy would result to
C. Decline in fertility increase ageing. Life expectancy is defined as
D. Increased rates of childhood vaccination "how long, on average, a newborn can expect to
live, if current death rates do not change."
B. Increase in mortality means increase in people
who die of illness, etc. (vs. morbidity =
illness/sick), thus DECREASING population
ageing; should be DECREASE in mortality
C. Decline in fertility is accompanied with
lengthening life expectancy by shifting relative
weight from younger to older groups; PRIMARY
DETERMINANT OF POPULATION AGEING
D. Increased rates of childhood vaccination will
contribute to population ageing because
vaccinations will prevent children from contracting
the disease, maximizing their chances to LIVE
LONGER

7. The dependency ratio is the ratio of the: ANSWER: B

A. Young to working aged people

B. Young and old to working-aged people
C. Young to middle age people
D. Old to middle aged peopl
E. Young to old people
8. Natural increase is:
A. The difference between the number of
births and the number of deaths
B. The sum of the number of births and the
number of deaths
C. The difference between the number of
immigrants and the number of emigrants
D. The sum of the number of immigrants and
the number of emigrants
9. A population pyramid with a wide base
narrowing as the age increases indicates
______ in the total population.
A. Decline
B. Rapid growth
C. Slow growth
D. Stability
10. Population projections are:
A. Suitable as predictions
B. Based on assumptions for the future using
current data
C. Used for assessing crude death rates
alone
D. Used for countries with annual consensus
ANSWER: A
Keywords: Natural, decrease
Natural = caused by nature
Decrease = difference
Based on the keywords above, we can eliminate
letters B and D. We are now left with either A or C.
Among A and C,which is more natural? The
answer is A since birth and death are considered
such.
"Natural decrease is the difference between the
number of births and the number of deaths in a
population."
ANSWER: B
"Stationary" pyramid - percentages of the
population remains constant over time. Population
contains equal birth rates and death rates.
"Expansive" pyramid - Population pyramid that
very wide at the younger ages, characteristic of
high birth rate and low life expectancy. Population
is fast-growing, and the size of each birth cohort
gets larger than the size of the previous year.
"Constrictive" pyramid - Population pyramid that
is narrowed at the bottom. Population is generally
older on average, as the country has long life
expectancy, low death rate, and low birth rate.
ANSWER: B
Keywords: Population, projection
"Population projections are calculations of future
birth rate, death rate and migration of
population based on their past and present
conditions. They are neither predictions, nor
forecasts, nor estimates. Rather they are in
 between predictions and forecasts."

According to UN study, "Population projections

are calculations which show the future course of
fertility, mortality and migration. They are in
general purely formal calculations, developing the
implications of the assumptions that are made."

11.Population growth slows down only when: ANSWER: A

A. Birth rates are low

B. Death rates are high
C. Both birth rates and death rates are low
D. Both birth rates and death rates are high

12.The statistic is used to estimate the risk of ANSWER: A

acquiring a disease, it may be measured as a rate
or a proportion. Incidence - Number of persons in a population
that developed a disease (new cases) during
A. Incidence specified period
B. Prevalence
C. Ratio “Acquiring” = new cases

13. This statistic describes the probability that ANSWER: B

someone selected at random from the population
will have the disease in question. Incidence - Number of persons in a population
that developed a disease (new cases) during
A. Incidence specified period
B. Prevalence
C. Ratio Prevalence - Measures the proportion of existing
D. Risk cases of a disease in the population at a specified
period of time
Answers the question: What proportion of the
population are ill with a particular disease?

Ratio - A relative number expressing the

magnitude of one occurrence or condition in
relation to another

Risk - A measure of the frequency with which an

event occurs in a defined population in a defined
time

14. In a certain locality in Quezon Province where ANSWER: C

they did not require chicken pox vaccination, a
boarding house where certain students/boarders The denominator should include the population at
are staying, experienced a prolonged outbreak of risk. The boarders were already at risk on
varicella among its boarders that began in September since they started living at the
September and continued through December. To boarding house on that month.
calculate the probability or risk of illness among
the students, which denominator would you use?

