GROUP – A (LAQ-15 MARKS) 1. What is latent period? Enumerate the risk factors of Non-communicable Diseases. Mention different preventive & control methods for any one of the Non-communicable Diseases as per National guidelines. (2 + 3 + 10) [JIMSH] 2. A 35-year sedentary obese man with smoking habit is found to have blood pressure of 126/100mm Hg. What is your provisional diagnosis? How will you classify this blood pressure? Describe the risk factors of hypertension. Discuss the levels of prevention with special emphasis on diet of the person. What is tracking of blood pressure? (1 + 2 + 4 + 6 + 2 = 15) [ICARE] 3. A 52-year-old male obese school teacher attended the outpatient department of a rural health centre for a routine health check-up. He has a history of sedentary lifestyle, smoking 10 cigarettes daily for the last 20 years, and frequent consumption of salty snacks. His father had hypertension and died of a stroke at the age of 60 years. On examination, his blood pressure is 154/96 mm of Hg. • What is the diagnosis? Mention the criteria used for diagnosis. (2 Marks) • Enumerate the modifiable and non- modifiable risk factors present in this patient. (3 Marks) • Classify hypertension according to the current Indian WHO guidelines. (2 Marks) • Describe the Rule of Halves in hypertension. (1 Mark) • List four lifestyle modification measures that should be advised to this patient. (2 Marks) • Mention any four complications of uncontrolled hypertension. (2 Marks) [DHGMCH] 4. Classify hypertension. What are risk factors & complication of essential hypertension. Write down the preventive measures of essential hypertension.( 2+4+4+5 = 15) [CNMCH] 5. A 15 years old adolescent boy is brought to school health clinic with complaint of easy fatigability. Examination reveals BMI above 95 th percentile for age and sex. The boy spends most of time on screen-based activities and consumes fast food regularly. What is the most likely public health problem in this adolescent? Identify behavioral risk factor in this case. Mention two health consequences with this condition if left untreated. What preventive strategies can be implemented at school level for these cases? Which level of prevention applicable to this scenario? Mention the name of National Programme related to it. (2+2+2+6+2+1) [MCK] 6. A non-pregnant, non-lactating female patient aged 27 years reports to PHC with complaints of fever and cough with expectoration since 3 weeks. There was h/o weight loss and night sweats. She belongs to a nuclear family with her 30 years old husband and one son aged six years. • What is the probable diagnosis? What is the national programme against the disease? • Discuss the diagnostic algorithm and treatment regimen for this case according to National Program guidelines. • What preventive measures will you adopt for her family? (1+1+4+4+5 = 15) [IQCITY]

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All six answers are above. Here is a quick reference summary of what each answer covers:

Quick Reference Summary

Q1 (JIMSH) - NCD / Latent Period (2+3+10)
  • Latent period = time between first exposure and first symptoms; very long in NCDs (years-decades)
  • NCD risk factors: 4 WHO behavioural (tobacco, alcohol, inactivity, unhealthy diet) + metabolic (HTN, DM, obesity, dyslipidaemia)
  • HTN prevention per NPCDCS: Primordial → Population strategy (DASH diet, weight, exercise) → High-risk strategy → Secondary (screening, treatment) → Tertiary (complication management)
Q2 (ICARE) - HTN Case, 35-year-old male (1+2+4+6+2)
  • Diagnosis: Grade 2 Essential Hypertension (diastolic 100 mm Hg dominates)
  • WHO classification table (Optimal → Normal → High Normal → Grade 1/2/3)
  • Risk factors: obesity, smoking, sedentary, high salt/fat
  • Levels of prevention with DASH diet emphasis (salt <5g/day, K-rich foods, fibre, low saturated fat)
  • Tracking = BP percentile rank maintained from childhood to adulthood; rationale for early screening
Q3 (DHGMCH) - HTN Case, 52-year-old teacher (2+3+2+1+2+2)
  • Grade 1 HTN (154/96); criteria = 2+ readings on 2+ occasions
  • Modifiable: obesity, smoking, sedentary, salty snacks | Non-modifiable: age, sex, family history
  • WHO classification (same table)
  • Rule of Halves: only 1/8 all hypertensives are adequately controlled at community level
  • 4 lifestyle modifications: diet, weight, smoking cessation, exercise
  • 4 complications: stroke, CAD/LVH, CKD, hypertensive retinopathy
Q4 (CNMCH) - HTN Classification, RF, Complications, Prevention (2+4+4+5)
  • Classification by grade + by aetiology (essential vs secondary) + malignant HTN
  • Full list of modifiable and non-modifiable risk factors
  • Complications by system: cardiac, cerebrovascular, renal, ocular, vascular
  • Prevention: ABCDE approach + pharmacotherapy + NPCDCS screening + tertiary rehabilitation
Q5 (MCK) - Adolescent Obesity (2+2+2+6+2+1)
  • Public health problem: Childhood/Adolescent Obesity (BMI ≥95th percentile)
  • Behavioural risks: screen time + fast food
  • Consequences: T2DM + CVD risk (+ psychological)
  • School strategies: healthy canteen, compulsory PE, nutrition education, screening, parent involvement, environment
  • Level: Secondary prevention (for identified obese child), Primary (school population)
  • Programme: NPCDCS + RKSK (Rashtriya Kishor Swasthya Karyakram) + RBSK
Q6 (IQCITY) - Tuberculosis Case (1+1+4+4+5)
  • Diagnosis: Pulmonary TB | Programme: NTEP (formerly RNTCP)
  • Diagnostic algorithm: Presumptive TB → CBNAAT (first-line) → Smear microscopy → CXR → Classify
  • Treatment: 2HRZE + 4HR (daily FDC under DOT); Pyridoxine; Ni-kshay notification + portal
  • Family prevention: Contact tracing (husband + son), TPT/IPT for child (INH 6 months), BCG, ventilation, respiratory hygiene, HIV testing, health education, DOT support
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