A schoolteacher in Pune with mild asthma notices that her wheeze flares when she jogs at about 3 p.m. on hot, sunny days in April, even though the city's PM2.5 readings on those days are only in the Satisfactory range. The pollution board's station near her home shows that one sub-index rises sharply every afternoon and falls after sunset, while NO2 peaks in the morning and evening rush hours. Her asthma is otherwise well controlled on an inhaled steroid. Which pollutant is the likely trigger, and what is the best advice?

Ozone; jog in the early morning instead

PM10; jog in the late afternoon instead

Carbon monoxide; jog indoors at noon

Sulphur dioxide; wear a cloth mask

On the second day in the ICU, a soldier who collapsed during a 20 km march in April is now conscious; rapid cooling in casualty had brought his core temperature down from 42.0 °C to 38.8 °C. His urine is dark brown and positive for blood on dipstick, but microscopy shows no red cells. CK is 48,000 U/L (normal under 200), serum creatinine has risen from 1.1 to 2.4 mg/dL and potassium is 5.4 mmol/L (3.5-5.0). He has had no fits. Urine output is 25 mL/hour. What is the most appropriate next step?

Aggressive IV isotonic fluids for a high urine flow

IV dantrolene to stop muscle breakdown

IV furosemide to restore urine output at once

Climate change, One Health and NCD risk factors

29 NEET-PG practice questions on Climate change, One Health and NCD risk factors, part of Community Medicine. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Easy
Which air pollutant, small enough to reach the alveoli and enter the bloodstream, is most strongly linked with cardiovascular deaths?
1. APM10
2. BSulphur dioxide
3. CPM2.5
4. DOzone
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Answer: C · PM2.5
Fine particles under 2.5 micrometres reach the alveoli, enter the circulation and cause systemic inflammation, endothelial damage and thrombosis, so PM2.5 is the pollutant most strongly tied to ischaemic heart disease, stroke and overall mortality. PM10 is mostly trapped in the nose and large airways. Sulphur dioxide is highly soluble and absorbed in the upper airway. Key point: PM2.5 reaches the alveoli and blood and drives most air-pollution cardiovascular deaths.
- A: PM10 is mostly deposited in the upper airways.
- B: SO2 is absorbed in the upper airway because it is soluble.
- D: Ozone irritates airways but is not the main driver of cardiovascular deaths.
Question 2 · Medium
The factory medical officer of a glass works in Thrissur must set work-rest cycles for men who work near the furnaces, after two workers fainted there last summer. He needs one index that takes account of air temperature, humidity, radiant heat and air movement. Which index should he use?
1. ADry bulb air temperature
2. BHeat index
3. CWet bulb globe temperature
4. DKata thermometer cooling power
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Answer: C · Wet bulb globe temperature
The wet bulb globe temperature combines the natural wet bulb (humidity and air movement), globe (radiant heat) and dry bulb readings, and is the standard index for setting work-rest cycles in hot workplaces. The heat index uses only air temperature and humidity, so it misses radiant heat from furnaces. The kata thermometer measures the cooling power of air, mainly air movement. Key point: WBGT, which includes radiant heat, is the index used to set work-rest cycles in hot industries.
- A: Dry bulb temperature ignores humidity, radiant heat and air movement.
- B: The heat index leaves out radiant heat.
- D: The kata thermometer measures mainly air movement and cooling power.
Question 3 · Easy
The first city heat action plan in South Asia, drawn up after the deadly heat wave of 2010, was launched in which city?
1. AHyderabad
2. BNagpur
3. CAhmedabad
4. DDelhi
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Answer: C · Ahmedabad
Ahmedabad launched South Asia's first heat action plan in 2013 after the May 2010 heat wave caused a large rise in deaths. It set up early warnings, inter-agency coordination, training of health workers and public awareness, and became the model for state and city plans across India. NDMA later issued national guidelines on heat waves. Key point: Ahmedabad (2013) had South Asia's first heat action plan, the model for Indian plans.
- A: Hyderabad developed its plan later.
- B: Nagpur prepared a plan later, following the Ahmedabad model.
- D: Delhi developed its plan later.
Question 4 · Hard
A schoolteacher in Pune with mild asthma notices that her wheeze flares when she jogs at about 3 p.m. on hot, sunny days in April, even though the city's PM2.5 readings on those days are only in the Satisfactory range. The pollution board's station near her home shows that one sub-index rises sharply every afternoon and falls after sunset, while NO2 peaks in the morning and evening rush hours. Her asthma is otherwise well controlled on an inhaled steroid. Which pollutant is the likely trigger, and what is the best advice?
1. APM10; jog in the late afternoon instead
2. BOzone; jog in the early morning instead
3. CCarbon monoxide; jog indoors at noon
4. DSulphur dioxide; wear a cloth mask
Show answerHide answer
Answer: B · Ozone; jog in the early morning instead
Ground-level ozone is a secondary pollutant formed when NO2 and volatile organic compounds react in sunlight, so it peaks on hot, sunny afternoons after the morning traffic and falls after sunset. It irritates the airways and triggers asthma, especially during exercise, so she should exercise in the early morning or evening and keep her reliever with her. Cloth masks do not filter gases. Key point: Ozone peaks on sunny afternoons from NO2 and VOCs; people with asthma should exercise in the early morning.