A. Number of susceptible students at the

ending of the period (i.e., December)
B. Number of susceptible students at the
 midpoint of the period (i.e., late
October/early November)
C. Number of susceptible students at the
beginning of the period (i.e., September)
D. Average number of susceptible students
during outbreak

15. Sustainable Development Goals (SGD) Goal 3 ANSWER: D

governs what concern?
SGD3: Ensure healthy lives and promote well-
A. Gender equality being for all at all ages
B. Clean water and sanitation
C. No poverty
D. Good health and well being

16. The denominator used in computing for Period ANSWER: B

Prevalence is

A. Total population at a given point in time

B. Midyear population
C. Total population
D. Population at risk

17. In a standard population pyramid the age ANSWER: A

range of each bar is
Waley siya sa trans so I used the internet and
A. 5 years here’s what I found. Sabay sabay tayong
B. 10 years magbilang 0 1 2 3 4 (0-4), 5 6 7 8 9 (5-9) and so
C. 15 years on. So ilan yan diba 5? Kaya 5 years
D. 20 years

Ref:
https://www.populationeducation.org/content/what
-population-pyramid

18. Defined as the measure of the proportion of ANSWER: C

existing cases of a disease in the population at a
specified period of time.
 A. Incidence
B. Ratio
C. Prevalence
D. Rate

19. In computing for the Case Fatality Rate, the ANSWER: D

denominator being used is

A. Total number of deaths

B. Total population
C. Number of deaths from a particular
disease
D. Number of cases of same disease

20. The denominator used in computing for the ANSWER: C

Incidence Rate is

A. Midyear population
B. Number of cases of same disease
C. Population at risk
D. Total population

CDX3: INTERNATIONAL REFERENCE STANDARDS (Dr. Djhoanna Pedro)

FOR NUMBERS 21 – 27, REFER TO THE CASE BELOW:

Caleb, born to a 25 y.o. G3 P2 (2,0,1,2) mother, was voted by the Barangay Health Workers during
Operation Training (OPT) in their barangay. The following results were noted and observed:
Birthdate: May 2, 2015
Birthplace: Barangay Health Center/Lying-in
Wt: 7.5 kgs
Ht: 80 cms

21. What is Caleb’s nutritional status in terms of ANSWER: A

Weight-for-Height?
Weight: 7.5 kgs
A. Severely wasted Height: 80 cms
B. Wasted
C. Normal Using the weight-for-age growth chart, simply
D. Overweight locate the given weight and age on the chart and
E. Obese interpret.

22. What is Caleb’s nutritional status in terms of ANSWER: A

Length-for-Age?
Using the weight-for-age growth chart, simply
A. Severely wasted locate the given weight and age on the chart and
B. Wasted interpret.
C. Normal
D. Overweight
E. Obese
23. Based on weight-for-age measurement, what ANSWER: A
is Caleb’s nutritional status?
Using the weight-for-age growth chart, simply
A. Severely underweight/wasted locate the given weight and age on the chart and
B. Underweight/wasted interpret.
C. Normal
D. Obese

The Municipal Health Officer (MHO) plotted the weight and height of Caleb from the previous OPT
activities, and the results are as follows:

DATE WEIGHT HEIGHT AGE IN MONTHS

5 -26 – 2017 7.0 kgs 78 cms
7 – 26 – 2017 7.1 kgs 79 cms
8 – 26 – 2017 6.9 kgs 79.5 cms

24. A flat growth curve was noted when Caleb’s ANSWER: D

previous weights were plotted, and interpreted as:

A. Manifestation of poor growth needing

special attention for correct intervention
B. The child is losing weight and needs
immediate help because he/she may be
suffering from a congenital defect or
chronic condition
C. Child is “obese”, and early precaution is
needed for the child to grow with normal
weight.
D. Manifestation that the child is not gaining
weight and stopped growing.

25. What nutritional assessment index should the ANSWER: A

MHO use to measure the past and long-term
nutritional status and/or adverse environment of
Caleb?

A. Height/Length-for-age
B. Weight-for-age
C. Weight-for-height
D. Head circumference
E. Body Mass Index-for-age

26. What nutritional assessment index should be ANSWER: C

the MHO use if he wants to measure the present
nutritional status of Caleb? This nutritional Weight for Height/ Weight for Length
Assessment Index can quantify undernutrition - Current malnutrition (acute) from past
along with overweight and obesity in children? malnutrition (chronic)
- Wasted or thin child from a child who
A. Length for age may be light in weight because he/she is
B. Weight for age short but currently healthy
C. Weight for height - Assess level of fatness of the child who
D. Body mass index for age may be heavy in weight but currently short
in length or height
- Assessment of the nutritional status when
exact age of the child is not known
Length for Age
- Will estimate past and chronic malnutrition
Weight for Age
- Basic and simplest among the indicators
- Assess body mass
- Indicator of current nutritional status

27. A physical examination was done to Caleb, ANSWER: B

and the following were noted: pallor, spooning of
nails and sore mouth and tongue. What is Caleb’s Iron deficiency
nutritional deficiency? (Diagnosis) - Pallor, spooning of nails, sore mouth and
tongue
A. Vitamin B deficiency Vitamin B deficiency
B. Iron deficiency - Follicular hyperkeratosis, flaking
C. Vitamin A deficiency dermatitis, pallor, photophobia
D. Protein deficiency Vitamin A deficiency
- Night blindness, xerophthalmia,
photophobia, leukoplakia, bleeding and
spongy gums, corkscrew coiled hair
Protein deficiency
- Transverse lines of nails, glossitis, easy to
pull out hair

