Nutrition and Health — MCQs

Nutrition and Health Indian Medical PG Practice Questions and MCQs

Question 531: Neuro lathyrism results due to which of the following?

A. Aflatoxin
B. Pyruvic acid
C. BOAA (Correct Answer)
D. Sanguinarine

Explanation: **Explanation:** **Neurolathyrism** is a form of permanent spastic paraplegia caused by the excessive consumption of *Lathyrus sativus* (Khesari Dal). **Why BOAA is the correct answer:** The causative toxin in Khesari Dal is **BOAA (Beta-Oxalyl-Amino-Alanine)**, also known as **ODAP** (Oxalyldiaminopropionic acid). It is a potent neurotoxin that acts as a glutamate analogue, causing excitotoxic damage to the upper motor neurons in the spinal cord. This leads to the characteristic clinical presentation of sudden-onset, non-progressive spasticity of the lower limbs. **Analysis of Incorrect Options:** * **A. Aflatoxin:** Produced by *Aspergillus flavus*, it contaminates stored grains (like groundnuts and maize) and is primarily associated with **Hepatocellular Carcinoma**. * **B. Pyruvic acid:** High levels of pyruvic acid in the blood are associated with **Wet Beriberi** (Vitamin B1/Thiamine deficiency), as thiamine is a cofactor for pyruvate dehydrogenase. * **D. Sanguinarine:** This is the toxin found in **Argemone mexicana** (Prickly Poppy) seeds. When mixed with mustard oil, it causes **Epidemic Dropsy**, characterized by bilateral edema, cardiac failure, and glaucoma. **High-Yield Clinical Pearls for NEET-PG:** * **Safe Limit:** Neurolathyrism occurs when Khesari Dal constitutes >30% of the diet for 2–6 months. * **Stages:** Latent → No-stick → One-stick → Two-stick → Crawler stage. * **Prevention:** Steeping (soaking in hot water) or Parboiling the pulses helps remove the water-soluble BOAA toxin. * **Lathyrism Act:** The government banned the sale of Khesari Dal under the PFA Act (though cultivation continues in some regions).

Question 532: Rukmini is attending the village health nutrition and sanitation program day. How frequently is this conducted?

A. Every month (Correct Answer)
B. Every 3 months
C. Every 14 days
D. Every week

Explanation: ***Every month***- The **Village Health, Nutrition, and Sanitation (VHNS) Day** is a pivotal platform under the **National Health Mission (NHM)** and is officially required to be conducted **monthly** in every village. - This monthly meeting, often held at the Anganwadi Centre, integrates services such as **immunization**, antenatal and postnatal care, growth monitoring, and sanitation awareness, typically involving the **AWW**, **ANM**, and **ASHA**.*Every week*- Weekly scheduling would place an undue burden on field staff like the **ANM** and Medical Officer, who are responsible for covering multiple Sub-centres and villages.- While specific services or training sessions might occur weekly, the full, integrated delivery of the authorized VHNS program interventions is reserved for the designated **monthly VHNS Day**.*Every 14 days*- The established guidelines for the VHNS Day specify a **monthly** event, ensuring regular but feasible service delivery without overwhelming the rural health structure.- Bi-weekly (every 14 days) is not the prescribed national norm for organizing this comprehensive community mobilization and service delivery day.*Every 3 months*- A quarterly (every 3 months) schedule would be considered inadequate for effective monitoring of children's growth, timely completion of the **immunization schedule**, and addressing immediate maternal health needs.- The high-frequency nature of certain health interventions like nutritional supplementation and growth charting necessitates the established **monthly** meeting to track progress and intervene promptly.

Question 533: A patient whose diet mainly consists of pulses and rice presents with bowed legs. Which of the following vitamins could have prevented this condition?

