Non-Communicable Diseases — MCQs

What type of indicator is Sustainable Development Goal target 3.4, which calls for a one third reduction in premature mortality from Non Communicable Diseases (NCDs) by year 2030? Consider the following statements: 1. Impact 2. Coverage/risk factor 3. Risk factor/determinants Which of the above statement(s) correctly identifies the type of indicator?

Q576

Which one of the following statements regarding WHO Global Action Plan for the prevention and control of NCDs (2013–2020) is NOT correct?

Q577

In the context of NCD prevention and control in India, the extent of relative reduction in household use of solid fuels as a primary source of energy for cooking by 2025 is targeted at:

Q578

All of the following are global targets for WHO Global Action Plan (2013–2020) for Prevention and Control of NCDs, EXCEPT:

Q579

True about Cardiovascular disease (CVD)

Q580

Most cost effective approach for the prevention of non-communicable disease is by -

Non-Communicable Diseases Indian Medical PG Practice Questions and MCQs

Question 571: Which of the following will be target population for screening of diabetes?

A. People over 40 years of age
B. People with family history of diabetes
C. Women who have had a baby weighing more than 4·5 kg
D. All of the options (Correct Answer)

Explanation: ***All of the options*** - All listed groups—**people over 40 years of age**, **individuals with a family history of diabetes**, and **women who have had a baby weighing more than 4.5 kg**—are considered high-risk populations for developing diabetes. - Screening these groups is a **cost-effective strategy** to identify diabetes early, allowing for timely intervention and prevention of complications. *People over 40 years of age* - **Age** is a significant risk factor for type 2 diabetes, with incidence progressively increasing after 40 due to decreased insulin sensitivity. - Routine screening is recommended by guidelines for adults in this age group, regardless of other risk factors. *People with family history of diabetes* - A **genetic predisposition** plays a crucial role in the development of type 2 diabetes, making a family history a strong indicator for increased risk. - Screening is essential for these individuals to detect the condition early, even if they are otherwise asymptomatic. *Women who have had a baby weighing more than 4·5 kg* - Delivering a **large-for-gestational-age infant** (macrosomia) is a strong indicator of prior **gestational diabetes (GDM)**, even if not formally diagnosed at the time. - Women with a history of GDM have a significantly increased risk of developing type 2 diabetes later in life.

Question 572: Which National Programme came into existence during 11th Five Year Plan?

A. National Cardiovascular diseases and Stroke control programme
B. National Diabetes and Cancer control programme
C. National Cancer control programme
D. National Programme for prevention and control of Cancer, Diabetes, Cardiovascular diseases and Stroke (Correct Answer)

Explanation: ***National Programme for prevention and control of Cancer, Diabetes, Cardiovascular diseases and Stroke*** - This comprehensive national program was launched during the **11th Five Year Plan** to address the growing burden of non-communicable diseases in India. - It integrates the prevention and control efforts for **Cancer, Diabetes, Cardiovascular diseases, and Stroke** under a single umbrella. *National Cardiovascular diseases & Stroke control programme* - While cardiovascular diseases and stroke are a major focus, this particular phrasing does not represent the full scope of the program initiated during the 11th Five Year Plan. - The actual program was broader, encompassing other significant non-communicable diseases. *National Diabetes and Cancer control programme* - This option is incomplete as it omits **cardiovascular diseases (CVDs)** and **stroke**, which were crucial components of the integrated program. - The 11th Five Year Plan emphasized a more holistic approach to major non-communicable diseases. *National Cancer control programme* - A **National Cancer Control Programme** existed prior to and was integrated into the broader initiative during the 11th Five Year Plan. - This option only refers to a specific disease, failing to capture the comprehensive nature of the new program.

Question 573: Which of the following is the most common malignant tumour in adult males in India?

