Nutrition (Macro/Micronutrients, RDA, PEM, Nutritional Programmes) MCQs

Community Medicine (PSM) · 114 free questions with answers & explanations.

1. ICMR-NIN revised the Recommended Dietary Allowances (RDA) for Indians in 2020. The protein RDA for a reference Indian adult male (sedentary, 65 kg) is approximately:
2. A 2-year-old child from a tribal district presents with oedema of hands and feet, moon face, misery, flaky-paint dermatosis, and hair changes (flag sign). Serum albumin is severely low. This presentation is most consistent with:
3. NFHS-5 (2019–21) reported that the prevalence of anaemia among children aged 6–59 months in India was approximately:
4. Under the ICDS scheme, the supplementary nutrition target for a SEVERELY MALNOURISHED child (per day) is:
5. A 2-year-old child is brought with weight 60% of expected for age, bilateral pitting pedal oedema, skin changes (flaky-paint dermatosis), and fine reddish discoloration of hair. The diagnosis is Kwashiorkor. The primary biochemical mechanism responsible for oedema in this condition is:
6. The Integrated Child Development Services (ICDS) scheme provides supplementary nutrition. The caloric and protein supplement targeted for a severely malnourished child (6 months–6 years) under ICDS per day is:
7. In assessing the protein quality of a food source, the ratio of essential amino acids to total nitrogen in the food compared to that of a reference protein (usually egg protein) is measured by the:
8. In Protein Energy Malnutrition, the pathological finding of 'fatty liver' (hepatomegaly with fatty infiltration) is characteristic of which condition?
9. The Nutritional Rehabilitation Centre (NRC) under the ICDS/NHM programme is designed for the management of Severe Acute Malnutrition (SAM). The minimum period for inpatient stay at an NRC for stabilization and rehabilitation is:
10. The Mid-Day Meal (PM POSHAN) scheme provides a minimum of how many kilocalories and grams of protein per meal for primary school children (classes 1–5)?
11. Bitot's spots in a 5-year-old child indicate which nutritional deficiency, and at which WHO grade of xerophthalmia are they classified?
12. A child weighing 6.2 kg is presented at 18 months of age. His weight-for-height Z-score is -3.2 (severe wasting). He has bilateral pitting pedal edema. As per WHO/IMNCI guidelines, this child has:
13. A child has bilateral pitting oedema of the feet, a 'flaky paint' rash over the trunk, miserable affect, and hepatomegaly. Weight-for-height Z-score is −2.5. The MOST likely diagnosis and the pathophysiological basis for oedema is:
14. The 'double burden of malnutrition' concept in India refers to:
15. The Global Acute Malnutrition (GAM) rate in a refugee camp survey is found to be 16% by weight-for-height Z-score criteria. According to WHO classification, this represents:
16. A child in India is diagnosed with Bitot's spots on the temporal conjunctiva. According to WHO grading of Vitamin A Deficiency (VAD) in xerophthalmia, this is classified as:
17. Under the Pradhan Mantri Matru Vandana Yojana (PMMVY), a cash incentive is provided to pregnant and lactating women for first living child. The total incentive amount is:
18. The Poshan Abhiyaan (National Nutrition Mission) identifies which of the following as its four core indicators for tracking malnutrition reduction?
19. Which of the following is the CORRECT definition of 'hidden hunger' in nutrition science?
20. The ICMR-NIN 2020 dietary guidelines revised RDA for protein for a sedentary adult Indian male (60 kg). Which correctly reflects this revision and its basis?
21. A 2-year-old child has pitting oedema of feet, skin lesions, and hair changes (flag sign). Weight is 75% of expected. Serum albumin is 1.8 g/dL. This is most consistent with:
22. PM POSHAN (erstwhile Mid Day Meal Scheme, renamed 2021) mandates caloric provision for primary school children. What is the current stipulated minimum caloric content per meal?
