Adolescent Health — MCQs
All of the following are characteristic features of treatment of iron deficiency anemia with oral iron supplements, except which of the following?
What is the iron requirement for a normal menstruating adult female?
When was the National Mental Health Programme (NMHP) started in India?
A 14-year-old victim of sexual assault with 22 weeks gestation has been brought for Medical Termination of Pregnancy (MTP). Which of the following statements is true?
A sexually active 16-year-old presents for STI screening with recent assault history, multiple partners, inconsistent condom use. Which comprehensive prevention strategy is most appropriate?
Indira Gandhi Matritva Sahyog Yojana is targeted at which age group?
All of the following are sexually transmitted, except.
Which of the following is NOT considered a phase of child sexual abuse?
Which of the following is NOT a key intervention implemented under the Reproductive and Child Health (RCH) programme?
Main focus of UNICEF is on?
Adolescent Health Indian Medical PG Practice Questions and MCQs
Question 1: All of the following are characteristic features of treatment of iron deficiency anemia with oral iron supplements, except which of the following?
- A. Bioavailability is enhanced with vitamin C
- B. The proportion of iron absorbed reduces as hemoglobin improves
- C. The reticulocyte count should begin to increase within 7-10 days and peak at 2-4 weeks; this suggests good response to treatment
- D. The treatment should be discontinued immediately once hemoglobin normalizes to prevent side effects of iron (Correct Answer)
Explanation: ***The treatment should be discontinued immediately once hemoglobin normalizes to prevent side effects of iron*** - Treatment of **iron deficiency anemia** with oral iron supplements should continue for at least **3-6 months** after hemoglobin normalizes to replenish **iron stores**. - Premature cessation can lead to a rapid **recurrence of anemia** due to depleted iron reserves, despite normal hemoglobin levels. *Bioavailability is enhanced with vitamin C* - **Ascorbic acid (vitamin C)** creates an acidic environment in the stomach and reduces ferric iron (Fe3+) to ferrous iron (Fe2+), which is more readily absorbed. - This enhancement of **ferrous iron absorption** is a common practice to improve the efficacy of oral iron supplements. *The proportion of iron absorbed reduces as hemoglobin improves* - The body's **iron absorption mechanism** is tightly regulated by **hepcidin**, a hormone that increases when iron stores are sufficient. - As hemoglobin levels improve and iron stores are replenished, hepcidin levels rise, leading to a **decrease in iron absorption** to prevent iron overload. *The reticulocyte count should begin to increase in two weeks and peak in 4 weeks this suggests good response to treatment* - An increase in **reticulocyte count** by approximately **7-10 days** and peaking around **2-4 weeks** after starting iron therapy indicates that the bone marrow is effectively responding to the increased iron availability by producing new red blood cells. - This **reticulocytosis** is an early and reliable sign of a positive treatment response before a significant rise in hemoglobin is observed.
Question 2: What is the iron requirement for a normal menstruating adult female?
- A. 30 mg/day
- B. 35 mg/day
- C. 20 mg/day
- D. 15 mg/day (Correct Answer)
Explanation: ***15 mg/day*** - The recommended daily iron intake for a normal menstruating adult female was **15 mg/day** according to guidelines at the time of this examination (NEET-2013). - This higher requirement compared to males and post-menopausal women is due to **iron loss in menstrual blood**, averaging approximately **0.5-1 mg/day** additional iron loss. - **Note:** Current guidelines recommend **18 mg/day** (US RDA) or **21 mg/day** (ICMR, India), but this question reflects the 2013 standard. *20 mg/day* - This amount is **higher than the typical recommendation** for healthy menstruating women without significant pathology. - While some women with heavier menstrual bleeding might require this, it's not the baseline requirement for normal menstruation. *30 mg/day* - This intake level is typically recommended for **pregnant women** in the second and third trimesters or individuals with **diagnosed iron deficiency anemia** requiring therapeutic supplementation. - It is significantly more than the daily requirement for a healthy menstruating female. *35 mg/day* - This is an **excessively high** daily iron intake for a healthy menstruating female. - Such high doses are usually prescribed for **severe iron deficiency anemia** or specific medical conditions under supervision. - Chronic intake at this level without medical indication could potentially lead to adverse effects.
Question 3: When was the National Mental Health Programme (NMHP) started in India?
- A. 1987
- B. 1995
- C. 1982 (Correct Answer)
- D. 1990
Explanation: ***1982*** - The **National Mental Health Programme (NMHP)** was launched in India in **1982**. - Its objective was to ensure the availability and accessibility of minimum mental healthcare for all. *1987* - This year is not recognized as the starting point for a major national mental health program in India. - While there may have been mental health initiatives, 1982 marks the official launch of the NMHP. *1995* - While subsequent amendments and enhancements to the NMHP occurred, 1995 was not the year of its inception. - The **District Mental Health Programme (DMHP)** was initiated as a pilot project in 1996, building on the NMHP. *1990* - This year did not mark the beginning of the national mental health program in India. - The initial framework and goals for mental healthcare were established earlier in the 1980s.
