Non-Communicable Diseases Practice Questions

Q: A 20-year-old male is found to have blood pressures of 134/82 mmHg and 136/83 mmHg on two separate occasions. How will he be classified?

High normal BP. ### Explanation The classification of blood pressure (BP) in this case is based on the **JNC-7** and **WHO/ISH** guidelines, which are frequently tested in NEET-PG. **1. Why "High Normal BP" is correct:** According to the WHO/ISH classification, **High Normal BP** is defined as a Systolic BP (SBP) of **130–139 mmHg** and/or a Diastolic BP (DBP) of **85–89 mmHg**. In this patient, the readings (134/82 and 136/83) fall squarely within the systolic range for High Normal BP. Even if only one value (systolic or diastolic) falls into a higher category, the higher value determines the classification. **2. Why other options are incorrect:** * **Normotensive:** Normal BP is defined as SBP **<120 mmHg** and DBP **<80 mmHg**. This patient’s readings exceed these limits. * **Stage 1 Hypertension:** This requires an SBP of **140–159 mmHg** or a DBP of **90–99 mmHg**. The patient's readings are below this threshold. * **Stage 2 Hypertension:** This is defined as SBP **≥160 mmHg** or DBP **≥100 mmHg**. **High-Yield Clinical Pearls for NEET-PG:** * **JNC-7 vs. ACC/AHA 2017:** While JNC-7 uses "Pre-hypertension" (120–139/80–89), the WHO classification uses "High Normal." Note that the **2017 ACC/AHA guidelines** (often used in clinical practice) would classify this patient as **Stage 1 Hypertension** (130–139/80–89), but for Community Medicine exams, stick to the WHO/JNC-7 definitions unless specified otherwise. * **Diagnosis Rule:** Hypertension should be diagnosed based on the average of **two or more** properly measured readings on **two or more** separate occasions. * **Rule of Halves:** 1/2 of cases are known, 1/2 of known cases are treated, and 1/2 of treated cases are controlled.

Q: What is the approximate risk of mother-to-child transmission of HIV?

25%. **Explanation:** The risk of Mother-to-Child Transmission (MTCT) of HIV, also known as vertical transmission, occurs in the absence of any medical intervention (antiretroviral therapy, elective cesarean section, or avoidance of breastfeeding). **1. Why 25% is correct:** In untreated cases, the transmission rate is generally estimated to be between **20% and 30%** (averaging approximately **25%**). The transmission occurs at three stages: * **In-utero (Antenatal):** 5–10% * **During Labor/Delivery (Intranatal):** 10–15% (This is the period of highest risk per hour) * **Breastfeeding (Postnatal):** 5–20% **2. Why other options are incorrect:** * **50%, 60%, and 75%:** These values are significantly higher than the biological reality of HIV transmission. Even with high viral loads, the placental barrier and maternal immune factors prevent the majority of fetuses from contracting the virus. A 50-75% risk would imply that transmission is the "rule" rather than a 1-in-4 statistical probability. **High-Yield Clinical Pearls for NEET-PG:** * **With Intervention:** With Effective ART (Antiretroviral Therapy), viral suppression, and proper postnatal care, the risk of MTCT can be reduced to **less than 2%**. * **PPTCT Protocol (India):** The current WHO/NACO recommendation is **Option B** (Lifelong ART for all pregnant and breastfeeding women regardless of CD4 count). * **Drug of Choice:** **Tenofovir (TDF) + Lamivudine (3TC) + Dolutegravir (DTG)** is the preferred regimen. * **Infant Prophylaxis:** Nevirapine syrup is typically given to the infant for 6 weeks. * **Most common route:** The most common route of pediatric HIV infection worldwide is vertical transmission.

Q: What is the normal waist-hip ratio for a female?

0.8. **Explanation:** The **Waist-Hip Ratio (WHR)** is a critical anthropometric index used to measure abdominal (central) obesity and assess the risk of developing non-communicable diseases (NCDs) like Type 2 Diabetes and Cardiovascular diseases. **1. Why Option B (0.8) is Correct:** According to the World Health Organization (WHO), the cut-off point for a "normal" or healthy waist-hip ratio in **females is ≤ 0.80**. A ratio higher than this indicates "android" or apple-shaped obesity, which carries a significantly higher metabolic risk. In females, fat distribution is typically "gynoid" (pear-shaped), resulting in a lower ratio compared to males. **2. Analysis of Incorrect Options:** * **Option A (0.7):** While this is a healthy ratio, it is not the standard clinical "cut-off" or threshold used to define the upper limit of normalcy in medical examinations. * **Option C (0.9):** This is the **normal cut-off for Males (≤ 0.90)**. In females, a ratio of 0.9 indicates significant central obesity and high health risk. * **Option D (1.0):** A ratio of 1.0 or higher indicates severe abdominal obesity in both sexes and is associated with a high risk of metabolic syndrome. **3. High-Yield Clinical Pearls for NEET-PG:** * **Measurement Technique:** Waist circumference is measured midway between the lower rib margin and the iliac crest; Hip circumference is measured at the widest portion of the buttocks. * **WHO Cut-offs for Obesity:** * **Males:** > 0.90 (High Risk) * **Females:** > 0.85 (High Risk) — *Note: 0.80 is the ideal/normal threshold often tested.* * **Waist Circumference (WC) alone:** In Asian Indians, the cut-off for abdominal obesity is **> 90 cm for men** and **> 80 cm for women**. * **Significance:** WHR is a better predictor of mortality in older adults than Body Mass Index (BMI).