23. A 3-year-old child has oedema of both feet, skin lesions (flaky-paint dermatosis), and sparse, reddish-brown hair. His weight-for-height Z-score is -1.5. The diagnosis and the key pathophysiological mechanism is:
24. The ICMR-NIN (2020) Recommended Dietary Allowance for iron for a non-pregnant, non-lactating Indian woman of reproductive age (20–39 years) is:
25. Poshan Abhiyaan (National Nutrition Mission) uses a direct benefit transfer model to improve child nutrition outcomes. It primarily focuses on reducing stunting in children under 5 by what target percentage point reduction annually?
26. The POSHAN Abhiyaan (National Nutrition Mission), launched in 2018, targets reduction of stunting and undernutrition in India by __ percentage points per year:
27. Mid-Upper Arm Circumference (MUAC) is used for nutritional screening in children aged 6–59 months. A MUAC of <__ cm (red zone) indicates severe acute malnutrition (SAM):
28. A community survey of 6–59 month-old children uses mid-upper arm circumference (MUAC) for SAM (Severe Acute Malnutrition) screening. The WHO/UNICEF cut-off for SAM by MUAC in children aged 6–59 months is:
29. Pellagra from niacin deficiency can occur even with adequate dietary tryptophan in populations consuming a staple diet of which cereal, due to the presence of bound (unabsorbable) niacin?
30. The Integrated Child Development Services (ICDS) supplementary nutrition component provides take-home rations to which beneficiary group, and the caloric supplement target for a severely malnourished child (SAM) differs from a normally nourished child by:
31. The ICMR-NIN 2020 RDA for vitamin D for adults in India is 600 IU/day (15 µg). Despite abundant sunlight in India, widespread vitamin D deficiency persists. The PRIMARY epidemiological reason for this paradox is:
32. The Gomez classification of protein-energy malnutrition (PEM) uses weight-for-age as <60% of median reference weight for Grade III malnutrition. The key limitation of the Gomez classification compared to the Wellcome Trust classification is:
33. Pellagra due to niacin deficiency shows the '3 D' presentation. The underlying biochemical mechanism—specifically the relationship with tryptophan—is that:
34. The ICMR-NIN RDA 2020 revised the recommended dietary allowance for Vitamin D in adult Indians (18–60 years, both sexes) to:
35. The 'SAM' (Severe Acute Malnutrition) management protocol under India's National Programme differentiates complicated from uncomplicated SAM using RUTF (Ready-to-Use Therapeutic Food). The WHO recommended RUTF composition per 100 g contains approximately:
36. The ICMR-NIN 2020 recommended dietary allowance (RDA) for iron for a non-pregnant, non-lactating adult Indian woman (20–39 years) is:
37. Kwashiorkor (edematous malnutrition) differs from marasmus primarily in that it is characterized by:
38. The Mid-Day Meal Scheme (PM-POSHAN) provides a cooked meal to children in classes I–VIII. The caloric and protein norms for upper primary (classes VI–VIII) per meal are:
39. Vitamin A supplementation under India's NHM is given to children at 9 months, 16–18 months, and then every 6 months until 5 years. The dose of vitamin A given at 9 months along with measles vaccine is:
40. The 'Integrated Child Development Services' (ICDS) scheme provides supplementary nutrition to which beneficiary groups?
41. The ICMR-NIN (2020) revised Recommended Dietary Allowances (RDA) for a sedentary adult Indian man includes protein at 0.83 g/kg/day. This figure represents which specific concept?
42. In the ICMR-NIN Dietary Guidelines for India (2024), the double burden of malnutrition is addressed. Which combination of conditions defines this 'double burden'?
43. Anemia Mukt Bharat (AMB) strategy addresses anaemia across life stages using a 6×6×6 framework. Which of the following is NOT one of the 6 target beneficiary groups?
44. A 3-year-old boy presents with pitting oedema of the feet, a miserable appearance, hepatomegaly, and a 'flaky paint' dermatosis but without significant wasting. His weight-for-height is 89% of standard. Which form of PEM is MOST likely?
