Community Medicine — Non-Communicable Disease, NMC MBBS licence examination syllabus (Nepal Medical Council).
Non-communicable disease — NMC-style practice questions
Practice questions written for this chapter. These are not past NMC papers.
📋 About these questions: These are practice questions written to test the reasoning in this chapter. They are NOT reproduced from any past Nepal Medical Council examination, and no verified past NMC questions were supplied for this chapter. They test principles rather than prevalence figures, which come from current survey data.
Level 1–2 — recall and understanding
Q1. The four shared behavioural risk factors for major
non-communicable diseases are:
A. Tobacco, unhealthy diet, physical inactivity and
harmful alcohol use
B. Infection, poverty, age and genetics
C. Smoking, obesity, stress and pollution
D. Salt, sugar, fat and caffeine
ANSWER: A.
Why: these four behaviours produce the intermediate risk
factors — raised blood pressure, glucose, lipids and weight —
which in turn drive cardiovascular disease, cancer, chronic
lung disease and diabetes.
LEARNING POINT: shared risk factors mean one intervention acts
on several diseases at once.
Q2. The "double burden of disease" in low-income countries
means:
A. Two epidemics of the same disease
B. Infectious disease and undernutrition PERSIST while
NCDs RISE alongside them
C. Disease in both adults and children
D. Two causes of death per patient
ANSWER: B.
Why: the classical epidemiological transition suggests
infection is replaced by chronic disease, but in practice the
old burden does not disappear.
LEARNING POINT: health systems must manage both
simultaneously.
Level 3–4 — application and reasoning
Q3. A district proposes to reduce stroke by treating only
those with the very highest blood pressures. The main
limitation is:
A. Treatment is ineffective at high pressures
B. MOST CASES arise from the larger number of people at
MODERATE risk
C. Screening is impossible
D. High-risk strategies are never useful
ANSWER: B.
Why: a high-risk strategy benefits each person found but
misses the bulk of future events, because the moderate-risk
group is far larger.
LEARNING POINT: combine it with population measures such as
salt reduction and tobacco control.
Q4. A woman stops her antihypertensive medication. She lives
four hours away, the clinic has been out of stock, and the
drugs are expensive. Calling this "non-compliance" is:
A. Accurate and helpful
B. MISLEADING — these are system failures, and the label
prevents anyone fixing them
C. Correct because she chose to stop
D. Irrelevant to her care
ANSWER: B.
Why: cost, distance and stock-outs are the classic barriers to
chronic care. Her decision is rational, and the label shifts
blame away from the fixable problem.
LEARNING POINT: ask about cost, distance and supply
explicitly.
Q5. A man with a non-healing oral ulcer says he has never
smoked. The question that must still be asked is:
A. Whether he drinks tea
B. Whether he uses SMOKELESS (chewed or applied) TOBACCO
C. His blood group
D. Whether he exercises
ANSWER: B.
Why: smokeless tobacco is widely used in this region, is
frequently not reported as "smoking", and is a major risk
factor for oral cancer.
LEARNING POINT: a persistent oral ulcer is a red flag needing
biopsy, not empirical treatment.
Level 5 — exception-based
Q6. Which tobacco control measure is generally the MOST
effective at reducing consumption?
A. Health education leaflets
B. PRICE increases through taxation
C. Voluntary industry agreements
D. Advice at hospital discharge only
ANSWER: B — taxation and price.
Why: price has the strongest and most consistent effect, and
works disproportionately in young people and those on low
incomes — the two groups where prevention matters most.
LEARNING POINT: other effective measures include smoke-free
places, advertising bans and pack warnings.
Q7. Two years of health education on salt and exercise
produces no change in population blood pressure. The best
interpretation is:
A. People are not motivated
B. Education alone rarely changes behaviour at scale —
STRUCTURAL measures are needed alongside it
C. Salt does not affect blood pressure
D. The measurement was wrong
ANSWER: B.
Why: advice competes with price, availability and
environment. Where salt is cheap and abundant and there is
nowhere safe to walk, information does not translate into
behaviour.
LEARNING POINT: education supports policy; it rarely
substitutes for it.
Syllabus points
Recall and understanding questions
Application and reasoning questions
Exception-based questions
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