- A: PM10 does not follow this afternoon pattern, and late afternoon is when ozone is high.
- C: CO peaks with traffic, not with sunshine, and does not trigger wheeze.
- D: SO2 comes mainly from industry, and cloth masks do not stop gases.
Question 5 · Hard
On the second day in the ICU, a soldier who collapsed during a 20 km march in April is now conscious; rapid cooling in casualty had brought his core temperature down from 42.0 °C to 38.8 °C. His urine is dark brown and positive for blood on dipstick, but microscopy shows no red cells. CK is 48,000 U/L (normal under 200), serum creatinine has risen from 1.1 to 2.4 mg/dL and potassium is 5.4 mmol/L (3.5-5.0). He has had no fits. Urine output is 25 mL/hour. What is the most appropriate next step?
1. AAggressive IV isotonic fluids for a high urine flow
2. BIV dantrolene to stop muscle breakdown
3. CIV furosemide to restore urine output at once
4. DAn antipyretic infusion
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Answer: A · Aggressive IV isotonic fluids for a high urine flow
Exertional heat stroke has caused rhabdomyolysis: dipstick blood without red cells means myoglobinuria, and the very high CK with rising creatinine shows acute kidney injury. The key step is aggressive isotonic fluid to keep urine output high (about 200-300 mL/hour), with close monitoring of potassium and dialysis if hyperkalaemia or AKI worsens. Dantrolene does not help in heat stroke, and diuretics before volume repletion worsen kidney injury. Key point: Rhabdomyolysis after exertional heat stroke: aggressive IV isotonic fluids for high urine output to protect the kidneys.
- B: Dantrolene is for malignant hyperthermia; it does not help in heat stroke.
- C: Furosemide before volume repletion worsens kidney injury.
- D: Antipyretics have no role; cooling is complete.
Question 6 · Hard
The district health officer of a district in the plains of Vidarbha checks the IMD station data before deciding whether to activate the heat action plan. The normal maximum temperature for these dates is 37.5 °C. Actual maximum temperatures recorded were 41.0 °C on day 1, 42.3 °C on day 2 and 44.2 °C on day 3. The local newspaper has already called day 1 a heat wave. Using the IMD criterion for plains stations based on departure from normal, once the actual maximum is at least 40 °C, which description is correct?
1. ADay 1 heat wave; days 2-3 severe
2. BNo heat wave, as none reached 45 °C
3. CDays 1-3 are all heat-wave days
4. DDay 2 heat wave; day 3 severe heat wave
Answer and explanation in LearnFree account
Question 7 · Medium
Kanpur is one of the non-attainment cities that has drawn up a city-specific action plan to cut particulate matter, with central funds linked to measured improvement in air quality. The plan includes road dust control, cleaner public transport and curbs on open waste burning. Under which national programme, launched in 2019, is this done?
1. ANational Clean Air Programme
2. BNational Air Quality Monitoring Programme
3. CPradhan Mantri Ujjwala Yojana
4. DGraded Response Action Plan
Answer and explanation in LearnFree account
Question 8 · Medium
AQI sub-indices from a monitoring station in Kanpur on a November day: PM2.5 312, PM10 246, NO2 88, O3 64, CO 40. Winds were calm, there was a morning temperature inversion, and stubble burning was reported nearby. A local newspaper wants to print the day's AQI and its category. What should be reported?
1. A312, Severe
2. B312, Very poor
3. C150, Moderately polluted
4. D246, Poor
Answer and explanation in LearnFree account
Question 9 · Medium
The AQI in Delhi has been Very poor (330) for four days. A mother brings her son, a schoolboy whose asthma is well controlled on an inhaled corticosteroid, to the paediatric OPD and asks what she should do until the air improves. What is the best advice?
1. AStart oral prednisolone for the whole period
2. BStop the inhaled steroid and use only the reliever
3. CLimit outdoor exertion and continue his inhaler
4. DKeep him in school sports to build his lung strength
Answer and explanation in LearnFree account
Question 10 · Hard
During an occupational health camp at a tea estate in Idukki, a tractor driver completes the WHO AUDIT questionnaire. He drinks arrack three or four times a week, about five standard drinks each time, and once missed work after a binge. He denies morning drinking, tremors or failed attempts to cut down, and lives with his wife and two school-going children. His total score is 12. AST is 48 U/L and ALT 40 U/L (normal up to 40). He asks whether he needs medicines to stop. As the camp medical officer, what is the most appropriate response?
1. ABrief counselling with continued monitoring
2. BHome detoxification with chlordiazepoxide
3. CSimple brief advice on cutting down, with feedback
4. DReferral to a specialist de-addiction centre
Answer and explanation in LearnFree account
Question 11 · Medium
In the casualty at 2 p.m. during a May heat wave in Palakkad, a construction worker is brought after collapsing at the site. He is confused and agitated, his rectal temperature is 41.2 °C, pulse 128/min and BP 96/60 mmHg, and his skin is hot. Capillary blood glucose is 112 mg/dL. The airway is patent. What is the most important immediate step?
1. ACT head before any other treatment
2. BIV paracetamol to bring down the fever
3. CRapid cooling, such as cold-water immersion
4. DOral ORS and observation in a cool room
Answer and explanation in LearnFree account
Question 12 · Hard
Sub-indices for one day from a city station whose particulate analysers have been out of order for a week: NO2 140, SO2 60, CO 95. No PM2.5 or PM10 data are available. The municipal health officer is asked to issue the day's AQI with health advice. What should be reported?
1. A295, Poor, as the sum of all three sub-indices
2. B140, Moderately polluted, set by NO2