45. POSHAN Abhiyaan (National Nutrition Mission), launched in 2018, set a target to reduce stunting in children under 5 years by what percentage per year?
46. The ICMR recommended dietary allowance (RDA) for calcium in a pregnant woman is approximately:
47. A 2-year-old child has bilateral pitting pedal oedema, adequate weight for height, and depigmented flag-sign hair. Serum albumin is low. The MOST likely diagnosis is:
48. Under India's PM POSHAN (formerly Mid-Day Meal) scheme, which component has been RECENTLY added to address 'hidden hunger' (micronutrient deficiency) in school children?
49. The recommended daily allowance (RDA) of vitamin A for a lactating woman (as per ICMR 2020 guidelines) is:
50. Iodised salt in India is required to contain how much iodine at the point of production (as per PFA/FSSAI standards)?
51. A 2-year-old child presents with bilateral pitting pedal edema, hepatomegaly, and a 'flaky paint' skin rash. Serum albumin is 1.8 g/dL. The diagnosis is kwashiorkor. Which of the following pathophysiological mechanisms explains the edema in this condition?
52. The Integrated Child Development Services (ICDS) scheme provides supplementary nutrition to children under 6 years and pregnant/lactating women. The nutritional norm for a moderately undernourished child (6 months to 3 years) under ICDS provides approximately how many additional calories per day?
53. A 28-year-old pregnant woman from a coastal village is found to have a goiter. Her dietary iodine intake is adequate. Further evaluation reveals selenium deficiency. How does selenium deficiency worsen iodine deficiency disorders?
54. Anemia Mukt Bharat (AMB) strategy under the National Iron Plus Initiative (NIPI) identifies 'six interventions across six target beneficiary groups' to combat anemia. Which of the following is a targeted beneficiary group under AMB?
55. Vitamin A supplementation under the National Programme for Prevention and Control of Blindness gives high-dose Vitamin A to children. The dose for a child aged 9 months to less than 1 year is:
56. A 3-year-old child with bilateral pitting edema, moon-face, skin lesions (crazy-pavement dermatosis), and adequate height for age most likely has:
57. POSHAN Abhiyaan (PM's Overarching Scheme for Holistic Nutrition) aims to reduce stunting by how many percentage points per year among children under 6 years?
58. POSHAN 2.0 (launched 2021) integrates which of the following programmes?
59. The Global Acute Malnutrition (GAM) rate in a population survey is 15%. According to WHO thresholds, this indicates:
60. India's Food Safety and Standards Authority (FSSAI) mandates fortification of rice with which micronutrients under the PM-POSHAN scheme?
61. The Integrated Child Development Services (ICDS) programme in India provides supplementary nutrition to children under 6 years. The nutritional norm for supplementary nutrition for severely malnourished children (6 months to 6 years) under ICDS is:
62. A 2-year-old child presents with bilateral pitting pedal oedema, sparse reddish hair, skin changes (flaky paint dermatosis) and a miserable affect, but weight is only mildly reduced. The most likely diagnosis and the predominant macronutrient deficiency is:
63. India's National Iron Plus Initiative (NIPI) recommends iron-folic acid (IFA) supplementation for adolescent girls (10–19 years). The recommended regimen for non-anaemic adolescent girls is:
64. A child with bilateral pitting oedema, adequate weight for age, and fatty liver is diagnosed with kwashiorkor. The pathophysiological basis of oedema in this condition is primarily:
65. The Integrated Child Development Services (ICDS) scheme provides supplementary nutrition to children up to 6 years of age. The energy and protein content per beneficiary per day for a 3-6 year-old child is:
66. The POSHAN Abhiyaan (National Nutrition Mission) in India tracks which indicator as its primary nutritional target for children under 2 years?
67. The ICMR-NIN 2020 recommended daily allowance (RDA) for iron in an adult Indian woman (non-pregnant) aged 18–29 years is:
68. In Protein Energy Malnutrition (PEM), which index is used to diagnose 'stunting' according to WHO growth standards?
69. PM POSHAN (formerly Mid-Day Meal Scheme) was renamed and expanded in 2021 to include which additional provision beyond cooked hot meals for primary school children?