Question 4: A 14-year-old victim of sexual assault with 22 weeks gestation has been brought for Medical Termination of Pregnancy (MTP). Which of the following statements is true?
- A. One doctor is involved
- B. MTP done in 2nd trimester only when mother's life is in danger
- C. MTP can be carried out up to 24 weeks (Correct Answer)
- D. MTP cannot be more than 20 weeks
Explanation: ***MTP can be carried out up to 24 weeks*** - The **Medical Termination of Pregnancy (Amendment) Act, 2021**, allows termination of pregnancy up to **24 weeks** for certain vulnerable groups, including survivors of sexual assault and minors. - As a 14-year-old victim of sexual assault, she falls under the category which permits MTP up to 24 weeks. *One doctor is involved* - For pregnancies between 12 and 20 weeks, the opinion of **two registered medical practitioners** is required for MTP. - Beyond 20 weeks up to 24 weeks, as in this case, the opinion of **two registered medical practitioners** is also mandatory. *MTP done in 2nd trimester only when mother's life is in danger* - While danger to the mother's life is a valid reason for MTP, the **MTP Act 2021** has expanded the grounds for MTP in the second trimester (beyond 12 weeks) to include other categories like **sexual assault survivors** and **minors**, even if the mother's life is not immediately in danger. - The primary consideration here is the **vulnerability** of the pregnant person, not solely imminent danger to life. *MTP cannot be more than 20 weeks* - This statement is incorrect as per the **Medical Termination of Pregnancy (Amendment) Act, 2021**. - The Act raised the upper gestation limit from 20 to **24 weeks** for specific categories of women, including victims of sexual assault and minors, aligning with the current case.
Question 5: A sexually active 16-year-old presents for STI screening with recent assault history, multiple partners, inconsistent condom use. Which comprehensive prevention strategy is most appropriate?
- A. HPV vaccination, counseling, PrEP evaluation, and regular screening (Correct Answer)
- B. Condoms and annual screening
- C. Single STI screen and treatment if needed
- D. Abstinence counseling only
Explanation: ***HPV vaccination, counseling, PrEP evaluation, and regular screening*** - This option offers a **comprehensive approach** addressing multiple risk factors and potential exposures, including **vaccination** for HPV, **counseling** for risk reduction, **PrEP evaluation** for HIV prevention due to multiple partners and inconsistent condom use, and **regular screening** for early detection. - The patient's history of **sexual assault**, **multiple partners**, and **inconsistent condom use** necessitates a multi-faceted prevention strategy that goes beyond basic screening. *Condoms and annual screening* - While **condoms** are essential for preventing STIs, and **annual screening** is important, this strategy is not comprehensive enough given the patient's high-risk profile (multiple partners, inconsistent condom use, sexual assault history). - It omits important preventive measures like **HPV vaccination** and consideration for **PrEP**, which are crucial for this patient's age and risk factors. *Single STI screen and treatment if needed* - A **single STI screen** is insufficient as it only provides a snapshot of current infections and does not incorporate **prevention strategies** for future encounters or address the ongoing risk factors. - This approach fails to provide **proactive protection** through vaccination or PrEP and does not include ongoing counseling for risk reduction. *Abstinence counseling only* - While **abstinence** is the most effective way to prevent STIs, relying solely on **abstinence counseling** is often unrealistic and insufficient for a sexually active individual, especially one with a history of sexual assault and current high-risk behaviors. - This option completely disregards the need for **medical interventions** like vaccination, PrEP, and regular screening that are vital for this patient's health.
Question 6: Indira Gandhi Matritva Sahyog Yojana is targeted at which age group?
- A. Above 65 years old
- B. Above 50 years old
- C. Above 30 years old
- D. 19 years and above (Correct Answer)
Explanation: ***19 years and above*** - The **Indira Gandhi Matritva Sahyog Yojana (IGMSY)**, now known as the **Pradhan Mantri Matru Vandana Yojana (PMMVY)**, is a **conditional cash transfer scheme** for pregnant and lactating women. - Eligibility for the scheme generally applies to women aged **19 years and above** for their first live birth. *Above 65 years old* - This age group is typically associated with schemes targeting **senior citizens** or those needing geriatric care, not maternal benefits. - The **Indira Gandhi Matritva Sahyog Yojana** focuses on reproductive age and maternal health. *Above 50 years old* - Women above 50 years old are generally past their child-bearing age, making them largely irrelevant for a **maternity benefit scheme**. - This age group may be eligible for different types of social security or health schemes. *Above 30 years old* - While women above 30 years old can be pregnant and benefit from the scheme, the eligibility criteria start earlier, at **19 years and above**. - Stating "above 30 years old" would exclude a significant portion of eligible beneficiaries in their early reproductive years.
