Cardiovascular disease screening US Medical PG Practice Questions and MCQs
Practice US Medical PG questions for Cardiovascular disease screening. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Cardiovascular disease screening US Medical PG Question 1: A 72-year-old woman comes to the physician for follow-up care. One year ago, she was diagnosed with a 3.8-cm infrarenal aortic aneurysm found incidentally on abdominal ultrasound. She has no complaints. She has hypertension, type 2 diabetes mellitus, and COPD. Current medications include hydrochlorothiazide, lisinopril, glyburide, and an albuterol inhaler. She has smoked a pack of cigarettes daily for 45 years. Her temperature is 37°C (98.6°F), pulse is 90/min, respirations are 12/min, and blood pressure is 145/85 mm Hg. Examination shows a faint abdominal bruit on auscultation. Ultrasonography of the abdomen shows a 4.9-cm saccular dilation of the infrarenal aorta. Which of the following is the most appropriate next step in management?
- A. Elective endovascular aneurysm repair (Correct Answer)
- B. Adjustment of cardiovascular risk factors and follow-up ultrasound in 12 months
- C. Adjustment of cardiovascular risk factors and follow-up ultrasound in 6 months
- D. Elective open aneurysm repair
- E. Adjustment of cardiovascular risk factors and follow-up CT in 6 months
Cardiovascular disease screening Explanation: ***Elective endovascular aneurysm repair***
- The patient's **infrarenal aortic aneurysm** has grown from 3.8 cm to 4.9 cm in one year, approaching the **5.0 cm threshold for intervention in women** (compared to 5.5 cm for men). The **rapid growth rate of 1.1 cm/year** (normal is <0.5 cm/year) significantly increases rupture risk and is an indication for intervention even before reaching the absolute size threshold.
- Given her multiple comorbidities (hypertension, diabetes, COPD, 45 pack-year smoking history), **endovascular aneurysm repair (EVAR)** is preferred over open repair due to lower perioperative morbidity and mortality in high-risk surgical candidates.
- The combination of near-threshold size and rapid growth makes elective repair appropriate now rather than continued surveillance.
*Adjustment of cardiovascular risk factors and follow-up ultrasound in 12 months*
- While **risk factor modification** (smoking cessation, blood pressure control) is essential, it is insufficient as the primary management given the aneurysm's significant growth and imminent rupture risk.
- A 12-month follow-up interval is too long for a rapidly growing aneurysm (grew 1.1 cm in the past year), as this increases the risk of rupture without intervention.
*Adjustment of cardiovascular risk factors and follow-up ultrasound in 6 months*
- **Risk factor management** is important but does not address the immediate need for intervention due to the aneurysm's size approaching the threshold and concerning growth rate.
- While 6-month surveillance might be considered for smaller aneurysms with slower growth, this aneurysm's rapid expansion rate suggests it will exceed 5.0 cm well before the next surveillance interval, increasing rupture risk unnecessarily.
*Elective open aneurysm repair*
- **Open aneurysm repair** is an effective treatment but carries significantly higher perioperative risks (30-day mortality 3-5% vs 1-2% for EVAR) compared to endovascular repair, especially in patients with multiple comorbidities.
- Given this patient's COPD, smoking history, and cardiovascular risk factors, EVAR is the preferred approach to minimize surgical stress and improve perioperative outcomes.
*Adjustment of cardiovascular risk factors and follow-up CT in 6 months*
- **Risk factor modification** alone is insufficient given the aneurysm's proximity to intervention threshold and rapid growth rate.
- While CT provides more detailed anatomic imaging for surgical planning, continued surveillance is inappropriate when the patient already meets criteria for intervention. Additionally, CT involves radiation exposure and is typically reserved for pre-operative planning rather than routine surveillance.
Cardiovascular disease screening US Medical PG Question 2: A 75-year-old Caucasian man presents to the emergency department with abdominal pain. The patient states he was at home eating dinner when he began to experience severe abdominal pain. The patient has a past medical history of diabetes, hypertension, and atherosclerosis. He lives at home alone, smokes cigarettes, and drinks 1 to 2 alcoholic drinks per day. The patient is given IV morphine and an ultrasound is obtained demonstrating a dilated abdominal aorta. The patient states that his father died of a similar finding and is concerned about his prognosis. Which of the following is the greatest risk factor for this patient's presentation?
