Diabetes Control Program — MCQs
According to WHO Global Action Plan for prevention and control of Non-communicable Diseases 2013-2020, targeted reduction in prevalence of raised blood pressure is :
Which of the following is not the criteria for diagnosis of Metabolic syndrome?
Which of the following screening methods is primarily used under the National Tuberculosis Elimination Program (NTEP)?
On republic day, a camp was organized and people were screened for Hypertension by checking BP and for diabetes by checking their BMI and Blood sugar level, which level of prevention is this?
Primordial prevention in myocardial infarction is all except -
A single disease control strategy implemented by a program is known as?
Which of the following procedures is not typically covered by the National Programme for Control of Blindness (NPCB) for reimbursement of surgery done by a non-governmental organization (NGO) eye hospital?
A diabetic patient's fasting blood glucose level is found to be $160 \mathrm{mg} / \mathrm{dL}$. What will you advise the patient regarding non-pharmacological management?
Provision of the Mental Health Act 2017, based on WHO guidelines, includes all, except:
What is the primary method of primordial prevention for Coronary Artery Disease (CAD)?
Diabetes Control Program Indian Medical PG Practice Questions and MCQs
Question 1: According to WHO Global Action Plan for prevention and control of Non-communicable Diseases 2013-2020, targeted reduction in prevalence of raised blood pressure is :
- A. 25% (Correct Answer)
- B. 33%
- C. 10%
- D. 50%
Explanation: ***25%*** - The **WHO Global Action Plan for the Prevention and Control of Non-communicable Diseases 2013-2020** set a target to reduce the prevalence of **raised blood pressure** (hypertension) by 25%. - This target is one of the nine global NCD targets aimed at curbing the NCD epidemic by 2025. *33%* - A 33% reduction is not a specific target for raised blood pressure in the WHO Global Action Plan for NCDs. - While significant reductions are sought across various NCD risk factors, this exact percentage isn't linked to hypertension prevalence. *10%* - A 10% reduction is generally considered too low for the ambitious goals set by the WHO for major NCD risk factors like raised blood pressure. - The plan aims for more substantial public health impact. *50%* - A 50% reduction in the prevalence of raised blood pressure is a very ambitious target, even beyond the scope of initial global NCD goals for this particular indicator. - While desirable, it was not the specific target set for raised blood pressure in the 2013-2020 action plan.
Question 2: Which of the following is not the criteria for diagnosis of Metabolic syndrome?
- A. High LDL (Correct Answer)
- B. Hyperiglyceridemia
- C. Hypertension
- D. Central obesity
Explanation: ***High LDL*** - While **high LDL (low-density lipoprotein)** is a risk factor for cardiovascular disease [1], it is **not** one of the specific diagnostic criteria for metabolic syndrome. - The criteria for metabolic syndrome focus on a cluster of metabolic abnormalities associated with insulin resistance. *Hypertriglyceridemia* - **Elevated triglycerides** (typically ≥ 150 mg/dL or on drug treatment for elevated triglycerides) is one of the key diagnostic criteria for metabolic syndrome. - It reflects impaired lipid metabolism often associated with insulin resistance [2]. *Hypertension* - **Elevated blood pressure** (systolic ≥ 130 mmHg or diastolic ≥ 85 mmHg, or on antihypertensive drug treatment) is a core component of metabolic syndrome. - Hypertension in this context is often linked to underlying insulin resistance. *Central obesity* - **Increased waist circumference** (varying by ethnicity and sex, e.g., >102 cm in men and >88 cm in women for adults of European descent) is a primary criterion for metabolic syndrome. - It is a strong indicator of visceral fat accumulation, which is closely linked to insulin resistance [3].
Question 3: Which of the following screening methods is primarily used under the National Tuberculosis Elimination Program (NTEP)?
- A. Active
- B. Passive (Correct Answer)
- C. Mass
- D. None of the options
Explanation: ***Passive*** - Under the NTEP, **passive screening** involves individuals presenting to health facilities with symptoms suggestive of TB. - This method relies on **patient self-reporting** and healthcare provider suspicion, rather than active outreach. - Passive case finding is the **primary screening strategy** used across the general population in the NTEP framework. *Active* - **Active screening** involves community-based interventions to proactively identify individuals with TB, often in high-risk populations. - While active case finding is crucial for specific vulnerable groups (contacts, HIV patients, etc.), it is **not the primary screening method** under the standard NTEP framework for initial detection across the entire population. *Mass* - **Mass screening** involves testing large numbers of people in the general population, regardless of symptoms, to detect disease. - This is generally **cost-prohibitive** and not routinely implemented as a primary screening strategy for TB by the NTEP due to resource limitations and low yield in the general population. *None of the options* - **Passive screening** is indeed a primary method used under the NTEP, making this option incorrect. - The NTEP heavily relies on individuals seeking care when they experience symptoms, which aligns with the definition of passive case finding.