3. C98, Satisfactory, the mean of the three
4. DNo AQI; no particulate data are available
Answer and explanation in LearnFree account
Question 13 · Easy
In IMD's colour-coded heat-wave warnings for districts, which colour signals that authorities and the public must take action?
1. AOrange
2. BGreen
3. CRed
4. DYellow
Answer and explanation in LearnFree account
Question 14 · Medium
A traffic policeman on afternoon duty in Kollam feels dizzy, nauseated and weak, with a headache and heavy sweating. At the PHC his oral temperature is 38.4 °C and pulse 110/min, and he is fully oriented and answers questions normally. What is the most likely diagnosis?
1. AExertional heat syncope
2. BHeat cramps
3. CHeat stroke
4. DHeat exhaustion
Answer and explanation in LearnFree account
Question 15 · Easy
Under NP-NCD, population-based screening for hypertension, diabetes and oral, breast and cervical cancer is offered to everyone above which age?
1. A18 years
2. B45 years
3. C30 years
4. D40 years
Answer and explanation in LearnFree account
Question 16 · Medium
Regarding the WHO MPOWER measures for tobacco control, consider: 1. M stands for monitoring tobacco use and prevention policies. 2. P stands for protecting people from tobacco smoke. 3. O stands for offering help to quit tobacco use. 4. R stands for regulating the contents of tobacco products. Which statements are correct?
1. A1 and 2 only
2. B2, 3 and 4 only
3. C1, 2 and 3 only
4. D1, 2, 3 and 4
Answer and explanation in LearnFree account
Question 17 · Medium
From 1 March each year, every district hospital in Kerala reports daily cases and deaths from heat stroke and heat exhaustion on the IHIP portal. Under which national programme was this heat-related illness surveillance started?
1. ARashtriya Kishor Swasthya Karyakram
2. BNational Programme for NCDs
3. CIntegrated Disease Surveillance Programme
4. DNational Programme on Climate Change and Human Health
Answer and explanation in LearnFree account
Question 18 · Easy
Under COTPA 2003, which section bans the sale of tobacco products within 100 yards of an educational institution?
1. ASection 7
2. BSection 4
3. CSection 6(b)
4. DSection 5
Answer and explanation in LearnFree account
Question 19 · Medium
Annual mean PM2.5 in a city in the Indo-Gangetic plain was 42 µg/m3 last year. India's national ambient air quality standard for annual PM2.5 is 40 µg/m3, and the city health department is preparing a report for the municipal council. How does the city compare with the WHO 2021 air quality guideline?
1. AIt meets both; the WHO guideline is 45 µg/m3
2. BIt exceeds both; the WHO guideline is 5 µg/m3
3. CIt meets WHO; the WHO guideline is 50 µg/m3
4. DIt exceeds both; the WHO guideline is 10 µg/m3
Answer and explanation in LearnFree account
Question 20 · Medium
Following a complaint from a college principal in Kozhikode, police raid a stationery shop near the campus and seize flavoured e-cigarette pods, refill liquids and vaping devices; the owner had also been selling them online to students and claims they are a safer alternative to smoking. Which law makes the sale, storage and advertisement of these devices an offence?
1. AFood Safety and Standards Act 2006
2. BDrugs and Cosmetics Act 1940
3. CCigarettes and Other Tobacco Products Act 2003
4. DProhibition of Electronic Cigarettes Act 2019
Answer and explanation in LearnFree account
Question 21 · Medium
A district is drafting its heat action plan. Which of these belong in it? 1. Early warnings with coordination between IMD and departments. 2. Training health staff to recognise and treat heat illness. 3. Cool roofs, shaded rest areas and drinking water points. 4. Closing all hospital OPDs on red-alert days.
1. A2 and 3 only
2. B1 and 2 only
3. C1, 2 and 3 only
4. D1, 2, 3 and 4
Answer and explanation in LearnFree account
Question 22 · Medium
During a heat wave, a man with schizophrenia on chlorpromazine and trihexyphenidyl is brought from a rehabilitation home with a temperature of 40.6 °C, confusion and hot, dry skin. The home has no air-conditioning, and two other residents are also unwell. Which drug effect most impaired his ability to lose heat?
1. AAnticholinergic block of sweating
2. BDopamine block raising heat production
3. CAlpha block lowering blood pressure
4. DHistamine block reducing thirst
Answer and explanation in LearnFree account
Question 23 · Medium
In a village in Rajasthan, women cook with dung cakes and firewood on chulhas inside poorly ventilated huts, and the PHC sees many children under 5 with pneumonia. Most households are poor and have no LPG connection. Which national scheme, launched in 2016, most directly reduces this household air pollution?
1. ANational Clean Air Programme
2. BPradhan Mantri Ujjwala Yojana
3. CSwachh Bharat Mission (Gramin)
4. DPradhan Mantri Awas Yojana
Answer and explanation in LearnFree account
Question 24 · Medium
At an Ayushman Arogya Mandir, a trained staff nurse applies 5% acetic acid to the cervix of a woman aged 38 during NP-NCD screening; after one minute no acetowhite area is seen near the squamocolumnar junction. She asks when she should come again. What is the recommended screening interval?
1. AOnce every 5 years
2. BEvery year
3. CEvery 3 years
4. DOnce every 10 years
Answer and explanation in LearnFree account
Question 25 · Medium
Oral visual examination on an NCD screening day: marbled blanching of the buccal mucosa, palpable vertical fibrous bands and mouth opening of two finger-breadths in a migrant construction worker who chews gutka many times a day. He complains of burning with chillies. Which component of his habit is chiefly responsible?
1. AArecoline in the areca nut
2. BCatechu used for flavour
3. CNicotine in the tobacco
4. DSlaked lime in the mixture
Answer and explanation in LearnFree account

