Important University Exam Questions - Epidemiology

from reportlab.lib.pagesizes import A4
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import cm
from reportlab.lib import colors
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, PageBreak
)
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY
from reportlab.platypus import KeepTogether

OUTPUT = "/home/daytona/workspace/epidemiology-pdf/Epidemiology_Important_Questions.pdf"

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    rightMargin=2*cm,
    leftMargin=2*cm,
    topMargin=2.5*cm,
    bottomMargin=2.5*cm,
    title="Important Questions - Epidemiology",
    author="Orris Medical Education"
)

styles = getSampleStyleSheet()

# Custom styles
title_style = ParagraphStyle(
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)

subtitle_style = ParagraphStyle(
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    alignment=TA_CENTER,
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section_style = ParagraphStyle(
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subsection_style = ParagraphStyle(
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)

body_style = ParagraphStyle(
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    spaceAfter=2,
    fontName='Helvetica',
    textColor=colors.HexColor('#2d2d2d')
)

bullet_style = ParagraphStyle(
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    leftIndent=16,
    spaceAfter=2,
    fontName='Helvetica',
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note_style = ParagraphStyle(
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    fontSize=9,
    textColor=colors.HexColor('#555555'),
    fontName='Helvetica-Oblique',
    alignment=TA_CENTER,
    spaceBefore=8,
    spaceAfter=4
)

def section(title):
    return [
        Spacer(1, 0.2*cm),
        Paragraph(f"  {title}", section_style),
        Spacer(1, 0.1*cm)
    ]

def subsection(title):
    return Paragraph(title, subsection_style)

def body(text):
    return Paragraph(text, body_style)

def bullet(text):
    return Paragraph(f"• {text}", bullet_style)

def space(h=0.2):
    return Spacer(1, h*cm)

story = []

# ── TITLE PAGE ──
story.append(space(1.5))
story.append(Paragraph("EPIDEMIOLOGY", title_style))
story.append(Paragraph("Important University Exam Questions", subtitle_style))
story.append(Paragraph("Based on Park's Textbook of Preventive and Social Medicine", subtitle_style))
story.append(space(0.3))
story.append(HRFlowable(width="100%", thickness=2, color=colors.HexColor('#1a3c6e')))
story.append(space(0.3))
story.append(Paragraph("Community Medicine | Preventive & Social Medicine", note_style))
story.append(space(2))

# ── SECTION 1: DEFINITIONS ──
story += section("1. DEFINITIONS & CONCEPTS")
story.append(subsection("Long Answer Questions (10 marks)"))
for q in [
    "Define epidemiology. Describe the aims and uses of epidemiology.",
    "Explain the concept of natural history of disease and the levels of prevention.",
    "Describe the differences between epidemiology and clinical medicine."
]:
    story.append(bullet(q))

story.append(space())
story.append(subsection("Short Answer Questions (5 marks)"))
for q in [
    "Define: Incidence, Prevalence, Attack rate, Secondary attack rate",
    "Difference between Incidence and Prevalence",
    "Herd immunity — definition and significance",
    "Define: Epidemic, Endemic, Pandemic, Sporadic",
    "Difference between Rate, Ratio, and Proportion",
    "Epidemiology vs. Clinical medicine — key differences"
]:
    story.append(bullet(q))

# ── SECTION 2: MEASUREMENTS ──
story += section("2. MEASUREMENTS IN EPIDEMIOLOGY")
story.append(subsection("Long Answer Questions (10 marks)"))
for q in [
    "Describe the basic measurements in epidemiology — mortality and morbidity indicators.",
    "Explain Crude Death Rate, Specific Death Rate, Standardized Mortality Ratio (SMR) and their uses.",
    "Write about measurement of morbidity. Describe incidence and prevalence with formulas and examples."
]:
    story.append(bullet(q))

story.append(space())
story.append(subsection("Short Answer Questions (5 marks)"))
for q in [
    "Incidence rate — definition and formula",
    "Prevalence rate (point vs. period) — definitions and formulas",
    "Attack rate and secondary attack rate with formulas",
    "Proportional Mortality Rate (PMR)",
    "Case Fatality Rate — definition and use",
    "Standardized Mortality Ratio (SMR)"
]:
    story.append(bullet(q))

