Non-Communicable Diseases Practice Questions

Q: 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:

50 %. ***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.

Q: Visual inspection based screening test with 5 % acetic acid is used for the screening of which one of the following cancers?

Cervix cancer. ***Cervix cancer*** - Visual inspection with **acetic acid (VIA)** is a widely used, low-cost screening method for **cervical cancer**, particularly in low-resource settings. - Acetic acid causes abnormal (dysplastic or cancerous) cervical cells to turn **white (acetowhite lesion)**, making them visible to the naked eye. *Oral cancer* - Screening for **oral cancer** typically involves a visual and tactile examination of the oral cavity by a dentist or healthcare provider. - While acetic acid can highlight some oral lesions, it is **not a standard diagnostic or screening tool** for oral cancer like it is for cervical cancer. *Lung cancer* - Screening for **lung cancer** usually involves **low-dose computed tomography (LDCT)** for high-risk individuals. - There is **no role for acetic acid** in the screening or diagnosis of lung cancer. *Breast cancer* - Screening for **breast cancer** is primarily done through **mammography**, clinical breast exams, and sometimes MRI. - **Acetic acid** has **no application** in the detection or screening of breast cancer.

Q: Which of the following measures can help reduce the risk of systemic hypertension? 1. Reduction in dietary intake of common salt 2. Maintaining healthy body weight 3. Increasing potassium rich foods in the diet Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - **Reduction in dietary intake of common salt** (sodium) is crucial as excessive sodium leads to fluid retention and increased blood volume, directly contributing to **hypertension**. WHO recommends <5g/day salt intake. - **Maintaining healthy body weight** (controlling BMI) significantly reduces the risk of hypertension, as obesity is a major independent risk factor. Even 5-10% weight loss can substantially lower blood pressure. - **Increasing potassium-rich foods** helps counteract the effects of sodium, promoting sodium excretion and relaxing blood vessel walls, thereby lowering blood pressure. Recommended intake is 3.5-5g/day. *2 and 3 only* - This option is incorrect because **reducing salt intake** (measure 1) is a fundamental and highly effective strategy for preventing and managing hypertension. - Excluding salt reduction from the recommended measures would disregard a cornerstone of cardiovascular health proven by DASH diet trials. *1 and 2 only* - This option is flawed because **increasing potassium-rich foods** (measure 3) is a recognized dietary intervention that contributes to blood pressure control. - Potassium helps counterbalance sodium effects, and its omission makes this answer incomplete. *1 and 3 only* - This option is incorrect as it excludes **maintaining healthy body weight** (measure 2), which is a critical and well-established lifestyle modification for preventing and managing hypertension. - Obesity is a significant risk factor, and weight management is essential for blood pressure control.

Q: True about Cardiovascular disease (CVD)

Primordial prevention is best strategy. ***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.

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

Primordial prevention. ***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.

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: According to the U.S. Preventive Services Task Force (USPSTF) guidelines, what is the recommended age to begin routine screening mammography for average-risk women?

50 years. ***50 years*** - The **USPSTF recommends** starting biennial (every two years) screening mammography for women of **average risk** at age **50 years** (Grade B recommendation). - This recommendation balances the benefits of early cancer detection against the potential harms of false positives and unnecessary interventions in younger women. *30 years* - This age is **too early** for routine screening mammography in average-risk women according to most major guidelines, including the USPSTF. - Screening at this age could lead to a higher rate of **false positives** and associated anxiety and unnecessary follow-up procedures without significant mortality benefit. *40 years* - While some organizations, like the **American Cancer Society (ACS)**, recommend women begin screening at age 40, the USPSTF specifically advises against routine screening before age 50 for average-risk women due to a less favorable **risk-benefit profile**. - **Individualized decision-making** is considered for women aged 40-49, weighing personal values and potential benefits/harms. *20 years* - **No major health organization** recommends routine screening mammography for average-risk women at this age. - Breast tissue is typically **denser** in younger women, making mammographic interpretation more difficult and less effective, and the incidence of breast cancer is very low.

Question 1

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

Accepted Answer

A 10 percent relative reduction in mean population intake of salt/sodium

Answer

Halt the rise of diabetes and obesity

Answer

At least 10 percent relative reduction in the harmful use of alcohol as appropriate within national context

Answer

A 10 percent relative reduction in prevalence of insufficient physical activity

Question 2

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:

Accepted Answer

50 %

Answer

40 %

Answer

60 %

Answer

30 %

Question 3

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

Accepted Answer

A 15% relative reduction in healthcare costs related to NCDs

Answer

A 30% relative reduction in mean population intake of salt/sodium

Answer

A 25% relative reduction in risk of premature mortality from cardiovascular diseases, cancer, diabetes and chronic respiratory diseases

Answer

At least 10 % relative reduction in the harmful use of alcohol

Question 4

Visual inspection based screening test with 5 % acetic acid is used for the screening of which one of the following cancers?

Accepted Answer

Cervix cancer

Answer

Oral cancer

Answer

Lung cancer

Answer

Breast cancer

Question 5

Which of the following measures can help reduce the risk of systemic hypertension?

1. Reduction in dietary intake of common salt
2. Maintaining healthy body weight
3. Increasing potassium rich foods in the diet

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

2 and 3 only

Answer

1 and 2 only

Answer

1 and 3 only

Question 6

True about Cardiovascular disease (CVD)

Accepted Answer

Primordial prevention is best strategy

Answer

Coronary heart disease causes 25% of total deaths

Answer

Urban and rural areas have equal incidence

Answer

RHD is the most common cause of CVD

Question 7

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

Accepted Answer

Primordial prevention

Answer

Primary prevention

Answer

Specific protection

Answer

Secondary prevention

Question 8

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 9

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 10

According to the U.S. Preventive Services Task Force (USPSTF) guidelines, what is the recommended age to begin routine screening mammography for average-risk women?

Accepted Answer

50 years

Answer

30 years

Answer

40 years

Answer

20 years

Non-Communicable Diseases — MCQs

Non-Communicable Diseases — MCQs

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