Adolescent Health and ARSH · 50 MCQs
NEET PG-style questions. Tap an option: you are marked instantly and every option is explained, including why the wrong ones are wrong.
A state plans one programme spanning the whole transition from the onset of puberty to adult roles, covering the 10–24-year age band.
Which WHO term denotes this band?
Why A is correct: WHO uses three deliberately overlapping bands: adolescents 10–19, youth 15–24 and young people 10–24 — the union of the two, used when a programme must cover the whole transition from puberty to adult roles.
Ruling out the others:
- B. Adolescents are 10–19 years — the biological/developmental band used by RKSK.
- C. Youth is 15–24 years — the band used for education, employment and civic participation.
- D. 'Teenagers' (13–19) is a lay term, not a WHO programming band.
A school counsellor finds that two-wheeler stunts, first alcohol use and fights cluster in students aged 14–16 years.
Which phase of adolescence is this?
Why B is correct: Adolescence is subdivided into early (10–13), middle (14–16) and late (17–19). Middle adolescence is when the gap between early-maturing reward systems and late-maturing prefrontal control is widest — the years of maximum risk-taking and identity formation.
Ruling out the others:
- A. Early adolescence (10–13) is when physical change begins and peers start to displace family.
- C. Late adolescence (17–19) is when abstract reasoning and future orientation consolidate.
- D. Emerging adulthood refers to the late teens–twenties, beyond the 14–16 band described.
A 12-year-old girl had breast budding at 10 years and has grown 9 cm in the past year. She has not yet menstruated.
Relative to her growth spurt, when is menarche expected?
Why C is correct: The sequence in girls is thelarche → pubarche → growth spurt → menarche, which comes late — about two years after breast budding and after peak height velocity. By the time a girl menstruates she has done most of her growing, though some growth continues afterwards.
Ruling out the others:
- A. Reverses the sequence; menarche is one of the last pubertal events.
- B. The spurt begins soon after thelarche; menarche comes later.
- D. Growth continues (a few cm) after menarche; it does not wait for final height.
A school wellness session links adolescent calcium, vitamin D and weight-bearing play to prevention of osteoporosis decades later.
About what share of adult peak bone mass is laid down during adolescence?
Why C is correct: About 45% of peak bone mass is laid down during adolescence (with ~20% of adult height and up to 50% of adult weight). What is not built now cannot be built later — which turns adolescent calcium, vitamin D and activity into osteoporosis prevention.
Ruling out the others:
- A. Understates the adolescent contribution.
- B. Understates it; closer to the share gained in the two years around peak height velocity alone.
- D. Overstates the share accrued within adolescence itself.
At a Class 6 health check-up many girls are taller than boys of the same age, but by Class 12 the boys are taller.
What best explains this pattern?
Why A is correct: In boys the growth spurt occurs about two years later than in girls and is larger and longer. Girls are therefore briefly taller in early adolescence; boys end up taller.
Ruling out the others:
- B. Epiphyseal fusion follows puberty, driven by oestrogen; it does not precede it.
- C. Prepubertal growth velocities are similar in the two sexes.
- D. Thelarche marks the start of female puberty, not the end of growth.
A 13-year-old girl is assessed with the sexual maturity rating (Tanner staging) to judge whether her puberty is delayed.
Which features are rated in girls?
Why A is correct: Tanner staging has five stages (1 prepubertal → 5 adult), rated on breast and pubic hair development in girls and on genital and pubic hair development in boys. It is charted against chronological age, not used instead of it.
Ruling out the others:
- B. Bone age is a radiological measure, not part of Tanner staging.
- C. Menarche is a single event, and axillary hair is not a Tanner criterion.
- D. Growth velocity is plotted on growth charts, separately from sexual maturity.
A 15-year-old boy accurately explains the crash risk of speeding when asked in clinic, yet speeds on his two-wheeler whenever friends are watching.
Which neurodevelopmental pattern best explains this?
Why A is correct: The limbic/reward systems (sensation-seeking, sensitivity to peer approval) mature early; the prefrontal cortex (impulse control, risk appraisal) matures late, into the twenties. The accelerator is developed before the brake — so knowledge of risk does not stop risky behaviour in front of peers.
Ruling out the others:
- B. Maturation is uneven, not a global delay — the unevenness is the point.
- C. Prefrontal maturation continues into the mid-twenties.
- D. The limbic/reward system matures early, not late.
A district survey finds that 90% of Class 9–10 students correctly state the harms of alcohol, yet first use at parties keeps rising.
Given adolescent brain development, which strategy is most likely to reduce initiation?
Why D is correct: The deficit is not knowledge — 90% already know the harms. Because peer approval drives behaviour while prefrontal control is immature, the effective levers are skills, social norms and peers. This is why RKSK is built around peer educators and life-skills education rather than information.
Ruling out the others:
- A. Adds information to a group that already has it; information alone changes little.
- B. Rules and penalties do not change the peer norms that drive first use; they push use out of sight.
- C. Informs adults, not the adolescents whose peer group drives the behaviour.
A medical officer launches WIFS in a government school, with a supervised iron–folic acid tablet every Monday.
Which other drug must be scheduled as part of the same package?
Why B is correct: WIFS pairs the supervised weekly IFA tablet with biannual deworming (albendazole 400 mg) and education on dietary iron — worm infestation is a major contributor to adolescent anaemia. (Dose note: Park 27th ed. gives the original WIFS tablet as 100 mg elemental iron + 500 µg folic acid; Anaemia Mukt Bharat 2018 revised the adolescent 10–19 y tablet to 60 mg elemental iron + 500 µg folic acid, blue.)
Ruling out the others:
- A. Vitamin A 2 lakh IU six-monthly is the under-five prophylaxis schedule (9 months–5 years).
- C. Calcium is not part of the WIFS package.
- D. Zinc for 14 days is given with ORS in childhood diarrhoea.
At a WIFS review meeting, a teacher asks why adolescents take iron–folic acid once a week instead of daily.
Which reason underlies the weekly schedule?
Why D is correct: Weekly supervised dosing was chosen for adherence and tolerability — fewer gastrointestinal side effects and a single fixed, supervised day in school — while still preventing anaemia in a population-level prophylaxis programme.
Ruling out the others:
- A. Adolescent iron needs are high (growth plus menstrual loss), not low.
- B. Iron overload is not the reason; prophylactic doses do not cause overload in healthy adolescents.
- C. Deworming is biannual and does not dictate the IFA frequency.
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