Non-Communicable Diseases Practice Questions

Q: WHO defines blindness as counting fingers at a distance of:

3 meters. **Explanation:** The World Health Organization (WHO) defines **blindness** as visual acuity of less than **3/60** (Snellen’s chart) or its equivalent in the better eye with best possible correction. In practical field conditions where Snellen’s charts are unavailable, this is clinically assessed as the inability to count fingers at a distance of **3 meters**. * **Why 3 meters is correct:** According to the WHO ICD-11 classification, "Blindness" (Vision Category 3, 4, and 5) starts when the patient cannot see the 3/60 line. Since the numerator (3) represents the distance from the chart, the bedside equivalent is counting fingers at 3 meters. * **Why other options are incorrect:** * **6 meters:** This represents the standard distance for normal visual acuity (6/6). * **1 meter:** This corresponds to "Severe Visual Impairment" (less than 1/60), but it is not the threshold for the definition of blindness itself. * **9 meters:** This distance does not correspond to any standard WHO diagnostic threshold for visual impairment. **High-Yield Clinical Pearls for NEET-PG:** 1. **WHO Definition of Blindness:** VA < 3/60 in the better eye. 2. **NPCB (National Programme for Control of Blindness - India) Definition:** India previously used < 6/60, but has now aligned with the WHO criteria of **< 3/60** to achieve the goals of "Vision 2020." 3. **Visual Impairment Categories:** * **Moderate:** < 6/18 to 6/60. * **Severe:** < 6/60 to 3/60. * **Blindness:** < 3/60 to No Light Perception. 4. **Most Common Cause:** Cataract remains the leading cause of blindness in India, followed by Refractive Errors.

Q: Which of the following is a non-modifiable risk factor for hypertension?

Gender. **Explanation:** Risk factors for hypertension are broadly categorized into two groups: **Non-modifiable** (factors that cannot be changed) and **Modifiable** (behavioral or environmental factors that can be intervened upon). **Why Gender is the Correct Answer:** Gender is a biological attribute determined at birth and cannot be altered through lifestyle or medical intervention. In the context of hypertension, males are generally at a higher risk at younger ages. However, post-menopause, the risk in females increases and often equals or exceeds that of males due to the loss of the protective effects of estrogen. Other non-modifiable factors include age, genetics/family history, and ethnicity. **Analysis of Incorrect Options:** * **B. Obesity:** This is a major modifiable risk factor. Weight reduction (maintaining a BMI between 18.5–24.9 kg/m²) is one of the most effective lifestyle interventions to lower blood pressure. * **C. Salt Intake:** High dietary sodium (>5g of NaCl/day) is a modifiable risk factor. Reducing salt intake is a primary preventive strategy in community medicine. * **D. Cultural characteristics:** While "culture" sounds fixed, these are "acquired over time" (e.g., dietary habits, sedentary lifestyle, or tobacco use). Since these are learned behaviors, they are considered modifiable through health education and behavioral change. **High-Yield NEET-PG Pearls:** * **Rule of Halves:** In hypertension, half the people in a community are aware of their status; half of those aware are on treatment; and half of those treated have their BP controlled. * **Most common modifiable risk factor:** Obesity/Sedentary lifestyle. * **Primary Prevention:** Focuses on population-based strategies (e.g., salt reduction) and high-risk strategies (e.g., weight loss). * **Tracking of Blood Pressure:** This phenomenon suggests that children whose BP is in the higher percentiles tend to maintain that position into adulthood.

Q: Screening of cervical cancer at Primary Health Centre (PHC) levels is done by which method?

