LATEST PUBLIC HEALTH & GENERAL
PREVENTIVE MEDICINE CERTIFICATION EXAM
OFFERED BY AMERICAN BOARD OF
PREVENTIVE MEDICINE | COMPLETE EXAM
Q&A WITH RATIONALES
1. A 45-year-old male with hypertension and diabetes
has a 10-year cardiovascular risk of 20% according
to the Pooled Cohort Equations. Which is the most
appropriate recommendation for statin therapy?
A) No statin indicated
B) Moderate-intensity statin
C) High-intensity statin
D) Statin only if LDL >190 mg/dL
Correct answer: C
Rationale: ACC/AHA guidelines recommend high-
intensity statin for primary prevention when 10-year
risk ≥20% (diabetes plus hypertension qualifies in
many models).
2. A public health department is investigating an
outbreak of gastroenteritis. Which measure best
describes the number of new cases per population at
risk over a specified time period?
,A) Prevalence
B) Incidence rate
C) Attack rate
D) Case-fatality rate
Correct answer: B
Rationale: Incidence rate is the number of new cases
in a population over a defined time period. Attack
rate is a cumulative incidence used in outbreaks.
3. A screening test for colorectal cancer has a
sensitivity of 80% and specificity of 90%. The
prevalence of colorectal cancer in the screened
population is 1%. What is the positive predictive value
(PPV)?
A) 7.5%
B) 8.9%
C) 50%
D) 80%
Correct answer: A
Rationale: PPV = (sensitivity × prevalence) /
[(sensitivity × prevalence) + ((1 - specificity) × (1 -
prevalence))] = (0.8×0.01)/(0.8×0.01 + 0.1×0.99) =
0.008/0.107 = 0.0748 = 7.5%.
,4. A community health assessment identifies that
opioid overdose deaths have increased 300% over 3
years. Which level of prevention is distribution of
naloxone to high-risk individuals?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quaternary prevention
Correct answer: B
Rationale: Secondary prevention aims to reduce the
impact of a disease or injury that has already
occurred (naloxone reverses overdose, preventing
death). Primary prevention prevents initial use.
5. A randomized controlled trial of a new
antihypertensive medication compared to placebo
shows a relative risk reduction (RRR) of 25% for
stroke. The absolute risk reduction (ARR) is 2%. What
is the number needed to treat (NNT)?
A) 4
B) 10
C) 25
D) 50
, Correct answer: D
Rationale: NNT = 1/ARR = 1/0.02 = 50. For every 50
patients treated, one stroke is prevented.
6. A vaccine has a vaccine efficacy of 95% against
disease. In a population of 100,000 unvaccinated
individuals, the disease incidence is 1,000 cases per
year. How many cases would be expected in 100,000
vaccinated individuals?
A) 5
B) 50
C) 500
D) 950
Correct answer: B
Rationale: Vaccine efficacy = 1 - (incidence
vaccinated/incidence unvaccinated). 0.95 = 1 -
(x/1000) → x/1000 = 0.05 → x = 50 cases.
7. A study of a new cancer screening test finds that
the test detects cancer earlier than usual, but overall
mortality from cancer is unchanged. This is most
likely an example of:
A) Lead-time bias
B) Length-time bias
PREVENTIVE MEDICINE CERTIFICATION EXAM
OFFERED BY AMERICAN BOARD OF
PREVENTIVE MEDICINE | COMPLETE EXAM
Q&A WITH RATIONALES
1. A 45-year-old male with hypertension and diabetes
has a 10-year cardiovascular risk of 20% according
to the Pooled Cohort Equations. Which is the most
appropriate recommendation for statin therapy?
A) No statin indicated
B) Moderate-intensity statin
C) High-intensity statin
D) Statin only if LDL >190 mg/dL
Correct answer: C
Rationale: ACC/AHA guidelines recommend high-
intensity statin for primary prevention when 10-year
risk ≥20% (diabetes plus hypertension qualifies in
many models).
2. A public health department is investigating an
outbreak of gastroenteritis. Which measure best
describes the number of new cases per population at
risk over a specified time period?
,A) Prevalence
B) Incidence rate
C) Attack rate
D) Case-fatality rate
Correct answer: B
Rationale: Incidence rate is the number of new cases
in a population over a defined time period. Attack
rate is a cumulative incidence used in outbreaks.
3. A screening test for colorectal cancer has a
sensitivity of 80% and specificity of 90%. The
prevalence of colorectal cancer in the screened
population is 1%. What is the positive predictive value
(PPV)?
A) 7.5%
B) 8.9%
C) 50%
D) 80%
Correct answer: A
Rationale: PPV = (sensitivity × prevalence) /
[(sensitivity × prevalence) + ((1 - specificity) × (1 -
prevalence))] = (0.8×0.01)/(0.8×0.01 + 0.1×0.99) =
0.008/0.107 = 0.0748 = 7.5%.
,4. A community health assessment identifies that
opioid overdose deaths have increased 300% over 3
years. Which level of prevention is distribution of
naloxone to high-risk individuals?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Quaternary prevention
Correct answer: B
Rationale: Secondary prevention aims to reduce the
impact of a disease or injury that has already
occurred (naloxone reverses overdose, preventing
death). Primary prevention prevents initial use.
5. A randomized controlled trial of a new
antihypertensive medication compared to placebo
shows a relative risk reduction (RRR) of 25% for
stroke. The absolute risk reduction (ARR) is 2%. What
is the number needed to treat (NNT)?
A) 4
B) 10
C) 25
D) 50
, Correct answer: D
Rationale: NNT = 1/ARR = 1/0.02 = 50. For every 50
patients treated, one stroke is prevented.
6. A vaccine has a vaccine efficacy of 95% against
disease. In a population of 100,000 unvaccinated
individuals, the disease incidence is 1,000 cases per
year. How many cases would be expected in 100,000
vaccinated individuals?
A) 5
B) 50
C) 500
D) 950
Correct answer: B
Rationale: Vaccine efficacy = 1 - (incidence
vaccinated/incidence unvaccinated). 0.95 = 1 -
(x/1000) → x/1000 = 0.05 → x = 50 cases.
7. A study of a new cancer screening test finds that
the test detects cancer earlier than usual, but overall
mortality from cancer is unchanged. This is most
likely an example of:
A) Lead-time bias
B) Length-time bias