A. Vitamin D (Correct Answer)
B. Vitamin A
C. Vitamin B₁₂
D. Vitamin C

Explanation: ***Vitamin D*** - This vitamin is essential for the absorption of **calcium** and **phosphate**, minerals necessary for bone mineralization. - A deficiency results in **Rickets** (softening and weakening of bones in children), leading to classic deformities like **bowed legs (genu varum)**. *Vitamin A* - Vitamin A deficiency primarily affects vision, causing **night blindness** and **xerophthalmia**. - It is crucial for cell differentiation and immune function, but its deficiency does not cause **rickets** or bowed legs. *Vitamin B₁₂* - Deficiency leads to **megaloblastic anemia** and often **peripheral neuropathy** (subacute combined degeneration). - While essential for cell division and nerve function, it is not directly involved in the calcium homeostasis required to prevent bone deformities. *Vitamin C* - Vitamin C deficiency causes **scurvy**, characterized by impaired **collagen synthesis**, leading to bleeding gums and poor wound healing. - It is not the primary factor preventing defective bone mineralization (rickets) that causes **bowed legs**.

Question 534: A patient presents with increased consumption of Bajra (pearl millet) roti and now complains of drowsiness and giddiness. What is the most likely diagnosis?

A. Fusarium Toxicity
B. Ergotism (Correct Answer)
C. Botulism
D. Epidemic Dropsy

Explanation: ***Ergotism*** - This condition results from ingesting grains, such as **pearl millet (Bajra)**, contaminated by the fungus *Claviceps fusiformis*. - The neurotoxic effects of **ergot alkaloids** cause the central nervous system (CNS) symptoms of the convulsive form, including **drowsiness** and **giddiness**. *Epidemic Dropsy* - This toxicity is caused by ingesting edible oils (typically mustard oil) contaminated with **argemone oil**. - The cardinal features are non-pitting **edema** (dropsy), skin pigmentation, and rarely, secondary glaucoma, not primarily CNS giddiness. *Botulism* - This illness is caused by the potent neurotoxin produced by *Clostridium botulinum*, usually found in improperly canned or preserved food. - The defining clinical presentation is a classic descending, symmetric **flaccid paralysis** often starting with cranial nerve symptoms (**diplopia, dysphagia**). *Fusarium Toxicity* - This involves various mycotoxins (e.g., **fumonisins, T-2 toxin**) contaminating cereals, most commonly maize. - Clinical syndromes include severe immunosuppression (Alimentary Toxic Aleukia) or liver/kidney damage, not the primary presentation of acute drowsiness and giddiness.

Question 535: A family consumes a diet predominantly of rice and pulses and developed signs of muscle weakness and movement. Which of the following should be given for prophylaxis?

A. Iron
B. Vitamin D
C. Calcium
D. Thiamine (Correct Answer)

Explanation: ***Thiamine*** - A diet relying mainly on **polished rice** lacks essential micronutrients, particularly **thiamine (Vitamin B1)**, which is removed during the polishing process. - Deficiency of thiamine causes **Beriberi**, manifesting as neurological deficits (dry Beriberi leading to muscle weakness and neuropathy) or cardiovascular symptoms (wet Beriberi leading to high-output cardiac failure). *Calcium* - Calcium deficiency typically results in **hypocalcemia**, presenting as symptoms like **tetany**, muscle spasms, and paresthesia, which are distinct from Beriberi's clinical picture. - Although important for musculoskeletal health, supplementing calcium alone would not prevent the severe neurological and motor impairment seen in **thiamine deficiency**. *Vitamin D* - Deficiency of Vitamin D causes disorders of bone mineralization—**Rickets** in children and **Osteomalacia** in adults, primarily characterized by bone pain and fractures. - While Vitamin D deficiency can cause myopathy, it does not explain the specific cluster of symptoms (weakness and movement issues) related to a rice-dominant diet lacking the coenzyme necessary for carbohydrate metabolism. *Iron* - Iron deficiency leads to **microcytic hypochromic anemia**, whose primary symptoms include fatigue, dizziness, and pallor, not the characteristic movement and muscle weakness indicative of **Beriberi**. - Iron supplementation would address anemia but would fail to protect against severe neurological illness resulting from the lack of **thiamine**, which is crucial for energy generation in neural tissues.

Question 536: Which of the following is not caused by food adulteration?

