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DNB Paediatrics topic wise question bank part 2

Updated: Apr 29, 2020

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15. DIGESTIVE SYSTEM

BASIC SCIENCE

1. A) Embryology and antomy of pancreas B) Physiology of exocrine pancreas C) How would you assess the pancreatic functions. (15/1) 3+3+4 2. Liver function tests (15/1)5 3. Tracheoesophageal Fistula and Esophageal atresia (06/1)10 4. Enlist the functions of pancreas. Outline the pancreatic function tests and their implications in pediatric practice. (10/2)4+6 5. A. Development of diaphragm,trachea,and esophagus 2+2+2 b. Diagrammatically depict various types of trachea esophageal fistulae 4(1/16)

GERD

1. Gastro esophageal Reflux (94/2)15 2. Describe physiological basis of Gastroesophageal reflux. Discuss clinical features and management of GERD (14/2) 3+(2+5) 3. Define gastro – esophageal reflux disease (GERD). Describe its clinical features, diagnosis and treatment. (12/1)1+3+3+3 4. Gastroesophageal reflux disease (GERD) in pediatric population 5(15/2)

DIARRHOEA

1. Pathogenesis of Persistent Diarrhea of infancy (96/2)10 2. Persistent Diarrhea (99/1)15 3. Chronic Diarrhea in Infancy (00/1)15 4. Enumerate the etiology and discuss the pathogenesis of acute diarrhoea. Describe the approach to management of a child with acute watery diarrhoea. (04/2)3+3+4 5. Write management of Persistent Diarrhea (06)5 6. Approach and management of a child with Persistent Diarrhea (06)10 7. Describe the etiology, pathogenesis, diagnosis and treatment of antibiotic associated diarrhoea. (10/2)1+2+3+4 8. Discuss the management of acute diarrhea with particular reference to low osmolarity ORS, zinc, probiotics and antibiotics. (10/2)3+2+3+2 9. Outline the etiopathogenesis of chronic diarrhea and provide a scheme of investigating for a child with chronic diarrhea. (11/1)5+5 10. Describe the types of diarrhoea with examples. Discuss their pathophysiological mechanisms. (11/2)5+5 11. A 9 month old child with acute watery diarrhea develops seizures and altered sensorium. Discuss the differential diagnosis of CNS symptoms. Provide diagnostic algorithm for managing this child. (12/1)6+4 12. A 3 year old child is brought with history of acute dysentery around 10 days back. Now the child developed pallor with oliguria. Discuss the differential diagnosis, investigative approach and treatment of this child. (13/1) 3+4+3

CHRONIC ABDOMINAL PAIN

1. What is H.Pylori Bacillus? How is it associated with chronic abdominal pain (98/2)10 2. Discuss the treatment of the following: Persistent constipation (14/1) 3

MALABSORPTION

1. Diagnosis of carbohydrate intolerance (95/1)15 2. Define malabsorption. Enlist the generalized and specific malabsorption states. Discuss the investigative plan for a child with generalized malabsorption. (08/1)10 3. Define Recurrent Abdominal Pain (RAP) and list the diagnostic features of functional RAP. Suggest a plan for investigations and managing a 10 year old girl with RAP (09/1)4+6 4. Outline the clinical approach to diagnosis of a child with: (13/1) a) Short duration / acute pain abdomen; and 5 b) Long duration/ recurrent pain abdomen 5 5 .a) Recurrent abdominal pain in children 5 b) chronic pancreatitis in children 5(14/2)

CELIAC DISEASE

1. Pathogenesis of Celiac Disease (97/2)15 2. Diagnosis and management of a child with Celiac Disease (06/1)10 3. Aetiopathogenesis and diagnosis of celiac disease (07/2)10 4. Discuss evaluation of a child with suspected intestinal malabsorption. Describe genetics, pathogenesis, clinical spectrum and extra intestinal manifestations of celiac disease. (13/2)5+5 5. Pathophysiology ,clinical manifestations and management of gluten sensitive enteropathy. 3+4+3(15/2)

PREBIOTICS & PROBIOTICS

1. Outline the benefits of bacterial colonization of the intestine and the disorders they can produce. (04/2)5+5 2. Define probiotics. Explain their physiological mechanism of action. Opportunities and threats associated with the use of probiotics in pediatric practice. (08/2)10 3. Define probiotics and prebiotics and enumerate their essential characteristics. Outline the effects of probiotic in various gastrointestinal disorders. (09/1)(5+5) 4. Define probiotics and prebiotics. Outline their important properties and mechanisms of action. Enlist four most important indications of their clinical use in Pediatric clinical practices. (11/1)4+4+2 5. Write short notes on: Prebiotics, probiotics and symbiotics (13/2)(5) 6. Write short notes on Probiotics (14/1)

HEPATOBILIARY

BASIC SCIENCE

1. Differential Diagnosis of Ascites in children (93/1)10 2. Describe clinical, laboratory and radiologic evaluation of possible liver dysfunction in children. (11/2)3+4+3 3. Enumerate the causes and discuss the types, pathogenesis and evaluation of ascites in children. (11/2)2+2+3+3

HEPATITIS

1. Diagnosis and management of Acute Viral Hepatitis (96/2)12

HEPATIC FAILURE

1. Describe Biochemical and Pathological changes in various organs in Hepatic Encephalopathy. How will you manage a case (93/2)10 2. Laboratory Finding of Fulminant Hepatic Failure (98/2)10 3. Hepatic Encephalopathy- pathophysiology and management (03/2)25 4. Discuss the management of Fulminant Hepatic Failure. Add a note on Liver Transplantation (06) 5. Define Fulminant Hepatic Failure and outline the staging of severity of Hepatic encephalopathy. Discuss the steps in its management. (09/1)4+6 6. Outline the management of an 8 year old child with acute liver cell failure and hepatic encephalopathy. (10/2)10 7. Define fulminant hepatic failure. Discuss factors precipitating hepatic encephalopathy and management of hepatic encephalopathy. (14/2)2+(3+5) 8. a) define chronic liver disease 1 b) causes clinical approach and management of a case of chronic liver disease. 2+3+4 (15/1) 9. Define Fulminant Hepatic Failure.Write stages of Hepatic encephalopathy. Outline steps in its management. 2+3+5 (Apr 16) Rpt (1/16)

CHOLESTASIS

1. Cholestatic Jaundice 15 2. Biliary Atresia (95)15 3. List the causes of infantile cholestasis. Provide an algorithm for the diagnosis of infantile cholestasis. (04/2)3+7 4. Persistent Jaundice in neonates (06)10 5. Clinical approach, investigations and management of a neonate with Cholestatic jaundice (06/1)10 6. A 6 week old child is brought with a history of jaundice since 3 weeks of age, high colored urine with staining of napkins and pale colored stools. Discuss the laboratory diagnosis of this condition. What is the differential diagnosis and treatment of this condition (06)10 7. Define neonatal cholestasis. Outline clinical features and scheme for evaluation of a neonate with cholestasis. (11/1)2+3+5

LIVER ABSCESS

1. Outline the differential diagnosis of tender hepatomegaly. Describe the management of liver abscess. (10/1)5+5

WILSONS DISEASE

1. Write in brief the etiopathogenesis, clinical manifestations of Wilson’s disease. Outline the desired investigation helpful in making a diagnosis of Wilson’s disease. (11/1)3+3+4 2. Discuss the pathogenesis, clinical presentations, diagnosis and treatment of Wilson’s disease. (13/1)2+3+3+2

PORTAL HYPERTENSION

1. Pathophysiology of Portal Hypertension (98/2)10 2. Discuss the causes, clinical features and management of portal hypertension in children. (04/2)3+3+4 3. Diagrammatically represent the portal venous system and the sites of Porto-systemic vascular anastomosis in portal hypertension. Discuss the types, cause and pathophysiology of portal hypertension (07/1)10

PANCREATITIS

1. Etiology, pathogenesis, clinical features and management of acute pancreatitis in children. (10/1)2+2+2+4

GI BLEEDING

1. Hematemesis (94)15 2. A 5 yr old child brought to the emergency- H/o 2 bouts of massive hematemesis. On examination the child is pale and BP is 90/60. Discuss the emergency room management of this child. After the child is stabilized what laboratory diagnosis would you do in this child. What is the Differential Diagnosis and treatment of this condition (05)10 3. Management of Acute Upper GI Bleeding (06)10 4. Discuss the management of acute upper gastrointestinal bleeding in a 5 year old child. (08/1)10 5. Define hematemesis, malena and hematochezia. A 3 years old child presents with sudden onset vomiting of blood. Describe the approach to this child (including history and examination). Outline the steps of management. (08/2)10

BASIC SCIENCES

1. Write notes on embryological development of abdominal diaphragm and types of congenital diaphragmatic hernia (06)10 2. Name the steps in morphogenesis of respiratory system .Enumerate congenital lung malformations. Describe natural course of congenital cystic adenomatous malformations. (14/2) 3+3+4

PHYSIOLOGY

1. Respiratory system defense mechanisms (93/2)15 2. Define ventilation/ perfusion ratio. (11/1) 2 Outline Va/Q changes in a) Pneumonia 2 b) Obstructive lung disease 2 c) ARDS 2 d) Pulmonary thromboembolism 2

CLINICAL APPLICATION

1. Indications to use antibiotics in children with Upper Respiratory Infections (97/1)10 2. Pulse Oximetry and its limitations (98/1)15 3. Briefly discuss the non invasive estimation of gas exchange in children. (04)10 4. Enumerate 4 adventitious sounds that can be heard during examination of respiratory system. At what anatomical level are they produced? In which conditions are they produced. (06)10 5. Outline the pulmonary function testing in children with emphasis on performance and interpretation of spirometry. (08/1)10 6. Discuss Pulmonary Function Tests and their clinical utility. (13/2)7+3 7. Write short notes: (14/1)3+4+3 a) End – Tidal carbon dioxide monitoring b) Pulse oximetry c) Amplitude integrated EEG. 8. Utility of Blood gas (ABG) in localosing pathology and severity of disease in respiratory problems (15/1)5+5 9. Pulseoxymetry 2 (15/1) 10. A.Give graphical picture and explaination of elastic volume-pressure relationship of lung and chest wall in children 6 b. How would you distinguish restrictive vs obstructive lung disease based on PFT? 4 (1/16)

