Screening tests Practice Questions

Question 1

Group of 100 medical students took an end of the year exam. The mean score on the exam was 70%, with a standard deviation of 25%. The professor states that a student's score must be within the 95% confidence interval of the mean to pass the exam. Which of the following is the minimum score a student can have to pass the exam?

Accepted Answer

65%

Answer

45%

Answer

63.75%

Answer

67.5%

Answer

20%

Question 2

A 32-year-old woman makes an appointment with her family physician for a new-employment physical examination. She has no complaints and the physical examination is unremarkable. The family history is negative for malignancies and inherited disorders. During the visit, she provides the results of a Pap smear taken last week, which reports the presence of atypical squamous cells of undetermined significance (ASC-US), along with a test for HPV, which was negative. The previous Pap smear was normal (negative for intraepithelial lesions or malignancy). When would you recommend that she have another Pap smear?

Accepted Answer

3 years

Answer

1 year

Answer

Immediately

Answer

6 months

Answer

5 years

Question 3

You conduct a medical research study to determine the screening efficacy of a novel serum marker for colon cancer. The study is divided into 2 subsets. In the first, there are 500 patients with colon cancer, of which 450 are found positive for the novel serum marker. In the second arm, there are 500 patients who do not have colon cancer, and only 10 are found positive for the novel serum marker. What is the overall sensitivity of this novel test?

Accepted Answer

450 / (450 + 50)

Answer

450 / (450 + 10)

Answer

490 / (10 + 490)

Answer

490 / (50 + 490)

Answer

490 / (450 + 490)

Question 4

A group of gastroenterologists is concerned about low colonoscopy screening rates. They decide to implement a free patient navigation program to assist local residents and encourage them to obtain colonoscopies in accordance with U.S. Preventive Services Task Force (USPSTF) guidelines. Local residents were recruited at community centers. Participants attended monthly meetings with patient navigators and were regularly reminded that their adherence to screening guidelines was being evaluated. Colonoscopy screening rates were assessed via chart review, which showed that 90% of participants adhered to screening guidelines. Data collected via chart review for local residents recruited at community centers who did not participate in the free patient navigation system found that 34% of that population adhered to USPSTF guidelines. Which of the following has most likely contributed to the observed disparity in colonoscopy screening rates?

Accepted Answer

Hawthorne effect

Answer

Recall bias

Answer

Confirmation bias

Answer

Reporting bias

Answer

Sampling bias

Question 5

A 58-year-old woman presents to the physician for a routine gynecological visit. She denies any acute issues and remarks that she has not been sexually active for the past year. Her last Pap test was negative for any abnormal cytology. A pelvic examination and Pap test is performed at the current visit with no remarkable findings. Which of the following approaches to cervical cancer screening is most appropriate for this patient?

Accepted Answer

Pap test and HPV test in 5 years

Answer

Colposcopy in 3 years

Answer

Pap test only in 5 years

Answer

Discontinue screening until the patient becomes sexually active

Answer

Colposcopy at the current visit to verify Pap test results

Question 6

A 32-year-old woman presented for her annual physical examination. She mentioned that her family history had changed since her last visit: her mother was recently diagnosed with breast cancer and her sister tested positive for the BRCA2 mutation. The patient, therefore, requested testing as well. If the patient tests positive for the BRCA1 or BRCA2 mutation, which of the following is the best screening approach?

Accepted Answer

Twice-yearly clinical breast exams, annual mammography, annual breast MRI, and breast self-exams

Answer

Order magnetic resonance imaging of the breast

Answer

Annual ultrasound, annual mammography, and monthly self-breast exams

Answer

Annual clinical breast exams, annual mammography, and monthly self-breast exams

Answer

Refer to radiation therapy

Question 7

A student health coordinator plans on leading a campus-wide HIV screening program that will be free for the entire undergraduate student body. The goal is to capture as many correct HIV diagnoses as possible with the fewest false positives. The coordinator consults with the hospital to see which tests are available to use for this program. Test A has a sensitivity of 0.92 and a specificity of 0.99. Test B has a sensitivity of 0.95 and a specificity of 0.96. Test C has a sensitivity of 0.98 and a specificity of 0.93. Which of the following testing schemes should the coordinator pursue?

Accepted Answer

Test C on the entire student body followed by Test A on those who are positive

Answer

Test A on the entire student body followed by Test B on those who are positive

Answer

Test A on the entire student body followed by Test C on those who are positive

Answer

Test C on the entire student body followed by Test B on those who are positive

Answer

Test B on the entire student body followed by Test A on those who are positive

Question 8

A 50-year-old male presents to his primary care physician for a routine check-up. He reports that he is doing well overall without any bothersome symptoms. His past medical history is significant only for hypertension, which has been well controlled with losartan. Vital signs are as follows: T 37.0 C, HR 80, BP 128/76, RR 14, SpO2 99%. Physical examination does not reveal any concerning abnormalities. The physician recommends a fecal occult blood test at this visit to screen for the presence of any blood in the patient's stool that might be suggestive of an underlying colorectal cancer. Which of the following best describes this method of disease prevention?

Accepted Answer

Secondary prevention

Answer

Primary prevention

Answer

Primordial prevention

Answer

Tertiary prevention

Answer

Quaternary prevention

Question 9

A 5-year-old patient presents to the pediatrician's office with fatigue and swollen lymph nodes. Extensive work-up reveals a diagnosis of acute lymphoblastic leukemia. In an effort to better tailor the patient's treatments, thousands of genes are arranged on a chip and a probe is made from the patient's mRNA (converted to cDNA). This probe is then hybridized to the chip in order to measure the gene expression of thousands of genes. The technology used to investigate this patient's gene expression profile is best for detecting which of the following types of genetic abnormalities?

Accepted Answer

Chromosomal translocations

Answer

Trisomies

Answer

Large scale chromosomal deletions

Answer

Frame-shift mutations

Answer

Single nucleotide polymorphisms

Question 10

A 38-year-old G2P2 presents to her gynecologist to discuss the results of her diagnostic tests. She has no current complaints or concurrent diseases. She underwent a tubal ligation after her last pregnancy. Her last Pap smear showed a high-grade squamous intraepithelial lesion and a reflex HPV test was positive. Colposcopic examination reveals areas of thin acetowhite epithelium with diffuse borders and fine punctation. The biopsy obtained from the suspicious areas shows CIN 1. Note the discordancy between the cytology (HSIL) and histology (CIN 1) results. Which of the following is an appropriate next step in the management of this patient?

Accepted Answer

Repeat cytology and HPV co-testing in 6 months

Answer

Test for type 16 and 18 HPV

Answer

Cryoablation

Answer

Cold-knife conization

Answer

Loop electrosurgical excision procedure

Screening tests

Study Resources

Lessons

Questions

Flashcards

Lessons

First trimester screening

Cell-free DNA screening

Second trimester serum screening

Ultrasound markers and anomaly screening

Carrier screening for genetic disorders

Cervical cancer screening in pregnancy

Diabetes screening in pregnancy

Gestational diabetes management

Group B streptococcus screening

Screening for preeclampsia risk factors

Prenatal infection screening (TORCH, HIV, STIs)

Genetic counseling principles

Diagnostic testing (amniocentesis, CVS)

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