- A. Male gender and age
- B. Caucasian race
- C. Cigarette smoking (Correct Answer)
- D. Family history
- E. Atherosclerosis
Cardiovascular disease screening Explanation: ***Cigarette smoking***
- **Cigarette smoking** is the most significant modifiable risk factor for the development and expansion of **abdominal aortic aneurysms (AAAs)**, directly contributing to vascular inflammation and degradation.
- The patient's history of smoking suggests a strong causal link to his current presentation of a dilated aorta, which is highly indicative of an AAA.
*Male gender and age*
- While **male gender** and **advanced age (over 65)** are significant demographic risk factors for AAA, they are considered non-modifiable and less impactful than smoking in terms of risk magnitude.
- These factors increase predisposition but do not exert the same direct, damaging effect on the arterial wall as chronic smoking.
*Caucasian race*
- **Caucasian race** is a known demographic risk factor for AAA, with higher prevalence rates compared to other ethnic groups.
- However, this is a non-modifiable genetic predisposition and contributes less to the overall risk than modifiable lifestyle factors like smoking.
*Family history*
- A **family history** of AAA, as suggested by the patient's father having a similar condition, increases an individual's susceptibility.
- This is a significant non-modifiable risk factor, indicating genetic predisposition, but its overall impact on aneurysm formation and progression is typically less than that of active smoking.
*Atherosclerosis*
- **Atherosclerosis** is a strong associated condition with AAA, as both share common risk factors and pathology related to arterial wall degeneration.
- While atherosclerosis contributes to the overall vascular compromise, smoking specifically has a more direct and potent effect on promoting aneurysm formation and rupture independently.
Cardiovascular disease screening US Medical PG Question 3: A 65-year-old patient presents with acute left lower quadrant abdominal pain and is diagnosed with diverticulitis. Which of the following is most likely to have prevented this patient's condition?
- A. Anticoagulation with warfarin
- B. High-fiber diet (Correct Answer)
- C. Different antibiotic regimen for bronchitis
- D. Sitz baths and nifedipine suppositories
- E. Long-term use of aspirin
Cardiovascular disease screening Explanation: ***High-fiber diet***
- A **high-fiber diet** increases stool bulk and reduces intracolonic pressure, thereby preventing the formation of **diverticula** and reducing the risk of diverticulitis.
- It helps maintain **regular bowel movements** and minimizes straining, which are key in preventing diverticular disease.
*Anticoagulation with warfarin*
- **Warfarin** is an anticoagulant used to prevent blood clots; it has no direct impact on the formation of **diverticula** or the prevention of diverticulitis.
- While bleeding is a potential complication of diverticular disease, anticoagulation would generally *increase* the risk of bleeding, not prevent the condition itself.
*Different antibiotic regimen for bronchitis*
- Antibiotics treat **bacterial infections** and are irrelevant in the prevention of diverticulitis, which primarily relates to dietary and colonic pressure issues.
- Changing an antibiotic regimen for an unrelated respiratory infection like bronchitis would not affect the risk factors for **diverticular disease**.
*Sitz baths and nifedipine suppositories*
- **Sitz baths** and **nifedipine suppositories** are treatments for anorectal conditions like **hemorrhoids** or **anal fissures** and do not influence the development of diverticulitis.
- These interventions target symptoms in the anal region and have no physiological connection to the colon's diverticular disease processes.
*Long-term use of aspirin*
- **Aspirin** is an anti-inflammatory and antiplatelet agent used for pain relief and cardiovascular protection; it does not prevent the formation of **diverticula** or diverticulitis.
- Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin can actually **increase the risk of diverticular complications**, such as bleeding or perforation, rather than prevent the disease.
Cardiovascular disease screening US Medical PG Question 4: A 15-year-old girl comes to the physician for a well-child examination. She feels well. Her father has coronary artery disease and hypertension. Her mother has type 2 diabetes mellitus, hypercholesterolemia, and had a myocardial infarction at the age of 52 years. She is at the 25th percentile for height and above the 95th percentile for weight. Her BMI is 32 kg/m2. Her temperature is 37°C (98.6°F), pulse is 99/min, and blood pressure is 140/88 mm Hg. Physical examination shows no abnormalities. Random serum studies show:
Glucose 160 mg/dL
Creatinine 0.8 mg/dL
Total cholesterol 212 mg/dL
HDL-cholesterol 32 mg/dL
LDL-cholesterol 134 mg/dL
Triglycerides 230 mg/dL
In addition to regular aerobic physical activity, which of the following is the most appropriate next step in management?