A. Endemic ascites
B. Epidemic dropsy
C. Fluorosis (Correct Answer)
D. Neurolathyrism

Explanation: ***Fluorosis***- It results from excessive ingestion of **fluoride**, primarily through naturally high fluoride content in **drinking water** and not typically through intentional adulteration of processed food products.- The toxicity (dental or skeletal fluorosis) reflects a chronic environmental exposure problem rather than a case of acute or intentional food substance contamination.*Epidemic dropsy*- This condition is classically caused by the adulteration of **mustard oil** with **Argemone oil**, which contains the toxic alkaloid **sanguinarine**.- It is a recognized consequence of food fraud characterized by edema, skin pigmentation, and sometimes glaucoma.*Neurolathyrism*- It results from consuming food (such as chickpea flour) adulterated with excessive amounts of **Khesari dal (Lathyrus sativus)**.- The neurotoxin responsible is **BOAA (β-N-Oxalylamino-L-alanine)**, which causes irreversible motor neuron damage and spastic paraparesis.*Endemic ascites*- This condition, often presenting as **hepatic veno-occlusive disease (VOD)**, is caused by chronic consumption of food grains contaminated by **Pyrrolizidine alkaloids (PAs)**.- PAs are often found in weeds growing among food crops (like wheat or millets), and their inclusion during harvest is a form of accidental food contamination/adulteration leading to chronic liver damage.

Question 537: Which of the following is the use of Shakir's tape?

A. Intersectoral coordination
B. Appropriate technology (Correct Answer)
C. Community participation
D. Equitable distribution

Explanation: ***Appropriate technology*** - *Shakir's tape* (or **Mid-Upper Arm Circumference/MUAC tape**) is a simple, **low-cost device** used for screening **acute malnutrition** in children, making it an example of appropriate technology for primary healthcare settings - Appropriate technology refers to tools, techniques, and practices that are **practical, sustainable, and easily adaptable** to local conditions, perfectly describing the utility and design of Shakir's tape - It exemplifies the WHO principle of appropriate technology: simple, affordable, culturally acceptable, and maintainable with local resources *Intersectoral coordination* - This refers to collaboration between different sectors (e.g., health, education, agriculture) to achieve health goals - Shakir's tape is a **diagnostic/screening tool**, not a mechanism for policy coordination - Does not involve the organizational structures or policy dialogue necessary for effective intersectoral action *Equitable distribution* - This principle focuses on fair allocation of resources (e.g., vaccines, drugs, services) - While assessing malnutrition helps prioritize resource distribution, the tape itself is a **screening tool**, not a distribution mechanism - Equitable distribution is driven by **policy and resource management**, whereas the tape is a device used in **clinical assessment** *Community participation* - This involves involving the local population in health planning and implementation - While health workers often use the tape within the community, the tape itself is a **measurement instrument**, not a method for fostering participation - Community participation is achieved through **dialogue, decision-making inclusion**, and volunteerism, not through a specific measuring tool

Question 538: The Anemia Mukt Bharat program aims to address anemia across India through targeted interventions. Which statement accurately describes its administration of Iron and Folic Acid (IFA) supplementation?

A. IFA supplementation is administered solely during pregnancy
B. Administering IFA during the 1st trimester is adequate.
C. A 100-day course of IFA supplementation is sufficient
D. IFA is provided during the 2nd trimester of pregnancy and continues during lactation for up to 6 months (Correct Answer)

