A survey of 1,600 children aged 24-71 months in a drought-affected block finds 12 children with night blindness, 10 with Bitot's spots, no corneal xerosis or ulceration, and no corneal scars. Using the WHO criteria for vitamin A deficiency as a public health problem (night blindness above 1%, Bitot's spots above 0.5%, corneal xerosis or ulceration above 0.01%, corneal scars above 0.05%), what does the survey show?

A public health problem on Bitot's spots

No public health problem in the block

A public health problem on night blindness

A public health problem on both criteria

In a district nutrition survey, a 4-year-old boy has a height-for-age below -2 SD of the WHO standard, a normal weight-for-height and no oedema. He has had repeated diarrhoea since infancy. By the Waterlow approach, what does this pattern show?

Stunting from chronic undernutrition

Wasting from acute undernutrition

Nutrition, nutritional programmes and deficiency disorders

22 NEET-PG practice questions on Nutrition, nutritional programmes and deficiency disorders, part of Community Medicine. The first 22 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
A 3-month-old exclusively breastfed baby in a coastal village is brought to a PHC with sudden breathlessness, vomiting, a weak hoarse cry and a fast pulse; the liver is enlarged. The mother lives mostly on highly polished rice and has numbness of her feet. Which deficiency is the most likely cause?
1. AVitamin B1 (thiamine)
2. BVitamin B12 (cobalamin)
3. CVitamin B2 (riboflavin)
4. DVitamin B3 (niacin)
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Answer: A · Vitamin B1 (thiamine)
Infantile beriberi affects breastfed babies aged about 2-6 months whose mothers are thiamine deficient, as here (a polished-rice diet and maternal peripheral neuropathy). The acute cardiac form causes sudden heart failure with tachycardia, breathlessness and hepatomegaly, and an aphonic or hoarse cry is typical. Milling and washing remove thiamine from rice, while parboiling preserves it. Thiamine given promptly to the baby and the mother reverses the illness, and untreated cardiac beriberi can kill within hours.
- B: Infant B12 deficiency causes anaemia and developmental regression, not acute heart failure.
- C: Riboflavin deficiency causes angular stomatitis and glossitis, not heart failure.
- D: Niacin deficiency causes pellagra with dermatitis, diarrhoea and dementia.
Question 2 · Medium
At a convergence meeting between a PHC and the ICDS project, the officers list four of the six ICDS services: 1. Immunisation. 2. Health check-up. 3. Referral services. 4. Non-formal pre-school education. Which of these are delivered through the public health system rather than by the Anganwadi worker herself?
1. A1 and 4 only
2. B1, 2 and 3 only
3. C1, 3 and 4 only
4. D2 and 3 only
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Answer: B · 1, 2 and 3 only
ICDS offers six services: supplementary nutrition, immunisation, health check-up, referral services, non-formal pre-school education, and nutrition and health education. Immunisation, health check-ups and referral are delivered through the public health infrastructure (ANM, PHC and hospitals of the health department), with the Anganwadi worker mobilising beneficiaries. Supplementary nutrition, pre-school education and nutrition and health education are run by the Anganwadi worker and helper. This shared delivery is why the Village Health, Sanitation and Nutrition Day is held at the Anganwadi centre.
- A: Pre-school education is run by the Anganwadi worker, and two services are left out.
- C: Pre-school education is not delivered through the health system.
- D: Leaves out immunisation, which is delivered by the ANM.
Question 3 · Hard
A survey of 1,600 children aged 24-71 months in a drought-affected block finds 12 children with night blindness, 10 with Bitot's spots, no corneal xerosis or ulceration, and no corneal scars. Using the WHO criteria for vitamin A deficiency as a public health problem (night blindness above 1%, Bitot's spots above 0.5%, corneal xerosis or ulceration above 0.01%, corneal scars above 0.05%), what does the survey show?
1. ANo public health problem in the block
2. BA public health problem on night blindness
3. CA public health problem on Bitot's spots
4. DA public health problem on both criteria
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Answer: C · A public health problem on Bitot's spots
Night blindness is 12/1,600 = 0.75%, below the 1% cut-off. Bitot's spots are 10/1,600 = 0.625%, above the 0.5% cut-off, so vitamin A deficiency is a public health problem in the block on this criterion alone; one criterion is enough. Corneal criteria are not met. The response is to ensure full coverage of the biannual prophylactic vitamin A doses for children up to 5 years, promote vitamin A-rich foods, and treat every affected child.
