Non-Communicable Diseases Practice Questions

Q: WHO global target for prevention and control of non-communicable diseases by 2025 is to decrease hypertension by:

25%. ***25%*** - The World Health Organization (WHO) set a **global target** to reduce the prevalence of high blood pressure (hypertension) by **25%** among individuals aged 18+ years by 2025, from a 2010 baseline. - This target is part of a broader WHO effort to combat **non-communicable diseases (NCDs)** and improve global health outcomes. *55%* - This percentage is not recognized as a specific WHO global target for the reduction of hypertension prevalence. - The NCD targets generally focus on more achievable and evidence-based reductions to ensure global feasibility. *75%* - A 75% reduction in hypertension prevalence is an exceptionally ambitious target that has not been set by WHO for the 2025 timeframe. - Such a drastic reduction is typically not seen in global public health goals due to the complex nature of NCDs and their determinants. *35%* - While significant, a 35% reduction is not the specified WHO global target for hypertension by 2025. - The established target reflects a balance between ambition and realistic attainability across diverse global health systems.

Q: The preferred public health approach to control non-communicable disease is -

Shift to the population-based approach. ***Shift to the population-based approach*** - A **population-based approach** aims to reduce the average risk across the entire population, leading to a larger overall reduction in NCD burden. - This strategy focuses on broad interventions like health promotion, policy changes, and environmental modifications that benefit everyone. *Focus on high risk individuals for reduction of risk* - This approach, while important, only targets a smaller subset of the population and may miss individuals who are at moderate risk but contribute significantly to the overall disease burden. - It relies on identifying and intervening with specific individuals, which can be resource-intensive and may not achieve widespread impact. *Early diagnosis and treatment of identified cases* - This is a crucial component of secondary prevention but primarily addresses **existing disease** rather than preventing its occurrence in the first place across the population. - While it improves outcomes for affected individuals, it does not tackle the root causes of NCDs at a population level. *Individual disease-based vertical programs* - **Vertical programs** are highly focused on a single disease, which can lead to fragmentation of services and inefficient use of resources. - They often fail to address the common risk factors and determinants that contribute to multiple NCDs, hindering a holistic public health response.

Q: Descending order of cancer prevalence in males in India?

Lung > oral > pharynx > esophagus. ***Lung > oral > pharynx > esophagus*** - This order represents the **most common cancer prevalence pattern** in Indian males according to **ICMR-NCDIR** population-based cancer registries. - **Lung cancer** ranks highest nationally, strongly associated with **smoking** (bidi and cigarette use). - **Oral cavity cancer** is extremely prevalent in India due to **tobacco chewing, betel quid, and gutka consumption**. - **Pharyngeal cancer** and **esophageal cancer** follow, also linked to tobacco and alcohol use. - Regional variations exist, but this order reflects **national-level data** for Indian males. *Oral > lung > pharynx > esophagus* - While **oral cancer prevalence is very high** in India (competing with lung cancer in some regions), at the **national aggregate level**, lung cancer typically ranks first. - This order may be accurate for **specific regions** with high tobacco chewing prevalence but does not represent the overall national pattern. *Pharynx > lung > oral > esophagus* - **Pharyngeal cancer** is less prevalent than both **lung and oral cancers** in Indian males. - This sequence incorrectly places pharyngeal cancer at the top, which contradicts **Indian cancer registry data**. *Esophagus > oral > stomach > lung* - This order is incorrect as **esophageal and stomach cancers** are significantly less prevalent than **lung and oral cancers** in Indian males. - **Lung cancer consistently ranks at or near the top** in Indian male cancer statistics, making this order epidemiologically inaccurate.

Q: Which of the following is primordial prevention for non-communicable diseases?

Preservation of traditional diet in low NCD area. ***Preservation of traditional diet in low NCD area*** - **Primordial prevention** targets the underlying causes of disease before risk factors are established, often at a population level. - Preserving a **healthy traditional diet** in an area with low rates of non-communicable diseases (NCDs) prevents the emergence of shared risk factors like processed food consumption and sedentary lifestyles. *Salt restriction in high NCD area* - This is an example of **primary prevention**, as it aims to reduce a specific risk factor (high salt intake) in a population susceptible to NCDs like hypertension. - It intervenes when risk factors are already present or emerging, unlike primordial prevention which aims to prevent their development. *Smoking cessation in high NCD area* - Also a form of **primary prevention**, as it targets an existing modifiable risk factor (smoking) to prevent the onset of NCDs. - It focuses on individuals or groups already exposed to a risk factor rather than preventing the societal conditions that lead to its emergence. *Early diagnosis & Treatment* - This falls under **secondary prevention**, which aims to detect and treat diseases early to halt their progression and prevent complications. - It occurs after the disease has already begun but before significant symptoms or irreversible damage have occurred.