A. Lung cancer
B. Gastric carcinoma
C. Oro-pharyngeal carcinoma (Correct Answer)
D. Colo-rectal carcinoma

Explanation: ***Oro-pharyngeal carcinoma*** - Traditionally, **oropharyngeal carcinoma** (oral cavity and pharyngeal cancers) has been cited as the most prevalent malignant tumor in adult males in India, primarily due to high rates of **tobacco chewing** (gutka, betel quid) and **smoking**. - This type of cancer accounts for approximately **25-30%** of all male cancers in many Indian cancer registries. - The high burden is attributed to widespread tobacco and areca nut consumption, particularly in states like Bihar, Uttar Pradesh, and northeastern regions. - **Note:** Recent epidemiological data (GLOBOCAN 2020) suggests lung cancer may have overtaken oral cancers in overall incidence, though variations exist across different registries and regions. *Lung cancer* - **Lung cancer** is a major cause of cancer mortality in Indian males and shows rising incidence trends. - In recent data, it competes closely with oral cancers for the top position, with some registries showing it as the most common cancer. - Associated primarily with **smoking** (bidis and cigarettes) and exposure to indoor air pollution. - The increasing urbanization and smoking prevalence contribute to its growing burden. *Gastric carcinoma* - **Gastric carcinoma** has moderate incidence in India, with higher rates in southern states. - Linked to dietary factors (high salt, smoked foods) and **Helicobacter pylori** infection. - Ranks lower than oral and lung cancers in overall male cancer incidence. *Colo-rectal carcinoma* - **Colorectal carcinoma** is less common in India compared to Western countries. - Its incidence is gradually increasing with changing dietary patterns and lifestyle factors. - Ranks significantly lower in prevalence among adult male cancers compared to oral and lung cancers.

Question 574: Which of the following are non-modifiable risk factors for hypertension? 1. Age 2. Sex 3. Genetic factors Select the correct answer using the code given below:

A. 1, 2 and 3 (Correct Answer)
B. 1 only
C. 1 and 2 only
D. 2 and 3 only

Explanation: ***1, 2 and 3*** - **Age** is a significant non-modifiable risk factor for hypertension; blood pressure tends to increase with advancing age due to arterial stiffness and other physiological changes. - While lifestyle and environmental factors play a role, **genetic predisposition** (hereditary factors) is a well-established non-modifiable risk factor that influences an individual's susceptibility to hypertension. - **Sex** is also considered a non-modifiable risk factor, as hormonal differences and physiological variations between biological sexes influence the prevalence and progression of hypertension across different life stages. *1 only* - This option is incomplete as it excludes other well-recognized non-modifiable risk factors like **sex** and **genetic factors**. - While **age** is a crucial non-modifiable risk factor, focusing solely on it would overlook a comprehensive understanding of inherent risks. *1 and 2 only* - This option incorrectly omits **genetic factors**, which are fundamental non-modifiable determinants of hypertension risk. - Although **age** and **sex** are valid non-modifiable factors, the absence of **genetic predisposition** makes this option incomplete. *2 and 3 only* - This option incorrectly excludes **age**, which is one of the most prominent non-modifiable risk factors for hypertension, as blood pressure generally rises with age. - Omitting **age** from the list of non-modifiable factors provides an incomplete understanding of inherent hypertension risks.

Question 575: What type of indicator is Sustainable Development Goal target 3.4, which calls for a one third reduction in premature mortality from Non Communicable Diseases (NCDs) by year 2030? Consider the following statements: 1. Impact 2. Coverage/risk factor 3. Risk factor/determinants Which of the above statement(s) correctly identifies the type of indicator?

A. 2 and 3
B. 1 only (Correct Answer)
C. 3 only
D. 1 and 3

Explanation: ***1 only*** - Sustainable Development Goal target 3.4, aiming for a one-third reduction in **premature mortality** from NCDs, is an **impact indicator**. - **Impact indicators** measure the overall effect of interventions on health outcomes, such as mortality rates. *2 and 3* - **Coverage/risk factor indicators** measure the proportion of the target population receiving an intervention or the prevalence of risk factors. - While reducing NCD mortality is related to controlling risk factors, the target itself directly measures a reduction in **death (an impact)**, not the risk factor prevalence or intervention coverage. *3 only* - **Risk factor/determinant indicators** specify factors that contribute to the disease or health outcome, like smoking rates or unhealthy diet. - The target of reducing **premature mortality** is a direct outcome of these risk factors, making it an impact indicator rather than a separate risk factor indicator. *1 and 3* - Although risk factors are determinants of NCD mortality, the **reduction in mortality** itself is a measure of the ultimate outcome or impact, not solely a risk factor. - The core of SDG 3.4 is the decrease in deaths, which unequivocally points to it being an **impact indicator**.

