Non-Communicable Diseases Practice Questions

Q: Chandler index is used for the diagnosis of which condition?

Ancylostomiasis. **Explanation:** The **Chandler Index** is a specific epidemiological tool used to measure the intensity of infection in a community for **Ancylostomiasis (Hookworm infestation)**. It is calculated by taking the average number of hookworm eggs per gram of feces across a sampled population. * **Why Option A is correct:** The Chandler Index assesses the "worm burden." It is clinically significant because the severity of iron-deficiency anemia in hookworm disease is directly proportional to the number of worms present. An index of **less than 200** is considered low, while an index **greater than 250** indicates a significant public health problem where clinical anemia is likely prevalent in the community. * **Why other options are incorrect:** * **Ascariasis (B):** Diagnosis is typically made via stool microscopy for eggs or the passage of adult worms; there is no specific "index" named after Chandler for this. * **Dracunculiasis (C):** Diagnosis is clinical (visualizing the emerging Guinea worm). * **Filariasis (D):** Epidemiological assessment uses the **Microfilaria Rate**, **Density**, and the **Mosquito Infection/Infectivity Rate**, not the Chandler Index. **High-Yield Clinical Pearls for NEET-PG:** * **Hookworm species:** *Ancylostoma duodenale* (consumes ~0.15 ml blood/day) and *Necator americanus* (consumes ~0.03 ml blood/day). * **Stoll’s Egg Counting Technique:** Another method used to estimate worm load. * **Key Association:** Ground itch (at entry site) and Loeffler’s syndrome (during pulmonary migration).

Q: What is the standard treatment for P. Vivax malaria?

Chloroquine plus Primaquine. The standard treatment for *Plasmodium vivax* malaria requires a dual approach to ensure both clinical cure and the prevention of relapse. **Explanation of the Correct Answer:** *Plasmodium vivax* (and *P. ovale*) has a unique life cycle stage called the **hypnozoite**, which remains dormant in the liver. 1. **Chloroquine** is a blood schizonticide that kills the erythrocytic stages of the parasite, thereby providing symptomatic relief and clearing the clinical infection. 2. **Primaquine** is a tissue schizonticide (anti-relapse drug) that targets the dormant hypnozoites in the liver. To achieve a **radical cure**, both drugs must be administered concurrently. **Why other options are incorrect:** * **Option A (Chloroquine alone):** While it treats the active blood infection, it cannot kill liver hypnozoites. Using Chloroquine alone leads to frequent relapses. * **Option B (Primaquine alone):** Primaquine is relatively weak against the erythrocytic (blood) stages. Using it alone would not provide rapid clinical improvement or clear the high parasite load in the blood. **High-Yield Clinical Pearls for NEET-PG:** * **Dosage:** Under the National Vector Borne Disease Control Programme (NVBDCP) in India, the regimen for *P. vivax* is Chloroquine (25 mg/kg over 3 days) plus Primaquine (**0.25 mg/kg daily for 14 days**). * **G6PD Deficiency:** Before administering Primaquine, patients should ideally be screened for G6PD deficiency, as the drug can cause life-threatening **hemolysis**. * **Contraindication:** Primaquine is strictly **contraindicated in pregnancy** and in infants under 6 months of age. * **P. falciparum vs. P. vivax:** For *P. falciparum*, Primaquine is given as a single dose (0.75 mg/kg) on Day 2 as a gametocide to prevent transmission, not for radical cure.

Q: At what temperature should the measles vaccine be stored at a primary health care centre?

+2°C to 8°C. **Explanation:** The correct answer is **C (+2°C to 8°C)**. In the Universal Immunization Programme (UIP) in India, the storage temperature for vaccines at the peripheral level (Primary Health Centres and Community Health Centres) is standardized. While the measles vaccine is heat-sensitive and can be stored at sub-zero temperatures at higher levels of the cold chain (like GMSDs or State stores), it is stored in the **ILR (Ice-Lined Refrigerator)** at **+2°C to 8°C** at the PHC level to ensure operational uniformity and to prevent accidental freezing of other co-stored vaccines. **Analysis of Incorrect Options:** * **A (-20°C):** This is the storage temperature for the **OPV (Oral Polio Vaccine)** at the district level and for measles at the national/regional level. However, at the PHC level, deep freezers are primarily used for preparing ice packs, not for vaccine storage. * **B (0°C):** This is not a standard storage temperature for any vaccine in the cold chain. * **D (Room Temperature):** Measles is a live-attenuated vaccine and is highly heat-sensitive. Exposure to room temperature leads to rapid loss of potency. **High-Yield Clinical Pearls for NEET-PG:** * **Most Heat-Sensitive Vaccine:** OPV (followed by Measles). * **Most Heat-Resistant Vaccine:** TT (Tetanus Toxoid). * **Freeze-Sensitive Vaccines:** Hep B, DPT, Pentavalent, and TT. These must **never** be frozen (the "Shake Test" is used to check if they have been damaged by freezing). * **Reconstitution Rule:** Once reconstituted, the measles vaccine must be used within **4 hours** or discarded. It must be kept on an ice pad during the session. * **VVM (Vaccine Vial Monitor):** Always check the VVM before administration. If the inner square matches or is darker than the outer circle, the vaccine must be discarded.