70. Under the Pradhan Mantri POSHAN Shakti Nirman (formerly Mid-Day Meal Scheme), the calorie requirement provided per meal for children in primary classes (Classes I-V) is:
71. MUAC (Mid-Upper Arm Circumference) cut-off for diagnosing Severe Acute Malnutrition (SAM) in children aged 6-59 months is:
72. Vitamin A supplementation under the National Vitamin A Prophylaxis Programme is given to children aged 9 months to 5 years, with the dose for children above 12 months being:
73. Bitot's spots are an early sign of vitamin A deficiency. These are best described as:
74. The Recommended Dietary Allowance (RDA) for iron for an adolescent girl (13–18 years) as per ICMR 2020 guidelines is:
75. Kwashiorkor is differentiated from marasmus pathophysiologically because kwashiorkor results from:
76. Under PM POSHAN (formerly Mid-Day Meal Scheme), the prescribed caloric and protein content for upper primary students (Classes VI–VIII) per meal is:
77. The ICMR-NIN 2020 revised RDA for vitamin D (cholecalciferol) for adults in India is:
78. In the Gomez classification of malnutrition, a child with weight 65% of the expected median weight-for-age is classified as:
79. Under the PM-POSHAN scheme (formerly Mid-Day Meal scheme), which additional micronutrient supplementation component was integrated to address 'hidden hunger' in school-age children?
80. Therapeutic feeds used in the management of severe acute malnutrition (SAM) include F-75 (starter) and F-100 (catch-up). The CRITICAL difference between F-75 and F-100 is:
81. WASTING in children is defined by WHO using which anthropometric criterion as the primary measure?
82. Iodine Deficiency Disorders (IDD) are endemic in India. The current salt iodization standard in India requires iodized salt to contain at least how much iodine at the point of production and at the consumer level respectively?
83. The PM-POSHAN Scheme (formerly Mid-Day Meal Scheme) underwent restructuring under the National Education Policy 2020 framework. Under PM-POSHAN (as of 2022), the scheme covers children in government and government-aided schools up to which class?
84. A 2-year-old child in a tribal community is found to have bilateral pitting edema of feet, depigmented hair, a 'flaky paint' skin rash on the buttocks, and is extremely irritable. Weight-for-height Z score is −2.8. Serum albumin is 1.4 g/dL. What is the therapeutic food of choice as recommended by WHO/UNICEF for community-based management?
85. The Anemia Mukt Bharat (AMB) strategy intensified under NHM uses a '6×6×6' strategy. The first '6' in this framework refers to:
86. A child is found to have mid-upper arm circumference (MUAC) of 10.8 cm, bilateral pitting oedema up to mid-shin, and presence of flaky-paint skin changes. The MOST accurate diagnosis and WHO severity classification is:
87. Under Poshan 2.0 (Saksham Anganwadi and Poshan 2.0), which of the following represents a CHANGE from the earlier ICDS nutritional supplementation norms?
88. The Pradhan Mantri Poshan Shakti Nirman (PM POSHAN), formerly the Mid-Day Meal scheme, mandates cooked meal provision. The calorie and protein content per meal for upper primary students (Classes 6-8) is:
89. In the assessment of protein-energy malnutrition, the Waterlow classification uses two indices. A child with height-for-age < −2 SD (stunted) but weight-for-height in the normal range is classified as:
90. A 2-year-old child presents with bilateral pitting oedema, skin lesions ('flaky paint' dermatosis), pale sparse hair, and a 'miserable' affect. Weight-for-height Z-score is −1.5. The MOST likely diagnosis and its primary biochemical defect are:
91. The POSHAN Abhiyaan (National Nutrition Mission) sets targets for India by 2022-2024. Which of the following is the correct target for reduction of stunting under POSHAN 2.0?