- A. Atorvastatin therapy
- B. Reduced-calorie diet (Correct Answer)
- C. Fenofibrate therapy
- D. Metformin therapy
- E. Niacin therapy
Cardiovascular disease screening Explanation: ***Reduced-calorie diet***
- Given the patient's **obesity (BMI 32 kg/m2)**, **elevated blood pressure (140/88 mmHg)**, **impaired fasting glucose (160 mg/dL)**, and **dyslipidemia (high triglycerides, low HDL)**, lifestyle modifications, particularly a **reduced-calorie diet**, are the cornerstone of initial management. This approach aims to address the underlying metabolic cluster contributing to her risk.
- A **reduced-calorie diet** combined with regular aerobic physical activity can lead to weight loss, which in turn can improve blood pressure, glucose levels, and lipid profiles, thereby mitigating her significant risk factors for cardiovascular disease and type 2 diabetes.
*Atorvastatin therapy*
- **Atorvastatin (a statin)** is typically indicated for severe dyslipidemia, particularly elevated LDL-cholesterol, or in patients with established cardiovascular disease in adults. For adolescents, statin use is reserved for those with **severe primary hypercholesterolemia** unresponsive to lifestyle changes.
- While her **LDL is elevated (134 mg/dL)**, given her age and the multifactorial nature of her metabolic abnormalities, initial management should focus on lifestyle modifications before considering pharmacotherapy like statins.
*Fenofibrate therapy*
- **Fenofibrate** is primarily used to treat **severe hypertriglyceridemia** and to improve low HDL-cholesterol. While her **triglycerides are elevated (230 mg/dL)**, similar to statins, pharmacologic interventions for dyslipidemia in adolescents usually follow a trial of intensive lifestyle modifications.
- Addressing the patient's overall metabolic syndrome through weight loss and dietary changes is a more comprehensive initial approach, as it can simultaneously improve her dyslipidemia, hyperglycemia, and hypertension.
*Metformin therapy*
- **Metformin** is used to manage **type 2 diabetes mellitus** and often for **insulin resistance**, particularly in obese individuals. While her **random glucose is elevated (160 mg/dL)**, indicating impaired glucose regulation, a definitive diagnosis of type 2 diabetes or prediabetes requiring metformin typically involves fasting glucose levels, oral glucose tolerance tests, or HbA1c.
- For a 15-year-old with these findings, intensive lifestyle intervention to achieve weight loss is the **first-line therapy** to improve glucose metabolism and prevent the progression to type 2 diabetes.
*Niacin therapy*
- **Niacin** is used to reduce LDL-cholesterol and triglycerides, and to increase HDL-cholesterol. However, it can have significant side effects like flushing and hepatotoxicity.
- Its role in the management of dyslipidemia, especially in adolescents, is generally limited and considered after other agents or in specific conditions, as lifestyle modification remains the initial and most appropriate step.
Cardiovascular disease screening US Medical PG Question 5: A 56-year-old Caucasian male presents to the clinic to establish care. He has never seen a physician and denies any known medical problems. Physical examination is notable for central obesity, but the patient has regular heart and lung sounds. He has a blood pressure of 157/95 mm Hg and heart rate of 92/min. He follows up 2 weeks later, and his blood pressure continues to be elevated. At this time, you diagnose him with essential hypertension and decide to initiate antihypertensive therapy. Per the Joint National Committee 8 guidelines for treatment of high blood pressure, of the following combinations of drugs, which can be considered for first-line treatment of high blood pressure in the Caucasian population?
- A. ACE inhibitor, ARB, CCB, or thiazide (Correct Answer)
- B. ACE inhibitor, angiotensin receptor blocker (ARB), beta-blocker (BB), or thiazide
- C. ACE inhibitor, ARB, CCB, or loop diuretic
- D. ACE inhibitor, ARB, alpha-blocker, or loop diuretic
- E. ACE inhibitor, ARB, alpha-blocker, or direct vasodilator
Cardiovascular disease screening Explanation: **ACE inhibitor, ARB, CCB, or thiazide**
- The **JNC 8 guidelines** recommend **ACE inhibitors**, **ARBs**, **calcium channel blockers (CCBs)**, and **thiazide diuretics** as first-line agents for essential hypertension in the general non-Black population.