- A: One criterion met (Bitot's spots) is enough to call it a public health problem.
- B: Night blindness is 0.75%, below the 1% cut-off.
- D: Only the Bitot's spots criterion is met.
Question 4 · Medium
In a district nutrition survey, a 4-year-old boy has a height-for-age below -2 SD of the WHO standard, a normal weight-for-height and no oedema. He has had repeated diarrhoea since infancy. By the Waterlow approach, what does this pattern show?
1. AOverweight for his height
2. BWasting from acute undernutrition
3. CStunting from chronic undernutrition
4. DSevere acute malnutrition
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Answer: C · Stunting from chronic undernutrition
Waterlow separated two forms of malnutrition: wasting, a low weight-for-height reflecting recent or acute undernutrition, and stunting, a low height-for-age reflecting long-standing (chronic) undernutrition and repeated infections. This child is short for his age but proportionate in weight for his height, so he is stunted but not wasted. Stunting is largely irreversible after the first 2 years, which is why the first 1,000 days are the target of programmes such as POSHAN Abhiyaan. NFHS reports stunting, wasting and underweight separately.
- A: A normal weight-for-height is not overweight.
- B: Wasting needs a low weight-for-height, and his is normal.
- D: SAM needs severe wasting, low MUAC or oedema.
Question 5 · Easy
Under Anaemia Mukt Bharat, an ASHA tests a 3-year-old girl with a digital haemoglobinometer during a home visit. Using the WHO cut-off, below what haemoglobin level is a child aged 6-59 months considered anaemic?
1. A12.0 g/dL
2. B10.0 g/dL
3. C11.5 g/dL
4. D11.0 g/dL
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Answer: D · 11.0 g/dL
WHO defines anaemia in children aged 6-59 months as haemoglobin below 11.0 g/dL, the same cut-off used for pregnant women. Children aged 5-11 years are anaemic below 11.5 g/dL, adolescents aged 12-14 and non-pregnant women below 12.0 g/dL, and men below 13.0 g/dL. Anaemia Mukt Bharat uses digital haemoglobinometers for point-of-care testing so that anaemia can be detected and treated at the same contact. Iron deficiency remains the commonest cause in Indian children.
- A: 12.0 g/dL is the cut-off for adolescents and non-pregnant women.
- B: 10.0 g/dL marks moderate anaemia in children, not the threshold.
- C: 11.5 g/dL is the cut-off for children aged 5-11 years.
Question 6 · Easy
A new medical officer is told that the Anganwadi centres in her PHC area run the Integrated Child Development Services scheme. Which ministry of the Government of India runs ICDS?
1. AMinistry of Women and Child Development
2. BMinistry of Health and Family Welfare
3. CMinistry of Rural Development
4. DMinistry of Education
Answer and explanation in LearnFree account
Question 7 · Medium
The mother of a 14-month-old boy asks the Anganwadi worker why her son receives a packet of food to take home, while her 4-year-old daughter eats at the centre. Under ICDS, how is supplementary nutrition given to children aged 6 months to 3 years?
1. ACash transfer to the mother
2. BMorning snack at the centre
3. CHot cooked meal at the centre
4. DTake-home ration
Answer and explanation in LearnFree account
Question 8 · Hard
At a village health and nutrition day, a 30-year-old non-pregnant woman from a landless labourer family weighs 40 kg and is 1.55 m tall. Using the BMI grading of chronic energy deficiency in adults, how is she classified?
1. ACED grade III
2. BCED grade I
3. CCED grade II
4. DNormal nutritional status
Answer and explanation in LearnFree account
Question 9 · Medium
An Anganwadi worker identifies a 3-year-old girl as severely underweight on the growth chart; she has no oedema or medical complication and is referred for medical check-up. Under the ICDS supplementary nutrition norms, how much should the centre provide her each day?
1. A500 kcal and 12-15 g of protein
2. B600 kcal and 18-20 g of protein
3. C300 kcal and 8-10 g of protein
4. D800 kcal and 20-25 g of protein
Answer and explanation in LearnFree account
Question 10 · Hard
A 20-month-old girl with severe acute malnutrition and bilateral pedal oedema is admitted to a Nutrition Rehabilitation Centre. On day 1 she is warmed, given F-75 feeds every 2 hours, oral antibiotics, and folic acid and other micronutrients. The resident also wants to start oral iron for her haemoglobin of 8.5 g/dL. What is the correct advice?
1. AStart oral iron today with F-75
2. BGive a blood transfusion today
3. CStart iron in the rehabilitation phase
4. DStart iron only after discharge
Answer and explanation in LearnFree account
Question 11 · Medium
At a Nutrition Rehabilitation Centre, a 2-year-old boy weighs 6.6 kg against a reference median weight-for-age of 12 kg. He has bilateral pitting pedal oedema, sparse hypopigmented hair and areas of peeling skin. By the Wellcome Trust classification, what is his diagnosis?