Q: National Cancer Awareness Day is celebrated on:

7th November. ***7th November*** - **National Cancer Awareness Day** in India is observed annually on **November 7th** to raise awareness about cancer symptoms, prevention, and early detection. - This date marks the birth anniversary of **Madame Marie Curie**, whose pioneering work in radioactivity significantly contributed to cancer treatment. *31st November* - **November has only 30 days**, making "31st November" an invalid date. - This date is not recognized for any significant health awareness campaign related to cancer. *31st May* - **May 31st** is recognized globally as **World No Tobacco Day**, an initiative by the World Health Organization (WHO) to highlight the health risks of tobacco. - While tobacco use is a major cause of cancer, this day is not specifically designated as National Cancer Awareness Day. *7th May* - **May 7th** does not hold specific recognition as **National Cancer Awareness Day** in India. - While there are various cancer awareness initiatives throughout the year, this particular date is not associated with this specific observance.

Q: STEPS is done for:

Surveillance of risk factors of non-communicable disease. ***Surveillance of risk factors of non-communicable disease*** - STEPS is a **WHO-designed sequential survey** that tracks **risk factors** of non-communicable diseases (NCDs) in a stepwise approach. - It collects data on behavioral risk factors (e.g., tobacco use, unhealthy diet, physical inactivity), physical measurements (e.g., blood pressure, weight, height), and biochemical measurements (e.g., blood glucose, cholesterol). *Surveillance of mortality from non-communicable disease* - While related to NCDs, STEPS primarily focuses on **risk factors** that lead to these diseases, not directly on mortality data. - Mortality surveillance is typically conducted through **vital registration systems** and health information systems. *Surveillance of evaluation of treatment of non-communicable disease* - STEPS surveys are not designed to evaluate the **effectiveness of specific treatments** for NCDs. - Evaluating treatment efficacy usually involves **clinical trials** or specific cohort studies. *Surveillance of incidence of non-communicable disease* - Although the presence of risk factors influences incidence, STEPS primarily measures the **prevalence of risk factors**, not the incidence (new cases) of NCDs themselves. - Incidence studies require longitudinal follow-up of populations.

Q: STEPwise approach to surveillance for Non-Communicable diseases step 2 is

Physical measurement. ***Physical measurement*** - The **STEPwise approach** to NCD surveillance involves three steps, with Step 2 specifically focusing on **physical measurements**. - This step includes measurements like **blood pressure**, BMI, weight, height, and waist circumference, which provide crucial data on NCD risk factors. *Biochemical Measurement* - This is typically **Step 3** in the WHO STEPwise approach, focusing on biological measurements from blood or urine samples. - Examples include **blood glucose**, cholesterol levels, and other biomarkers. *Behavioral measurement* - This corresponds to **Step 1** of the WHO STEPwise approach, which involves self-reported data on lifestyle factors. - It covers aspects like **diet**, physical activity, and tobacco/alcohol consumption. *Emotional Assessment* - While emotional and mental health are relevant to overall well-being, **emotional assessment** is not a standard, distinct step in the core WHO STEPwise approach for NCD surveillance. - The STEPs focus on behavioral, physical, and biochemical indicators of NCD risk.

Q: Primordial prevention in coronary heart disease:

Salt restriction. ***Salt restriction*** - **Primordial prevention** aims to prevent risk factors from developing in the first place through population-wide policies and environmental changes. - **Salt restriction** through food industry regulations, public policy, and reducing salt content in processed foods is a classic example of primordial prevention targeting entire populations. - This prevents hypertension from developing at the population level, which is a key risk factor for coronary heart disease (CHD). *BP monitoring* - **BP monitoring** is a form of **primary prevention** (or secondary prevention if hypertension is already diagnosed), as it involves screening or managing an existing risk factor (high blood pressure). - It does not prevent the development of the risk factor itself but rather identifies or controls it once it has emerged. *Statins* - **Statins** are used for **primary or secondary prevention** of CHD by lowering cholesterol levels in individuals who already have elevated lipid levels or an increased risk of cardiovascular events. - This intervention manages an existing risk factor rather than preventing its initial development in the population. *Regular exercise program* - While promoting physical activity can be part of primordial prevention at the policy level, a **regular exercise program** typically refers to **primary prevention** aimed at individuals or high-risk groups to prevent disease onset. - In the context of this question, salt restriction through population-level policy interventions (e.g., reducing salt in processed foods) is the most direct and established primordial prevention strategy for CHD risk factors. - Exercise programs, when individualized, focus on preventing disease in susceptible individuals rather than preventing risk factors from emerging in the entire population.

Q: Which of the following is not a criterion suggesting causality in non communicable diseases?

Lack of temporal association. ***Lack of temporal association*** - For an exposure to cause a non-communicable disease, the exposure must precede the disease onset; therefore, a **lack of temporal association** explicitly argues *against* causality. - This criterion is a fundamental principle of causality, as the **cause must occur before the effect**. *Specificity of association* - This criterion suggests that a single exposure should lead to a single disease. However, in non-communicable diseases, a single risk factor may contribute to multiple diseases (e.g., smoking and lung cancer, heart disease, stroke), and a single disease can have **multiple causes**. - While it was important in the original Bradford Hill criteria, its relevance is diminished in modern epidemiology due to the **multifactorial nature of chronic diseases**. *Dose response relationship* - This criterion implies that as the **amount or duration of exposure increases**, the **risk or severity of the disease also increases**. - This is a strong indicator of causality because it suggests a biological gradient. *Strength of association* - A strong association, often measured by a **high relative risk or odds ratio**, increases the likelihood of a causal relationship. - A weak association, while not ruling out causality, makes it less likely to be directly causal and more likely to be influenced by other factors or confounding variables.

Question 1

WHO global target for prevention and control of non-communicable diseases by 2025 is to decrease hypertension by:

Accepted Answer

25%

Answer

55%

Answer

75%

Answer

35%

Question 2

The preferred public health approach to control non-communicable disease is -

Accepted Answer

Shift to the population-based approach

Answer

Focus on high risk individuals for reduction of risk

Answer

Early diagnosis and treatment of identified cases

Answer

Individual disease-based vertical programs

Question 3

Descending order of cancer prevalence in males in India?

Accepted Answer

Lung > oral > pharynx > esophagus

Answer

Oral > lung > pharynx > esophagus

Answer

Pharynx > lung > oral > esophagus

Answer

Esophagus > oral > stomach > lung

Question 4

Which of the following is primordial prevention for non-communicable diseases?

Accepted Answer

Preservation of traditional diet in low NCD area

Answer

Salt restriction in high NCD area

Answer

Smoking cessation in high NCD area

Answer

Early diagnosis & Treatment

Question 5

National Cancer Awareness Day is celebrated on:

Accepted Answer

7th November

Answer

31st November

Answer

31st May

Answer

7th May

Question 6

STEPS is done for:

Accepted Answer

Surveillance of risk factors of non-communicable disease

Answer

Surveillance of mortality from non-communicable disease

Answer

Surveillance of evaluation of treatment of non-communicable disease

Answer

Surveillance of incidence of non-communicable disease

Question 7

According to WHO guidelines, to decrease both coronary heart disease and diabetes, triple treatment involves:

Accepted Answer

Healthy diet, regular physical exercise, avoiding tobacco

Answer

Lipid lowering drug, avoiding tobacco, poly pill

Answer

Healthy diet, regular physical exercise, decreased salt intake

Answer

Decreased salt intake, poly pill, vegetarian diet

Question 8

STEPwise approach to surveillance for Non-Communicable diseases step 2 is

Accepted Answer

Physical measurement

Answer

Biochemical Measurement

Answer

Behavioral measurement

Answer

Emotional Assessment

Question 9

Primordial prevention in coronary heart disease:

Accepted Answer

Salt restriction

Answer

BP monitoring

Answer

Statins

Answer

Regular exercise program

Question 10

Which of the following is not a criterion suggesting causality in non communicable diseases?

Accepted Answer

Lack of temporal association

Answer

Specificity of association

Answer

Dose response relationship

Answer

Strength of association

Non-Communicable Diseases — MCQs

Non-Communicable Diseases — MCQs

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