STRIDOR

1. Management of Acute Stridor in a Preschool child (93/1)15 2. A 2 year old child presents to the hospital with fever and Stridor of 12 hour duration. Discuss the diagnosis (97/1)10 3. List the common causes of stridor in children. How will you diagnose and manage a case of stridor. (04/2)3+4+3 4. Clinical Evaluation and management of a child with stridor (06/1)10 5. 1 year old child is brought with a history of sudden onset of respiratory distress and stridor of 2 days duration. What is the differential diagnosis? Discuss the steps in the management of Viral Croup (06/2­)10 6. Discuss the differential diagnosis and management of a 3 year old girl with history of cough and cold, presenting with onset of noisy breathing, barking cough, hoarse voice and respiratory distress. (08/1)10 7. Differential diagnosis and management of acute stridor in a 2 years old child. (10/1)3+7 8. A 2 year old boy presents with fever, change of voice and stridor for 2 days. Outline the differential diagnosis and management options. (12/1)6+4

TONSILITIS

1. Management of Acute Tonsillitis in children (98/1)15 2. Discuss the treatment of Nasal polyps in children (14/1) 3

CONGENITAL MALFORMATIONS

1. Describe the congenital malformations of the lungs. Discuss the diagnosis and management of these malformations (96/2)25 2. Detail the causes for localized emphysema of the lung. Describe the presentation and management of congenital lobar emphysema. (08/1)10

BRONCHIAL ASTHMA

1. Management of Acute Severe Asthma (92/2)15 2. Use of Nebulizers in Pediatric practice (95/2)10 3. Aerosol therapy in children (95/2)15 4. Treatment of Bronchial asthma (96/2) 5. Discuss briefly the recent advances in the management of Bronchial Asthma (99/1)15 6. Describe the pathogenesis of Bronchial Asthma. Give an outline for prevention and treatment of recurrent episodes. (02/1)25 7. Management of Status Asthmaticus in a 3 yr old. (03/1)25 8. Discuss the pathophysiology of asthma. Outline the role of investigations in bronchial asthma. (04/2) 6+4 9. Classify Asthma in children. Outline the management of asthma and approach to a case of Status Asthmaticus. (05)3+4+3 10. Discuss the steps in evaluation of chronic asthma is children. Classify and discuss the drugs used in the treatment of chronic asthma. Write briefly on targeted delivery systems in treatment of asthma. (06)10 11. Pathophysiology and management of Asthma in children (06/1)10 12. Management of a 3 year old child with recurrent attacks of wheezing (07/2)10 13. Outline the stepwise approach for managing infants and young children (<= 5 year of age) with chronic asthma (09/1)10 14. How do you grade the severity of childhood asthma? Describe its stepwise treatment according to the severity. Compare and contrast oral therapy to inhaled therapy for asthma. (09/2)3+3+4 15. Enlist the drugs used for management of chronic asthma. Explain the pharmacological basis of their use. (10/1)3+7 16. Discuss the lung function abnormalities in severe asthma. What is the role of lung function evaluation in management of asthma in children. (10/2)6+4 17. Discuss categorization of chronic childhood asthma. Discuss stepwise management of chronic asthma in children . (11/2)3+7

PNEUMONIA

1. Treatment of Staphylococcal pneumonia (93/1)10 2. Discuss briefly the Differential diagnosis and management of a case of Persistent Pneumonia in a 3 month old infant (99/2)15 3. Define interstitial lung disease (ILD). Enlist pediatric ILDs. Write brief description of lymphocytic interstitial pneumonitis (LIP). Outline the treatment options for ILD in children. (08/1)10 4. Discuss differential diagnosis and management of a child with recurrent pneumonia. (11/2)4+6

BRONCHIOLITIS

1. Course and prognosis of Acute Bronchiolitis (98/2)10 2. Define acute bronchiolitis. Describe its etiopathogenesis and characteristics features. Outline the essential steps in management of bronchiolitis. (10/2) 2+2+2+4

RESPIRATORY FAILURE

1. Clinical and physiological features necessary to diagnose respiratory failure in children (94/2)15 2. How will you define acute respiratory failure. Write common causes of acute respiratory failure in a 2 year old child. What are the various methods of oxygen therapy in children. (04/2)3+3+4 3. Types of Acute Respiratory Failure in children, modes of assisted ventilation and indications for the same in Children (06)10 4. What are the criteria used to diagnose Acute Respiratory Distress Syndrome (ARDS). Write in brief the pathogenesis, clinical features and lab findings of the same. Discuss the treatment and ventilatory strategies to manage ARDS. (08/2)10 5. Describe the pathophysiology, etiology and management of acute respiratory distress syndrome. (09/2)3+3+4 6. Classify respiratory failure in children. List the modes of assisted ventilation and its indications. (13/1)10 7. Define Acute Lung Injury. Discuss the etiopathogenesis and management of a child with Acute Lung Injury. (14/1)2+3+5

CYSTIC FIBROSIS

1. Pathophysiology and clinical features of Cystic Fibrosis (06)10 2. Diagnostic work up of a child with cystic fibrosis(CF). Describe management of a child with CF. (14/2) 4+6 3. Outline management of pulmonary involvement with cystic fibrosis. 5(15/2)

ASPIRATION

1. List conditions predisposing children to Aspiration Lung injury. Mention clinical features and principles of management of Chronic Aspiration.Conditions predisposing children to aspiration lung injury (07/2)10

BRONCHIECTASIS

1. Discuss briefly etiology, clinical presentation, diagnosis and treatment of Bronchiectasis (07/1)10

MISCELLANEOUS

1. Diagnosis of Bronchial Foreign Body (93/2)10 2. Differential diagnosis of Hemoptysis in children (95/2)10 3. Describe the etiology, stages of evolution, clinical manifestations, diagnostic investigations and management of empyema thoracis (11/1)1+2+2+2+3 4. Describe location, structure and function of cilia in respiratory tract. Discuss the clinical presentation and management of primary ciliary dyskinesia? (11/2)3+7 5. Discuss the aetiology, pathogenesis, clinical presentation and management of a two months old child with chronic lung disease. (14/1) 2+2+2+4 An 8 month old baby presents with respiratory distress.Describe the differential diagnosis, evaluation and outline treatment for this infant. (14/1)3+3+4

17. CARDIOVASCULAR SYSTEM

BASIC SCIENCES

1. Fetal Circulation and cardiovascular adjustments after birth (06/1)10 2. Outline Fetal Circulation (07/2) 3. Draw a labeled diagram of fetal circulation. Indicate partial pressure of oxygen (PaO2) and oxygen saturation (SaO2) values at key points in this circulation. (08/1)10 4. Fetal circulation and changes after birth (10/1)5+5Rpt (15/1) 4+3 5. Depict diagrammatically fetal circulation. Highlight its unique features differentiating it from neonatal circulation. Outline important changes occurring at birth. (11/1)4+3+3

CLINICAL APPLICATION

1. Significance of S2 in clinical practice (98/1)15 2. Enumerate the conditions where you can get a. Loud S2 b. Wide splitting S2 Explain the pathophysiology of fixed splitting of S2 (05)10 3. Discuss the various minimally surgical invasive devices and procedures available for the management of common congenital heart diseases in children. (07/1)10 4. A one year old child is referred for an asymptomatic cardiac murmur. Outline the likely causes. How will you differentiate an innocent murmur from that of a congenital heart disease, on clinical grounds? (09/1)3+7 5. A 3 year old child having fever for 2 days suddenly develops breathlessness, tachycardia and sweating. Describe the differential diagnosis of this case and its treatment. (09/2)5+5 6. A 2 month old baby presents with history of failure to gain weight, tachypnea, tachycardia, difficulty in taking feed and excessive perspiration. On examination –no cyanosis, hepatomegaly and systolic murmur is noted. Discuss differential diagnosis, investigations and management. 4+3+3(15/2)

HEART FAILURE

1. Newer approaches in management of CCF (93/1)15 2. Treatment of Intractable CCF (93/2)10 3. Describe briefly the Pathophysiology of CCF and management of Refractory Failure (98/2)25 4. Intractable congestive heart failure- management approach (02/1) 15 5. ACE inhibitors in CCF with congenital heart disease (03/1)15 6. CCF- Pathophysiology and management (03/2)25 7. How will you manage a child in Refractory CCF (06)5 8. Discuss the pathogenesis of Congestive Heart failure and the role of vasodilators in its management (06)10 9. Refractory congestive heart failure- causes and management (07/2)10 10. Discuss the role of vasodilator therapy in congestive heart failure. Enumerate various vasodilator agents used in CHF and their respective mechanisms of action. (08/1)10 11. List the causes of congestive heart failure in a 2 years old child. Describe different types of VSD according to position and size. Write indicators for surgical intervention/ device closure. (08/1)10

CONGENITAL HEART DIAEASE

1. Cyanotic Spell (94/2)15 2. How do you classify congenital cyanotic heart disease? Discuss their investigations (97/2)15 3. Complications of Fallot’s Tetralogy and their management (99/2)10 4. Management of Paroxysmal Hypercyanotic spell (99/2)15 5. Pathophysiology of Cyanotic spells (02/1)15 6. What are the congenital heart diseases associated with cyanotic spells. Write clinical presentation and management of cyanotic spell. (04/2)2+3+5 7. How will you manage a child in cyanotic spell (06)5 8. Pathophysiology, diagnosis and treatment of Eisenmenger Syndrome (07/1)10 9. Discuss the hemodynamics and pathophysiology of Tetralogy of Fallot. Outline management of cyanotic spell in a 2 year old child. (12/1)4+3+3 10. Describe the hemodynamics and clinical features of tricuspid atresia in a neonate. Outline the expected findings on ECG and chest X-ray. (13/1) 3+3+2+2 11. Describe the development of ventricular septum. Discuss the clinical features and management of VSD, and enumerate the indications for surgical intervention. (14/1)3+3+2+2

RHYTHM DISORDERS

1. Classification of cardiac arrythmias and management of WPW Syndrome (92)15 2. Arrythmias- pathogenesis, diagnosis and management of different types (03/2)15 3. Describe the etiopathogenesis of supraventricular tachycardia in children. Discuss the diagnosis and management of a child with supraventricular tachycardia. (04/2)3+3+4 4. What are the causes, manifestations and management of a young child with SVT (06)10 5. Classify stable and unstable arrythmias. Discuss the types of SVT (Supra Ventricular Tachycardia) with their ECG changes. Outline the approach to manage unstable arrythmias. (08/2)10 6. Classify anti – arrhythmic drugs used in children. Describe the mechanism of action and uses of Amiodarone. (10/1)5+5 7. Enumerate the causes and outline the characteristics and treatment of Supraventricular Tachycardia (SVT) in an infant (10/2)3+3+4 8. Enumerate life threatening tachyarrhythmias in childhood. How would you diagnose them? Briefly outline their emergency interventions. (12/1) 2+4+4 9. AVNRT (AV Nodal Re-Entrant tachycardia) 4(1/16)

