Non-Communicable Diseases Practice Questions

Q: The net reproduction rate of 1 can be achieved only if which of the following rates exceeds 60%?

Couple protection rate. **Explanation:** The goal of the National Family Welfare Programme in India is to achieve a **Net Reproduction Rate (NRR) of 1**, which is the demographic equivalent of **Replacement Level Fertility**. NRR = 1 means that a mother is replaced by exactly one daughter who survives through her reproductive years. **Why the Correct Answer is Right:** To achieve an NRR of 1, the demographic transition requires a significant portion of the population to practice effective family planning. According to the National Health Policy, an NRR of 1 can only be achieved if the **Couple Protection Rate (CPR)** exceeds **60%**. CPR is the percentage of eligible couples effectively protected against childbirth by one or the other approved methods of family planning. It serves as a direct proxy for the success of family welfare programs in stabilizing the population. **Why the Incorrect Options are Wrong:** * **Total Fertility Rate (TFR):** This is the average number of children a woman would have in her lifetime. While NRR = 1 roughly corresponds to a **TFR of 2.1**, the question asks for the rate that must *exceed 60%*. TFR is a numerical count, not a percentage. * **Total Marital Fertility Rate (TMFR) & Age-Specific Marital Fertility Rate (ASMFR):** These measure fertility within marriage. While they influence population growth, they are indicators of birth patterns rather than the programmatic targets required to achieve NRR = 1. **High-Yield Pearls for NEET-PG:** * **NRR = 1** is the demographic goal of the National Health Policy. * **Replacement Level Fertility:** TFR = 2.1. * **Eligible Couple:** A currently married couple where the wife is in the reproductive age group (15–49 years). * **Proximate Determinant:** CPR is the most significant proximate determinant of fertility decline in a population.

Q: Typhoid vaccine is for which disease?

Typhoid. **Explanation:** The correct answer is **D. Typhoid**. Typhoid fever is a systemic infection caused by the bacterium *Salmonella Typhi*. Vaccination is a primary preventive strategy used to induce immunity against this pathogen, particularly in endemic regions like India. **Why the correct answer is right:** Typhoid vaccines (such as the Vi polysaccharide, live attenuated Ty21a, or the newer Typhoid Conjugate Vaccine - TCV) work by stimulating the immune system to produce antibodies against *S. Typhi* antigens. TCV is currently preferred as it provides longer-lasting immunity and can be administered to infants as young as 6 months. **Analysis of Incorrect Options:** * **A. Cholera:** Prevented by Oral Cholera Vaccines (OCVs) like Shanchol or Dukoral, which target *Vibrio cholerae*. * **B. Tuberculosis:** Prevented by the **BCG (Bacillus Calmette-Guérin)** vaccine, a live attenuated strain of *Mycobacterium bovis*. * **C. Pertussis:** Prevented by the **'P' component** of the DPT (Diphtheria, Pertussis, Tetanus) or DTaP vaccine. **High-Yield Clinical Pearls for NEET-PG:** * **Typhoid Conjugate Vaccine (TCV):** It is the only typhoid vaccine licensed for children <2 years of age. It provides ~80-85% efficacy. * **Route of Administration:** Vi polysaccharide is given Intramuscularly (IM), while Ty21a is an oral vaccine (given on days 1, 3, and 5). * **Public Health:** Typhoid is primarily transmitted via the **fecal-oral route**. While vaccines are effective, the "gold standard" for control remains the improvement of sanitation and safe drinking water. * **Diagnosis:** Remember the **BASU** mnemonic for timing of tests: **B**lood culture (1st week), **A**ntibody/Widal (2nd week), **S**tool culture (3rd week), **U**rine culture (4th week).

Q: The H1N1 strain of influenza is responsible for which of the following conditions?

Swine flu. **Explanation:** **Correct Answer: C. Swine flu** The **H1N1** strain is the primary subtype of Influenza A virus responsible for **Swine flu**. It gained global prominence during the 2009 pandemic. The nomenclature "H" and "N" refers to the surface glycoproteins: **Hemagglutinin (H)**, which facilitates viral entry into host cells, and **Neuraminidase (N)**, which assists in the release of new viral progeny. Swine flu is a respiratory disease of pigs that can cross the species barrier to cause human infections, primarily through droplet transmission. **Analysis of Incorrect Options:** * **Options A & B (Avian influenza / Bird flu):** These terms are synonymous. Avian influenza is caused by different strains of the Influenza A virus, most notably **H5N1** (highly pathogenic) and **H7N9**. While H1N1 is adapted to humans and swine, H5N1 remains primarily adapted to birds, though it carries a much higher mortality rate in humans. **High-Yield Clinical Pearls for NEET-PG:** * **Antiviral of Choice:** **Oseltamivir** (Tamiflu) is the drug of choice for H1N1, acting as a Neuraminidase inhibitor. * **Diagnostic Gold Standard:** Real-time **Reverse Transcriptase-PCR (RT-PCR)** is the preferred method for confirmation. * **Antigenic Shift vs. Drift:** * **Shift:** Major genetic changes (reassortment) leading to **pandemics** (e.g., 2009 H1N1). * **Drift:** Minor point mutations leading to **epidemics** and the need for annual vaccine updates. * **Vaccination:** The influenza vaccine is typically quadrivalent, covering two strains of Influenza A (H1N1, H3N2) and two lineages of Influenza B.