- These drug classes have demonstrated efficacy in reducing cardiovascular events and are generally well-tolerated.
*ACE inhibitor, angiotensin receptor blocker (ARB), beta-blocker (BB), or thiazide*
- While **ACE inhibitors**, **ARBs**, and **thiazides** are first-line, **beta-blockers** are generally not considered first-line for uncomplicated hypertension unless there are specific compelling indications (e.g., post-MI, heart failure).
- **Beta-blockers** are less effective than other first-line agents in preventing stroke in the elderly and may have more side effects in some populations.
*ACE inhibitor, ARB, CCB or loop diuretic*
- **ACE inhibitors**, **ARBs**, and **CCBs** are first-line options, but **loop diuretics** are typically reserved for patients with fluid overload or chronic kidney disease, not for initial management of essential hypertension.
- **Loop diuretics** have a shorter duration of action and a greater electrolyte-wasting effect compared to thiazide diuretics, making them less suitable for long-term monotherapy.
*ACE inhibitor, ARB, alpha-blocker, or loop diuretic*
- **Alpha-blockers** and **loop diuretics** are not considered first-line agents for essential hypertension. **Alpha-blockers** are typically used for benign prostatic hyperplasia or as add-on therapy for resistant hypertension.
- **Alpha-blockers** can cause significant orthostatic hypotension, particularly with the first dose, and have not shown the same cardiovascular protective benefits as true first-line agents.
*ACE inhibitor, ARB, alpha-blocker, or direct vasodilator*
- **Alpha-blockers** and **direct vasodilators** (e.g., hydralazine, minoxidil) are not first-line treatments for essential hypertension.
- **Direct vasodilators** are potent but often cause reflex tachycardia and fluid retention, requiring co-administration with other agents, and are typically reserved for severe or resistant hypertension.
Cardiovascular disease screening US Medical PG Question 6: A 49-year-old man with a past medical history of hypertension on amlodipine presents to your office to discuss ways to lessen his risk of complications from heart disease. After a long discussion, he decides to significantly decrease his intake of trans fats in an attempt to lower his risk of coronary artery disease. Which type of prevention is this patient initiating?
- A. Secondary prevention
- B. Delayed prevention
- C. Quaternary prevention
- D. Tertiary prevention
- E. Primary prevention (Correct Answer)
Cardiovascular disease screening Explanation: ***Primary prevention***
- This patient is initiating primary prevention by **modifying lifestyle choices** (decreasing trans fats) to **prevent the initial onset of coronary artery disease**, as he has a risk factor (hypertension) but no established heart disease.
- Primary prevention focuses on **preventing disease before it occurs** through health promotion and risk reduction.
*Secondary prevention*
- Secondary prevention involves **early detection and treatment of existing disease** to prevent progression or recurrence.
- Examples include **screening tests** like mammography or **medications for individuals already diagnosed** with a condition.
*Delayed prevention*
- This is **not a recognized category** of prevention in public health or medical practice.
- Prevention stages are typically classified as primary, secondary, tertiary, and sometimes quaternary.
*Quaternary prevention*
- Quaternary prevention aims to **protect patients from medical interventions** that may cause harm, such as over-medicalization or unnecessary procedures.
- It focuses on **reducing the burden of iatrogenic disease** and ensuring appropriate care.
*Tertiary prevention*
- Tertiary prevention focuses on **reducing the impact of an existing disease** or disability through rehabilitation and managing complications.
- It applies to patients who **already have an established disease** and seeks to improve their quality of life and functionality.
Cardiovascular disease screening US Medical PG Question 7: A 19-year-old woman presents for a sports physical. She says she feels healthy and has no concerns. Past medical history is significant for depression and seasonal allergies. Current medications are fluoxetine and oral estrogen/progesterone contraceptive pills. Family history is significant for a sister with polycystic ovarian syndrome (PCOS). The patient denies current or past use of alcohol, recreational drugs, or smoking. She reports that she has been on oral birth control pills since age 14 and uses condoms inconsistently. No history of STDs. She is sexually active with her current boyfriend, who was treated for chlamydia 2 years ago. She received and completed the HPV vaccination series starting at age 11. Her vital signs include: temperature 36.8°C (98.2°F), pulse 97/min, respiratory rate 16/min, blood pressure 120/75 mm Hg. Physical examination is unremarkable. Which of the following are the recommended guidelines for cervical cancer screening for this patient at this time?