CARDIOMYOPATHY

1. Cardiomyopathy (95/1)15 2. Diagnosis of Cardiomyopathy (96/2)12 3. Discuss in brief the etiopathogenesis, clinical features and management of dilated cardiomyopathy. (12/1)3+3+4

PERICARDITIS

1. Diagnosis and management of Constrictive Pericarditis (99/2)10

RHEUMATIC CARDITIS

1. Treatment of Acute Rheumatic carditis (97/1)15

INFECTIVE ENDOCARDITIS

1. Pathogens, clinical features and management of infective endocarditis. (10/1)2+4+4 2. Enumerate common pathogens of infective endocarditis. List conditions/ interventions which require prophylaxis for infective endocarditis in a child with underlying heart disease. Oultine antibiotic therapy for a child with RHD and infective endocarditis. (11/1)2+3+5 3. Outline Duke criteria for diagnosis of bacterial endocarditis. Discuss its application in clinical setting. (13/1)6+4

HYPERTENSION

1. Diagnosis of Essential Hypertension in children (93/1)10 2. Investigations in a child with Hypertension (95/1)10 3. Treatment of Hypertension (97/2)12 4. Discuss etiology, diagnosis and management of Childhood Hypertension (00/1)25 5. Severe Hypertension in infancy (00/1)15 6. Discuss the causes of Hypertension in a 7 year old child. Approach of investigation and management of such a case (02/1)25 7. A 8 year old child is brought with a history of convulsions and altered sensorium. On examination her BP was 180/110 mm Hg. Discuss the D/D and laboratory investigations in this child. Discuss the management of Hypertensive Encephalopathy in this child. Add a note on fundus changes in hypertension. (06)10 8. Recent advances in management of Hypertension (06/1)10 9. Essential Hypertension in children (07/1)10 10. Discuss the treatment of Hypertension in children. Classify the drugs used to treat hypertension and briefly mention their mechanism of action (07/2)10 11. A 10 year old boy is brought with a history of convulsions and altered sensorium. On examination, his BP was 180/110 mm of Hg. Describe differential diagnosis, laboratory investigations and treatment of this case. (09/2)3+4+3 12. Describe the causes and pathogenesis or renal and renovascular hypertension. Outline principles of management. (12/1)3+3+4 13. Define Hypertension in children. Enumerate the causes and discuss the management of an 8 years old boy presenting with a blood pressure of 210/160 mm Hg with seizures. (14/1)2+3+5 14. An 8 year old child is brought with a history of convulsions and altered sensorium. His BP is 180/110 mm Hg. Discuss the D/D and laboratory investigations and management of this patient. 3+3+4(Apr16)

MISCELLANEOUS

1. Cardiovascular Risk factors in children (96/1)15 2. Primary Endocardial Fibroelastosis (98/1)15 3. A 13 year old male is brought with an H/o progressive Dyspnea on exertion. He has past H/o recurrent joint pain. What is the most likely diagnosis? How will you investigate and manage the child. Add a note on Refractory CCF in a child (05)5+5 4. What advice will you give to a 35 year old patient with coronary artery disease regarding its prevention in his adolescent son? (06)10 5. Preventive cardiology in adolescents (07/2)10

18. DISEASES OF THE BLOOD

ANAEMIA

1. Discuss the etiology and investigations in a case of Anemia (94)25 2. Describe laboratory investigations in an infant with anemia and briefly outline the interpretation of test results (95/1)25 3. Severe anemia in the first year of life (02/1)15 4. What is peripheral smear finding in (05)2+2+2+2+2 · Thalassemia Major · Lead poisoning · Megaloblastic anemia · CRF · Malaria 5. List the causes of microcytic hypochromic anemia. How will you differentiate between iron deficiency anemia and thalassemia? Discuss briefly the oral iron chelators. (08/1)10

AUTOIMMUNE HEMOLYTIC ANEMIA

1. Discuss the etiology and management of Autoimmune Hemolytic Anemia (09/1)3+7 2. Discuss the etiology, pathogenesis and diagnostic workup of Acute autoimmune hemolytic anemia. (10/2)3+3+4 3. Diagnosis and management of Autoimmune Hemolytic Anemia 3(15/1)

PANCYTOPENIA

1. Classify causes of acquired pancytopenia. Write briefly about the management of acquired aplastic anemia. (09/1)3+7 2. Define pancytopenia. Enlist the causes and assessment of severity of aplastic anemia in children. (10/1)2+4+4 3. Define pancytopenia. Enumerate common causes in children. How will you assess severity of acquired anemia in children? (11/2)2+3+5 4. Characteristic hematological features ,laboratory findings and treatment of congenital hypoplastic anemia (Diamond Blackfan Anemia) 3+3+4 (15/2) 5. Management of Aplastic anemia 5 (Apr 16)

THALASSEMIA

1. Current management of Thalassemia Major (96/2)15 2. Newer modalities in the management of β Thalassemia Major (99/2)10 3. Antenatal diagnosis of Thalassemia (99/2)15 4. Genetic basis of Thalassemia syndromes (02/1)15 5. In relation to Thalassemia write a note on the following (05)10 a. Alkali desaturation test b. NESTROFT test c. Peripheral smear d. SQUID-BLS e. BMD 6. Alpha Thalassemia (07/1)10 7. Outline the antenatal management of a mother with an earlier child with thalasemia major (07/2)10 8. List the causes of microcytic hypochromic anemia. Provide diferentiating features between iron deficiency anemia and beta thalassemia trait. Describe the management of thalassemia major. (11/1)3+3+4 9. Outline the long term complications of thalassemia major. How will you monitor for such complications in a child with thalassemia major? (13/1)5+5 10. Describe the foetal hemoglobins. Discuss the transfusion therapy for Thalassemia major and its long term follow up plan. (14/1)3+4+3 11. Recent concepts/advances for treatment /managment of Thalassemia major in children (95/2)10 Rpt (14/2)5

IRON DEF ANEMIA

1. Prevention of Iron Deficiency Anemia in children (95/2)15 2. Management of Iron Deficiency anemia (98/2)10 3. Enlist the causes and outline the Differential Diagnosis and treatment of iron deficiency anemia (05)3+3+4 4. Outline the etiology of iron deficiency in children. Describe the clinical features and approach to diagnosis of a child suspected to be having nutritional anemia. (13/1)3+(2+5) 5. Describe the sequential pathological changes seen with iron deficiency states. What laboratory studies can be used to differentiate common microcytic anemias? (13/2) 5+5

G6PD DEFICIENCY

1. Pathogenesis of anemia in G6PD Deficiency (99/1)15 2. G6PD deficiency (99/2)10 3. 3yr old child-H/O Jaundice since 2 months, H/O Exchange transfusion at D2. Discuss the D/D. Classify Hemolytic Anemia. Add a note on management of Intravascular hemolysis in G6PD deficiency (05)4+4+2 4. Briefly outline normal erythropoiesis. Describe the diagnosis and treatment of G6PD deficiency (07/2)10 5. Enlist the red blood cell metabolic enzyme pathways and the enzymes responsible for hemolysis. Discuss the pathogenesis involved in these hemolytic anemias. (11/1)3+7

MEGALOBLASTIC ANEMIA

1. Megaloblastic anemia (03/2)15 2. List the common causes of macrocytic anaemia. Describe the laboratory diagnosis of megaloblastic anaemia and treatment of juvenile pernicious anaemia. (04/2)4+3+3 3. Clinicohematological profile of Megaloblastic Anaemia (06/1)10 4. Discuss causes, clinical manifestations, laboratory findings and treatment of Folate Deficiency anaemia in children (07/2)10 5. Enlist the common causes of macrocytic anemia. Describe the laboratory diagnosis and treatment of megaloblastic anemia. (09/2)2+3+5 6. Write short note on: Peripheral smear findings in iron deficiency and B12 deficiency anemia (10/2)2.5+2.5

HEREDITARY SPHEROCYTOSIS

1. Diagnosis and management of Congenital Hereditary Spherocytosis (97/1)15 2. Hereditary Spherocytosis (06)10

SICKLE CELL ANEMIA

1. Management of acute sickle cell crisis (99/1)15

SPLEEN

1. Outline the functions of Spleen. Describe the indications and complication of splenectomy and post –operative management. (09/1)3+7 2. Describe the functions of spleen. Describe clinical manifestations and management of asplenia/ polysplenia. (10/1)4+3+3

HEMORRHAGIC AND THROMBOTIC DISEASES

1. DIC (96/2)15 2. Antenatal diagnosis and carrier detection of Hemophilia (98/2)15 3. Explain coagulation cascade. A 4 year old child with h/o recurrent epistaxis and gum bleeding. Discuss laboratory diagnosis and management of this condition. Add a note of differentiating a bleeding disorder from a coagulation disorder (05)5+3+2 4. A 5 year old male child comes with a history of trivial fall and swelling of right knee. He has history of easy brusiability. Discuss the laboratory diagnosis and management of this child. Add a note on antenatal diagnosis and counseling (06)10 5. Discuss the various aspects of management of a child with Hemophilia A (07/2)10 6. Discuss the pathogenesis of disseminated intravascular coagulation (DIC) and relate it to the laboratory abnormalities observed in this entity. (08/1)10 7. Diagrammatically outline the Normal Coagulation Cascade. Outline diagnosis and management of disseminated Intravascular Coagulation (DIC) (09/1)4+6 8. A 10 year old boy with hemophilia A, weighing 30 kg has come with bleeding in both knee joints. Discuss briefly the specific, supportive and prophylactic management of this child. (11/1)4+3+3 9. An 8 year old girl has presented with epistaxis, bleeding gum and ecchymotic patches over trunk. Her platelet count is 20,000/cumm. Discuss the differential diagnosis with specific clinic-investigative pointers. Plan the diagnostic work up for this child. (13/2) 3+3+2+2 6. Draw the coagulation cascade. Describe the Hess capillary test and enumerate the screening tests for a bleeding and a clotting disorder. (14/1)4+6 7. Pathophysiology of thrombophilia 4(1/16)

ITP

1. Write differential diagnosis of a 5 year old child with petechial rash with fever. How will you manage a child with idiopathic thrombocytopenic purpura. (04/2)4+6 2. Various treatment modalities in acute ITP (06)10 3. Write in brief regarding the etiology and management of idiopathic Thrombocytopenic purpura (ITP). (11/1)4+6 4. Discuss the treatment options for acute ITP in a 14 year old girl child. (13/1)10