28. On follow-up examination of Caleb, the ANSWER: B

following signs were observed: glossitis, stomatitis
and pigmentation on his skin-truncal and facial Niacin deficiency
area. What is Caleb’s nutritional deficiency? - Glossitis, stomatitis, pigmentation on his
(Diagnosis) skin-truncal and facial area
Vitamin C deficiency
A. Vitamin C deficiency - Bruising, purpura, follicular
B. Niacin deficiency hyperkeratosis, sore mouth and tongue,
C. Zinc deficiency bleeding and spongy gums
D. Protein deficiency Zinc deficiency
- Flaking dermatitis
Protein deficiency
- Transverse lines of nails, glossitis, easy to
pull out hair

FOR NUMBERS 29-36, REFER TO THE CASE BELOW:

Marikit, born to a 20 y.o. G2P2 (2002) mother via VS on Sept. 14, 2012. The following data were
gathered during the Operation Timbang.

Weight: 13.5 kgs

 Height: 97 cms

29. What is Marikit’s nutritional status in terms of ANSWER: C

weight for height?
Please be familiar on how to locate the weight for
A. Severely wasted height using the appropriate growth chart. :)
B. Wasted
C. Normal
D. Overweight
E. Obese

30. What is Marikit’s nutritional status in terms of ANSWER: B

length for age?
Please be familiar on how to locate the length for
A. Severely stunted age using the appropriate growth chart. :)
B. Stunted
C. Normal
D. Tall

31. Based on the weight-for-age measurement, ANSWER: B

what is Marikit’s nutritional status?
Using the weight-for-age growth chart, simply
A. Severely underweight/wasted locate the given weight and age on the chart and
B. Underweight/wasted interpret.
C. Normal
D. Obese

32. The Municipal Health Officer (MHO) plotted ANSWER: B

the weight and height of Marikit from the previous
OPT activities. An Outside the Lower Reference A - This would show a falling growth curve (think
Line Curve (-25D) was noted… of “poor growth” = falling curve)

A. Manifestation of poor growth needing
special attention for the correct
intervention
B. The child is losing weight and needs
immediate help because he/she may be
suffering from a congenital defect or
chronic condition.
C. Child is “obese”, and early precaution is
needed for the child to grow with normal
weight.
D. Manifestation that the child is not gaining
weight and has stopped growing.
B - This is the correct answer, as this would show
what has been described in the question, which is
an outside the LOWER reference line (think of the
lower reference line being the limit for the lowest
weight a child can have… so if the line goes even
lower, then you get a child who is losing weight)
C - Would show an outside the UPPER reference
line (think of the upper reference line being the
limit for the highest weight a child can have… so if
the line goes even higher, then you get a child
who is obese or is gaining weight)

D - Would show a flat curve (always think of

“stopped growing” if the line is flat)

33. The MHO would like to identify if Marikit’s ANSWER: B

growth is faltering, or if she has acute infection.
What nutritional assessment index should be
used?
A. Length-for-age
A - Length-for-age, also known as Height-for-age,
can also be used as an indicator of growth (it is a
good indication of stunting), so you may think that
this is the answer, BUT this is a less sensitive
 B. Weight-for-age indicator of current nutritional status than Weight-
C. Weight-for-height for-age… SO THIS IS NOT THE BEST ANSWER!
D. Body Mass Index-for-age
E. Head circumference B - Correct/Best answer, because it is an indicator
of current nutritional status & assesses body
mass

C - Mainly used for current malnutrition vs. past

malnutrition; for comparing wasted/thin child vs.
child who is simply light in weight because he is
short but is currently healthy; for assessing level of
fatness in a child who may be heavy but currently
short in height; and for assessment of nutritional
status when exact age of child is not known

D - Used to screen for over- or undernutrition

E - Can also be used to monitor growth, but not

the best way compared to growth chart
measurements/ratios

34. If the MHO would like to quantify the degree of ANSWER: D

under-or-over nutrition of Marikit, and monitor and
evaluate changes in her nutrition over time, what Refer to ratio for #33
nutritional assessment index should the MHO
use?