- A. Cytology (pap smear) and HPV DNA co-testing every 3 years
- B. Cytology (pap smear) every 3 years
- C. Cytology (pap smear) annually
- D. Cytology (pap smear) and HPV DNA co-testing every 5 years
- E. No cervical cancer screening is indicated at this time (Correct Answer)
Cardiovascular disease screening Explanation: ***No cervical cancer screening is indicated at this time***
- Current guidelines recommend initiating **cervical cancer screening** at age 21, regardless of sexual activity initiation.
- The patient is 19 years old, therefore, screening is not yet indicated per standard recommendations.
*Cytology (pap smear) and HPV DNA co-testing every 3 years*
- This option is incorrect because **co-testing** with cytology and HPV DNA is generally recommended for women aged 30-65 years, not for women under 21.
- While cytology every 3 years is a recommendation for women 21-29, co-testing is not the primary recommendation in this age group, and the patient is below the screening age.
*Cytology (pap smear) every 3 years*
- This screening interval is recommended for women aged 21-29 years, but the patient is currently 19 years old.
- Initiating screening earlier than 21 years is not recommended due to the high incidence of **transient HPV infections** and low risk of cervical cancer in younger individuals.
*Cytology (pap smear) annually*
- **Annual Pap smears** are no longer recommended for routine screening; guidelines have shifted to longer intervals due to the slow progression of cervical cancer and high rates of HPV clearance.
- Even if screening were indicated, annual cytology is not the current recommendation for any age group, especially not for a 19-year-old.
*Cytology (pap smear) and HPV DNA co-testing every 5 years*
- This screening strategy (**co-testing every 5 years**) is recommended for women aged 30-65 years.
- This patient is only 19 years old, making this recommendation inappropriate for her age.
Cardiovascular disease screening US Medical PG Question 8: A 50-year-old Caucasian man presents for a routine checkup. He does not have any current complaint. He is healthy and takes no medications. He has smoked 10–15 cigarettes per day for the past 10 years. His family history is negative for gastrointestinal disorders. Which of the following screening tests is recommended for this patient according to the United States Preventive Services Task Force (USPSTF)?
- A. Abdominal ultrasonography for abdominal aortic aneurysm
- B. Carcinoembryonic antigen for colorectal cancer
- C. Low-dose computerized tomography for lung cancer
- D. Colonoscopy for colorectal cancer (Correct Answer)
- E. Prostate-specific antigen for prostate cancer
Cardiovascular disease screening Explanation: **Colonoscopy for colorectal cancer**
- The **USPSTF recommends screening for colorectal cancer in adults aged 45 to 75 years**. This patient is 50 years old, placing him squarely within this recommended age range for colonoscopy, irrespective of smoking status or other risk factors.
- **Colonoscopy** is a highly effective screening tool for colorectal cancer, allowing for the detection and removal of precancerous polyps.
*Abdominal ultrasonography for abdominal aortic aneurysm*
- The **USPSTF recommends one-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked**. This patient is 50 years old, falling outside the recommended age range for this screening, despite his smoking history.
- The benefit of screening for AAA is primarily for older men with a history of smoking, as the prevalence of AAA significantly increases with age.
*Low-dose computerized tomography for lung cancer*
- The **USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years**. This patient has a 10-pack-year smoking history (10-15 cigarettes/day for 10 years ≈ 0.5-0.75 packs/day * 10 years = 5-7.5 pack-years), which does not meet the 20 pack-year threshold.
- While the patient is within the age range, his smoking history is insufficient to meet the criteria for routine lung cancer screening with LDCT.
*Carcinoembryonic antigen for colorectal cancer*
- **Carcinoembryonic antigen (CEA) is a tumor marker primarily used for monitoring the recurrence of colorectal cancer after treatment**, not for initial screening in asymptomatic individuals.
