NCD Risk Factor Surveillance Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for NCD Risk Factor Surveillance. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
NCD Risk Factor Surveillance Indian Medical PG Question 1: Which of the following is NOT a core component of the WHO's global STI control strategy?
- A. Case management
- B. Universal mandatory screening (Correct Answer)
- C. Strategic information systems
- D. Prevention services
NCD Risk Factor Surveillance Explanation: ***Universal mandatory screening***
- While screening is part of STI control, **universal mandatory screening** for all STIs in the general population is not a core component of the WHO's strategy due to feasibility, cost, and ethical considerations.
- The strategy emphasizes **targeted screening** for at-risk populations and opportunistic screening.
*Case management*
- **Case management**, including accurate diagnosis and effective treatment, is a critical component for managing current infections and preventing further transmission.
- This involves syndromic or etiologic approaches to treatment and partner notification.
*Strategic information systems*
- **Strategic information systems** are essential for monitoring trends, evaluating interventions, and informing policy decisions related to STI control.
- This includes surveillance data, program monitoring, and research.
*Prevention services*
- **Prevention services** are a cornerstone of the WHO's strategy, aiming to reduce the incidence of new infections.
- These services encompass health education, condom promotion and distribution, vaccination, and pre-exposure prophylaxis (PrEP).
NCD Risk Factor Surveillance Indian Medical PG Question 2: HIV sentinel surveillance is used for:
- A. Detection of high-risk group
- B. Prevalence of HIV infection
- C. Monitoring trends in HIV infection (Correct Answer)
- D. Monitoring disease trends
NCD Risk Factor Surveillance Explanation: ***Monitoring trends in HIV infection***
- **HIV sentinel surveillance** is specifically designed to track **HIV prevalence trends** over time in selected sentinel populations (ANC attendees, STD clinic attendees, high-risk groups).
- The primary objective is to monitor **how HIV infection rates change** over time, helping identify emerging epidemics, evaluate intervention programs, and guide public health policy.
- As per **NACO and WHO guidelines**, sentinel surveillance provides repeated cross-sectional prevalence measurements at fixed sites to detect temporal trends in HIV infection.
*Monitoring disease trends*
- This is **too broad and vague** for the specific purpose of HIV sentinel surveillance.
- "Disease trends" could refer to AIDS progression, opportunistic infections, or other disease manifestations, which are **not the focus** of sentinel surveillance.
- Sentinel surveillance specifically tracks **infection (seroprevalence)**, not general disease patterns.
*Prevalence of HIV infection*
- While sentinel surveillance **does measure prevalence**, this is a **method rather than the ultimate purpose**.
- Prevalence measurements are taken repeatedly at different time points specifically to **monitor trends**, making this incomplete as the primary objective.
*Detection of high-risk group*
- Identification of high-risk groups is typically done through **epidemiological studies** and behavioral surveys, not sentinel surveillance.
- Sentinel surveillance may **include** high-risk populations as sentinel sites, but its purpose is to monitor trends **within** these groups, not to detect them.
NCD Risk Factor Surveillance Indian Medical PG Question 3: Which of the following is NOT considered a risk factor for atherosclerosis?
- A. Smoking
- B. Low LDL cholesterol (Correct Answer)
- C. Hypercholesterolemia
- D. Hypertension
NCD Risk Factor Surveillance Explanation: ***Low LDL cholesterol***
- **Low levels of low-density lipoprotein (LDL) cholesterol** are protective against atherosclerosis [3].
- LDL cholesterol is often referred to as "bad" cholesterol because high levels contribute to the **buildup of fatty plaques in arteries**.
*Smoking*
- **Smoking** is a major independent risk factor for atherosclerosis, damaging the **endothelium** and promoting plaque formation.
- It increases **oxidative stress** and reduces **nitric oxide bioavailability**, leading to vasoconstriction and inflammation [2].
*Hypercholesterolemia*
- **Hypercholesterolemia**, particularly high levels of **LDL cholesterol**, is a primary risk factor as it contributes to the deposition of cholesterol in arterial walls [3].
- This leads to the formation of **atheromatous plaques** which narrow arteries and impede blood flow [1].
*Hypertension*
- **Hypertension (high blood pressure)** damages the arterial walls, making them more susceptible to the accumulation of plaque [1].
- The constant high pressure creates **shear stress**, compromising the integrity of the **endothelial lining**.
NCD Risk Factor Surveillance Indian Medical PG Question 4: What is WHO's global target for the prevention and control of non-communicable diseases by 2025 regarding hypertension reduction?
- A. 25% (Correct Answer)
- B. 35%
- C. 55%
- D. 75%
NCD Risk Factor Surveillance Explanation: ***25%***
- The World Health Organization (WHO) set a global target to achieve a **25% relative reduction in the prevalence of raised blood pressure** (hypertension) by 2025.
- This target is part of the WHO's **Global Action Plan for the Prevention and Control of Non-Communicable Diseases (2013-2025)**, one of nine voluntary global targets aiming to reduce premature mortality from NCDs.