A. Length-for-age
B. Weight-for-age
C. Weight-for-height
D. Body Mass Index-for-age
E. Head circumference

35. On physical examination, Marikit was found to ANSWER: C

have flaking dermatitis on her lower extremities,
spare and thin hair which can also be easily pulled The question presented us with clinical signs of
out, and presence of transverse line on her nails. nutritional deficiency pertaining to Marikit’s skin,
What is Marikit’s nutritional deficiency? hair, and nails, so let us focus on that for the ratio:

A. Vitamin A deficiency A - Vit. A deficiency can also present with flaking

B. Vitamin B deficiency dermatitis, BUT it would present with corkscrew-
C. Protein deficiency coiled hair
D. Iron deficiency
E. Niacin deficiency B - Vit. B deficiency, specifically Vit. B2 deficiency,
can also present with flaking dermatitis, BUT it
would NOT manifest as spare and thin hair that
can be easily pulled out

C - This is the best answer, since it hits all the

points from the question. Protein deficiency
presents with flaking dermatitis, spare and thin
hair that can easily be pulled out, and nails with
transverse lines

D - Iron deficiency would present with SPOONING

 of nails, NOT nails with transverse lines. Also, the
patient should be pale (pallor), NOT have flaking
dermatitis.

E - Niacin deficiency would present with

pigmentation and desquamation of the skin.

36. On follow-up examination, the Medical Health ANSWER: D

Officer noted that Marikit is pale, with some non-
traumatic bruises and purpura on the upper and Vitamin A deficiency: corkscrew/coiled hair,
lower extremities and back, and presence of bleeding and spongy gums, night blindness,
bleeding and spongy gums. What is Marikit’s xerophthalmia, photophobia, conjunctival
nutritional deficiency? inflammation, flaking dermatitis
Vitamin C deficiency: corkscrew/coiled hair,
A. Vitamin A Deficiency bleeding and spongy gums, sore mouth and
B. Vitamin C Deficiency tongue, follicular hyperkeratosis, bruising and
C. Niacin Deficiency purpura
D. Folic Acid Deficiency Niacin deficiency: glossitis, bleeding and spongy
gums, angular stomatitis, cheilitis and fissured
tongue, leukoplakia, sore mouth and tongue,
pigmentation and desquamation, flaking dermatitis
Folic acid deficiency: glossitis, bleeding and
spongy gums, leukoplakia, sore mouth and
tongue, pallor, bruising and purpura

37. During the Community Diagnosis data ANSWER: D

collection, what method was used to assess the
nutritional status of children 0 – 71 months? Recall immersion experience. Salter scale and
tape measure lang naman dinala natin.
A. Clinical methods
B. Dietary evaluation methods
C. Biochemical, laboratory methods
D. Anthropometric methods

38. During the CDX data collection, a 4-month old ANSWER: E

infant is to be assessed for nutritional status, what
anthropometric measure should you use to screen Length-for-age
for congenital or genetic disorder? - good indication of stunting
- will estimate past & chronic malnutrition
A. Length-for-age - less sensitive indicator of current nutritional
B. Weight-for-age status than weight-for-age
C. Weight-for-height Weight-for-age
D. Body Mass Index-for-age - Assesses body mass
E. Head circumference - indicator of current nutritional status
Weight-for-height
- Most common indicators for measuring
growth or body size
- current malnutrition (acute) from past
malnutrition (chronic)
- wasted or thin child from a child who may
be light in weight because he/she is short
- assess level of fatness of the child who
may be heavy in weight but currently short
in length or height
- assessment of the nutritional status when
 exact age of the child is not known but
currently healthy
Body Mass Index-for-age:
Head circumference: used to screen for
congenital or genetic disorder

39. Identify the nutritional assessment of a 71- ANSWER: C

month old, male in your community/block, with
height of 107 cms and weight of 28 kgs. Consult table

A. Overweight/Obese and stunted

B. Overweight/Obese and Tall
C. Overweight/Obese and Normal height
D. Overweight/Obese and severely stunted

40. To assess the body composition or total body ANSWER: D

fat of the above child in your community, what
method should you use? All the other choices are available only in the
hospitals and cannot be used during community
A. Body scan or DXA diagnosis.
B. Ultrasound
C. Magnetic Resonance Imaging (MRI)
D. Skinfold thickness

CDX 4: WHO CRITERIA FOR HEALTH PROBLEM PRIORITIZATION (Dr. Jeriel De Silos)

FOR NOS. 41 – 45. REFER TO THE CASE BELOW:

Based on the last year’s health data, the town of turing registered the most number of dengue cases in
the entire country. On that same year, the mayor of turing commissioned his city councilors to formulate
a policy that will enable the creation of multiple health programs and strategies to address dengue and
its vector. The concerted effort of the mayor and his councilors was effective in decreasing the cases of
dengue in just a span of few months.

Meanwhile, scabies is one of the common causes of clinical results in turing, particularly among poor.
In fact, scabies is so common in turing that the people here thought that this skin disease is necessary
to boost the immaturity of their children against future illnesses.