Q: All of the following dietary goals are recommended for patients at high risk of coronary heart disease, EXCEPT:

Avoid alcohol. **Explanation:** The dietary management of Coronary Heart Disease (CHD) focuses on controlling dyslipidemia and hypertension. The correct answer is **D (Avoid alcohol)** because current clinical guidelines (such as the AHA/ACC and NCEP-ATP III) do not mandate absolute abstinence for CHD prevention. Instead, they recommend **moderation** (up to 1 drink/day for women and 2 for men). While excessive alcohol increases triglycerides and blood pressure, moderate consumption is not strictly contraindicated in primary or secondary prevention. **Analysis of Options:** * **LDL Cholesterol <100 mg/dL:** This is a primary target for high-risk individuals. For patients with established CHD or "CHD equivalents" (like Diabetes), the goal is often even more stringent (<70 mg/dL), but <100 mg/dL remains a standard benchmark for high-risk groups. * **Saturated fat <7% of total calories:** According to the **Therapeutic Lifestyle Changes (TLC) diet**, saturated fats must be restricted to less than 7% to effectively lower LDL levels. * **Salt restriction <6 gm/day:** The WHO and national guidelines recommend limiting salt to <5–6 grams/day (approx. 2.4g Sodium) to prevent hypertension, a major risk factor for CHD. **High-Yield Clinical Pearls for NEET-PG:** * **Dietary Fiber:** High-risk patients should consume **20–30 g/day** of total dietary fiber (specifically 10–25g of soluble fiber). * **Total Fat:** Should be limited to **25–35%** of total daily calories. * **Physical Activity:** At least **30 minutes** of moderate-intensity exercise most days of the week is recommended. * **Rule of Thumb:** In CHD prevention, "Restriction" is the keyword for salt and fats, while "Moderation" is the keyword for alcohol.

Q: Which one of the following is the most sensitive and specific screening test to detect breast cancer?

Mammography. ### Explanation **Correct Answer: C. Mammography** **Why Mammography is the Correct Choice:** Mammography is currently the "Gold Standard" for breast cancer screening. It is highly sensitive (77–95%) and specific (90–95%), capable of detecting non-palpable tumors and microcalcifications (the earliest sign of malignancy) up to two years before they can be felt clinically. In the context of public health and screening programs, it is the only method proven to reduce breast cancer mortality by approximately 20–30% in women over 50. **Analysis of Incorrect Options:** * **A. Regular X-ray:** Standard chest or skeletal X-rays lack the soft-tissue resolution required to differentiate between normal glandular tissue and malignant masses. Mammography is a specialized low-dose X-ray technique designed specifically for breast tissue. * **B. Self Breast Examination (SBE):** While SBE increases "breast awareness," it has low sensitivity and high false-positive rates. Large-scale trials have shown that SBE does not reduce mortality and often leads to unnecessary biopsies of benign lesions. * **D. Regular Biopsy:** A biopsy is a **diagnostic** tool, not a screening test. It is invasive, expensive, and impractical for asymptomatic populations. Screening is applied to healthy individuals to identify those at risk, whereas biopsy confirms the disease. **NEET-PG High-Yield Pearls:** * **Screening Age:** The WHO recommends mammography screening every 1–2 years for women aged 50–69 in settings with good health infrastructure. * **Triple Assessment:** The standard diagnostic protocol for a breast lump includes: 1. Clinical Examination, 2. Imaging (Mammography/Ultrasound), and 3. Pathology (FNAC/Core Biopsy). * **MRI Breast:** More sensitive than mammography but less specific; it is reserved for high-risk screening (e.g., BRCA1/2 carriers). * **BI-RADS:** The standardized reporting system used for mammography results.