AUTO IMMUNE LYMPHOPROLIFERATIVE SYNDROME

1. Pathogenesis ,clinical features and diagnostic criteria of autoimmune lymphoproliferative syndrome (14/2) 4+3+3

BONE MARROW TRANSPLANTATION

1. Describe the risks and benefits of bone marrow transplantation in children (94/2)15 2. Bone marrow transplantation for children (06/1)10 3. Define febrile neutropenia and describe the treatment and care of a child with febrile neutropenia. (08/1)10 4. Febrile neutopenia- definition and management (15/2)1+4

BLOOD TRANSFUSION

1. Transfusion of Blood fractions 10 2. Discuss the inherent hazards of Blood Transfusion in children and the necessary measures to avoid and minimize them (07/1)10 3. Outline the method of extracting various blood components. What are the indications of usage of Fresh Frozen Plasma (FFP) and cryoprecipitate? (09/2)5+5 4. Discuss briefly the risks associated with blood transfusion therapy. (13/2)10

19. NEOPLASTIC DISEASES AND TUMOURS

ALL

1. Treatment and prognosis of ALL (97/2)15 2. Management of CNS Leukemia (96/1)14 3. Management of a case of ALL in a 3 year old (03/1)25 4. Discuss management of a child with acute leukemia (06/1)10 5. Management of a child with acute leukemia (06/2)10 6. Prognostic indicators in Acute Leukemia (07/2)10 7. Define tumour lysis syndrome. Enlist its important constituents. Outline its etiology and describe the management. (08/1)10 8. Utility of immunophenotyping in the diagnosis of leukemia in children. Outline the treatment of acute lymphoblastic leukemia. (09/2)4+6 9. Outline the essential components and pathophysiology of tumor lysis syndrome. Describe its management. (11/1)2+4+4 10. Define tumour lysis syndrome. Describe the pathophysiology of tumour lysis syndrome. How will you prevent occurrence of tumour lysis syndrome? (11/2)2+4+4 11. A)classification of childhood leukemias b)management of Tumour lysis syndrome (14/2)5+5 12. Managment of Acute Myeloid Leukemia 5(Apr 16) 13. Enumerate the oncological emergencies occurring in leukmia/lymphomas 2(1/16)

LYMPHOMA

1. Different types of Lymphomas in children and their Histopathological classification (93/2)15

HLH

1. Write in brief the clinical manifestations, laboratory findings and management principles of Langerhans Cell Histocytosis. (09/1)10 2. Classify childhood histiocytosis. Describe the clinical manifestations, diagnosis and treatment of Langerhan’s cell histiocytosis. (10/1)3+3+2+2 3. A) Classify childhood histiocytosis. 3 B) Clinical features and management of a case of Langerhan’s cell histiocytosis. (15/1)3+4 4. How will you classify childhood Histiocytosis? Describe the diagnostic criteria, clinical manifestations and treatment for hemophagocytic lymphohistiocytosis. What are the infections associated with it? (11/2) 2+2+2+2+2 10. a. How will you classify childhood Histiocytosis? 2 b.Describe the diagnostic criteria, clinical manifestations and treatment for hemophagocytic lymphohistiocytosis. 2+3+3 (1/1

20. NEPHROLOGY

BASIC SCIENCES

1. a) Structure of glomerulus with diagrammatic representation. 6 b) What are the Glomerular changes in rapidly progressive glomerulonephritis? 4(Apr16)

GLOMERULAR FILTRATION

1. List the children to be selected for assessing renal function. Briefly Discuss the tests used to assess the renal function in children. (04)3+7 2. Outline the development of glomerular filtration. Outline the methods for evaluating GFR in children. (08/1)10

PROTEINURIA

1. Persistent asymptomatic proteinuria (98/2)(07/1)10 2. Proteinuria (96/2)15

HEMATURIA

1. A 3 year old child was brought for Hematuria. Discuss the differential diagnosis and management (94/2)25 2. Diagnosis and management of recurrent Hematuria (96/1)12 3. Evaluation of a child with Hematuria 15 4. Outline the differential diagnosis of an abdominal lump with hematuria in a 3 year old child. Describe its investigations and treatment. (09/2)3+3+4 5. Write the common causes and differential diagnosis of gross symptomatic hematuria. Provide an algorithm for its laboratory and radiological evaluation. (10/2)2+2+6 6. Outline the causes of red coloured urine. Provide an approach for evaluation of a child with headache. (11/1)3+7 7. Discuss the pathology, clinical manifestations, diagnosis and treatment of infantile polycystic kidney. (11/2)2+2+3+3

PSGN

1. Discuss the pathogenesis, clinical features and management of acute PSGN 2. Enumerate the complications of acute post – streptococcal glomerulonephritis. Describe their management in brief. (10/2) 3+7

NEPHROTIC SYNDROME

1. Relapse in Nephrotic Syndrome (94)15 2. What factors will you consider in deciding the prognosis of a child with Nephrotic syndrome (95/1)15 3. Pathophysiology of Nephrotic Syndrome (96/2)10 4. Enumerate the principles of management of Idiopathic Nephrotic syndrome (98/2)10 5. Frequently relapsing steroid resistant Nephrotic Syndrome (03/2)15 6. What factors help you to clinically decide non-minimal nature of Nephrotic Syndrome? Enumerate the steps to test urine for albumin using heat methods (05)10 7. Histopathological changes in RPGN 15 8. Write the management of a 6 year old child with Nephrotic syndrome who is frequently relapsing. Enumerate complications that can occur (06/2)10 9. Management of steroid dependent nephrotic syndrome (07/2)10 10. Describe the diagnostic approach and management in a case of frequently relapsing and steroid dependent nephritic syndrome. (09/2)4+6 11. Management of steroid resistant nephrotic syndrome. (10/1)10 12. Define steroid dependent and frequently relapsing nephrotic syndrome. Describe management of an 8 year old child with frequent relapsing nephrotic syndrome. (11/1)2+2+6 13. Enumerate the causes of SRNS and discuss its management.(14/2)4+6 14. Outline management of steroid resistant nephritic syndrome 5(15/2) 15. Management of steroid resistant and steroid dependent nephritic syndrome 5+ 5(Apr 16) Rpt (1/16)

RENAL FAILURE

1. Biochemical and endocrinal changes in CRF 2. Describe the pathogenesis of CRF and outline important principles in the management of such a case (95/2)25 3. What are the causes of ARF in children? How will you investigate such a case? Discuss management. (97/1)25 4. What are the causes of acute renal failure in a 4 year old child. How will you investigate such a case. Discuss the management of acute renal failure. (04/2)4+3+3 5. Outline the etiopathogenesis of ARF in children. Discuss briefly the management (05)5+5 6. List the causes of renal failure in a 3 month old child. Discuss the clinical features, laboratory diagnosis and treatment of acute renal failure in children. Discuss the indications of renal biopsy in children (06)10 7. Discuss the etiology of cortical necrosis in newborns and older children, separately. State the most important clinical manifestations of cortical injury and factors governing prognosis. (08/1)10 8. Discuss the role of recombinant human erythropoietin therapy (indication, dose, aim, precaution, benefits and complications) in management of chronic renal failure. List reasons of resistance to such therapy. (08/1)10 9. What is acute renal failure? List the common causes leading to it. Tabulate the laboratory indices used to differentiate pre-renal and intrinsic acute renal failure. Outline the medical management of acute renal failure. (08/1)10 10. Define renal osteodystrophy. Enumerate its clinical features and outline the management. (09/2)2+3+5 11. Write short notes on: (13/1) a) Pediatric RIFLE criteria for acute kidney injury 5 b) Urinary indices in acute renal failure 5 12. Define Chronic kidney Disease (CKD) and its stages. What are the clinical manifestations of CKD. Outline its treatment. (13/2) 3+4+3

RENAL REPLACEMENT THERAPY

1. Renal replacement therapy in ESRD (00/1)15 2. Peritoneal dialysis (03/1)15 3. Renal replacement therapy (06/1)10 4. Discuss renal replacement therapy (07/1)10

HUS

1. Diagnostic features of HUS (93/2)15 2. HUS- etiopathogenesis and diagnosis (98/1)15 3. Classify Haemolytic Uremic Syndrome. Discuss its pathogenesis, clinical features and management. (13/2)2+3+3+2 4. Classification, etiopathogenesis and management of hemolytic uremic syndrome. (16/1)3+4+3

RENAL TUBULAR ACIDOSIS

1. Diagnosis and management of RTA (92/2)15 2. Classify types of RTA and their management principles (02/1)15 3. Pathogenesis, clinical features and management of Distal Renal Tubular disorder (07/2)10 4. Define anion gap and its utility. Outline the major causes of metabolic acidosis in children. Outline the treatment of renal tubular acidosis. (04/2)2+4+4 5. Enumerate renal tubular functions and describe the tests to evaluate tubular disorders for the proximal tubule. How will you treat a child with proximal renal tubular acidosis? (14/1)3+4+3 6. Diagnosis and management of Distal renal tubular acidosis. 5(1/16)

MISCELLANEOUS

1. Nephrogenic Diabetes Insipidus (98/2)15 2. How do you classify and treat lupus nephritis 5 (1/16)

21. UROLOGIC DISORDERS IN INFANTS AND CHILDREN

UTI

1. Investigation of a 7 year old boy with Recurrent UTI (93/2)10 2. Describe the etiological factors, clinical manifestations and management of children with UTI (95/2)25 3. Management of a 2 year old child with first attack of UTI (99/2)10 4. Recurrent UTI in childhood (02/1)15 5. Recurrent UTI (03/2)15 6. Classify UTI and provide an algorithm for management of a child with first episode of UTI (05)3+7 7. Imaging studies indicated in a child with UTI (06)10 8. Discuss approach to a child with recurrent urinary tract infections. What are the indications, goal and schedule of antimicrobial prophylaxis in treating such a child? (09/1)10 9. What are the clinical manifestations of urinary tract infections (UTI) in children? Describe the plan of investigations and management of a 2 year old boy with recurrent UTI. (09/2)2+4+4 10. How is urinary tract infection diagnosed? Draw an algorithm for evaluation of a child after the first episode of UTI. Describe the utility of a DMSA scan. (14/1)2+5+3

VUR

1. Discuss criteria for diagnosis, staging and management of VUR(92)25 2. Management of an infant with VUR (93/1)15 3. Outline the grades of vesico-ureteric reflux. Discuss the management of a child with recurrent urinary tract infection with grade 4 vesico-ureteric reflux. (04/2)4+3+3 4. Give the grading of VUR. Outline its evaluation and management in children (07/2)10 5. Clinical features, grading and management of vesico-ureteric reflux (10/1)3+3+4 6. Write short note on: Grading of vesico-ureteric reflux and indications of surgical intervention in children with vesico-ureteric reflux (10/2)3+2 7. Define vesicoureteral reflux (VUR). Classify the grades of VUR. Discuss in brief the medical and surgical management of VUR in children. (11/1)2+2+6 8. Grading ,classification and natural history of vesicoureteral reflux (VUR). (15/1)3+3+4