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Climate change, One Health and NCD risk factors

Which air pollutant, small enough to reach the alveoli and enter the bloodstream, is most strongly linked with cardiovascular deaths?

The factory medical officer of a glass works in Thrissur must set work-rest cycles for men who work near the furnaces, after two workers fainted there last summer. He needs one index that takes account of air temperature, humidity, radiant heat and air movement. Which index should he use?

The first city heat action plan in South Asia, drawn up after the deadly heat wave of 2010, was launched in which city?

The AQI in Delhi has been Very poor (330) for four days. A mother brings her son, a schoolboy whose asthma is well controlled on an inhaled corticosteroid, to the paediatric OPD and asks what she should do until the air improves. What is the best advice?

Sub-indices for one day from a city station whose particulate analysers have been out of order for a week: NO2 140, SO2 60, CO 95. No PM2.5 or PM10 data are available. The municipal health officer is asked to issue the day's AQI with health advice. What should be reported?

In IMD's colour-coded heat-wave warnings for districts, which colour signals that authorities and the public must take action?

A traffic policeman on afternoon duty in Kollam feels dizzy, nauseated and weak, with a headache and heavy sweating. At the PHC his oral temperature is 38.4 °C and pulse 110/min, and he is fully oriented and answers questions normally. What is the most likely diagnosis?

Under NP-NCD, population-based screening for hypertension, diabetes and oral, breast and cervical cancer is offered to everyone above which age?

From 1 March each year, every district hospital in Kerala reports daily cases and deaths from heat stroke and heat exhaustion on the IHIP portal. Under which national programme was this heat-related illness surveillance started?

Under COTPA 2003, which section bans the sale of tobacco products within 100 yards of an educational institution?

At an Ayushman Arogya Mandir, a trained staff nurse applies 5% acetic acid to the cervix of a woman aged 38 during NP-NCD screening; after one minute no acetowhite area is seen near the squamocolumnar junction. She asks when she should come again. What is the recommended screening interval?