Q: Which Indian state has the least neonatal mortality rate?

Tamil Nadu. **Explanation:** The **Neonatal Mortality Rate (NMR)** is defined as the number of deaths of infants under 28 days of age per 1,000 live births. It is a key indicator of the quality of antenatal, intrapartum, and postnatal care. **Why Tamil Nadu is Correct:** Among the given options, **Tamil Nadu** consistently performs as a leader in healthcare indices in India. According to the Sample Registration System (SRS) and NFHS-5 data, Tamil Nadu has successfully reduced its NMR (approx. 10-12 per 1,000 live births) through robust public health infrastructure, high rates of institutional deliveries (nearly 100%), and the effective implementation of the "Sick Newborn Care Units" (SNCU) model. **Analysis of Incorrect Options:** * **Delhi:** While it has advanced tertiary care centers, the NMR remains higher than Tamil Nadu due to a large migratory population and disparities in primary healthcare access in urban slums. * **Maharashtra & Karnataka:** Both states have made significant progress in maternal and child health; however, their NMR figures (ranging between 14-18) remain statistically higher than Tamil Nadu's due to regional disparities in tribal and rural belts. **High-Yield NEET-PG Pearls:** * **Lowest NMR in India:** **Kerala** holds the absolute lowest NMR (approx. 4-5 per 1,000 live births). Since Kerala is not in the options, Tamil Nadu is the best choice. * **Highest NMR in India:** Madhya Pradesh or Uttar Pradesh (per SRS data). * **Target:** The Sustainable Development Goal (SDG) 3.2 aims to reduce NMR to at least **12 per 1,000 live births** by 2030. * **Most Common Cause of Neonatal Mortality:** Preterm birth/Low Birth Weight (LBW), followed by Birth Asphyxia and Neonatal Sepsis.

Question 1

Eradication is possible in all of the following diseases except?

Accepted Answer

Tuberculosis

Answer

Measles

Answer

Polio

Answer

Dracunculosis

Question 2

Chandler index is used for the diagnosis of which condition?

Accepted Answer

Ancylostomiasis

Answer

Ascariasis

Answer

Dracunculiasis

Answer

Filariasis

Question 3

Under the National Polio Eradication Programme, a case of Acute Flaccid Paralysis is confirmed as Polio under which of the following circumstances, except?

Accepted Answer

If a patient develops paralysis 30 days after diagnosis of AFP

Answer

If a case is lost to follow-up

Answer

If a case could not be confirmed because the patient died before confirmation

Answer

If a wild strain of poliovirus is isolated from stool

Question 4

What is the standard treatment for P. Vivax malaria?

Accepted Answer

Chloroquine plus Primaquine

Answer

Chloroquine

Answer

Primaquine

Answer

None of the above

Question 5

At what temperature should the measles vaccine be stored at a primary health care centre?

Accepted Answer

+2°C to 8°C

Answer

-20°C

Answer

0°C

Answer

Any temperature not exceeding room temperature

Question 6

Which of the following statements is FALSE regarding coronary heart disease?

Accepted Answer

Coronary heart disease in India typically occurs one decade later than in Western populations.

Answer

Heavy cigarette smoking is a risk factor.

Answer

Males are affected more frequently than females.

Answer

None of the above statements are false.

Question 7

All of the following dietary goals are recommended for patients at high risk of coronary heart disease, EXCEPT:

Accepted Answer

Avoid alcohol

Answer

LDL cholesterol <100 mg/dL

Answer

Saturated fat < 7% of total calories

Answer

Salt restriction < 6 gm/day

Question 8

Which one of the following is the most sensitive and specific screening test to detect breast cancer?

Accepted Answer

Mammography

Answer

Regular X-ray

Answer

Self breast examination

Answer

Regular biopsy

Question 9

What is true about the Oral Polio Vaccine?

Accepted Answer

Causes poliomyelitis in recipients

Answer

Causes poliomyelitis in contacts of non-recipients

Answer

Causes Guillain-barre syndrome

Answer

Causes vomiting and fever

Question 10

Which Indian state has the least neonatal mortality rate?

Accepted Answer

Tamil Nadu

Answer

Delhi

Answer

Karnataka

Answer

Maharashtra

Non-Communicable Diseases — MCQs

Non-Communicable Diseases — MCQs

On this page

Practice by Chapter

Want unlimited practice?