The rainy season had already started in turing, and though there already programs against dengue, the
people are still cautious and vigilant for possible dengue cases in their community.

Right now, the mayor of turing has two major health issues: sustaining the programs on dengue and
solving the high prevalence of scabies. As the new health consultant in Turing, the mayor asked for
your help on how to handle his current dilemma.

The table below shows the WHO criteria matrix that you presented to the mayor in one of your
meetings:

Problem Magnitude of Vulnerability Social Existing Score

the Problem to Concern Policy
Technology

Dengue 1 3 3
 Scabies 3 1 0

Scale: 0 = none, 1 = low significance, 2 = moderate significance, 3 = high significance

41. The column for “vulnerability to technology” is ANSWER: D

currently empty. What information will you
consider or investigate before filling up the said
table?

A. Availability of effective technology

B. Feasibility of using technological devices
in the area
C. financial capacity of the government to
fund and maintain medical devices
D. all of the above

42. While the magnitude of the problem for ANSWER: B

scabies is high, it was rated low for social concern
due to the fact that many of the residents of Turing This can be answered by analyzing the problem
considered having scabies as a part of their life. given. It can be seen that even though scabies is
What is the possible cause of the mismatch prevalent in the area, it has low rate for social
between the actual magnitude of the problem and concern due to the fact that the people living there
the community’s perception? are not well equipped with proper knowledge
regarding scabies.
A. Insufficient medicines
B. Lack of information (health education)
about scabies
C. The government is too preoccupied on
dengue cases
D. The rating for social concern is not correct

43. Though the cases of dengue in the community ANSWER: D

is way lower compared to the data last year, it was
still rated high for “Social Concern”. What could be
the reason/reasons for trend?

A. Negative experience of the community vs.

dengue
B. Increased awareness of the community
from the anti-dengue campaign of the city
government
C. The community is active in vector control
and monitoring potential cases All of the choices mentioned pertain to social
D. All of the above concern.

44. The final scores in the WHO Criteria will help
you and the mayor in prioritizing health problems
in the city. How is the score interpreted?
A. Problems with high scores in the criteria
should be addressed last
B. Low scoring health problems should be
totally ignored
ANSWER: C
There is a direct relationship between the score
and level of priority when it comes to the WHO
criteria. The health problem with the highest score
will be the top priority in budget and time.
Additional info: There is an inverse relationship
 C. The highest-scoring health problem must between Scale score and Vulnerability to
get the highest priority in terms of budget Technology and Existing Health Policy. When
allocation and time there is High Technology and Existing High Policy,
D. All of the above there is low scale score (low priority)

45. Which of the following is true about the scoring ANSWER: A

system used in the WHO Criteria above?

A. Grading magnitude of the problem relies

on available health data like incidence and
prevalence.
B. The grading for existing health policies
relies on the availability of laws, programs
and projects for a certain illness only. The
manner and effectiveness of
implementation is not important in
analyzing these criteria.
C. The ranking system is an objective way of
measuring the significance of addressing
certain health problems in the community.
D. All of the above

CDX 5: DATA MANAGEMENT AND VISUALIZATION (Dr. Jeriel De Silos)

FOR ITEMS 46 – 50, SELECT THE BEST CHOICE:

A. Frequency Distribution Table

B. Cross/ Pivot Table
C. Bar Graph
D. Histogram
E. Boxplot

46. Used to visualize outliers, the median and ANSWER:

quartiles
46. E
47. Used for visualizing categorical data
47. C
48. Useful for counting and organizing raw data
48. A
49. This tool is useful for illustrating relationships
between two variables 49. B

50. Frequency distribution can also be 50. D

summarized into a _______
Frequency Distribution Table: Organized
tabulation showing exactly how many individuals
are located in each category on the scale of
measurement

Cross Table: One way of assessing the

relationship between two variables. A table based
on 2 variables where the cell entries are the
counts or percentages of cases that fall in that row
or column category.
 Bar Graph: A graph wherein separate but related
items are represented by rectangular shapes
called bars. It is useful when your data is classified
in non-numeric categories

Histogram: A type of bar chart that shows the

frequency distribution of data at a regular interval

Boxplot: Method for showing numeric data in

terms of quartiles. Suitable for comparing range
and distribution for groups of numerical data.