Question 576: Which one of the following statements regarding WHO Global Action Plan for the prevention and control of NCDs (2013–2020) is NOT correct?

A. Halt the rise of diabetes and obesity
B. At least 10 percent relative reduction in the harmful use of alcohol as appropriate within national context
C. A 10 percent relative reduction in mean population intake of salt/sodium (Correct Answer)
D. A 10 percent relative reduction in prevalence of insufficient physical activity

Explanation: ***A 10 percent relative reduction in mean population intake of salt/sodium*** - The target set by the WHO Global Action Plan for the prevention and control of NCDs (2013-2020) was a **30% relative reduction in mean population intake of salt/sodium by 2025**, not 10%. - This option incorrectly states the percentage reduction target for salt/sodium intake, making it the incorrect statement. *Halt the rise of diabetes and obesity* - This statement is **correct** and represents one of the nine global NCD targets specified in the WHO Global Action Plan. - The goal is to stop the increase in the prevalence of diabetes and obesity, reflecting a focus on preventing these conditions. *At least 10 percent relative reduction in the harmful use of alcohol as appropriate within national context* - This statement is **correct** and accurately reflects another key target of the WHO Global Action Plan for NCDs. - The plan aims to significantly reduce the **harmful consequences of alcohol consumption**, recognizing national differences. *A 10 percent relative reduction in prevalence of insufficient physical activity* - This statement is **correct** and aligns with one of the global NCD targets established by the WHO. - The objective is to encourage increased physical activity to combat **sedentary lifestyles** and promote better health.

Question 577: In the context of NCD prevention and control in India, the extent of relative reduction in household use of solid fuels as a primary source of energy for cooking by 2025 is targeted at:

A. 50 % (Correct Answer)
B. 40 %
C. 60 %
D. 30 %

Explanation: ***50 %*** - The **WHO Global Action Plan for Prevention and Control of NCDs 2013-2020** includes voluntary global targets, which India has adopted through its **National Action Plan for NCDs**. - Target 5 of this action plan addresses environmental risk factors and aims for a **50% relative reduction** in household use of solid fuels as a primary source of energy for cooking by 2025. - This target is aligned with efforts to improve **indoor air quality** and reduce the burden of **respiratory and cardiovascular NCDs** associated with solid fuel combustion and household air pollution. *40 %* - While significant, a **40% reduction** is less ambitious than the established national target for solid fuel use reduction adopted from WHO's voluntary global targets. - This figure does not correspond to the specific goal outlined in India's NCD prevention strategies for 2025 regarding solid fuels. *60 %* - A **60% reduction** would be a more aggressive target, exceeding the current official target set for 2025 in the context of NCD prevention. - While desirable for public health impact, it is not the officially stated target adopted by India from the WHO Global Action Plan for solid fuel use reduction by 2025. *30 %* - A **30% reduction** represents a less ambitious target and would likely be insufficient to achieve the desired public health impact on NCDs related to indoor air pollution. - This figure falls short of the adopted national health policy goals for household solid fuel reduction by 2025 under the NCD action framework.

Question 578: All of the following are global targets for WHO Global Action Plan (2013–2020) for Prevention and Control of NCDs, EXCEPT:

A. A 30% relative reduction in mean population intake of salt/sodium
B. A 25% relative reduction in risk of premature mortality from cardiovascular diseases, cancer, diabetes and chronic respiratory diseases
C. At least 10 % relative reduction in the harmful use of alcohol
D. A 15% relative reduction in healthcare costs related to NCDs (Correct Answer)