Q: After two doses of vaccination against plague, for how long will the immunity last?

Six months. **Explanation:** The correct answer is **Six months (Option A)**. Plague vaccines, historically used to prevent *Yersinia pestis* infections, are known for providing relatively short-lived immunity. The standard killed whole-cell vaccine (the most common type historically) requires a primary series of two doses. However, the antibody levels decline rapidly following the initial series. According to the World Health Organization (WHO) and standard textbooks of Community Medicine (Park’s PSM), the immunity conferred by the plague vaccine lasts for only about **6 months**. Therefore, individuals at continuous high risk (such as laboratory workers or field researchers in endemic areas) require booster doses every 6 months to maintain protective titers. **Analysis of Incorrect Options:** * **Option B (One year):** While many bacterial vaccines (like the injectable Typhoid vaccine) offer protection for 1–3 years, the plague vaccine's cell-mediated and humoral response wanes much faster, making one year an overestimate. * **Options C and D (18 and 24 months):** These durations are significantly longer than the documented efficacy of the plague vaccine. No currently available plague vaccine provides two years of protection without multiple boosters. **High-Yield Clinical Pearls for NEET-PG:** * **Vaccine Type:** The traditional vaccine is a killed (formalin-inactivated) vaccine. Live attenuated vaccines (EV76 strain) exist but are generally not used due to high reactogenicity. * **Indications:** Vaccination is **not** recommended for the general public during an outbreak; it is reserved for high-risk occupational groups. * **Chemoprophylaxis:** For immediate protection during an outbreak or post-exposure, the drug of choice is **Doxycycline** or **Tetracycline**. * **Control of Outbreak:** In a plague outbreak, the priority is **flea control** (using insecticides) *before* rodent control to prevent "flea jump" to humans.

Q: What is the recommended cholesterol level for the prevention of coronary artery disease?

< 200 mg/dl. **Explanation:** The correct answer is **D. < 200 mg/dl**. In the context of Community Medicine and Preventive Cardiology, the primary goal for preventing Coronary Artery Disease (CAD) is to maintain a favorable lipid profile. According to the **National Cholesterol Education Program (NCEP) - Adult Treatment Panel (ATP III)** guidelines, Serum Total Cholesterol levels are classified as follows: * **Desirable:** 240 mg/dl is a major modifiable risk factor for myocardial infarction. * **B (< 220 mg/dl):** While lower than 250, this falls into the "Borderline High" range (200–239 mg/dl), which still necessitates lifestyle modifications to prevent progression to CAD. **High-Yield Clinical Pearls for NEET-PG:** * **LDL (The "Bad" Cholesterol):** The primary target of lipid-lowering therapy. Optimal level is **< 100 mg/dl**. * **HDL (The "Good" Cholesterol):** Protective against CAD. Levels **< 40 mg/dl** are considered a major risk factor, while **≥ 60 mg/dl** is considered protective. * **Triglycerides:** Normal level is **< 150 mg/dl**. * **Rule of Thumb:** For every 1% reduction in total serum cholesterol, there is a 2% reduction in the risk of coronary heart disease.

Q: Which of the following statements is NOT true about the Inactivated Polio Vaccine (IPV)?

It cannot be given in an AIDS patient.. **Explanation:** The core concept tested here is the safety profile of **Killed (Inactivated) vs. Live Attenuated vaccines** in immunocompromised individuals. **Why Option B is the correct answer (The False Statement):** Inactivated vaccines, like IPV, do not contain live organisms; therefore, they cannot replicate or cause disease in the recipient. Consequently, **IPV is safe and indicated for immunocompromised individuals**, including those with AIDS, symptomatic HIV, or those on immunosuppressive therapy. In contrast, the Oral Polio Vaccine (OPV) is a live vaccine and is strictly contraindicated in these patients due to the risk of Vaccine-Associated Paralytic Poliomyelitis (VAPP). **Analysis of Incorrect Options:** * **Option A:** Under the current National Immunization Schedule (NIS) in India, the **Fractional IPV (fIPV)** is administered in 3 doses (6, 14 weeks, and 9 months). However, the global **Sequential Polio Vaccination Schedule** or specific catch-up schedules often involve 4 doses to ensure full seroconversion, making this a plausible true statement in a general clinical context. * **Option C:** IPV is indeed a **killed vaccine**, produced by inactivating wild-type poliovirus strains (Mahoney, MEF-1, and Saukett) using formaldehyde. * **Option D:** IPV was developed by **Jonas Salk** in 1955, hence it is universally known as the Salk vaccine (whereas OPV is the Sabin vaccine). **NEET-PG High-Yield Pearls:** * **Route:** fIPV is given **Intradermal (ID)** on the right upper arm; full-dose IPV is given **Intramuscular (IM)**. * **VAPP & VDPV:** These are risks associated only with OPV, never with IPV. * **Herd Immunity:** IPV provides excellent individual (humoral) immunity but poor intestinal (mucosal) immunity compared to OPV; thus, it does not effectively stop community transmission.