FOR ITEMS 51 – 60, INTERPRET THE BOXPLOT:

51. What is the median value for tips given during ANSWER: A
dinner?
The boxplot of concern is located on the RIGHT.
A. 3.25 The horizontal line inside the box is the median
B. 2.00 value and this answer is the closest when we try
C. 4.25 to trace the line towards the numbers on the left.
D. 10.00

52. What is the median value for tips given during ANSWER: A
lunch?
The boxplot of concern is located on the LEFT.
A. 2.25 The horizontal line inside the box is the median
B. 4.00 value and this answer is the closest when we try
C. 5.75 to trace the line towards the numbers on the left.
D. 10.00

53. Which of the following boxplot portions are ANSWER: A

equal for both the tips given during
lunch and dinner? The most bottom part of the box is the 1st quartile,
the middle part is the median, and the upper part
A. 1st Quartile of the box is the 2nd quartile. The portions in
B. 2nd Quartile which the boxes have the same value is at the first
C. 3rd Quartile quartile in which their lines correspond to the
D. Interquartile Range same value when traced to the numbers of the left
side. In this case, their 1st quartiles have the
same value.

54. How many outliers are present in the boxplot ANSWER: C

for dinner?
The boxplot of concern is located on the RIGHT.
A. 2 The outliers are values not located on the box nor
B. 7 the whiskers (the extending vertical lines outside
C. 5 the box). In this case, there are 5 diamonds which
D. 0 represent the outliers that can be found above the
whiskers.

55. How many outliers are present in the boxplot ANSWER: A

for lunch?
The boxplot of concern is located on the LEFT.
A. 2 The outliers are values not located on the box nor
B. 7 the whiskers (the extending vertical lines outside
C. 5 the box). In this case, there are 2 diamonds which
D. 0 represent the outliers that can be found above the
whiskers.

56. What is the interquartile range of the dinner ANSWER: A

category?
The boxplot of concern is located on the RIGHT.
A. 1.75 Interquartile Range (IQR) = Q3 − Q1
B. 5.50 Q1 (1st Quartile): median of first half
C. 6.00 Q3 (3rd Quartile): median of second half
IQR = 3.75 - 2
= 1.75

57. The maximum amount of tip in the dinner ANSWER: A

category is _________.
The boxplot of concern is located on the RIGHT.
A. 10 10 is the largest number in the data (the highest
B. 7.50 value including outliers)
C. 6

58. The maximum amount of tip in the lunch ANSWER: B

category is _________
The boxplot of concern is located on the LEFT.
A. 5.25 6.80 is the largest number in the data (highest
B. 6.80 value including outliers)
C. 10

59. The 2nd quartile is always equal to the ANSWER: A

____________.
2nd quartile (Q2) is the 50th percentile which is
A. Median also the median
B. Mean
C. Interquartile range
D. Upper limit

60. The line inside the boxplot represents the ANSWER: D

_____________. The ends of the box are at Q1 and Q3 (25th and
75th percentile) while the line through the box is at
A. Median Q2/median/50th percentile
B. Mean
C. 2nd quartile
D. A and C
E. All of the above

ACUTE RESPIRATORY INFECTION

61. Which of the following statement/s is/are true ANSWER: D

about the Integrated Global Action Plan for
Pneumonia and Diarrhea (GAPPD)?
A. It is intended primarily for national
governments and their partners
B. It does not present a change of direction
in terms of what needs to be done.
C. It recognizes that community-level groups
and individuals will be critical
for effective implementation of the
strategy
D. All of the choices are correct
Statement A is correct since the GAPPD is
intended for National Governments and their
partners
Statement B is correct because the GAPPD only
provides an integrated framework for preventing
morbidity and mortality from Pneumonia and
Diarrhea. It admits that effective interventions are
already established but these meaures are not
being utilized or promoted to be optimally
effective.

Statement C is also correct since the GAPPD

recovnizes the importance of the involvement of
stakeholders and other groups.

Source for 61-65: GAPPD Executive Summary

62. Which of the following is a specific goal of the ANSWER: A

GAPPD by 2025?

A. Reduce mortality from pneumonia in

children less than 5 years of age to
fewer than 3 per 1000 live births
B. Reduce the incidence of severe
pneumonia by 85% in children less than 5
years of age compared to 2010 levels.
 C. Reduce by 50% the global number of
children less than 5 years of age who are
stunted compared to 2010 levels.
D. Reduce the incidence of severe diarrhea
by 85% in children less than 5 years of
age compared to 2010 levels.

63. To achieve the goals of the GAPPD, which of ANSWER: E

the following targets will need to be maintained or
reached by the end of 2025?

A. 90% full-dose coverage of each relevant

vaccine
B. 90% access to appropriate pneumonia
and diarrhea case management
C. At least 50% coverage of exclusive
breastfeeding during the first 6
months of life
D. Virtual elimination of pediatric HIV
E. All of the choices

64. Based on the GAPPD, which of the following ANSWER: B

interventions reduces the incidence of pneumonia
by 23%

A. Vaccination against measles

B. Exclusive breastfeeding for six months
C. Adequate complimentary feeding among
children 6 – 23 months
D. Vaccination against Hib
65. Based on the GAPPD, which of the following ANSWER: B
is/are interventions to PREVENT pneumonia?