Pap smear. **Explanation:** **1. Why Pap Smear is the Correct Answer:** In the context of the Indian healthcare system and National Health Programs, the **Pap smear** (Exfoliative Cytology) is the gold-standard screening tool for cervical cancer at the primary and secondary levels. It is a cost-effective, simple, and non-invasive procedure used to detect pre-malignant (dysplastic) changes in the cervix. Under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), opportunistic screening for women aged 30–65 is encouraged at PHCs. **2. Why Other Options are Incorrect:** * **History taking (A):** While essential for identifying risk factors (early marriage, parity, smoking), it cannot diagnose or screen for cellular changes. * **Colposcopy (B):** This is a **diagnostic** tool, not a primary screening tool. It is performed at tertiary centers (Medical Colleges) if a screening test (Pap smear or VIA) returns positive. * **CT Scan (D):** This is an imaging modality used for **staging** known cases of cervical cancer to check for metastasis; it has no role in mass screening. **3. High-Yield Clinical Pearls for NEET-PG:** * **VIA (Visual Inspection with Acetic Acid):** In low-resource settings (Sub-centers/PHCs), VIA is often preferred over Pap smears because it provides "see-and-treat" immediate results. However, if the question asks for the standard cytological screening method, Pap smear is the answer. * **Target Age:** Screening in India is generally recommended for women aged **30 to 65 years**. * **Etiology:** HPV types **16 and 18** are responsible for ~70% of cervical cancers. * **Vaccination:** The HPV vaccine is most effective when given to girls aged **9–14 years** (before sexual debut).

Q: What is the most common cancer affecting both males and females worldwide?

Lung cancer. **Explanation:** The correct answer is **Lung Cancer**. According to the latest **GLOBOCAN** data (published by the WHO/IARC), lung cancer remains the most frequently diagnosed cancer and the leading cause of cancer-related mortality globally when considering both sexes combined. **Why Lung Cancer is Correct:** Lung cancer accounts for approximately 12.4% of all new cancer cases worldwide. While Breast cancer has recently surpassed Lung cancer as the most common cancer in *females*, when the data for **both males and females are aggregated**, Lung cancer retains the top position due to its high prevalence in men and rising incidence in women. **Analysis of Incorrect Options:** * **A. Cancer of the Pancreas:** While highly lethal with a poor prognosis, it does not rank among the top five most common cancers globally. * **B. Buccal Mucosa Cancer:** This is a subset of Oral Cancer. While it is highly prevalent in specific regions like **India** (due to tobacco and betel nut chewing), it is not the most common cancer on a global scale. * **D. Colo-rectal Cancer:** This is currently the third most common cancer worldwide. While its incidence is rising due to Westernized diets and sedentary lifestyles, it still trails behind Lung and Breast cancer. **High-Yield Clinical Pearls for NEET-PG:** * **Global (Both Sexes):** Most common = Lung Cancer; Leading cause of death = Lung Cancer. * **Global (Females):** Most common = Breast Cancer. * **India (Both Sexes):** Most common = Breast Cancer (followed by Lip/Oral cavity). * **India (Males):** Most common = Lip and Oral Cavity cancer. * **India (Females):** Most common = Breast Cancer (followed by Cervical cancer). * **Screening:** Low-dose CT (LDCT) is the recommended screening tool for high-risk smokers for lung cancer.

Q: Which of the following is NOT an early warning sign of cancer that the public should be aware of?