Explanation: ***IFA is provided during the 2nd trimester of pregnancy and continues during lactation for up to 6 months***- Under the **Anemia Mukt Bharat (AMB)** strategy, pregnant women receive 180 days of IFA supplementation (1 tablet containing 60 mg elemental iron and 500 µg folic acid) starting from the **2nd trimester** (after 3 months gestation).- The protocol mandates continuation of the same dose for a minimum of **180 days** (6 months) even during the **postpartum/lactation period**, ensuring sustained iron stores.*IFA supplementation is administered solely during pregnancy*- This statement is inaccurate; the AMB program specifically targets women in the **reproductive age group**, including pregnant women, lactating mothers, and women of child-bearing age (WIFs).- IFA supplementation is critical during the **postpartum and lactation period** (up to 6 months) to rebuild maternal iron stores depleted during pregnancy and delivery.*A 100-day course of IFA supplementation is sufficient*- The recommended duration for continuous IFA supplementation during pregnancy under AMB is **180 days** (6 months), starting from the 2nd trimester until delivery.- In addition to pregnancy, IFA is provided for 180 days during the postpartum period and for different duration/dosage schedules for **adolescents** and **WIFs**, making 100 days insufficient for the target group.*Administering IFA during the 1st trimester is adequate.*- Although iron demand begins early, routine IFA supplementation typically starts after 12 weeks (in the **2nd trimester**) to minimize gastrointestinal side effects like **nausea and vomiting**, which are common in the first trimester.- The duration is not adequate, as supplementation must continue throughout the remainder of the pregnancy (180 days) and for 6 months postpartum.

Question 539: Wasting in a child is assessed by which of the following measures?

A. Height-for-age
B. Weight-for-age
C. Weight-for-height (Correct Answer)
D. Height-for-weight

Explanation: ***Weight-for-height***- This index is the standard measure used to assess **wasting** (acute malnutrition) as it determines if a child's weight is appropriate for their length or height, regardless of their age.- A low **Weight-for-height** Z-score strongly indicates that the child is too thin for their height, often reflecting recent severe weight loss or inadequate energy intake.*Weight-for-age*- This measure assesses whether a child is **underweight**, which is a composite parameter reflecting both acute (wasting) and chronic (stunting) malnutrition.- Because it is influenced by height (stunting), it does not specifically isolate **wasting** as the primary nutritional concern.*Height-for-weight*- This is not a standardized or clinically recognized anthropometric index used by global health organizations (like WHO) for assessing nutritional status.- The ratios commonly used are weight-for-height, weight-for-age, and height-for-age. *Height-for-age*- This index is the gold standard for assessing **stunting** (chronic malnutrition), revealing if a child is too short relative to the expected height for their age.- It indicates long-term nutritional deprivation and past growth faltering, not the current state of acute malnutrition (wasting).

Question 540: Vitamin A deficiency leads to?

A. Xerophthalmia (Correct Answer)
B. Beriberi
C. Neuropathy
D. Pellagra

Explanation: ***Xerophthalmia***- **Vitamin A** (retinol) is essential for the formation of **rhodopsin**, the photopigment necessary for low-light vision, making deficiency a primary cause of **night blindness** (nyctalopia).- Deficiency leads to **keratinization** of the *corneal and conjunctival epithelium*, resulting in dryness of the eye (*xerosis*), progressing to corneal ulcers and potentially blindness (*keratomalacia*).*Beriberi*- Caused by a deficiency of **Vitamin B1** (**thiamine**), which is crucial for carbohydrate metabolism.- Symptoms include **peripheral neuropathy** (dry beriberi) or high-output cardiac failure (wet beriberi).*Pellagra*- Caused by a deficiency of **Vitamin B3** (**niacin**), or its precursor **tryptophan**.- Classically presents with the '3 Ds': **dermatitis**, **diarrhea**, and **dementia** (and eventually death).*Neuropathy*- While severe Vitamin A deficiency can cause secondary issues, primary **neuropathy** is mainly associated with deficiencies of B-vitamins like **B1** (thiamine), **B6** (pyridoxine), or **B12** (cobalamin).- *Neuropathy* is a symptom and not the specific disease term commonly linked directly and primarily to Vitamin A deficiency, which is **xerophthalmia**.

Practice by Chapter

Basic Nutritional Requirements

Practice Questions

Assessment of Nutritional Status

Practice Questions

Protein-Energy Malnutrition

Practice Questions

Micronutrient Deficiencies

Practice Questions

Nutritional Programs in India

Practice Questions

Dietary Guidelines

Practice Questions

Food Safety and Security

Practice Questions

Diet and Non-Communicable Diseases

Practice Questions

Nutrition in Pregnancy and Lactation

Practice Questions

Infant and Young Child Nutrition

Practice Questions

Nutrition in Emergencies

Practice Questions

Food Fortification and Supplementation

Practice Questions

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