Question 4: On republic day, a camp was organized and people were screened for Hypertension by checking BP and for diabetes by checking their BMI and Blood sugar level, which level of prevention is this?
- A. Secondary (Correct Answer)
- B. Tertiary
- C. Primary
- D. Primordial
Explanation: ***Secondary*** - This level of prevention focuses on **early detection** and prompt treatment of a disease to halt or slow its progression. - **Screening for hypertension and diabetes** through BP checks, BMI, and blood sugar levels aims to identify these conditions in their early stages before overt symptoms appear. *Tertiary* - This level of prevention involves measures to **reduce the impact** of an established disease, prevent complications, and improve quality of life. - Examples include rehabilitation programs or medications for long-term disease management, which are not described in the scenario. *Primary* - This level of prevention aims to **prevent a disease from occurring** in the first place, typically by addressing risk factors. - Examples include vaccination, health education on healthy eating, or promoting physical activity to prevent the development of hypertension or diabetes. *Primordial* - This is the **earliest level of prevention**, targeting the underlying social, environmental, and economic conditions that contribute to risk factors for disease. - It involves interventions to *prevent the emergence of risk factors* in populations, such as broad public health policies or community-wide initiatives.
Question 5: Primordial prevention in myocardial infarction is all except -
- A. Change in life style
- B. Change in Nutritional habits
- C. Maintenance of normal body weight
- D. Screening for hypertension (Correct Answer)
Explanation: ***Screening for hypertension*** - **Screening for hypertension** falls under **primary prevention**, as it aims to detect and treat a risk factor in individuals who have already developed a predisposition to the disease. - **Primordial prevention** focuses on preventing the development of risk factors themselves, rather than detecting them once they've emerged. *Change in life style* - **Lifestyle changes** such as promoting regular physical activity and avoiding smoking are key components of **primordial prevention**, preventing the development of risk factors like obesity and hypertension. - These interventions aim to stop risk factors from even appearing in healthy populations. *Change in Nutritional habits* - Promoting **healthy nutritional habits** from an early age is a fundamental strategy in **primordial prevention**, aiming to prevent the development of conditions like obesity and hyperlipidemia. - This proactive approach seeks to establish healthy patterns before disease risk factors take hold. *Maintenance of normal body weight* - Encouraging and supporting the **maintenance of normal body weight** in the general population is a classic example of **primordial prevention**. - This prevents the emergence of obesity, a major risk factor for cardiovascular diseases like myocardial infarction.
Question 6: A single disease control strategy implemented by a program is known as?
- A. Horizontal program
- B. Interventional program
- C. Volunteer program
- D. Vertical program (Correct Answer)
Explanation: ***Vertical program*** - A **vertical program** focuses on the specific control or eradication of a **single disease** or a highly integrated group of diseases. - These programs often operate with a dedicated infrastructure, resources, and personnel, distinct from the broader health system, to achieve their targeted objectives. *Horizontal program* - A **horizontal program** integrates multiple health services and diseases under a single, overarching health system. - It emphasizes strengthening the **primary healthcare infrastructure** and delivering comprehensive care rather than targeting individual diseases. *Interventional program* - An **interventional program** is a broad term that could apply to any health program designed to intervene in the progression or incidence of a disease. - It doesn't specifically define whether the intervention targets a single disease or multiple health issues; its focus is on the act of intervention itself. *Volunteer program* - A **volunteer program** refers to initiatives where individuals offer their time and services without receiving monetary compensation. - While volunteers can be part of any type of health program (vertical or horizontal), the term itself describes the nature of the labor force rather than the program's strategic approach to disease control.
Question 7: Which of the following procedures is not typically covered by the National Programme for Control of Blindness (NPCB) for reimbursement of surgery done by a non-governmental organization (NGO) eye hospital?