Unexplained weight gain. **Explanation:** The early warning signs of cancer are traditionally summarized by the American Cancer Society using the mnemonic **CAUTION**. The correct answer is **Unexplained weight gain** because, in the context of malignancy, **unexplained weight loss** (typically >10% of body weight over 6 months) is a classic systemic warning sign, not weight gain. Weight loss in cancer is often due to hypermetabolism and the release of cytokines like TNF-alpha (cachexin). **Analysis of Options:** * **A. Persistent cough:** This is the **'C'** in CAUTION (Cough or hoarseness). A cough lasting more than 3 weeks can be an early indicator of lung or laryngeal cancer. * **B. Lump or hard area in breast:** This represents the **'T'** in CAUTION (Thickening or lump in breast or elsewhere). It is one of the most common early signs of breast or soft tissue malignancies. * **D. Change in wart or mole:** This represents the **'O'** in CAUTION (Obvious change in a wart or mole). It is a critical warning sign for malignant melanoma, often assessed using the ABCDE criteria. **NEET-PG High-Yield Pearls:** * **CAUTION Mnemonic:** * **C:** Change in bowel/bladder habits (Colorectal/Bladder CA) * **A:** A sore that does not heal (Skin/Oral CA) * **U:** Unusual bleeding or discharge (Cervical/Endometrial CA) * **T:** Thickening or lump (Breast/Testicular CA) * **I:** Indigestion or difficulty swallowing (Esophageal/Gastric CA) * **O:** Obvious change in wart/mole (Melanoma) * **N:** Nagging cough or hoarseness (Lung/Laryngeal CA) * **Primary Prevention:** Tobacco cessation is the most effective strategy to reduce cancer burden. * **Secondary Prevention:** Screening for early detection (e.g., Pap smear for Cervical CA, Mammography for Breast CA).

Q: Which of the following is NOT a risk factor for head and neck cancers?

Unflourinated water. **Explanation:** Head and neck cancers (HNCs) are primarily associated with lifestyle-related carcinogens and viral infections. Understanding the distinction between established risk factors and unrelated environmental factors is crucial for NEET-PG. **Why "Unfluorinated water" is the correct answer:** There is no scientific evidence linking the absence (or presence) of fluoride in water to the development of head and neck cancers. Fluoridation of water is a public health measure intended to prevent dental caries. While excessive fluoride can lead to dental or skeletal fluorosis, it is not classified as a carcinogen for the mucosal linings of the upper aerodigestive tract. **Analysis of incorrect options:** * **Tobacco use (C) and Smoking (B):** These are the most significant risk factors for HNCs. Tobacco contains potent carcinogens like nitrosamines and polycyclic aromatic hydrocarbons that cause DNA damage in the squamous epithelium. * **Alcohol consumption (A):** Alcohol acts as a solvent, enhancing the penetration of tobacco carcinogens into the mucosal cells. It also metabolizes into acetaldehyde, a known carcinogen. When combined with tobacco, alcohol has a **synergistic (multiplicative) effect** on cancer risk. **High-Yield Clinical Pearls for NEET-PG:** * **Most common histological type:** Squamous Cell Carcinoma (>90%). * **Emerging Risk Factor:** Human Papillomavirus (**HPV-16**) is now a major cause of oropharyngeal cancers, especially in non-smokers. * **Epstein-Barr Virus (EBV):** Specifically associated with Nasopharyngeal Carcinoma. * **Dietary Factors:** Deficiencies in Vitamin A and C are linked to increased risk, while "Plummer-Vinson Syndrome" (iron deficiency anemia) is a precursor for post-cricoid carcinoma.

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

<200 mg/dL. **Explanation:** The correct answer is **D. <200 mg/dL**. Coronary Artery Disease (CAD) is strongly associated with dyslipidemia. According to the guidelines established by the National Cholesterol Education Program (NCEP) and adopted by the World Health Organization (WHO), the **desirable level** for total serum cholesterol in adults to minimize the risk of atherosclerosis and CAD is **less than 200 mg/dL**. * **Why <200 mg/dL is correct:** This threshold is considered "desirable." Levels between 200–239 mg/dL are classified as "borderline high," and levels ≥240 mg/dL are classified as "high risk," doubling the risk of a cardiovascular event compared to the desirable range. * **Why other options are incorrect:** * **<220 mg/dL (Option B):** While previously used in older literature, modern guidelines consider 220 mg/dL as "borderline high." * **<250 mg/dL and <300 mg/dL (Options A & C):** These levels are significantly elevated and fall into the high-risk category, where aggressive lifestyle or pharmacological intervention is required. **High-Yield Pearls for NEET-PG:** 1. **LDL (The "Bad" Cholesterol):** The primary target for therapy. Desirable level is **<100 mg/dL**. 2. **HDL (The "Good" Cholesterol):** Protective against CAD. Levels **<40 mg/dL** are a major risk factor, while **≥60 mg/dL** is considered protective. 3. **Triglycerides:** Desirable level is **<150 mg/dL**. 4. **Rule of Thumb:** For every 1% reduction in total serum cholesterol, there is a 2% reduction in the risk of coronary heart disease.