NEUROGENIC BLADDER

1. Neurogenic Bladder (98/2)15 2. Write short notes on: a) Voiding dysfunctions in children (13/2) 5

GYNAECOLOGY

1. Write a short note on non-specific vulvo-vaginitis in children with special emphasis on its etiopathogenesis and treatment (08/1)10

22. ENDOCRINE SYSTEM

THYROID GLAND

1. Management of Puberty Goiter (93/1)15 2. Diagnosis of Congenital Hypothyroidism (95/1)15 3. Management of Puberty Goiter (98/2)15 4. Endemic Cretinism (99/2)15 5. Congenital Hypothyroidism (00/1)15 6. Etiopathology of Congenital Hypothyroidism 15 7. Goitrogenic Hypothyroidism (03/2)15 8. Briefly list the various thyroid function tests. Describe clinical presentation and management of autoimmune thyroiditis. (04/2)6+4 9. What are the changes seen in Thyroid Hormone levels around birth. Describe the salient features of Neonatal Thyroid Screening programme (06)10 10. Congenital Hyperthyroidism (07/1)10 11. Neonatal Thyroid Screening (07/2)10 12. Discuss causes, clinical features and management of Acquired Hypothyroidism (07/2)10 13. Discuss the synthesis of thyroid Hormones. Outline the causes of congenital hypothyroidism and a brief comment on neonatal thyroid screening. (09/1)3+7 14. Thyroid hormone synthesis and its derangements. (10/1) 6+4 15. Enlist common causes of acquired hypothyroidism in a 12 year old girl. Discuss in brief the clinical manifestations and laboratory findings. (12/1)3+4+3 16. Clinical features and management of Hashimoto’s thyroiditis 5(1/16)

DIABETES MELLITUS

1. Emergency management of DKA (93/1)15 2. Management of DKA (95/2)15 3. Complications of Juvenile Diabetes Mellitus and their management (97/1)15 4. Describe briefly the biochemical changes and management of DKA (98/1) 25 5. 8 year, h/o vomiting, severe abdominal pain for 2 days. Dehydrated, acidotic breathing, Blood glucose (random) 400. Outline the management (05)10 6. Write management of DKA (06)5 7. Management of a child with IDDM (06/2)10 8. Write risk factors, pathogenesis and treatment of Type 2 Diabetes Mellitus in children (07/2)10 9. Classify severity of diabetic ketoacidosis on the basis of clinical and blood gas examination. Briefly describe Somogyi and Dawn phenomenon in type 1 diabetes. (08/1)10 10. Discuss the metabolic changes associated with diabetic ketoacidosis with steps of treatment of diabetic ketoacidosis. (08/2)10 11. A 10 year old child (body weight 22kg) presents with severe diabetic ketoacidosis. Write down the expected clinical and investigate findings. Outline the plan of management in first 24 hours. (09/1)4+6 12. What are the biochemical criteria for the diagnosis of Diabetic Ketoacidosis (DKA)? What are the goals of therapy? How will you manage a 7 yr old child with DKA? (11/2)3+3+4 Rpt (Apr16 same marks) 13. Discuss the pathophysiological abnormalities in diabetic ketoacidosis. Describe the management of diabetic ketoacidosis in a child weighing 20 kg. (13/2) 4+6 14. Hyperosmolar non ketotic diabetic coma 5(1/16) 15. A. What are the biochemical criteria for the diagnosis of Diabetic Ketoacidosis (DKA)? B. What are the goals of therapy? C. How will you manage a child with DKA? 3+2+5(1/16)

METABOLIC SYNDROME

1. Diagnosis and complication of Metabolic syndrome 4(1/16) HYPOTHALAMUS AND PITUITARY 1. Indications of Growth Hormone Therapy (93/2)10 2. What are the causes of Dwarfism? How will you investigate such a case (97/2)15 3. SIADH (99/1)(99/2)10 4. How will you diagnose and treat SIADH in a child (06)5 5. How will you assess a child presenting with features of Diabetes Insipidus (06)10 6. A 4 year old child presents with polydipsia and polyuria. How will you establish a diagnosis of diabetes insipidus in this case? Discuss its management. (08/1)10 7. Diagnostic approach for a child who presented with polyuria and polydipsia. (10/1)10 8. Outline the diagnostic criteria of diabetes insipidus. Discuss the management of nephrogenic diabetes insipidus. (10/2)4+6 9. Enumerate the hormones secreted by anterior pituitary and list the factors stimulating and inhibiting secretion of growth hormone. (10/2)3+7 10. Outline the diagnostic criteria for Syndrome of Inappropriate ADH Secretion (SIADH). Discuss its etiopathogenesis. (12/1)6+4 11. Discuss approach to the diagnosis of a child presenting with polyuria and polydipsia. (13/2)10 12. A 5 year old boy has attained a height of 137 cm. What could be the cause(s) for this situation and which specific clinical pointers may be useful for determining the cause. How will you evaluate this child for an underlying endocrinological disorder? (13/2) 6+4 13. Write short notes on the evaluation and treatment for a child with: a.SIADH 5(14/1) b.Virilisation 5 14. A) Enumerate hormones secreated by anterior pituitary. B) Factors stimulating and inhibiting secretion of growth hormone (15/1) 3+7 15. Causes , clinical presentation ,investigations and management of diabetes insipidus 1+2+3+4(15/1) 16. A child with suspected diabetes insipidus is brought to hospital. How will you approach, investigate and manage this patient? 2+3+5 (1/16)

ADRENAL GLAND

1. Management of adrenogenital syndrome (96/2)15 2. Short note- female with Ambiguous genitilia at birth (02/1)15 3. Salt losing CAH (03/1)15 4. Outline human sex differentiation. Provide an outline of the approach to an infant with ambiguous genitalia. (04/2)4+6 5. Explain synthesis of Steroid Hormones. Discuss Briefly approach to a child born with ambiguous genitilia (05)5+5 6. Causes of Adrenal Crises and discuss its management (06)10 7. Diagnosis and management of a child with CAH (06/1)10 8. Discuss approach to a child with ambiguous Genitilia (06/2)10 9. Enumerate the causes of adrenal crisis. Provide key features of clinical presentation and discuss its management. (08/1)10 10. Discuss karyotype abnormalities, clinical features and management of true hermaphroditism. (08/1)10 11. Define delayed puberty in a male child. List the possible causes. Describe changes in male genitals in different stages of sexual maturation. (08/2)10 12. Discuss the normal physiology of puberty and its relation to sexual development. (09/1)4+6 13. A 1 ½ year old female is brought to you with obesity, short stature, hypertension and hypertrichosis of face and trunk. Provide differential diagnosis and approach to investigating and managing this child. (09/1)3+7 14. Describe the diagnostic approach in a 2 year old child with ambiguous genitalia (09/2)10 15. Physiology of puberty in boys and girls (10/1)10 16. Clinical features, investigations & treatment of pheochromocytoma. (10/1)3+3+4 17. Outline the diagnostic approach to a 14 years old boy with infantile genitalia. (10/1)10 18. Define and classify precocious puberty in boys according to its etiology. Outline the approach for investigating a boy with precocious puberty. (11/1)2+4+4 19.Describe normal sexual differentiation in fetus. What is intersex? Describe etiological classification of disorders of Sex Development (DSD). (11/2)2+2+6 20.Define delayed puberty. Describe its etiology and diagnostic evaluation. (13/2)2+4+4 21. Define precocious puberty in boys. Enumerate causes of precocious puberty in boys (14/2)5 22. A)Define disorders of sexual differentiation( DSD ) in new born b)Nursery evaluation of a newborn with suspected DSD by history, physical examination and diagnostic tests. c)issues in management of DSD (15/1)2+6+2 23.a)Adrenal steroid hormone synthesis 5 b)Outline biochemical consequences of defects in the classical 21- hydroxylase deficiency and its management (2+3)(APR16) 24. a)Outline steps involved in synthesis of steroid hormones. 3 b)clinical features & management of classical congenital hyperplasia. (4+3)(01/16) 25. Enumerate causes and management of adrenal crisis 5(1/16)

PARATHYROID GLAND

1. Role of hormones in calcium balance (03/2)15 2. Outline the calcium metabolism. Discuss the causes and management of Hypocalcaemia in 3 yrs old. (07/2)10 3. Differentiate between the laboratory features of hypoparathyroidism, pseudohypoparathyroidism and hyperparathyroidism. (08/1)(12/1)10 4. Describe the calcium metabolism in a child. Detail the clinical manifestation, diagnosis and treatment of a child with pseudohypoparathyroidism. (08/2) 10 5. Discuss the etiopathogenesis, clinical manifestations, diagnosis and treatment of hypercalcemia. (09/1)10 6. Define hypocalcemia. Enumerate hormones affecting calcium balance in the body. Describe the respective roles in calcium homoestasis (13/1)2+3+5

23. NERVOUS SYSTEM

BASIC SCIENCES

1. Newer antiepileptic drugs (13/1) 5 rpt 15/1 (4),(15/2) (5marks) 2. Tabulate the mechanism of action ,dosage, indications and side effects of the following a) Zonisamide b) Rufinamide c) Stiripentol d) Levetricetam e) Lacosamide 2x5(15/2) 2. a) CSF formation and CSF circulation 4 b) Enumerate the causes and management of i) Communicating hydrocephalus 3 ii) Non - communicating hydrocephalus 3(Apr 16)

NEUROLOGICAL EVALUATION

1. Newer Antiepileptic drugs (99/1)15 2. Modified Glasgow Coma Scale in a 1 year old Child (03/1)15 3. Outline the pathway of seventh cranial. Discuss the diagnosis and management of Bell’s palsy. (04/2)4+3+3 4. Briefly discuss the role of electrophysiological studies in pediatric neurological disorders. (04/2)10 5. What are the signs of meningeal irritation in a 2 year old child? How do you elicit them? How will you rule out Pseudo-neck rigidity(05)10 6. Give 5 examples each of UMN and LMN lesion. How do you clinically differentiate between UMN and LMN lesions? What is the importance of fundus examination in a child with Para paresis (05)10 7. Clinical significance of Postural Reflexes (06)10 8. A). What are the demyelinating disorders of CNS? 2 B). Etiopathogenesis, clinical features, investigations and management of ADEM (Acute demyelinating encephalomyelitis) (15/1) (2+2+2+2) 8.Utility of newer Neuro-imaging modalities in pediatric age group and their cost-effectiveness. 5+5(15/2) 9. a) Modified Glasgow Coma Scale for children and infants 5 b) Its advantages and disadvantages 2 c) What is AVPU pediatric response Scale 3(Apr 16)