A. Improved care seeking and referral

B. Reduction in household air pollution
C. Adequate complimentary feeding among
children 6 – 23 months
D. Continued feeding
E. All of the choices

66. Based on the GAPPD, which of the following ANSWER: A

is/are interventions to PROTECT
children from pneumonia?
A. Exclusive breastfeeding for six months
B. Vaccination against measles, pertussis,
Hib, and PCV
C. HIV preventions
D. Handwashing with soap
E. All of the choices
Interventions to PROTECT children from
pneumonia:
● Exclusive breastfeeding for 6 months
● Adequate complementary feeding
● Vitamin A supplementation
The remaining choices are to PREVENT children
from having pneumonia.

Source: Ending-Preventable-Child-Deaths-from-
Pneumonia-and-Diarrhoea-by-2025.pdf

67. Which of the following is/are key action/s ANSWER: D

needed to implement coordinated country work on
pneumonia? Only letter D was correct. The remaining
statements had 1 or more incorrect word/s. Listed
A. Develop different indicators for tracking below are the key action/s needed to implement
progress coordinated country work on pneumonia.
B. Develop an exclusive overall work plan
C. All interventions should be given
emphasis
D. Apply lessons from other integrated
disease prevention and control efforts
E. All of the choices
 Source: Ending-Preventable-Child-Deaths-from-
Pneumonia-and-Diarrhoea-by-2025.pdf

68. This vaccine has a potential effectiveness of ANSWER: D

30% in reducing overall childhood mortality from
pneumonia. “Hib vaccine reduces radiologically confirmed
pneumonia by 18%; 23 – 35% reduction in
A. Measles vaccine incidence of radiological pneumonia for PCV;
B. Pertussis vaccine reduction in very severe rotavirus infection by
C. Hib vaccine 74%; potential effectiveness of 30% for PCV in
D. Pneumococcal conjugate vaccine reduction of overall childhood pneumonia
mortality”
Source: Ending-Preventable-Child-Deaths-from-
Pneumonia-and-Diarrhoea-by-2025.pdf
69. Child deaths with pneumonia have the highest ANSWER: D
incidence in __________.
“Most child deaths from pneumonia and diarrhoea
A. Sub-Saharan Africa occur in the world’s poorest regions – with nearly
B. South Asia 90% in sub-Saharan Africa and South Asia.”
C. Latin America
D. Sub-Saharan Africa and South Asia Source: Ending-Preventable-Child-Deaths-from-
E. South Asia and Latin America Pneumonia-and-Diarrhoea-by-2025.pdf

70. Which of the following are the two most ANSWER: D

common cause of bacterial pneumonia?
“Use of vaccines against Streptococcus
A. Haemophilus influenzae and Klebsiella pneumoniae (Spn) and Haemophilus
pneumoniae influenzae type b (Hib), the two most common
B. Mycoplasma pneumoniae and bacterial causes of childhood pneumonia, and
Streptococcus pneumoniae against rotavirus, the most common cause of
C. Klebsiella pneumoniae and Mycoplasma childhood diarrhoea deaths, substantially reduces
pneumonia the disease burden and deaths caused by these
D. Haemophilus influenzae and infectious agents, as evidenced by countries that
Streptococcus pneumoniae have introduced these vaccines.”

Source: Ending-Preventable-Child-Deaths-from-
Pneumonia-and-Diarrhoea-by-2025.pdf

71. Lily, three years old, tested positive for HIV ANSWER: B
infection. At present, Lily is doing fine and remains
to be asymptomatic. In order for her to avoid Cotrimoxazole prophylaxis for HIV-infected
acquiring pneumonia, what prophylaxis children can cause a 33% reduction in AIDS-
medication should you give? related deaths.

A. Amoxicillin
B. Cotrimoxazole
C. Chloramphenicol
D. Fluconazole

72. Which of the following condition will increase ANSWER: B

the risk of acquiring pneumonia in children?
A is wrong because undernourished children are
A. Obesity more prone to acquiring pneumonia. Allergic
B. Exposure to parental smoking rhinitis was not stated as a risk factor.
C. Allergic rhinitis
D. All of the choices are correct RISK FACTORS
● Children and infants with compromised
immune systems have weakened
defenses
● Undernourished children, particularly
those not exclusively breastfed or with
inadequate zinc intake
● Children and infants with other illnesses,
such as AIDS or measles
● Environmental factors: living in crowded
homes and exposure to parental
smoking or indoor air pollution
73. Juliana, 11-month-old, was brought to your
clinic due to five days of cough. He is able to drink
without vomiting. He has not had any episode of
convulsion. Physical examination revealed the
following findings: HR: 90, RR_ 48, T: 37.4OC.
There is absence of retraction and adventitious
sounds. Classify the severity of the disease based
on the IMCI.
ANSWER: A
Vital signs are normal, patient only presents with
cough. She does not present with any of the
warning signs of pneumonia. Based on the IMCI,
she does not have any general danger signs
either. Refer to image below for IMCI classification
:)