Q: All of the following dietary goals are recommended for patients with a high risk of coronary heart disease, EXCEPT:

Alcohol consumption. ### Explanation The primary goal in managing patients at high risk for Coronary Heart Disease (CHD) is the aggressive modification of lipid profiles and lifestyle factors to prevent atherosclerotic progression. **Why "Alcohol Consumption" is the correct answer:** While some observational studies suggest a "J-shaped curve" regarding moderate alcohol intake and cardioprotection, **alcohol consumption is never a recommended dietary goal** or a prescription for heart health. Alcohol can contribute to hypertension, hypertriglyceridemia, and cardiomyopathy. In the context of medical guidelines (like the NCEP-ATP III or AHA), the focus is on *limiting* intake rather than encouraging it as a goal. **Analysis of Incorrect Options:** * **LDL cholesterol <100 mg/dL:** This is a standard target for high-risk individuals. For those with established CHD or "CHD equivalents" (like Diabetes Mellitus), the goal is often even more stringent (<70 mg/dL). * **Saturated fat < 7% of total calories:** According to the Therapeutic Lifestyle Changes (TLC) diet, reducing saturated fats to less than 7% is a cornerstone for lowering LDL-C levels. * **Salt restriction < 6 gm/day:** High sodium intake is directly linked to hypertension, a major risk factor for CHD. The WHO and national guidelines recommend limiting salt to 30g/day). * **Rule of 5/6:** For general population health, salt intake should be <5g/day; for hypertensive/CHD patients, it is strictly monitored.

Q: Oral Rehydration Solution (ORS) contains 75 mmol/litre of which of the following electrolytes or solute?

Sodium. The correct answer is **Sodium**. This question refers to the **WHO Reduced Osmolarity ORS**, which has been the standard recommendation since 2002 to reduce the need for unscheduled IV fluids and decrease stool output. ### Why Sodium is Correct In the current WHO ORS formulation, the concentration of **Sodium is exactly 75 mmol/L**. This concentration is optimized to facilitate the co-transport of sodium and glucose across the intestinal epithelium via the SGLT-1 transporter. This mechanism remains intact even during secretory diarrheas like Cholera, allowing for effective rehydration. ### Why Other Options are Incorrect * **Glucose (75 mmol/L):** While Glucose also has a concentration of 75 mmol/L in the current formula, Sodium is the primary electrolyte being asked about in the context of "electrolytes or solutes" where Sodium is the physiological priority for volume expansion. (Note: In many exams, if both are 75, Sodium is the classic answer for osmolarity discussions). * **Chloride (65 mmol/L):** The chloride content was reduced in the new formulation to 65 mmol/L to maintain electrochemical balance while lowering total osmolarity. * **Potassium (20 mmol/L):** Potassium remains at 20 mmol/L to replace losses and prevent hypokalemia, but it does not match the 75 mmol/L threshold. ### High-Yield Clinical Pearls for NEET-PG * **Total Osmolarity:** The total osmolarity of Reduced Osmolarity ORS is **245 mOsm/L** (Old ORS was 311 mOsm/L). * **Citrate:** Trisodium citrate (10 mmol/L) is used instead of bicarbonate because it increases the shelf life of ORS packets. * **Zinc Supplementation:** Always remember that for children with diarrhea, Zinc (20 mg/day for 14 days; 10 mg for infants <6 months) is given alongside ORS to reduce the duration and severity of the episode. * **Composition Summary (mmol/L):** Na+ (75), Cl- (65), Glucose (75), K+ (20), Citrate (10).