- A. Cataract surgery
- B. Pan retinal photocoagulation for diabetic retinopathy
- C. Syringing and probing of the nasolacrimal duct (Correct Answer)
- D. Trabeculectomy surgery
Explanation: ***Syringing and probing of the nasolacrimal duct*** - While important for lacrimal drainage issues, procedures like **syringing and probing** are generally considered minor and less vision-restoring compared to the major surgeries targeted by the **NPCB**. - The **NPCB** focuses on interventions for leading causes of blindness, primarily **cataract** and other significant vision-threatening conditions, which this procedure typically isn't. *Cataract surgery* - **Cataract surgery** is a cornerstone of the **NPCB's** efforts, as cataracts are the leading cause of reversible blindness. - Reimbursement for **cataract surgery** is a primary objective to improve access and reduce the burden of blindness. *Pan retinal photocoagulation for diabetic retinopathy* - **Diabetic retinopathy** is a major cause of preventable blindness, and **pan retinal photocoagulation (PRP)** is a key intervention to preserve vision. - The **NPCB** includes procedures for **diabetic retinopathy** management due to its significant public health impact. *Trabeculectomy surgery* - **Trabeculectomy** is a surgical procedure for **glaucoma**, which is another significant cause of irreversible blindness. - The **NPCB** includes interventions for **glaucoma** given its severe vision-threatening nature and the need for surgical management in many cases.
Question 8: A diabetic patient's fasting blood glucose level is found to be $160 \mathrm{mg} / \mathrm{dL}$. What will you advise the patient regarding non-pharmacological management?
- A. At least 25-35 g of dietary fibre
- B. <30 % of the calories should come from fat (Correct Answer)
- C. Dietary cholesterol <300 mg per day
- D. <2.3 g sodium intake every day
Explanation: ***<30 % of the calories should come from fat*** - Reducing dietary fat intake to less than 30% of total calories is a crucial non-pharmacological strategy for diabetic patients to manage blood glucose levels and prevent cardiovascular complications [1]. - Excess dietary fat, especially saturated and trans fats, can contribute to insulin resistance and weight gain, both of which negatively impact glycemic control [1]. *At least 25-35 g of dietary fibre* - While adequate dietary fiber (typically 25-30g for adults, sometimes up to 35g for men) is beneficial for managing blood glucose, it is generally recommended as a baseline for healthy eating and not the primary or most impactful intervention to address a fasting glucose of 160 mg/dL [1]. - Fiber helps slow glucose absorption and can improve insulin sensitivity, but a specific "at least 25-35g" statement without further context on total caloric intake or other macronutrient distribution might not be the most targeted advice for this specific glucose level [1]. *Dietary cholesterol <300 mg per day* - Limiting dietary cholesterol to less than 300 mg per day is a general recommendation for cardiovascular health, which is particularly important for diabetic patients due to their increased risk of atherosclerosis [2]. - However, for directly addressing a fasting blood glucose of 160 mg/dL, focusing on overall fat intake and carbohydrate quality would have a more immediate impact on glucose control than dietary cholesterol alone. *<2.3 g sodium intake every day* - Restricting sodium intake to less than 2.3 g per day is recommended for managing hypertension and reducing cardiovascular risk, which is often comorbid with diabetes [2]. - While important for overall health in diabetic patients, this recommendation does not directly target blood glucose control and would not be the primary non-pharmacological advice for a fasting glucose of 160 mg/dL.
Question 9: Provision of the Mental Health Act 2017, based on WHO guidelines, includes all, except:
- A. Social support
- B. Screening family members (Correct Answer)
- C. Human rights
- D. Communication regarding care and treatment
Explanation: ***Screening family members*** - The Mental Health Act 2017 focuses on the **rights, treatment, and support of individuals with mental illness**, not routine screening of their family members. - The Act does not contain provisions mandating **screening of asymptomatic family members**, though family history may be relevant for clinical assessment. - This is **not a provision** outlined in the Act based on WHO guidelines. *Human rights* - The Act is explicitly grounded in the **protection and promotion of human rights** for persons with mental illness (Chapter I). - Ensures care with **dignity, respect, and freedom from discrimination** as core principles. - Aligns with WHO's mental health action plan and human rights framework. *Communication regarding care and treatment* - **Section 4** emphasizes the right to information and **informed consent** for all treatment decisions. - Patients must receive clear communication about their **diagnosis, treatment options, and care plans**. - Includes provisions for **advance directives** and involvement in treatment decisions. *Social support* - **Chapter V** addresses rehabilitation and community-based services, emphasizing the role of **social support systems**. - Promotes **community integration** and access to social resources for recovery. - Recognizes family and community support as essential for long-term mental health management.
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
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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