1. AUnderweight
2. BMarasmus
3. CKwashiorkor
4. DMarasmic kwashiorkor
Answer and explanation in LearnFree account
Question 12 · Medium
During a measles outbreak in a tribal block, a 2-year-old child has Bitot's spots on the conjunctiva. The cornea is dry and hazy with a dull, granular surface, but there is no ulcer or softening. How is this eye finding graded in the WHO classification of xerophthalmia?
1. AX3A (corneal ulceration)
2. BX1B (Bitot's spots)
3. CXS (corneal scar)
4. DX2 (corneal xerosis)
Answer and explanation in LearnFree account
Question 13 · Medium
Under Anaemia Mukt Bharat, an ASHA visits the home of an 18-month-old boy to give him his prophylactic iron. How should she give it?
1. AOne pink IFA tablet weekly
2. BOne blue IFA tablet weekly
3. C1 mL of IFA syrup twice a week
4. D1 mL of IFA syrup daily
Answer and explanation in LearnFree account
Question 14 · Hard
An iodine survey of school children aged 6-12 years in a hill district finds a median urinary iodine concentration of 45 µg/L. Salt samples tested at households show a median iodine content of 8 ppm. What is the best interpretation of these findings?
1. AMild iodine deficiency, adequate salt iodisation
2. BAdequate iodine intake, poor salt iodisation
3. CModerate iodine deficiency, poor salt iodisation
4. DSevere iodine deficiency, adequate salt iodisation
Answer and explanation in LearnFree account
Question 15 · Medium
At a district review of POSHAN Abhiyaan (the National Nutrition Mission launched in 2018), the officer reads out the annual reduction targets. Which target was set for anaemia among young children, adolescent girls and women?
1. A5% a year
2. B2% a year
3. C1% a year
4. D3% a year
Answer and explanation in LearnFree account
Question 16 · Hard
A 2-year-old boy weaned onto a diet of thin rice gruel has generalised oedema, an enlarged smooth non-tender liver, a weight 70% of the reference, and serum albumin 2.0 g/dL. A medical student asks why his liver is enlarged. Which mechanism explains the hepatomegaly?
1. APortal hypertension from early cirrhosis
2. BCongestion from right heart failure
3. CPoor apolipoprotein synthesis traps fat in the liver
4. DExtramedullary haemopoiesis in the liver
Answer and explanation in LearnFree account
Question 17 · Easy
A 15-month-old exclusively breastfed boy who is rarely taken outdoors is brought to a PHC because he has not started walking. He has widened wrists, beading of the costochondral junctions and bowing of the legs. Which deficiency is the most likely cause?
1. AVitamin C
2. BVitamin A
3. CVitamin K
4. DVitamin D
Answer and explanation in LearnFree account
Question 18 · Medium
At a district anaemia review, the medical officer lists four activities as interventions of Anaemia Mukt Bharat: 1. Universal haemoglobin electrophoresis for all adolescents. 2. Biannual deworming of children and adolescents. 3. Testing with digital haemoglobinometers and treatment at the point of care. 4. Promoting delayed cord clamping at delivery. Which of these are interventions of the programme?
1. A2, 3 and 4 only
2. B3 and 4 only
3. C1 and 2 only
4. D1, 3 and 4 only
Answer and explanation in LearnFree account
Question 19 · Medium
A district supply officer explains that rice distributed through the public distribution system, PM POSHAN and ICDS is now fortified. Besides iron, which two micronutrients must this fortified rice contain under the FSSAI standards?
1. AVitamin C and calcium
2. BFolic acid and vitamin B12
3. CVitamin A and vitamin D
4. DIodine and zinc
Answer and explanation in LearnFree account
Question 20 · Medium
A 35-year-old man on daily isoniazid, rifampicin, pyrazinamide and ethambutol for pulmonary tuberculosis at a PHC develops a symmetrical dark, scaly rash on the backs of both hands and around the neck after sun exposure, with loose stools. Deficiency of which vitamin, caused by isoniazid, has led to this condition?
1. APyridoxine
2. BFolic acid
3. CThiamine
4. DRiboflavin
Answer and explanation in LearnFree account
Question 21 · Medium
At a growth monitoring session, a 2-year-old girl weighs 7.8 kg. The reference (50th centile) weight for her age is 12 kg. By the Indian Academy of Pediatrics classification, what grade of malnutrition does she have?
1. AGrade II
2. BGrade I
3. CGrade III
4. DGrade IV
Answer and explanation in LearnFree account
Question 22 · Easy
Under the weekly iron and folic acid supplementation of Anaemia Mukt Bharat, a teacher gives a blue tablet to a 14-year-old girl at a government school. What does this tablet contain?
1. A45 mg iron and 400 µg folic acid
2. B100 mg iron and 500 µg folic acid
3. C60 mg iron and 500 µg folic acid
4. D20 mg iron and 100 µg folic acid
Answer and explanation in LearnFree account