CONGENITAL ANOMALIES OF CNS

1. Hydrocephalus in infancy (96/2)14 2. Prevention of Neural Tube Defects (97/2)15 3. Role of Folic Acid in prevention of Neural Tube Defects (98/2)10 4. Normal CSF circulation in Newborns and the changes that take place in Aqueductal Stenosis (98/2)10 5. Etiology and pathophysiology of hydrocephalus (99/2)15 6. Dandy Walker Malformation (03/1)15 7. List the causes of Hydrocephalus in children. What is the pathogenesis and discuss the management (05)10 8. Discuss briefly the possible predisposing factors, types of open Neural Tube Defects in children and its prevention (07/1)10 9. Describe the normal cerebrospinal fluid pathway with the help of a diagram. Define and classify hydrocephalus and enlist its causes. (09/1)4+6 10. List the neurocutaneous syndromes. Describe the genetics, cellular defect, clinical manifestation and diagnosis of tuberous sclerosis. (09/2) 3+1+1+3+2 11. What are the causes of congenital hydrocephalus? Describe clinical features and management of an infant with Arnold Chiari malformation. (09/2)4+6 12. Describe growth velocity of head size from birth till 5 years of age. Define microcephaly. Enumerate its etiology and approach to diagnosis in a child with microcephaly. (10/1)3+2+2+3 13. Enumerate various types of neural tube defects and discuss their embryogenesis. Outline in brief management of meningomyelocele. (11/1) 3+3+4 14. Describe briefly cerebrospinal fluid formation, circulation, absorption and enumerate causes of hydrocephalus. (11/2)3+2+2+3 15. Define microcephaly. Enumerate causes of primary and secondary microcephaly. Outline the diagnostic approach of a 2 years old child brought to the hospital with small sized head. (12/1)1+4+5 16. Define craniosynostosis and its types. Name specific syndromes associated with craniosynostosis. Describe the clinical characteristics of common types of craniosynostosis. (13/2)3+3+4 17. Enumerate common types of neural tube defects .Discuss prevention and management of neural tube defects. (14/2)4+(2+4) 18. Enumerate 4 common neuronal migration disorders and their clinical features in brief. 6(Apr 16)

CNS INFECTIONS

1. Discuss diagnosis and management of Viral Encephalitis (97/1)15 2. Chronic Meningitis – clinical approach and management (02/1)15 3. Pathophysiology of Acute Encephalitis (03/1)15 4. Pathogenesis, management and prognosis of H.Influenzae Meningitis in children (06)10 5. Discuss briefly epidemiology, investigations and management of Viral Meningoencephalitis (07/1)10 6. Enumerate risk factors for brain abscess. Outline a scheme for investigating and treatment a 10 year old child with brain abscess. (08/1)10 7. Discuss the etiology, clinical presentation, diagnosis and treatment of Acute Disseminated Encephalomyelitis (ADEM) (09/1)4+6 8. Enumerate risk factors for brain abscess. Outline investigations and treatment of brain abscess in children. (09/2)4+2+4 9. Acute demyelinating encephalomyelitis (13/1)5

SEIZURES IN CHILDHOOD & CONDITIONS MIMICKING SEIZURES

1. Benign Rolandic Epilepsy of Childhood (93/1)15 2. Definition, prognosis and management of Febrile Convulsion (93/1)15 3. Management of children with partial epilepsy (95/1)15 4. Management of Children with Partial Seizures (95/1)15 5. Treatment of Status Epilepticus in a 5 year old Child (95/2)10 6. Classification of Epilepsy and treatment of Simple Partial Seizures (96/2)12 7. Treatment of Breath Holding spells (97/1)10 8. What are the causes of convulsions in infancy and childhood How will you investigate such a case (97/2)15 9. Breath Holding spells (98/1)15 10. Etiology and management of Febrile Seizures (98/1)15 11. Pseudoseizures (98/2)10 12. Management of a case of Complex Partial Seizure (98/2)10 13. Infantile spasms (99/2)10 14. Conditions mimicking seizures (99/2)15 15. Partial Seizures 15 16. Approach to an infant with myoclonic seizures (00/1)15 17. Enumerate newer drugs for treatment of Epilepsy with their uses (02/1)15 18. What are the causes of Convulsions in children? Discuss the management of Status Epilepticus (05)5+5 19. Define Febrile Convulsions. Discuss the management of a 2 year old child who presents to the emergency room with first episode of Febrile Seizure. Add a note on anticonvulsant Prophylaxis in febrile seizure. (06)10 20. Diagnosis and management of a child with Partial Focal Seizure (06/2)10 21. Indications for the therapeutic use of newer anticonvulsants in childhood seizure states and their potential adverse effects (07/1)10 22. Discuss conditions that mimic seizures in children (07/2)10 23. An 8 year old apparently well boy presents with generalized seizures for the last one hour. How will you approach (including history and examination) this child? Discuss the management of this patient. (08/2)10 24. Write the characteristic features of febrile seizures in children. Enumerate the differentiating points for atypical febrile seizure. Outline the indications and regime for continuous prophylaxis in febrile seizures. (10/2)2+2+3+3 25. Define myoclonic epilepsy. Discuss in brief the characteristic features of different types of myoclonic epilepsies, with onset in infancy. (10/2)2+8 26. Enumerate the etiology of first episode of complex partial seizures in a 7 year old boy. Provide an approach to management of this child.(11/1)4+6 27. Describe the etiology, types and EEG changes of infantile spasms. Outline the treatment protocol. (12/1)2+3+1+4

ACUTE STROKE SYNDROMES

1. Stroke in childhood (00/1)15 2. Discuss the etiopathogenesis of acute onset hemiplegia in a 3 year old child. How will you manage this child. (04/2)4+6 3. Discuss the etiopathogenesis, clinical symptomatology and differential diagnosis of childhood stroke (06/2)10 4. Briefly discuss the arterial supply of Brain. Outline the causes of acute hemiplegia in a 2 year old child (07/2)10 5. Describe the causes of arterial thromboembolism in children. Outline the management of a child with acute hemiplegia. (08/1)10 6. What are the causes of hypercoagulable state in children? How will you manage a case of acute hemiplegia? (09/2)4+6 7. Enumerate the causes of stroke in children. Discuss the diagnostic approach for managing a child with stroke. (11/2)3+7 8. Causes and investigations in a child with stroke (1/16)5

HEADACHE

1. Define Migraine in children. Discuss the classification of Migraine and write its management (07/2)10 2. Classification and management of Migraine (07/1)10 3. List causes of headache in children. Outline an approach for a 10 year old child with headache. (11/1)4+6

MISCELLANEOUS

1. Discuss the diagnosis and investigation plan for a 2 year old child with regression of milestones and generalized seizures (93/1)25 2. Signs and symptoms of a tumor at CP angle, in relation to the anatomy of different structures at this point (93/2)15 3. Differential diagnosis of Floppy Infant (96/1)12 4. Pseudotumor Cerebri (99/2)10 5. Toxic Neuropathy 15 6. Discuss the pathophysiology and management of Raised Intracranial Tension 25 7. Pathophysiology of Cerebral Edema (00/1)15 8. Pseudoparalysis (06)5 9. Enlist the possible conditions which could result in a 24 month old child with history of regression of milestones for past 8 month. The child also has a liver enlargement. Detail the clinical manifestation of Tay Sach Disease? (08/1)10 10. Outline the steps in managing intracranial hypertension and provide rationale for each of these steps. (09/1)10 11. Describe evaluation of a child with cerebral palsy. (09/2)10 12. Define raised intracranial pressure. Describe its clinical features and management. (10/1)2+3+5 13. Enumerate the causes for ataxia in children. Discuss the investigations and treatment for a 7 year old boy presenting with acute onset ataxia. (14/1)4+3+3 14. Discuss pathophysiology and types of cerebral edema. Write the medical management of raised ICT (14/2) 4+6 15. Management of infantile tremor syndrome (1/16)4 16. Familial dysautonomia (1/16)5 17. Autonomic neuropathies (1/16)5

24. NEUROMUSCULAR DISORDERS

1. Family Genetic Counseling to parents with 2 boys having calf hypertrophy and progressive proximal leg muscle weakness (07/1)10 2. Describe the different types of hereditary neuropathies. Outline the diagnostic approach and management of type 1 hereditary motor and sensory neuropathy. (10/1)4+6 3. Clinical features, diagnostic evaluation and treatment of myasthenia gravis. (10/1)3+3+4 4. Discuss about the clinical features, types, diagnosis and management of Myasthenia Gravis. (11/2)3+2+2+3 5. Discuss differential diagnosis of a floppy infant. Write a short note on clinical and laboratory characteristics of Werdnig- Hoffman disease. (13/1) 4+3+3 6. Types ,clinical presentation and management of spinal muscular atrophies (14/2) 2+4+4 7. A)Classification of spinal muscular atrophies (SMA) 5 b)Major distinguishing features amongst various forms of SMA (15/2)5

25. EYE

1. Proptosis (94)15 2. Evaluation and management of an infant with squint (95/2)15 3. What are the common causes of Blindness in children? Discuss steps to prevent Blindness in this group (05)3+7 4. Describe the characteristic changes observed in fundus examination of a child with (10/2)4+3+3 i ) Chronic Hypertension ii ) Acute Lymphoblastic leukemia iii ) Long standing diabetes mellitus 5. Describe the various age appropriate tests for checking visual acuity in children and their limitations. (13/2) 10 6. A) Enlist the acquired eye diseases in children 2 B) Common causes,clinical features and management of acquired eye diseases in children 2+3+3(15/1) 7. Congenital cataract 4 (Apr16) 26. EAR 1. Recurrent Acute Otitis Media in children (07/1)10 2. Outline development of normal hearing in children. List causes of Hearing impairment in a I year old child and its diagnostic approach (07/2)10 3. Describe the types of hearing loss in children. Enumerate the causes of hearing loss in children. (10/2)4+6 4. Outline the etiopathogenesis of acute suppurative otitis media. Discuss in brief the treatment and complications of acute suppurative otitis media (ASOM) in children. (11/1)3+4+3 5. Describe the etiopathogenesis and clinical features in a 3 year old child with hearing impairment. What are the laboratory tests for assessment of such a child? (12/1)3+3+4 6. Enumerate the causes of congenital deafness. Discuss Universal Neonatal Hearing Screening. (14/1)3+7 7. Management of acute otitis media (14/2)5