# ── SECTION 3: CAUSATION ──
story += section("3. CONCEPT OF CAUSATION")
story.append(subsection("Long Answer Questions (10 marks)"))
for q in [
    "Describe the concept of causation in epidemiology. Discuss the Epidemiological Triad, Web of Causation, and Koch's Postulates.",
    "Write about Henle-Koch's postulates and their limitations. What are Bradford Hill's criteria of causation?",
    "Describe the multifactorial causation model with examples."
]:
    story.append(bullet(q))

story.append(space())
story.append(subsection("Short Answer Questions (5 marks)"))
for q in [
    "Epidemiological triad — Agent, Host, Environment",
    "Web of causation (MacMahon's model)",
    "Koch's / Henle-Koch's postulates",
    "Bradford Hill's criteria for causation (all 9 criteria)",
    "Multifactorial causation",
    "Germ theory of disease and its limitations"
]:
    story.append(bullet(q))

# ── SECTION 4: STUDY DESIGNS ──
story += section("4. EPIDEMIOLOGICAL STUDY DESIGNS")
story.append(subsection("Long Answer Questions (10 marks)"))
for q in [
    "Classify epidemiological study designs. Compare and contrast Case-Control and Cohort studies.",
    "Describe the design, methodology, uses, advantages, and disadvantages of a Case-Control study.",
    "Describe the design, methodology, types, uses, advantages, and disadvantages of a Cohort study.",
    "Write a note on Randomized Controlled Trials (RCTs) — design, advantages, limitations.",
    "Describe cross-sectional study — design, uses, and limitations."
]:
    story.append(bullet(q))

story.append(space())
story.append(subsection("Short Answer Questions (5 marks)"))
for q in [
    "Cross-sectional (prevalence) study — uses and limitations",
    "Ecological/Correlational study",
    "Prospective vs. Retrospective cohort studies",
    "Odds Ratio — definition, formula, and when it is used",
    "Relative Risk (Risk Ratio) — definition and formula",
    "Attributable risk — definition and significance",
    "Double-blind trial",
    "Community trial vs. Field trial"
]:
    story.append(bullet(q))

# ── SECTION 5: DESCRIPTIVE EPIDEMIOLOGY ──
story += section("5. DESCRIPTIVE EPIDEMIOLOGY")
story.append(subsection("Long Answer Questions (10 marks)"))
for q in [
    "Describe descriptive epidemiology. Explain the variables of Person, Place, and Time.",
    "Write about the epidemiological approach to disease investigation."
]:
    story.append(bullet(q))

story.append(space())
story.append(subsection("Short Answer Questions (5 marks)"))
for q in [
    "Person, Place, Time variables in epidemiology",
    "Spot map and epidemic curve — significance",
    "Age-standardization — direct and indirect methods",
    "Secular trend in disease"
]:
    story.append(bullet(q))

# ── SECTION 6: BIAS & CONFOUNDING ──
story += section("6. BIAS AND CONFOUNDING")
story.append(subsection("Long Answer Questions (10 marks)"))
for q in [
    "Define bias. Describe the types of bias in epidemiological studies and how to minimize them.",
    "What is confounding? How is it controlled in epidemiological studies?"
]:
    story.append(bullet(q))

story.append(space())
story.append(subsection("Short Answer Questions (5 marks)"))
for q in [
    "Selection bias vs. Information bias",
    "Recall bias",
    "Berkson's bias",
    "Confounding variable — definition and methods of control",
    "Neyman's bias (prevalence-incidence bias)",
    "Methods to control confounding: matching, stratification, randomization, multivariate analysis"
]:
    story.append(bullet(q))

# ── SECTION 7: SCREENING ──
story += section("7. SCREENING")
story.append(subsection("Long Answer Questions (10 marks)"))
for q in [
    "Define screening. Describe the criteria for a good screening test and the principles of screening.",
    "Explain sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with formulas and a 2×2 table.",
    "Describe Wilson and Jungner criteria for screening."
]:
    story.append(bullet(q))

story.append(space())
story.append(subsection("Short Answer Questions (5 marks)"))
for q in [
    "Sensitivity and Specificity — definitions, formulas, and trade-off",
    "Positive Predictive Value (PPV) and Negative Predictive Value (NPV)",
    "Wilson and Jungner criteria for screening",
    "Mass screening vs. Selective screening",
    "Lead time bias in screening",
    "ROC curve — interpretation"
]:
    story.append(bullet(q))

# ── SECTION 8: EPIDEMICS ──
story += section("8. EPIDEMICS AND OUTBREAK INVESTIGATION")
story.append(subsection("Long Answer Questions (10 marks)"))
for q in [
    "Describe the steps in investigation of an epidemic (outbreak investigation).",
    "Classify epidemics. Describe common-source and propagated epidemics with examples and epidemic curves.",
    "Describe the investigation of a food-borne disease outbreak."
]:
    story.append(bullet(q))

story.append(space())
story.append(subsection("Short Answer Questions (5 marks)"))
for q in [
    "Point source vs. propagated epidemic — differences and epidemic curves",
    "Steps in epidemic investigation (10 steps)",
    "Herd immunity threshold",
    "Epidemic curve — types and interpretation",
    "Mixed epidemic"
]:
    story.append(bullet(q))