- The target allows for flexibility: countries can either achieve the 25% relative reduction or contain the prevalence according to national circumstances.
*35%*
- A 35% reduction in hypertension prevalence is **not a specific global target** set by the WHO for 2025.
- The WHO established standardized targets (including 25% for hypertension) to enable consistent monitoring and comparison across countries.
*55%*
- A 55% reduction is **significantly higher** than the internationally agreed-upon global target for hypertension reduction by 2025.
- Such an aggressive target would be challenging to achieve systematically across diverse healthcare systems worldwide within this timeframe.
*75%*
- A 75% reduction in hypertension prevalence represents an **unrealistically high goal** for the WHO's 2025 targets.
- Global health targets are designed to be ambitious yet attainable, balancing aspiration with feasibility to encourage widespread implementation and measurable progress.
NCD Risk Factor Surveillance Indian Medical PG Question 5: Which of the following is primordial prevention for non-communicable diseases?
- A. Salt restriction in high NCD area
- B. Smoking cessation in high NCD area
- C. Preservation of traditional diet in low NCD area (Correct Answer)
- D. Early diagnosis & Treatment
NCD Risk Factor Surveillance Explanation: ***Preservation of traditional diet in low NCD area***
- **Primordial prevention** targets the underlying causes of disease before risk factors are established, often at a population level.
- Preserving a **healthy traditional diet** in an area with low rates of non-communicable diseases (NCDs) prevents the emergence of shared risk factors like processed food consumption and sedentary lifestyles.
*Salt restriction in high NCD area*
- This is an example of **primary prevention**, as it aims to reduce a specific risk factor (high salt intake) in a population susceptible to NCDs like hypertension.
- It intervenes when risk factors are already present or emerging, unlike primordial prevention which aims to prevent their development.
*Smoking cessation in high NCD area*
- Also a form of **primary prevention**, as it targets an existing modifiable risk factor (smoking) to prevent the onset of NCDs.
- It focuses on individuals or groups already exposed to a risk factor rather than preventing the societal conditions that lead to its emergence.
*Early diagnosis & Treatment*
- This falls under **secondary prevention**, which aims to detect and treat diseases early to halt their progression and prevent complications.
- It occurs after the disease has already begun but before significant symptoms or irreversible damage have occurred.
NCD Risk Factor Surveillance Indian Medical PG Question 6: Match the following drugs in Column A with their contraindications in Column B.
| Column A | Column B |
| :-- | :-- |
| 1. Morphine | 1. QT prolongation |
| 2. Amiodarone | 2. Thromboembolism |
| 3. Vigabatrin | 3. Pregnancy |
| 4. Estrogen preparations | 4. Head injury |
- A. A-1, B-3, C-2, D-4
- B. A-4, B-1, C-3, D-2 (Correct Answer)
- C. A-3, B-2, C-4, D-1
- D. A-2, B-4, C-1, D-3
NCD Risk Factor Surveillance Explanation: ***A-4, B-1, C-3, D-2***
- **Morphine** is contraindicated in **head injury** as it can increase intracranial pressure and mask neurological symptoms.
- **Amiodarone** is contraindicated in patients with **QT prolongation** due to its risk of inducing more severe arrhythmias like Torsades de Pointes.
- **Vigabatrin** is contraindicated during **pregnancy** due to its potential for teratogenicity and adverse effects on fetal development.
- **Estrogen preparations** are contraindicated in patients with a history of **thromboembolism** due to their increased risk of blood clot formation.
*A-1, B-3, C-2, D-4*
- This option incorrectly matches **Morphine** with QT prolongation and **Estrogen preparations** with head injury, which are not their primary contraindications.
- It also incorrectly links **Vigabatrin** with thromboembolism and **Amiodarone** with pregnancy.
*A-3, B-2, C-4, D-1*
- This choice incorrectly associates **Morphine** with pregnancy and **Vigabatrin** with head injury, which are not the most critical or direct contraindications.
- It also misaligns **Amiodarone** with thromboembolism and **Estrogen preparations** with QT prolongation.
*A-2, B-4, C-1, D-3*
- This option incorrectly matches **Morphine** with thromboembolism and **Amiodarone** with head injury, which are not their most significant contraindications.
- It also incorrectly links **Vigabatrin** with QT prolongation and **Estrogen preparations** with pregnancy.
NCD Risk Factor Surveillance Indian Medical PG Question 7: Which condition has the maximum relative risk attributed to obesity?
- A. Hypertension
- B. CHD
- C. DM (Correct Answer)
- D. Cancer
NCD Risk Factor Surveillance Explanation: ***DM***
- Obesity is a major risk factor for Type 2 Diabetes Mellitus (T2DM), with a **relative risk often exceeding 3-7 times that of normal-weight individuals**, and even higher for severe obesity.
- The link is primarily due to **insulin resistance** caused by increased adipose tissue.
*Hypertension*
- Obesity significantly increases the risk of hypertension, with a relative risk typically in the range of **2 to 3 times higher** than normal-weight individuals.
- The mechanisms involve increased **blood volume**, **sympathetic nervous system activity**, and **renal sodium reabsorption**.