27. SKIN

1. New developments in management of Vascular Nevi and scabies in children (93/1) 2. Clinical conditions associated with Maculopapular rashes in children and their differential diagnosis (95/1)10 3. Diagnosis and management of a 2 year old child with Petechial skin rash (98/1)15 4. Erythema Nodosum (99/2)10 5. Review the etiology and management of adolescent acne. What are the psychological complications in children (06)10 6. Seborrheic Dematitis in children (07/1)10 7. Enumerate the causes of persistent fever which are not due to infection. Describe the clinical presentation of ectodermal dysplasias. (08/1)10 8. Outline the characteristic clinical features of ‘erythema multiforme’ and ‘Steven – Johnson syndrome’. Enumerate the principles of management of Steven – Johnson syndrome. (10/2)4+3+3 9. Discuss in brief etiopathogenesis, clinical features and treatment of seborrheic dermatitis in a neonate. (13/1)3+4+3 10. Discuss briefly etiology, clinical features and management of Steven Johnson syndrome. (13/2) 3+3+4 11. A six month old baby presents with rash over face and extensor aspect of extremities. Discuss the diagnosis and treatment of this baby. (14/1)5+5 12. Discuss the treatment of the following: Scabies (14/1) 4 13. Etiology ,clinical features and management of Steven Johnson Syndrome. (14/2) 3+2+5 14. Maculopapular rash (15/1)5 15. A) pathogenesis of toxic shock syndrome (TSS) 3 B) diagnostic criteria for TSS 2 C) differential diagnosis and management of TSS 2+3(15/1)

28. BONE AND JOINT DISORDERS

1. Congenital Dislocation of Hip (07/1)5 2. Achondroplasia (07/1)5 3. Classification and management of Osteogenesis Imperfecta (07/1)10 4. Describe developmental dysplasia of the hip (DDH). Enumerate risk factors for the same. Enlist its clinical features. How do you confirm its diagnosis? Outline the management. (08/1)10 5. Define skeletal dysplasia. Describe the clinical features and radiological changes of achondroplasia. (10/1)3+3+4 6. Discuss the clinical features, diagnosis and management of Developmental Dysplasia of Hip (DDH) (10/2)3+4+3 7. What is developmental dysplasia of hip and its classification? Describe the various age appropriate clinica tests for this condition. Outline the treatment modalities for this condition at different ages. (13/2) 2+4+4

29. ENVIRONMENTAL HEALTH HAZARDS

1. Adverse effects of Environmental pollution in children (96/1)15 2. Occupational and environment risks to the fetus (06/1)5 3. Enumerate various air pollutants and discuss their effects on health of children (09/1)3+7 4. Why children are vulnerable to chemical pollutants? what are the chemical pollutants in environment and their effects? what are the hazards of environmental tobacco smoke in children? (14/2)3+4+3

LEAD

1. Lead Toxicity in children (95/1)10 2. Management of Lead Poisoning and organophosphorous poisoning (07/2)10 3. Enumerate sources of lead poisoning. Outline the mechanism of toxicity and clinical features of lead poisoning. (10/2)3+3+4 4. Write the sources, clinical features, prevention and treatment of Lead poisoning (13/2)5 5. Diagnosis and management of lead poisoning (15/1)4 6. Lead poisoning (16/1)5

IRON

1. Steps and management of severe iron poisoning in children (06)10 2. Enumerate clinical features of iron poisoning and describe its management (09/2) 3+7

MERCURY

1. Write the sources, clinical features, prevention and treatment of Mercury poisoning 5(13/2) ORGANOPHOSPHOROUS AND PESTICIDES 1. Organophosphorous insecticide poisoning (95/1)15 2. Enumerate the major routes of pesticide exposure in children. Outline the manifestations of their toxicity. Discuss steps for minimization/ prevention of exposure to pesticides in children. (08/1)10 3. A 3 year old boy has swallowed an unknown amount of toilet cleaner and is brought to you in distress. Discuss the possible injuries, initial and late management of this patient. (08/2)10 4. Outline and discuss the diagnosis and management of organophosphorous poisoning. (13/1)4+6 5. Pathophysiology and management of Organophosphorous poisoning 5(Apr16)

CARBON MONOXIDE

1. Pathophysiology ,clinical presentations and management of carbon monoxide poisoning (14/2) Rpt (15/2) 3+3+4

SALICYLATE POISONING

1. Pathophysiology ,clinical features and mangament of Salicylate poisoning. 3+3+4 (15/2)

KEROSENE OIL

1. Management of Kerosene Oil poisoning (93/1)10 2. Kerosene oil poisoning (06)5 Rpt 5 marks (1/16)

30. SNAKE AND OTHER ANIMAL BITES

1. How will you manage acute anaphylaxis following a bee sting in a ten year old boy (06)10 2. An 8 year old child is bitten by a snake while playing in the field. Discuss the different types of pathological changes the patient can go through. How do you grade the severity of envenomation and discuss the management. (08/2)10 3. Outline the pre-hospital and hospital management of a 10 year old boy bitten by a poisonous snake. (09/1)10 4. Outline the management of dog bite in a four year old child. (10/2)10 5. Describe the pathogenesis, clinical features and management of scorpion sting. (13/1)3+3+4 6. How do you classify dog bites? Discuss its management. (13/2)4+6 7. A 4 year old child has been bitten on his foot by a snake. How is a poisonous snake identified? Discuss the management of this child. (14/1)3+7 8. Pathophysiology and management of Scorpion Bite 5 (Apr16)

31. SOCIAL PEDIATRICS

HEALTH SCENARIO

1. Discuss briefly the major goals for child survival and development by 2000AD (97/1) 25 2. What measures can reduce Birth Rate in next 5 years (98/2) 10 3. What is the Birth Weight specific mortality? Discuss the measures to reduce this mortality (05)10 4. Enumerate chief causes of neonatal mortality in India. Describe the current status in India and its status. Prepare a 5 year plan for reduction of neonatal mortality rate in your district. (08/1)10 5. List and define the important public health indicators of mortality in children. Also discuss their current status in India. (09/1)7+3 6. What are the major contributors to the high infant mortality in our country? What Specific areas of infant or/and newborn care can be strengthened to decrease infant mortality in India. Describe the salient features of the integrated management of neonatal and childhood illness strategy. (09/2) 2+3+5 7. Enumerate the Millennium Development Goals. Describe briefly the National Health Programs to achieve Millenium Development Goals (MDG) in India. Write the status of India in relation to health indicators in NHFS – 3. (10/1)2+4+4 8. Define under – 5 mortality rate. Comment on its current status and etiology in India. Outline important strategies/ programs undertaken by Govt. of India to improve Under 5 child survival. (10/2) 2+2+2+4 9. Define various indicators of child health which are important in context of monitoring child health in a developing country. Outline the interventions to reduce them. (12/1)5+5 10. Write short notes on: (13/2) 5+5 a) ASHA b) MDG (millennium Development Goal) focused on children. 11. A)Millenium development goals 4 Rpt 4 (Apr16) B)Swachh Bharat Abhiyan 3 C)Mission Indradhanush 3(15/1) 12.Iron plus initiative 3(15/1)

RCH

1. Use of Road To Health Charts in MCH clinics (95/2)10 2. RCH programme (98/2)15 3. National targets for MCH services 15 4. Pediatric components of RCH programme (99/2)15 5. RCH Programme-aims and strategies (02/1)15 6. Community management of Diarrhea and LRTI with indications for referral (02/1)15 7. RCH Programme in India (06)10

ICDS

1. ICDS scheme (97/2)15 2. Outline the components of ICDS programme. Briefly discuss its impact o child health in India and also causes for its failure. (04/2)3+4+4

CSSM

1. Objectives and strategies of ‘Maternal Child Survival And Safe Motherhood Programme’ (94/2)15 2. Child health care services provided through CSSM programme in India (95/1)15 3. CSSM Programme (96/2)15

IMNCI

1. IMNCI (03/2)15 2. IMNCI- what is the strategy. Discuss the factors in successful implementation of this strategy (05)5+5 3. What is IMCI? What are the various criteria and limitations of this Programme? Elaborate signs, symptoms and diseases covered under this programme (06)10 4. How do you classify the severity of acute respiratory infections using the IMNCI protocol? (06)10 5. Describe briefly the principles of integrated management of neonatal and childhood illness (IMNCI). Outline the broad steps of case management process. (08/1)10 6. Outline the essential components and principles of IMNCI strategy. Highlight the cardinal features of case management process of young infants (<2 months) (09/1)4+6 7. Discuss the justification for the addition of neonatal component to WHO generic IMCI programme for making IMNCI strategy. What are the key features of this strategy? (11/2)5+5 8. Enumerate the five high impact activities under RMNCH+ A programme 2x5 (Apr 16)

POLIO ERADICATION

1. Pulse Polio Immunization (96/1)15 2. a).Define polio eradication b).Polio eradication in india. c).Immunisation issues following polio eradication. (15/1) 1+2+3

RNTCP

1. Failure in control of Tuberculosis (93/1)15 2. DOTS chemotherapeutic management of Tuberculosis in National TB Control Programme (00/1)15 3. DOTS regimen and the problems involved in the implementation in childhood TB (06)10 4. What were the problems encountered in NTCP. Write the goals, strategies and essential components of RNTPC. Also discuss in brief categorization of patients and treatment protocols under RNTCP (06)10 5. a) Describe the category based treatment in childhood TB (09/2)3 b) Describe the pros and cons of intermittent therapy for tuberculosis (09/2)3+3 c) What are the components of DOTS strategy as defined by WHO? (09/2)4 6. Describe the flow chart for diagnosis of childhood tuberculosis under RNTCP. Write briefly on DOT PLUS program. (12/1) 6+4 7. A).Define DOTS, DOTS agents and DOTS plus. b).List at least 4 important components Of DOTS C)Give the categorization of treatment strategy in DOTS.(15/1)3+2+5

NRHM

1. Write a short note on National Rural Health Mission (07/1)(09/2)10 2. Expand the acronym ‘ASHA’. Outline the functions and remuneration of ASHA. Discuss the potential impact of ASHA in improving the health status and well being of a community. (11/1)1+4+5 3. Write short notes on: (13/2)5+5 a) Mid Day Meal programme b) Revised National Cancer Control programme. 4. ASHA 4(1/16)

AIDS AND OTHER CONTROL PROGRAMME

1. National AIDS control Programme in preventing Childhood AIDS (06/1)10 2. National Leprosy Eradication Programme 15 3. National Iodine Deficiency Disorder Control Programme (07/2) 10