Q: What is the commonest carcinoma in elderly males?

Prostate. **Explanation:** The correct answer is **Prostate (Option D)**. In the elderly male population (typically defined as >65 years), **Prostate Carcinoma** is the most frequently diagnosed malignancy. The incidence of prostate cancer is strongly age-dependent; it is rare before age 40 but increases exponentially thereafter. Autopsy studies have shown that nearly 50-60% of men over the age of 80 have histological evidence of prostatic adenocarcinoma, often referred to as "latent carcinoma." **Analysis of Incorrect Options:** * **Stomach (Option A):** While historically common in India and East Asia, its incidence is declining globally. It is not the most common cancer in the elderly compared to prostate or lung. * **Lung (Option B):** Lung cancer is the leading cause of **cancer-related mortality** (deaths) in men worldwide [2], but in terms of **incidence** (new cases) in the elderly, prostate cancer ranks higher. * **Esophagus (Option C):** This is common in specific geographical belts (like the "Asian Esophageal Cancer Belt") and is associated with smoking and alcohol, but it does not surpass the prevalence of prostate cancer. **High-Yield Clinical Pearls for NEET-PG:** * **Global vs. India:** Globally, Prostate is the commonest cancer in males. However, in **India**, according to recent ICMR data, **Lung cancer** or **Oral cavity cancer** often tops the list for males, but for the specific demographic of "elderly males" in a general medical context, Prostate remains the classic textbook answer. * **Screening:** PSA (Prostate Specific Antigen) is the screening marker, though its routine use is controversial due to overdiagnosis. * **Metastasis:** Prostate cancer characteristically spreads to the bone, causing **osteoblastic (sclerotic) lesions**, commonly involving the lumbar spine [1].

Question 1

WHO defines blindness as counting fingers at a distance of:

Accepted Answer

3 meters

Answer

1 meter

Answer

6 meters

Answer

9 meters

Question 2

Which of the following is a non-modifiable risk factor for hypertension?

Accepted Answer

Gender

Answer

Obesity

Answer

Salt intake

Answer

Cultural characteristics acquired over time

Question 3

Screening of cervical cancer at Primary Health Centre (PHC) levels is done by which method?

Accepted Answer

Pap smear

Answer

History taking

Answer

Colposcopy

Answer

CT Scan

Question 4

What is the most common cancer affecting both males and females worldwide?

Accepted Answer

Lung cancer

Answer

Cancer of the pancreas

Answer

Buccal mucosa cancer

Answer

Colo-rectal cancer

Question 5

Which of the following is NOT an early warning sign of cancer that the public should be aware of?

Accepted Answer

Unexplained weight gain

Answer

Persistent cough

Answer

Lump or hard area in breast

Answer

Change in wart or mole

Question 6

Which of the following is NOT a risk factor for head and neck cancers?

Accepted Answer

Unflourinated water

Answer

Alcohol consumption

Answer

Smoking

Answer

Tobacco use

Question 7

What is the desirable 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 8

All of the following dietary goals are recommended for patients with a high risk of coronary heart disease, EXCEPT:

Accepted Answer

Alcohol consumption

Answer

LDL cholesterol <100 mg/dL

Answer

Saturated fat < 7% of total calories

Answer

Salt restriction < 6 gm/day

Question 9

Oral Rehydration Solution (ORS) contains 75 mmol/litre of which of the following electrolytes or solute?

Accepted Answer

Sodium

Answer

Potassium

Answer

Glucose

Answer

Chloride

Question 10

What is the commonest carcinoma in elderly males?

Accepted Answer

Prostate

Answer

Stomach

Answer

Lung

Answer

Esophagus

Non-Communicable Diseases — MCQs

Non-Communicable Diseases — MCQs

On this page

Practice by Chapter

Want unlimited practice?