- The USPSTF and other guidelines do not recommend CEA as a screening test for colorectal cancer due to its low sensitivity and specificity in asymptomatic populations.
*Prostate-specific antigen for prostate cancer*
- The **USPSTF recommends that men aged 55 to 69 years should make an individual decision about being screened for prostate cancer with a prostate-specific antigen (PSA) test**, after discussing the potential benefits and harms with their clinician.
- This patient is 50 years old, which is younger than the age range where the USPSTF recommends shared decision-making for PSA screening.
Cardiovascular disease screening US Medical PG Question 9: A 46-year-old woman presents to her primary care physician for her annual examination. At her prior exam one year earlier, she had a Pap smear which was within normal limits. Which of the following health screenings is recommended for this patient?
- A. Colorectal screening (Correct Answer)
- B. Blood glucose and/or HbA1c screening
- C. Blood pressure at least once every 3 years
- D. Yearly Pap smear
- E. Bone mineral density screening
Cardiovascular disease screening Explanation: ***Colorectal screening***
- **Colorectal cancer screening** is generally recommended to start at age **45 years** for individuals at average risk.
- This patient is 46 years old, making immediate colorectal screening appropriate based on current guidelines.
*Blood glucose and/or HbA1c screening*
- **Blood glucose or HbA1c screening** for diabetes is recommended starting at age **35 for all adults** or earlier if there are risk factors such as obesity or a family history of diabetes.
- While this patient is 46, this screening should have already been initiated, and it is not the *most* uniquely recommended screening for this specific age that might have been overlooked.
*Blood pressure at least once every 3 years*
- **Blood pressure screening** should be performed **at least annually** for adults aged 40 and older, or more frequently if there are risk factors.
- Screening only every 3 years is insufficient for a 46-year-old patient.
*Yearly Pap smear*
- **Pap smear frequency** has changed; for women aged 30-65 with normal results, screening is recommended every **3 years** with cytology alone, or every 5 years with high-risk HPV testing alone or co-testing.
- A yearly Pap smear is no longer typical practice for a woman with normal prior results and no specific risk factors.
*Bone mineral density screening*
- **Bone mineral density (BMD) screening** for osteoporosis is typically recommended for women starting at age **65 years** or earlier if they have significant risk factors.
- This patient is 46 years old and has no mentioned risk factors, so BMD screening is not routinely indicated at this age.
Cardiovascular disease screening US Medical PG Question 10: A pharmaceutical corporation is developing a research study to evaluate a novel blood test to screen for breast cancer. They enrolled 800 patients in the study, half of which have breast cancer. The remaining enrolled patients are age-matched controls who do not have the disease. Of those in the diseased arm, 330 are found positive for the test. Of the patients in the control arm, only 30 are found positive. What is this test’s sensitivity?
- A. 330 / (330 + 30)
- B. 330 / (330 + 70) (Correct Answer)
- C. 370 / (30 + 370)
- D. 370 / (70 + 370)
- E. 330 / (400 + 400)
Cardiovascular disease screening Explanation: ***330 / (330 + 70)***
- **Sensitivity** measures the proportion of actual **positives** that are correctly identified as such.
- In this study, there are **400 diseased patients** (half of 800). Of these, 330 tested positive (true positives), meaning 70 tested negative (false negatives). So sensitivity is **330 / (330 + 70)**.
*330 / (330 + 30)*
- This calculation represents the **positive predictive value**, which is the probability that subjects with a positive screening test truly have the disease. It uses **true positives / (true positives + false positives)**.
- It does not correctly calculate **sensitivity**, which requires knowing the total number of diseased individuals.
*370 / (30 + 370)*
- This expression is attempting to calculate **specificity**, which is the proportion of actual negatives that are correctly identified. It would be **true negatives / (true negatives + false positives)**.
- However, the numbers used are incorrect for specificity in this context given the data provided.
*370 / (70 + 370)*
- This formula is an incorrect combination of values and does not represent any standard epidemiological measure like **sensitivity** or **specificity**.
- It is attempting to combine false negatives (70) and true negatives (370 from control arm) in a non-standard way.
*330 / (400 + 400)*
- This calculation attempts to divide true positives by the total study population (800 patients).
- This metric represents the **prevalence of true positives within the entire study cohort**, not the test's **sensitivity**.
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