A. No pneumonia Common symptoms of pneumonia in children and

B. Pneumonia infants:
C. Moderate pneumonia ● Rapid or difficult breathing
D. Severe pneumonia ● Cough
● Fever
● Chills
● Headache
● Loss of appetite
● Wheezing

Signs of severe pneumonia in children/infants:

● Struggle to breathe
● Chest indrawing
● Convulsions
● Unconsciousness
● Hypothermia
● Lethargy
● Feeding problems
74. For a child with cough or cold, advise the ANSWER: C
mother to return immediately once the child has
which of the following condition? Chest indrawing is a sign of SEVERE
PNEUMONIA and would warrant immediate
A. Decreased appetite consult (refer to #73).
B. Nasal congestion
C. Chest indrawing
D. Sore throat

75. Ram, two years old, was brought to your clinic ANSWER: B
due to cough. You advise his mother to observe
for fast breathing. To help Ram’s mother identify Fast breathing
fast breathing, you told her that Ram is breathing ● If the child is 2-12 months old
fast if he has ________breaths per minutes or ○ 50 breaths per minute or more
more. ● If the child is 12 months-5 years old
○ 40 breaths per minute or more
A. 30
B. 40 Source: WHO Manual for the Health Care of
C. 50 Children in Humanitarian Emergencies
D. 60

76. Twelve month-old Jayson was rushed to your ANSWER: B

clinic due to breathing difficulties. After thorough
examination, you diagnosed Jayson with
Pneumonia. Based on the IMCI, what should be
your management for this case?

A. Refer urgently to a hospital

B. Give Amoxicillin for 5 days
C. Give Cotrimoxazole for 5 days
D. Administer IV Antibiotics
E. None of the choices is correct
77. Pol, five years of age, has been coughing for ANSWER: C
seven days. He has not had any episode of
vomiting, convulsion and drowsiness. He has a Refer to #76
temperature of 37.9° C and a respiratory rate of
47 breaths per minutes. You decided to treat Pol
on an out-patient basis. Based on the IMCI, when
should his follow-up be?

A. After seven days

B. After five days, if not improving
C. After three days
D. After completion of medication

78. Four month-old Mara was brought to your ANSWER: C

clinic due to difficulty of breathing. She has been
coughing for three days, is very irritable and is  Streptococcus pneumonia- most common
drinking poorly Family history reveals that her cause of bacterial pneumonia in children;
parents are immunocompromised and have been leading pathogen in almost all studies
taking anti-retroviral drugs due to acquired around the world
immunodeficiency disorder. What is the most  Haemophilus influenzae type b (Hib)-
common etiologic agent of pneumonia in this second most common cause of bacterial
case? pneumonia
 Respiratory syncytial virus- most common
A. Streptococcus pneumoniae viral cause of pneumonia
B. Haemophilus influenza type B  Pneumocystis jiroveci- most common
C. Pneumocystis jiroveci cause of pneumonia in
D. Respiratory syncytial virus immunocompromised infant; responsible
for one quarter of all pneumonia deaths in
HIV-infected infants

79. Gelo, 24 months old, was diagnosed with ANSWER: D

Pneumonia and was prescribed with oral
amoxicillin. His mother was very compliant in Refer to #76
giving medications. After two days, he followed-up
and was observed to be eating less. A high pitch,
predominantly inspiratory sound can now be
heard. Based on the IMCI, what should be the
most appropriate measure to do?

A. Increased the dose of amoxicillin

B. Continue Amoxicillin for 10 days
C. Shift Amoxicillin to a second line drug
D. Refer urgently to a hospital

80. Len, five years old, was brought to your clinic ANSWER: C
due to three weeks of productive cough. She has
been having intermittent fever every afternoon. Refer to #76
This is accompanied by decreased appetite and
resulting weight loss. Physical examination
showed a heart rate of 88, respiratory rate of 25,
temperature of 37.0° C, and absence of
adventitious sounds. Based on IMCI, what should
be the most appropriate management for Len?

A. Give oral Amoxicillin, 5 ml three times a

day for seven days
B. Give an inhaled bronchodilator for three
days
C. Refer for possible T
D. Give first dose of antibiotic, and refer
urgently to a hospital