Q: What is the average number of fleas of each species per rodent called?

Specific Flea Index. ### Explanation In the study of plague epidemiology, flea indices are critical metrics used to monitor the risk of disease transmission from rodents to humans. **1. Why "Specific Flea Index" is correct:** The **Specific Flea Index** is defined as the average number of fleas of a **particular species** found per rodent host. For example, calculating the average number of *Xenopsylla cheopis* per rat gives the "Cheopis Index." This is a vital indicator because different flea species have varying efficiencies as plague vectors. A Cheopis Index greater than **1.0** is considered the critical threshold for an increased risk of a plague outbreak. **2. Why the other options are incorrect:** * **General Flea Index:** This refers to the average number of fleas of **all species** found per rodent. It provides a broad measure of infestation but does not account for the vector efficiency of specific species. * **Incidence of Flea Species:** This is not a standard epidemiological term in malariology or plague control. Incidence typically refers to the number of new cases of a disease in a population over a period. * **Flea Infestation Rate:** This is the **percentage** of rodents infested with fleas (of any species). It measures how widespread the infestation is among the host population, rather than the density of fleas per host. **3. High-Yield Facts for NEET-PG:** * **Vector of Plague:** *Xenopsylla cheopis* (Oriental rat flea) is the most efficient vector. * **Critical Threshold:** A Cheopis Index **> 1** indicates a potential plague epidemic. * **Blocking Phenomenon:** This occurs when *Yersinia pestis* multiplies in the flea's proventriculus, preventing blood from entering the stomach. The "blocked" flea bites repeatedly in an attempt to feed, thereby transmitting the bacteria. * **Total Flea Index:** Another name for the General Flea Index.

Q: Which of the following diseases involves a transmission chain with birds, arthropods, and humans?

Japanese encephalitis. **Explanation:** **Japanese Encephalitis (JE)** is the correct answer because it follows a complex **zoonotic transmission cycle** involving three key components: 1. **Birds:** Ardeid birds (herons and egrets) act as the **natural reservoir** hosts. 2. **Arthropods:** The primary vector is the **Culex tritaeniorhynchus** mosquito, which breeds in stagnant water like rice fields. 3. **Humans:** Humans act as **accidental, dead-end hosts** because the viremia in humans is insufficient to infect a biting mosquito. *Note: Pigs are the most important "amplifier hosts" in this cycle, but the bird-arthropod-human chain is a classic description of JE ecology.* **Why the other options are incorrect:** * **Malaria:** Involves an **Anopheles** mosquito and **Humans** only. There is no avian (bird) reservoir involved in human malaria. * **Paragonimus (Lung Fluke):** A parasitic infection involving a complex cycle with snails (1st intermediate host), crustaceans/crabs (2nd intermediate host), and humans/mammals. It does not involve birds or arthropod vectors. * **Plague:** Primarily involves **Rodents** (rats) and the **Rat Flea** (*Xenopsylla cheopis*). While birds are not part of the cycle, humans are accidental hosts. **High-Yield NEET-PG Pearls:** * **Vector:** *Culex tritaeniorhynchus* (Night biter, rice field breeder). * **Amplifier Host:** Pig (shows no symptoms but produces high viral titers). * **Dead-end Hosts:** Humans and Horses. * **Vaccine:** Live attenuated **SA-14-14-2** is commonly used in the Universal Immunization Programme (UIP) in endemic districts of India. * **Seasonality:** Peak incidence coincides with the rainy season and post-harvest periods.

Q: Secondary prevention is most useful in the early detection and treatment of which of the following cancers?

Cervical cancer. ***Cervical cancer*** - Cervical cancer is a classic example of successful **secondary prevention** due to effective screening tests like the **Papanicolaou (Pap) test** and **Human Papillomavirus (HPV) testing**, which can detect precancerous lesions (**cervical intraepithelial neoplasia, CIN**). - The image displays a **colposcopy**, where **acetic acid** is applied to the cervix, causing abnormal cells with high nuclear density to turn white (**acetowhite changes**). This guides biopsy and allows for early treatment, preventing progression to invasive cancer. *Pancreatic cancer* - There is currently no effective or recommended screening test for **pancreatic cancer** in the asymptomatic, average-risk population. - It often presents with non-specific symptoms at a late stage due to its retroperitoneal location, leading to a delayed diagnosis and poor prognosis. *Ovarian cancer* - Routine screening with **CA-125** and **transvaginal ultrasound** is not recommended for the general population as it has not been proven to reduce mortality. - These screening methods have a high rate of **false positives**, leading to unnecessary invasive procedures and patient anxiety. *Glioblastoma* - There are no established screening protocols for **glioblastoma**, a highly aggressive primary brain tumor. - Diagnosis is typically made after the onset of neurological symptoms, such as headaches or seizures, at which point the tumor is usually advanced.