Nutrition, nutritional programmes and deficiency disorders

A 3-month-old exclusively breastfed baby in a coastal village is brought to a PHC with sudden breathlessness, vomiting, a weak hoarse cry and a fast pulse; the liver is enlarged. The mother lives mostly on highly polished rice and has numbness of her feet. Which deficiency is the most likely cause?

In a district nutrition survey, a 4-year-old boy has a height-for-age below -2 SD of the WHO standard, a normal weight-for-height and no oedema. He has had repeated diarrhoea since infancy. By the Waterlow approach, what does this pattern show?

Under Anaemia Mukt Bharat, an ASHA tests a 3-year-old girl with a digital haemoglobinometer during a home visit. Using the WHO cut-off, below what haemoglobin level is a child aged 6-59 months considered anaemic?

A new medical officer is told that the Anganwadi centres in her PHC area run the Integrated Child Development Services scheme. Which ministry of the Government of India runs ICDS?

The mother of a 14-month-old boy asks the Anganwadi worker why her son receives a packet of food to take home, while her 4-year-old daughter eats at the centre. Under ICDS, how is supplementary nutrition given to children aged 6 months to 3 years?

At a village health and nutrition day, a 30-year-old non-pregnant woman from a landless labourer family weighs 40 kg and is 1.55 m tall. Using the BMI grading of chronic energy deficiency in adults, how is she classified?

An Anganwadi worker identifies a 3-year-old girl as severely underweight on the growth chart; she has no oedema or medical complication and is referred for medical check-up. Under the ICDS supplementary nutrition norms, how much should the centre provide her each day?

At a Nutrition Rehabilitation Centre, a 2-year-old boy weighs 6.6 kg against a reference median weight-for-age of 12 kg. He has bilateral pitting pedal oedema, sparse hypopigmented hair and areas of peeling skin. By the Wellcome Trust classification, what is his diagnosis?

During a measles outbreak in a tribal block, a 2-year-old child has Bitot's spots on the conjunctiva. The cornea is dry and hazy with a dull, granular surface, but there is no ulcer or softening. How is this eye finding graded in the WHO classification of xerophthalmia?

Under Anaemia Mukt Bharat, an ASHA visits the home of an 18-month-old boy to give him his prophylactic iron. How should she give it?

An iodine survey of school children aged 6-12 years in a hill district finds a median urinary iodine concentration of 45 µg/L. Salt samples tested at households show a median iodine content of 8 ppm. What is the best interpretation of these findings?

At a district review of POSHAN Abhiyaan (the National Nutrition Mission launched in 2018), the officer reads out the annual reduction targets. Which target was set for anaemia among young children, adolescent girls and women?

A 2-year-old boy weaned onto a diet of thin rice gruel has generalised oedema, an enlarged smooth non-tender liver, a weight 70% of the reference, and serum albumin 2.0 g/dL. A medical student asks why his liver is enlarged. Which mechanism explains the hepatomegaly?

A 15-month-old exclusively breastfed boy who is rarely taken outdoors is brought to a PHC because he has not started walking. He has widened wrists, beading of the costochondral junctions and bowing of the legs. Which deficiency is the most likely cause?

A district supply officer explains that rice distributed through the public distribution system, PM POSHAN and ICDS is now fortified. Besides iron, which two micronutrients must this fortified rice contain under the FSSAI standards?

At a growth monitoring session, a 2-year-old girl weighs 7.8 kg. The reference (50th centile) weight for her age is 12 kg. By the Indian Academy of Pediatrics classification, what grade of malnutrition does she have?

Under the weekly iron and folic acid supplementation of Anaemia Mukt Bharat, a teacher gives a blue tablet to a 14-year-old girl at a government school. What does this tablet contain?