BFHI

1. Baby Friendly Hospital Initiative (95/2)15 2. Briefly describe “baby friendly hospital initiative” and list ten steps to successful breast feeding. (08/1)10 3. What is BFHI (Baby Friendly Hospital Initiative)? Mention its aims and objectives, steps, benefits and assessments of baby friendly hospitals. (11/2)2+2+2+2+2 4. Outline the goals of baby Friendly Hospital Initiative (BFHI). Enumerate ten steps to successful breast feeding. Mention contraindications to breast feeding. (13/1)2+5+3 5. Describe the advantages and methods of giving Kangaroo Mother Care (KMC). Enlist metabolic consequences of hypothermia . (13/1)(4+4)+2

32. VACCINES

VACCINOLOGY

1. Enumerate all the diseases against which vaccines are currently available (93/2)15 2. Immunization schedule basis in child suffering from AIDS (94)15 3. Live vaccines used in pediatric age group (95/1)10 4. Adverse reactions that may occur following use of vaccines included in the National Immunization Schedule in India (95/2)10 5. Describe briefly various adverse reactions following vaccinations and discuss their management (97/2)25 6. Combination vaccine (99/2)(03/1)15 7. Vaccine Vial Monitor 15 8. Tabulate the various newer vaccines available to prevent respiratory disease in children, with their types, dosage schedule, route, important side effects and efficacy. (11/2)10 9. Salient differences between the National and IAP immunization schedule. (13/1)(5) 10. Describe the criteria or conditions to be considered for approving a ‘newer’ vaccine in an immunization program of a developing country. (08/1) (13/2) 10 11. Define the following: (13/1)2X5 a) Herd immunity b) Herd effect c) Vaccine immunogenicity d) Vaccine efficacy; and e) Vaccine effectiveness 12. Cold Chain (00/1)15 Rpt(14/2)5 13. Conjugate vaccines (15/1) 3

RABIES VACCINE

1. Write briefly about different types of vaccine against rabies. Discuss various schedules of pre and post-exposure prophylaxis for rabies.(12/1) 5+5 VARICELLA VACCINE 1. Varicella vaccine (00/1)15 MEASLES VACCINE 1. Complications of measles vaccination and management (94/2)15

HiB VACCINE 1. H Influenzae B vaccine (98/2)15 2. Tabulate the following details with regards to Rotavirus vaccine, HIB vaccine and pneumococcal vaccine: (09/2)10 a) Type of vaccine b) Dose c) Route d) Appropriate age of vaccination e) Justification of its usage f) Side effect and g) Drawback

TYPHOID VACCINE

1. Typhoid Vaccines (97/1)15

HEPATITIS B VACCINE

1. Hepatitis B immunization (93/2)10 2. Hepatitis B vaccine (96/1)Rpt(97/1)10

PNEUMOCOCCAL VACCINE

1. Pneumococcal vaccine (96/2)15

INFLUENZA

1. Influenza Type B vaccine (98/1)15

DPT

1) Current status of post-DPT vaccine encephalopathy (93/1) 15

PERTUSIS 1) Discuss the aetiology, pathogenesis and prevention of pertussis in children.Write the differences in efficacy, duration of protection and adverse effects between whole cell and acellular pertusis vaccine. (14/1)6+4 2) Complications of Pertussis 3(15/2) 3) Diagnosis and management of pertussis 5 (Apr16)

POLIO 1. Status of Polio vaccines (93/1)15 2. Discuss the current role, advantages and disadvantages of OPV and IPV in control and eradication of poliomyelitis in India. (11/1)4+6 3. What is inactivated polio vaccine (IPV). What are the advantages and disadvantages of IPV over OPV? What is the schedule of IPV as recommended by IAP. (14/2) 3+5+2 4. VAPP (Vaccine Associated Paralytic Poliomyelitis) 5 (Apr16)

HPV

1. Utility and controversy of HPV Vaccine. (10/1)5+5 2. HPV vaccine (15/1)4

ROTA VIRUS 1. Rota virus vaccine (15/1) 3

33. MISCELLANEOUS

STATISTICS 1. Define and describe the following concepts used for measuring growth: a) Percentile b) Percent of median c) Z scores. Discuss their relation to each other. (12/1) 2+2+3+3 2. Discuss the following: (14/1)3+3+4 a) Student’s ‘t’ test b) Sample size c) Ethics in research d) Types of error in research study (14/2)4 3. Define and explain sensitivity, specificity, positive predictive value and negative predictive value of a diagnostic test. (10/2)2.5 X 4(14/2) 2+2+2 4. a)Component of ethics in biomedical research 4 b) “p value” and its level of significance 3 c)Association concealment 3(15/1) 5. a)What is bias in medical research 2 b)Common types of bias and the methods to minimize bias in analytic studies 4+4(15/2) 6. a)What is relative risk (RR) and discuss its implications.? 1+3 b)What is usefulness of confidence interval? 3 c)Implications of sensitivity and specificity. 3(15/2)

EVIDENCE BASED MEDICINE 1. Define evidence based medicine, as applicable to pediatric practice. Enlist basic steps in the practice of evidence based medicine. Name few databases of systematic reviews. (08/1)10 2. Clarify the concept of evidence based medicine. Define ‘strength of evidence’and ‘quality of evidence’. Provide suitable examples to justify your definitions. (11/1)3+3+4 3. What is Evidence Based Medicine? How are the guidelines based on Evidence Based Medicine developed? How are the recommendation graded for the level of evidence? (11/2)2+4+4 4. a)Evidence based medicine 6 b)Forest plot in meta analysis 4(Apr16) 5 a)Clinical trials phase 1,phase 2, phase 3 and phase 4. 5 b)Ethics in biomedical research 5(Apr 16) 6. Forest plot graph 3 (01/16) 7. Meta-analysis 3 (01/16)

OTHER

1. PCR (92)15 2. Discuss diagnosis and management of an unconscious child (92/2) 25 3. Epidemiology and prevention of accidents in children (92/2)15 4. Value of USG in pediatrics (93/1)10 5. Role of Upper GI Endoscopy (93/1)15 6. Recent understanding of SIDS (94/1)15 7. Dimorphic child (94/2)15 8. Pathogenesis of oedema (95/1)15 9. Food Fussiness in children (95/1)10 10. Effect of Television watching in children (95/1)15 11. Tetany in children (96/1)12 12. Role of oxygen free radicals in the causation of childhood diseases (97/1)15 13. Discuss the measures to prevent accidents in children (98/1)25 14. Prevention of Vertically transmitted diseases (99/1)15 15. PCR and its significance in clinical practice (00/1)15 16. Outline the common ethical issues in pediatric practice. Briefly discuss the process of decision making in pediatric life sustaining interventions. (04) 4+6 17. Discuss management of child with injuries (05)5 18. CPAP (06)10 19. Hospital Waste Management (06)10 20. Role of Pediatrician in Disaster management (06/1)10 21. Discuss safe injection practices at a level three health care facility. Outline the management of a needle stick injury to a health care provider 10 minutes back. (08/2)10 22. Tips on parental guidance for computer and internet usage by children (13/1)(5) 23. Free radicals 5(15/2) 24. Safe injection practices at level III care with respect to burden / deficiencies, risks, technique, handling and disposal 2+2+2+2+2 (15/2) 25. Bioterrorism 3(Apr 16) 26. Radiation sickness 3(Apr 16) 27. Oxygenation index 3(1/16)

31. PHARMACOLOGY

IMMUNOGLOBULIN

1. Indications for using IV immunoglobulin in children (97/1)10 2. Role of IVIg in pediatric practice (00/1)15 3. Indications for use of I V Immunoglobulin in Pediatric Practice (06)10 4. Briefly outline the uses for I v immunoglobulin (IVIG) in children. (07/2)10 5. Enlist the common indications for the use of I.V.I.G.. Describe the mechanism of action, doses and its side effects. (10/1)3+3+2+2 6. Describe in brief the diseases in which IVIG is used for treatment. Write the dosage, administration and side effects of IVIG. (10/2) 5+2+1+2 7. Discuss indications and plausible mechanisms of action of intravenous immunoglobulin therapy in various pediatric disorders. (13/2)10

INTERFERON

1. Clinical importance of Interferon (98/2)10 NO 1. Physiological basis and therapeutic basis of NO (98/2)10 2. Clinical use of NO (03/2)15 ANTI TUBERCULAR DRUGS 1. Rifampicin Therapy in children (95/1)10 2. Preventive chemotherapy in childhood TB (96/1)15 3. Discuss the mechanism of Antibiotic resistance with special focus on ATD (97/2)25 CHELATING AGENTS 1. Oral chelating agents (94/2)15 2. Iron chelation therapy (06) (00/1)5

ANTIBIOTICS

1. Describe various mechanisms for development of Drug Resistance by bacterial pathogens against antibiotics. What factors are known to enhance drug resistance? Enumerate Anti Staphylococcal agents (92)25 2. Cephalosporins (94)15 3. Enumerate pediatric conditions in which Erythromycin is the drug of choice (97/1)10 4. Early detection of Chloramphenicol toxicity (03/1)15 5. Third generation cephalosporins (03/1)15 6. Aztreonam (03/2)15 7. Discuss the basis for development of antibiotic resistance. Outline the steps for prevention of antibiotic resistance. (04/2)5+5 8. Management of infections by organisms producing extended spectrum beta lactamase (06/1)10

ANTIFUNGALS

1. Describe the antifungals available for systemic use in India with their dosage, route and duration of therapy for treatment of a)systemic candidiasis; and b) Invasive aspergillosis (09/2)5+5 ANTIVIRAL DRUGS 1. Antiviral drugs (99/1)15

BRONCHODILATORS

1. Bronchodilators (94/2)15 ERYTHROPOIETIN 1. Recombinant Human Erythropoietin (94/2)15 LOW MOLECULAR WEIGHT HEPARINS 1. Mechanism of action, therapeautic dose, and adverse effects in children of low molecular weight heparins. 5 (1/16)

MAGNESIUM SULPHATE

1. Mechanism of action, therapeautic dose, and adverse effects in children of magnesium sulphate. 5(1/16)

MISCELLANEOUS

1. Mechanism of Drug resistance (97/1) 15

BIOMEDICAL WASTE MANAGEMENT

1. Define ‘biomedical waste’. Briefly categorize them. Enumerate their health hazards. List 4 important methods for disposal of biomedical wastes. (08/1)10 2. Define biomedical waste. Describe its hazards. Outline modes of disposal of biomedical waste generated in a hospital setting. (12/1)2+3+5

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