Q: The logo shown here belongs to which of the following programmes?

NTCP. ***NTCP*** - The logo displays a hand making a **'V' for victory** sign (or peace sign) with a flower, and the text in Hindi reads, "**Zindagi Chuno, Tambaku Nahi**" (Choose Life, Not Tobacco). - This message is directly aligned with the goals of the **National Tobacco Control Programme (NTCP)**, which aims to reduce tobacco consumption in India. *JSY* - JSY stands for **Janani Suraksha Yojana**, a conditional cash transfer scheme that promotes institutional deliveries among pregnant women. - Its logo and messaging are focused on **maternal health and safe deliveries**, not tobacco control. *NPCDCS* - NPCDCS refers to the **National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke**. - While it deals with non-communicable diseases, its primary focus is not **tobacco cessation** as explicitly indicated in the logo. *Mission Indradhanush* - Mission Indradhanush is a flagship program of the Government of India that aims to **achieve full immunization** coverage for all children and pregnant women. - Its logo and campaigns are specifically related to **vaccination**, not warnings against tobacco use.

Q: Which of the following is the most important modifiable risk factor for coronary heart disease?

Cigarette smoking. ***Cigarette smoking*** - **Cigarette smoking** is considered the most significant modifiable risk factor for coronary heart disease due to its direct and severe impact on **endothelial function** and **atherosclerosis**. - It causes vasoconstriction, increases **blood pressure**, lowers **HDL cholesterol**, and promotes **thrombosis**. *Obesity* - **Obesity** is a significant modifiable risk factor, often linked to other conditions like **hypertension** and **diabetes**, which increase CHD risk. - However, its impact is generally considered less direct and severe than that of active smoking. *Sedentary habits* - **Sedentary habits** contribute to CHD risk by promoting obesity, **insulin resistance**, and unfavorable lipid profiles. - While important, the direct and immediate harm caused by sedentary habits is typically less pronounced compared to smoking. *Age* - **Age** is a major risk factor for coronary heart disease, with risk increasing significantly as one gets older. - However, age is a **non-modifiable** risk factor, meaning it cannot be changed, unlike the factors listed in the other options.

Question 1

A 20-year-old male is found to have blood pressures of 134/82 mmHg and 136/83 mmHg on two separate occasions. How will he be classified?

Accepted Answer

High normal BP

Answer

Normotensive

Answer

Stage 1 hypertension

Answer

Stage 2 hypertension

Question 2

What is the approximate risk of mother-to-child transmission of HIV?

Accepted Answer

25%

Answer

50%

Answer

60%

Answer

75%

Question 3

What is the normal waist-hip ratio for a female?

Accepted Answer

0.8

Answer

0.7

Answer

0.9

Answer

1

Question 4

What is the average number of fleas of each species per rodent called?

Accepted Answer

Specific Flea Index

Answer

General Flea Index

Answer

Incidence of Flea Species

Answer

Flea Infestation Rate

Question 5

Which of the following statements is TRUE regarding the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)?

Accepted Answer

The district hospital has specialized facilities.

Answer

There is a separate center for stroke, diabetes mellitus, and cancer.

Answer

Implementation is in some 5 states over 10 districts.

Answer

Subcenters have facilities for diagnosis and treatment.

Question 6

Which of the following diseases involves a transmission chain with birds, arthropods, and humans?

Accepted Answer

Japanese encephalitis

Answer

Malaria

Answer

Paragonimus

Answer

Plague

Question 7

Secondary prevention is most useful in the early detection and treatment of which of the following cancers?

Accepted Answer

Cervical cancer

Answer

Pancreatic cancer

Answer

Ovarian cancer

Answer

Glioblastoma

Question 8

According to NPCBVI, blindness is defined as:

Accepted Answer

Presenting visual acuity < 3/60 in better eye

Answer

Corrected visual acuity 6/60 in better eye

Answer

Corrected visual acuity 3/60 in better eye

Answer

Presenting visual acuity 6/60 in better eye

Question 9

The logo shown here belongs to which of the following programmes?

Accepted Answer

NTCP

Answer

JSY

Answer

NPCDCS

Answer

Mission Indradhanush

Question 10

Which of the following is the most important modifiable risk factor for coronary heart disease?

Accepted Answer

Cigarette smoking

Answer

Obesity

Answer

Age

Answer

Sedentary habits

Non-Communicable Diseases — MCQs

Non-Communicable Diseases — MCQs

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