*CHD*
- Obesity is a strong independent risk factor for Coronary Heart Disease (CHD), contributing to a relative risk of approximately **1.5 to 2.5 times higher** than normal weight.
- It often acts by exacerbating other risk factors like **hypertension**, **dyslipidemia**, and **diabetes**.
*Cancer*
- Obesity is linked to various cancers, including endometrial, esophageal adenocarcinoma, renal cell, and breast cancer in postmenopausal women, with relative risks typically ranging from **1.2 to 2 times higher** for specific cancers.
- The pathways include **chronic inflammation**, altered **hormone levels** (e.g., estrogen), and **insulin-like growth factor signaling**.
NCD Risk Factor Surveillance Indian Medical PG Question 8: STEPS is done for:
- A. Surveillance of risk factors of non-communicable disease (Correct Answer)
- B. Surveillance of mortality from non-communicable disease
- C. Surveillance of evaluation of treatment of non-communicable disease
- D. Surveillance of incidence of non-communicable disease
NCD Risk Factor Surveillance Explanation: ***Surveillance of risk factors of non-communicable disease***
- STEPS is a **WHO-designed sequential survey** that tracks **risk factors** of non-communicable diseases (NCDs) in a stepwise approach.
- It collects data on behavioral risk factors (e.g., tobacco use, unhealthy diet, physical inactivity), physical measurements (e.g., blood pressure, weight, height), and biochemical measurements (e.g., blood glucose, cholesterol).
*Surveillance of mortality from non-communicable disease*
- While related to NCDs, STEPS primarily focuses on **risk factors** that lead to these diseases, not directly on mortality data.
- Mortality surveillance is typically conducted through **vital registration systems** and health information systems.
*Surveillance of evaluation of treatment of non-communicable disease*
- STEPS surveys are not designed to evaluate the **effectiveness of specific treatments** for NCDs.
- Evaluating treatment efficacy usually involves **clinical trials** or specific cohort studies.
*Surveillance of incidence of non-communicable disease*
- Although the presence of risk factors influences incidence, STEPS primarily measures the **prevalence of risk factors**, not the incidence (new cases) of NCDs themselves.
- Incidence studies require longitudinal follow-up of populations.
NCD Risk Factor Surveillance Indian Medical PG Question 9: The preferred public health approach to control non-communicable disease is -
- A. Focus on high risk individuals for reduction of risk
- B. Early diagnosis and treatment of identified cases
- C. Shift to the population-based approach (Correct Answer)
- D. Individual disease-based vertical programs
NCD Risk Factor Surveillance Explanation: ***Shift to the population-based approach***
- A **population-based approach** aims to reduce the average risk across the entire population, leading to a larger overall reduction in NCD burden.
- This strategy focuses on broad interventions like health promotion, policy changes, and environmental modifications that benefit everyone.
*Focus on high risk individuals for reduction of risk*
- This approach, while important, only targets a smaller subset of the population and may miss individuals who are at moderate risk but contribute significantly to the overall disease burden.
- It relies on identifying and intervening with specific individuals, which can be resource-intensive and may not achieve widespread impact.
*Early diagnosis and treatment of identified cases*
- This is a crucial component of secondary prevention but primarily addresses **existing disease** rather than preventing its occurrence in the first place across the population.
- While it improves outcomes for affected individuals, it does not tackle the root causes of NCDs at a population level.
*Individual disease-based vertical programs*
- **Vertical programs** are highly focused on a single disease, which can lead to fragmentation of services and inefficient use of resources.
- They often fail to address the common risk factors and determinants that contribute to multiple NCDs, hindering a holistic public health response.
NCD Risk Factor Surveillance Indian Medical PG Question 10: What is the primary method of primordial prevention for Coronary Artery Disease (CAD)?
- A. Lifestyle change (Correct Answer)
- B. Coronary bypass
- C. Treatment of CAD
- D. Screening for hypertension
NCD Risk Factor Surveillance Explanation: ***Lifestyle change***
- **Primordial prevention** aims to prevent the development of risk factors themselves, which is best achieved through promoting healthy behaviors like diet, exercise, and avoiding tobacco at the population level.
- This approach acts *before* the onset of risk factors, addressing societal and environmental determinants of health.
- Examples include promoting healthy eating habits in schools, creating walkable communities, and tobacco-free environments.
*Coronary bypass*
- **Coronary bypass surgery** is a treatment for established CAD with significant blockages, not a preventive measure.
- It falls under the category of **tertiary prevention**, aiming to reduce complications and improve quality of life in existing disease.
*Treatment of CAD*
- **Treating CAD** (e.g., medications like statins or antiplatelets, procedures like angioplasty) is a form of **secondary** or **tertiary prevention**.
- It focuses on managing existing disease or preventing its progression, rather than preventing the initial development of risk factors.
*Screening for hypertension*
- **Screening** is a form of **secondary prevention** aimed at early detection of risk factors or disease.
- While important, it occurs *after* risk factors have already developed, unlike primordial prevention which prevents risk factors from emerging.
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