Explanation: ***A 15% relative reduction in healthcare costs related to NCDs*** - While reducing healthcare costs is an important outcome of NCD prevention, it was **not explicitly stated as one of the nine global targets** in the WHO Global Action Plan (2013–2020) for the Prevention and Control of NCDs. - The targets primarily focused on **risk factor reduction and mortality reduction**, rather than direct cost reduction percentages. *A 30% relative reduction in mean population intake of salt/sodium* - This is one of the **specified global targets** of the WHO NCD Global Action Plan, aiming to reduce a significant dietary risk factor for cardiovascular diseases. - High sodium intake is a major contributor to **hypertension**, a leading risk factor for NCDs. *A 25% relative reduction in risk of premature mortality from cardiovascular diseases, cancer, diabetes and chronic respiratory diseases* - This represents the **overarching mortality reduction target** for the key NCDs, making it a central goal of the WHO action plan. - Reducing premature mortality is a direct measure of the **effectiveness of NCD prevention and control strategies**. *At least 10 % relative reduction in the harmful use of alcohol* - This is another **identified global target** within the WHO NCD Global Action Plan, recognizing alcohol as a major modifiable risk factor for NCDs. - Harmful alcohol use contributes to various NCDs, including **liver disease, cardiovascular disease, and certain cancers**.

Question 579: True about Cardiovascular disease (CVD)

A. Coronary heart disease causes 25% of total deaths
B. Urban and rural areas have equal incidence
C. Primordial prevention is best strategy (Correct Answer)
D. RHD is the most common cause of CVD

Explanation: ***Primordial prevention is best strategy*** - **Primordial prevention** aims to prevent the development of risk factors for CVD in the first place, often starting in childhood. - This strategy targets entire populations with public health initiatives to promote healthy lifestyles and environments, making it the most effective long-term approach to reduce CVD burden. *Coronary heart disease causes 25% of total deaths* - **Coronary heart disease (CHD)** accounts for approximately 16-17% of all deaths globally, not 25%. - While CHD is a leading cause of death, stating it causes 25% of total deaths is an overestimation. *RHD is the most common cause of CVD* - **Rheumatic Heart Disease (RHD)** is an important cause of cardiovascular disease in developing countries including India. - However, **ischemic heart disease** (coronary artery disease) and **hypertension** are the most common causes of CVD globally and in India, not RHD. *Urban and rural areas have equal incidence* - The incidence of cardiovascular disease differs significantly between **urban and rural areas**. - Urban areas typically have higher CVD incidence due to lifestyle factors (sedentary behavior, unhealthy diet, stress), though rural rates are increasing due to epidemiological transition.

Question 580: Most cost effective approach for the prevention of non-communicable disease is by -

A. Primary prevention
B. Specific protection
C. Secondary prevention
D. Primordial prevention (Correct Answer)

Explanation: ***Primordial prevention*** - This level of prevention targets the **root causes** of risk factors, preventing their emergence in the first place through societal-level interventions. - By shaping healthy environments and promoting healthy lifestyles from birth, it can avert the development of NCDs across entire populations, making it the **most cost-effective** long-term strategy. *Primary prevention* - This involves preventing the onset of disease in healthy individuals by controlling existing risk factors through measures like **vaccination** and health education. - While effective, it addresses risk factors once they exist, which is less cost-effective than preventing their initial emergence through primordial approaches. *Specific protection* - This is a subset of **primary prevention** focused on specific measures to protect against disease, such as immunizations or wearing protective gear. - It's effective for targeted diseases but does not address the broader societal determinants of health as comprehensively as primordial prevention. *Secondary prevention* - This aims to **detect and treat diseases early** to prevent complications and progression, such as through screening programs and early treatment. - While crucial for improving outcomes once a disease has begun, it is inherently more costly than preventing the disease from ever occurring.

Practice by Chapter

Epidemiology of NCDs

Practice Questions

Cardiovascular Disease Prevention

Practice Questions

Diabetes Control Program

Practice Questions

Cancer Screening and Control

Practice Questions

Chronic Respiratory Diseases

Practice Questions

Mental Health Program

Practice Questions

Blindness Control Program

Practice Questions

Accident and Injury Prevention

Practice Questions

NCD Risk Factor Surveillance

Practice Questions

National Program for Prevention and Control of Cancer, Diabetes, CVD, and Stroke

Practice Questions

Oral Health Program

Practice Questions

Geriatric Health Issues

Practice Questions

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