Q: Which of the following statements regarding leprosy is incorrect?

In paucibacillary leprosy, more than 2 nerves are involved.. ### Explanation This question tests your knowledge of the **WHO Classification of Leprosy** and the operational definitions used under the National Leprosy Eradication Programme (NLEP). **1. Why Option C is Incorrect (The Correct Answer):** According to the WHO clinical classification, **Paucibacillary (PB) leprosy** is defined by the involvement of **only one nerve trunk**. If more than one nerve is involved (even if skin lesions are few), it is classified as Multibacillary (MB) leprosy. Therefore, the statement that "more than 2 nerves are involved" in PB leprosy is false. **2. Analysis of Other Options:** * **Option A:** Correct. Under the WHO simplified classification, **Multibacillary (MB)** leprosy is defined as having **6 or more skin lesions**. * **Option B:** Correct. For operational purposes, a patient is considered "regular" on MDT if they have consumed at least **2/3rds (66%)** of the prescribed doses within the specified timeframe. * **Option C:** Correct. Cardinal signs of leprosy include hypopigmented patches with **partial or total loss of sensation**, thickened nerves, and a positive skin smear for Acid Fast Bacilli. --- ### High-Yield Clinical Pearls for NEET-PG * **WHO Classification (Based on Lesions):** * **PB:** 1 to 5 skin lesions; only 1 nerve involved; skin smear negative. * **MB:** 6 or more skin lesions; 2 or more nerves involved; skin smear positive (at any site). * **MDT Regimen Durations:** * **PB:** 6 blister packs to be completed within 6–9 months. * **MB:** 12 blister packs to be completed within 12–18 months. * **Drug of Choice for Reactions:** * **Type 1 (Reversal):** Corticosteroids. * **Type 2 (ENL):** Thalidomide (Drug of choice), but Clofazimine is also used. * **Accompanied MDT (A-MDT):** Provided to patients whose mobility is restricted, ensuring they have a full course of treatment at home.

Question 1

Dengue hemorrhagic fever most commonly occurs when:

Accepted Answer

A person previously infected with one dengue serotype is infected with a different serotype

Answer

Malnourished patients

Answer

Immunocompromised patients

Answer

Persons experiencing high-grade fever

Question 2

The net reproduction rate of 1 can be achieved only if which of the following rates exceeds 60%?

Accepted Answer

Couple protection rate

Answer

Total fertility rate

Answer

Total marital fertility rate

Answer

Age-specific marital fertility rate

Question 3

Which of the following is a characteristic of poliomyelitis?

Accepted Answer

Initial febrile illness followed by development of asymmetrical paralysis

Answer

Symmetrical muscle weakness with frequent paresthesia but normal reflexes

Answer

Ascending motor paralysis with preservation of reflexes and sensation

Answer

Pain in the affected limb with sensorimotor deficit

Question 4

Typhoid vaccine is for which disease?

Accepted Answer

Typhoid

Answer

Cholera

Answer

Tuberculosis

Answer

Pertussis

Question 5

The H1N1 strain of influenza is responsible for which of the following conditions?

Accepted Answer

Swine flu

Answer

Avian influenza

Answer

Bird flu

Answer

None of the above

Question 6

After two doses of vaccination against plague, for how long will the immunity last?

Accepted Answer

Six months

Answer

One year

Answer

Eighteen months

Answer

Twenty-four months

Question 7

Under the revised National Tuberculosis Control Programme, what is the schedule of treatment for category I patients?

Accepted Answer

2 HRZE+ 4 HRE

Answer

2 (HRZE)3 + 4(HR)3

Answer

2(HRZES)3 + 1(HRZE)3 + 5(HRE)3

Answer

2(HR)3 + 4 (HR)3

Question 8

What is the recommended cholesterol level for the prevention of coronary artery disease?

Accepted Answer

< 200 mg/dl

Answer

< 250 mg/dl

Answer

< 220 mg/dl

Answer

< 300 mg/dl

Question 9

Which of the following statements is NOT true about the Inactivated Polio Vaccine (IPV)?

Accepted Answer

It cannot be given in an AIDS patient.

Answer

It is given in 4 doses.

Answer

It is a killed vaccine.

Answer

It is also known as the Salk vaccine.

Question 10

Which of the following statements regarding leprosy is incorrect?

Accepted Answer

In paucibacillary leprosy, more than 2 nerves are involved.

Answer

Multibacillary leprosy is defined as having 6 or more skin lesions.

Answer

Regular multidrug therapy (MDT) implies that patients have completed 2/3rds of the prescribed treatment schedule.

Answer

Loss of sensation may be a presenting symptom of leprosy.

Non-Communicable Diseases — MCQs

Non-Communicable Diseases — MCQs

On this page

Practice by Chapter

Want unlimited practice?