Question 7: All of the following are sexually transmitted, except.
- A. Echinococcus (Correct Answer)
- B. Molluscum contagiosum
- C. Group B streptococcus
- D. Candida albicans
Explanation: ***Echinococcus*** - **Echinococcus** (*Echinococcus granulosus* or *Echinococcus multilocularis*) causes **echinococcosis** (hydatid disease) which is transmitted through **ingestion of parasite eggs** found in contaminated food, water, or soil, often from dog feces. - The life cycle involves a **definitive host** (dogs) and an **intermediate host** (sheep, humans), with transmission occurring via the **fecal-oral route**, NOT through sexual contact. *Candida albicans* - While *Candida albicans* is part of normal human flora, **candidiasis** can be **sexually transmitted** through intimate contact. - Vaginal candidiasis and balanitis can be transmitted between sexual partners. *Molluscum contagiosum* - **Molluscum contagiosum** is a **viral skin infection** caused by a poxvirus that is commonly **sexually transmitted in adults** through direct skin-to-skin contact. - The lesions are small, raised, and dome-shaped with a central dimple. *Group B Streptococcus* - **Group B Streptococcus (GBS)** can colonize the **genital and gastrointestinal tracts** and can be transmitted through sexual contact. - While GBS is more clinically significant for vertical (perinatal) transmission from mother to newborn during delivery, colonization in adults can occur through sexual activity.
Question 8: Which of the following is NOT considered a phase of child sexual abuse?
- A. Engagement
- B. Secrecy
- C. Bargaining (Correct Answer)
- D. Sexual interaction
Explanation: ***Bargaining*** - **Bargaining** is typically a phase associated with the Kubler-Ross model of grief (denial, anger, bargaining, depression, acceptance) and is not recognized as a distinct phase in the cycle or process of child sexual abuse. - While a child might attempt to bargain in some contexts for safety or to stop the abuse, it is not a universally accepted or described phase of the abuse process itself. *Engagement* - The **engagement** phase often involves the perpetrator grooming the child, building trust, and isolating them from protective factors. - This phase is crucial for the abuser to gain the child's compliance and reduce the likelihood of disclosure. *Secrecy* - **Secrecy** is a core component of child sexual abuse, where the perpetrator often instills fear or manipulates the child to keep the abuse hidden. - This phase typically involves threats, intimidation, or emotional manipulation to prevent the child from disclosing the abuse to others. *Sexual interaction* - The **sexual interaction** phase refers to the actual abusive acts and physical contact that define child sexual abuse. - This is the explicit act of sexual exploitation or assault that the perpetrator inflicts upon the child.
Question 9: Which of the following is NOT a key intervention implemented under the Reproductive and Child Health (RCH) programme?
- A. Immunization
- B. ORS therapy
- C. Vitamin A supplementation
- D. Management of hypertension (Correct Answer)
Explanation: ***Management of hypertension*** - While important for overall health, the **management of non-communicable diseases (NCDs)** like hypertension is not a primary, direct focus of the **Reproductive and Child Health (RCH) programme**. - RCH programs primarily target interventions related to women's reproductive health, safe motherhood, and child survival. *Immunization* - **Immunization** is a cornerstone intervention of the RCH program, crucial for preventing major childhood diseases and improving child survival rates. - It directly contributes to reducing **infant and child mortality** by protecting against vaccine-preventable diseases. *ORS therapy* - **Oral Rehydration Solution (ORS) therapy** is a key intervention within the RCH program aimed at reducing child mortality due to diarrheal diseases. - It is effective in treating **dehydration** caused by diarrhea, a common cause of death in young children. *Vitamin A supplementation* - **Vitamin A supplementation** is an essential RCH intervention, particularly for children, to prevent **vitamin A deficiency**. - It plays a vital role in **boosting immunity**, preventing blindness, and reducing the severity of common childhood infections.
Question 10: Main focus of UNICEF is on?
- A. Child health (Correct Answer)
- B. Social health
- C. Mental health
- D. Nutritional health
Explanation: ***Child health*** - UNICEF's primary mission focuses on advocating for the protection of children's rights, helping to meet their basic needs, and expanding their opportunities to reach their full potential. - This encompasses various aspects of child welfare, with **child health** being a fundamental and overarching priority. *Social health* - While UNICEF's work indirectly contributes to **social health** by fostering community well-being, its direct and explicit focus is not primarily on the broader concept of social health. - Social health is a very broad term that encompasses many aspects not directly and exclusively dealt with by UNICEF. *Mental health* - **Child mental health** is an increasingly recognized area of focus for UNICEF, but it falls under the broader umbrella of child health and well-being, rather than being its sole or main focus. - While important, mental health is a component of overall child health, not the singular main focus. *Nutritional health* - **Nutritional health** is a critical component of child health and a significant area of intervention for UNICEF. - However, it represents one vital aspect within the comprehensive scope of "child health," not the exclusive main focus.
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