# ── SECTION 9: SURVEILLANCE ──
story += section("9. SURVEILLANCE")
story.append(subsection("Long Answer Questions (10 marks)"))
for q in [
    "Define epidemiological surveillance. Describe the types and uses of surveillance systems.",
    "Describe the National Disease Surveillance system in India."
]:
    story.append(bullet(q))

story.append(space())
story.append(subsection("Short Answer Questions (5 marks)"))
for q in [
    "Sentinel surveillance",
    "Active vs. passive surveillance",
    "Disease notification system in India",
    "Uses of surveillance data",
    "Syndromic surveillance"
]:
    story.append(bullet(q))

# ── SECTION 10: APPLIED MEASURES ──
story += section("10. ASSOCIATION AND CAUSATION (Applied)")
story.append(subsection("Short Answer Questions (5 marks)"))
for q in [
    "Odds Ratio vs. Relative Risk — when each is used",
    "Number Needed to Treat (NNT) and Number Needed to Harm (NNH)",
    "Absolute Risk Reduction vs. Relative Risk Reduction",
    "Population Attributable Risk and Population Attributable Risk Percent",
    "P-value and confidence interval — interpretation",
    "Type I and Type II errors"
]:
    story.append(bullet(q))

# ── FORMULAS TABLE ──
story += section("KEY FORMULAS TO MEMORIZE")
story.append(space(0.3))

formula_data = [
    ["Measure", "Formula"],
    ["Incidence Rate", "New cases / Population at risk × 1000"],
    ["Prevalence", "All existing cases / Total population × 1000"],
    ["Attack Rate", "Cases / Population exposed × 100"],
    ["Secondary Attack Rate", "New cases in contacts / Total contacts × 100"],
    ["Case Fatality Rate", "Deaths from disease / Cases of disease × 100"],
    ["Odds Ratio (case-control)", "ad / bc"],
    ["Relative Risk (cohort)", "Incidence in exposed / Incidence in unexposed"],
    ["Attributable Risk", "Incidence exposed − Incidence unexposed"],
    ["Sensitivity", "TP / (TP + FN) × 100"],
    ["Specificity", "TN / (TN + FP) × 100"],
    ["PPV", "TP / (TP + FP) × 100"],
    ["NPV", "TN / (TN + FN) × 100"],
]

table = Table(formula_data, colWidths=[6.5*cm, 10*cm])
table.setStyle(TableStyle([
    ('BACKGROUND', (0, 0), (-1, 0), colors.HexColor('#1a3c6e')),
    ('TEXTCOLOR', (0, 0), (-1, 0), colors.white),
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    ('FONTSIZE', (0, 0), (-1, 0), 10),
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    ('VALIGN', (0, 0), (-1, -1), 'MIDDLE'),
    ('FONTNAME', (0, 1), (-1, -1), 'Helvetica'),
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    ('LEFTPADDING', (0, 0), (-1, -1), 8),
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story.append(table)

# ── TOP QUESTIONS ──
story += section("MOST LIKELY EXAM QUESTIONS")

story.append(space(0.2))
story.append(subsection("Long Essay (10 marks) — Top 8"))
for i, q in enumerate([
    "Case-Control study — design, methodology, advantages, disadvantages",
    "Cohort study — design, types, advantages, disadvantages",
    "Screening — criteria, sensitivity, specificity, PPV, NPV",
    "Epidemic investigation — steps",
    "Bradford Hill's criteria for causation",
    "Measurements in epidemiology (incidence, prevalence, mortality rates)",
    "Bias in epidemiological studies",
    "Randomized Controlled Trial"
], 1):
    story.append(bullet(f"{i}. {q}"))

story.append(space(0.3))
story.append(subsection("Short Notes (5 marks) — Top 10"))
for i, q in enumerate([
    "Odds Ratio",
    "Herd immunity",
    "Sentinel surveillance",
    "Attack rate and secondary attack rate",
    "Web of causation",
    "Epidemic curve",
    "Confounding and its control",
    "Sensitivity and Specificity",
    "Standardized Mortality Ratio",
    "Cross-sectional study"
], 1):
    story.append(bullet(f"{i}. {q}"))

# ── FOOTER NOTE ──
story.append(space(0.8))
story.append(HRFlowable(width="100%", thickness=1, color=colors.HexColor('#c0cce0')))
story.append(space(0.2))
story.append(Paragraph(
    "Source: Park's Textbook of Preventive and Social Medicine | Prepared by Orris Medical Education",
    note_style
))

doc.build(story)
print(f"PDF created: {OUTPUT}")