92. Which of the following micronutrient deficiencies is associated with 'Bitot's spots' and is the leading cause of preventable childhood blindness globally?
93. In protein-energy malnutrition, the key biochemical hallmark distinguishing Kwashiorkor from Marasmus is:
94. Under the Pradhan Mantri Poshan Shakti Nirman (PM POSHAN) scheme, formerly Mid-Day Meal Scheme, the calorie and protein content mandated for upper primary school children (Class 6–8) per meal is:
95. Iodine deficiency during the first trimester of pregnancy leads to the most severe consequence of:
96. A 3-year-old child is brought to a nutrition rehabilitation centre with severe bilateral pitting oedema up to the knees, a moon face, sparse reddish-brown hair that plucks out easily, and a miserable, apathetic expression. Weight-for-height Z-score is -2.5. What is the most likely diagnosis?
97. A national survey finds that 38% of children under 5 years are stunted. The ICMR-NIN recommended daily protein requirement for a reference Indian adult man (60 kg, sedentary) is closest to which of the following?
98. During a school health survey, a 9-year-old girl is found to have Bitot's spots in both eyes and night blindness. Her serum retinol level is 10 µg/dL. Under the National Programme for Prevention and Control of Vitamin A Deficiency, what is the recommended treatment dose for this child?
99. Iodine deficiency during the first trimester of pregnancy can result in which of the following most severe consequences for the newborn?
100. A public health nutritionist is calculating the caloric density of a mid-day meal that provides 45 g carbohydrate, 10 g protein, and 8 g fat. Using Atwater factors, what is the total energy content of this meal?
101. An 18-month-old child is brought with a haemoglobin of 7.5 g/dL, pallor, koilonychia, and delayed motor milestones. The mother has been exclusively breastfeeding without complementary foods. The most common cause of anaemia in this age group in India, and the recommended preventive iron supplementation schedule under the Anaemia Mukt Bharat programme for this age group is:
102. As per ICMR-NIN 2020 Dietary Reference Values (DRVs), the recommended dietary allowance (RDA) for iron for Indian adolescent girls (10–18 years) is approximately:
103. Therapeutic feeding with Ready-to-Use Therapeutic Food (RUTF) in the management of Severe Acute Malnutrition (SAM) is recommended when a child has:
104. The Vitamin A Supplementation Programme in India currently recommends high-dose Vitamin A supplementation for children aged:
105. POSHAN Abhiyaan 2.0 integrates which two earlier nutritional programmes under a single umbrella?
106. A 3-year-old child has weight-for-height Z-score of -3.5 SD, no oedema, and is alert and playful. According to WHO-UNICEF protocol, this child should be managed as:
107. Which vitamin deficiency is MOST specifically associated with 'spring catarrh' (vernal keratoconjunctivitis) and dry eyes in children from underprivileged communities, and is targeted by national supplementation programmes?
108. In Protein-Energy Malnutrition, which biochemical marker BEST differentiates kwashiorkor from marasmus?
109. In Protein-Energy Malnutrition (PEM), which biochemical finding BEST distinguishes Kwashiorkor from Marasmus?
110. Poshan Abhiyaan (National Nutrition Mission), launched in 2018, aims to reduce stunting, undernutrition, anaemia, and low birth weight. The target for stunting reduction per year is:
111. Mid-Upper Arm Circumference (MUAC) cut-off for Severe Acute Malnutrition (SAM) in children aged 6–59 months is:
112. Therapeutic feeding for severe acute malnutrition (SAM) involves two phases. The 'stabilization phase' diet (F-75) provides how many kcal/100 mL?
113. Vitamin A supplementation under the National Programme for Prevention and Control of Blindness is given to children in India as a Massive Dose Supplementation (MDS). The dose given to children 1–5 years at 6-monthly intervals is:
114. The POSHAN Abhiyaan (National Nutrition Mission) launched in 2018 has set specific targets to be achieved by 2022. Which of the following is the CORRECT target for reduction of stunting in children under 5?