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Topic wise DNB Paediatrics Theory question bank

Updated: Apr 22, 2020

Online DNB Paediatrics course with notes for theory and practicals




Topic wise DNB Paediatrics Theory question bank

1. GROWTH AND DEVELOPMENT

DELAYED SPEECH

1. Approach to a child with Delayed Speech (02/1)15

DEVELOPMENTAL REGRESSION

1. Discuss the causes and approach to a Preschool child with Developmental Regression (02/1)25 2. A 2 yr old child presents with history of regression of milestones for past 6 months and hepatosplenomegaly.Discuss the differential diagnosis and diagnostic approach 7+3(1/16)

GROWTH CHARTING AND MONITORING

1. Define Growth, Development, and Velocity of growth mean, median, percentiles. Enumerate causes of retarded growth. Briefly outline a schedule for investigation of such a case (92/2) 25 2. Factors affecting Development of children (92) 15 3. Gessel Developmental schedule (93/1)15 4. Describe the events of sexual development in relation to physical growth. Name the most important regulatory factors (94) 25 5. Discuss the basis for use of Growth Standards. What should be taken as a reasonable approach for India (94/2) 25 6. Sexual Maturity Rating in female adolescents (95/2) 15 7. Velocity and cross-sectional standards as applied to Human Growth (95/2) 15 8. What are the developmental disorders in preschool years? Discuss the management (97/1) 15 9. Growth Monitoring (98/1) 15 10. Growth Factors (99/1) 15 11. Principles of Growth and Development (00/1) 15 12. Importance of Bone age assessment in children 15 13. SMR (03/2) 14. What is SMR? Discuss the secular trend in Children 5+5 (05/02) 15. How would you assess sexual maturity of a female adolescent (06) 10 16. Write the height velocity curves of girls and boys from birth to adolescence, describe the principles and factors governing the growth and development in children (06)10 17. Bone age assessment and its usefulness (07/2) 10 18. Growth and development in second year of life in children (07/1) 10 19. Describe: (09/2) 5+5 a) Factors affecting child development b) Developmental screening tests available and suitable for use in Indian children. 20. Developmental milestones in first two years of life. (10/1) 10 21. Outline the fine motor milestones along with their normal age of achievement in sequence attained between birth and 5 years of age. (10/2)10 22. Discuss the evolution and characteristics of WHO growth charts. Discuss their implications on the magnitude of malnutrition in Indian setting. (11/1) 3 +4+3 23. Enumerate the available methods and indications for determination of bone age in children and adolescents. Outline the differential diagnosis of a child with short stature on the basis of bone age. (11/1) 3+3+4 24. Describe Tanner’s Sexual Maturity Rating (pubertal staging) in boys based on a) Genitalia and b) Pubic hair development. (11/2) 5+5 25. Describe in detail the physical growth and development in all domains from birth till completion of first year. (11/2) 5+5 26. Define growth velocity. Draw a typical height velocity curve from birth to puberty for boys and girls. Discuss the utility of determining growth velocity. (12/1) 2+4+4 27. What is developmental screening? Enumerate common developmental screening test. What issues they identify in a child? (12/1) 2+4+4 SHORT STATURE

1. Define Short Stature. Discuss the approach to a child with short stature and the role of GH in Short Stature (05)2+5+3 2. Approach to a child with short stature (06/1) (07/2) 10 3. Short stature – definition, differential diagnosis and management approach. (10/1) 2+3+5 4. Define short stature. Outline the approach to clinical evaluation and management of a child with short stature. (13/1) 2+8 5. A)What is short stature b) What are the common causes of short stature? c) Algorithmic approach to manage a 5 yr old child with short stature. 1+3+6(1/15) 6. A 12year old female child presents with short stature and delayed puberty. a. Enumerate various possible causes b. Approach to diagnosis and their management. 2+8(1/16)

DEVLOPMENTAL DELAY

1. What is developmental delay? Describe different tools used for screening of developmental delay. (11/2)3+7 2. Define developmental delay and developmental dissociation.Outline the screening and definitive tests for diagnosis of developmental delay. (13/1)5+5 3. What is global developmental delay? What are the common causes of global developmental delay? Discuss the algorithmic approach to evaluate a child with global developmental delay. (13/2)2+3+5 4. What is developmental delay? Describe different tools used for screening and for diagnosis of developmental delay. (15/2)2+4+4

2. PSYCHOLOGIC DISORDERS

PSYCHOSOMATIC ILLNESS

1. Management of Conversion reactions (98/1)15 VEGETATIVE DISORDER 1. Encopresis (99/2)15 2. What is Vegetative Disorder (05) 5 3. What is vegetative disorder? Discuss management of a child with injuries (05) 5+5 4. Rumination (06/1) 5 5. Pica (07/1) 5

HABIT DISORDER

1. Habit Disorders in children (07/1)10 MOOD DISORDER 1. Childhood Depression (06)10 2. A) Aetiology of depression in adolescents 2 (15/1) b) comorbidities ,clinical features and treatment of depression in adolescents 3+3+2 (15/1) 3. Management of a. Post traumatic stress disorder 4(1/16) b. Tourette’s disorder 3 c. PANDAS 3 DISRUPTIVE BEHAVIORAL DISORDERS

1. Common Behavioral problems in children (97/2) 15 PERVASIVE DEVELOPMENTAL DISORDER AND CHILDHOOD PSYCHOSIS 1. Autism (03/2)15 2. Define autism. Outline its etiology. Outline the clinical markers of autism and its prognosis. (04/2) 2+3+3+2 3. Etiology, clinical manifestations and treatment of Autistic Disorder (06/1)10 4. Autistic Disorder (07/1) 10 5. Autistic spectrum disorder (07/2) 10 Rpt Apr16 3marks 6. Describe the etiology, clinical manifestations and management of autistic spectrum disorders in children. (09/2)2+3+5 7. Discuss briefly the diagnostic features and management of Pervasive Developmental Disorders/ autistic spectrum disorders. (11/2)4+6 8. Enumerate various pervasive developmental disorders and autism spectrum disorders. Outline one core feature of each of them. (12/1) 5+5 9. Define autistic spectrum disorders. Enumerate their clinical features and discuss their managements (13/2) 2+4+4 10. What are Autistic Spectrum Disorders? Discuss the differential diagnosis and management of a child with Autism. (14/1) 3+3+4 11. Discuss the management of a child with schizophrenia (04/2)5 12. Discuss the management of a child with Schizophrenia (05)5 NEURODEVELOPMENTAL DYSFUNCTION IN THE SCHOOL AGED CHILD 1. Attention Deficit Disorders (97/1)(95/2) (00/1)15 2. ADHD (03/1)15Rpt (15/2) 5marks 3. Describe clinical manifestations, diagnosis and management of ADHD (06)10 4. Define Dyslexia. Briefly discuss its management. (14/2) 5

SLEEP MEDICINE

1. Sleep Disorders in children (99/2)10 2. Pathophysiology of Sleep Apnea (03/1)15 3. Outline the basic principles of sleep hygiene for children and adolescents (09/1)10 (12/1) 5+5 4. Principles of sleep hygiene in children (13/1) 5 5. Evaluation of Obstructive sleep Apnea (14/2) 5 6. A)mention anatomical and functional factors responsible for obstructive sleep apnea in children 5 b) How do you diagnose and treat this condition 2+3(15/2) 7. Obstructive sleep apnea: diagnosis and management 5(1/16)

ENURESIS

1. Enuresis (96/2)15 2. Define Enuresis. Discuss its manifestations and management (06)5 3. Management of nocturnal Enuresis. (07/1)5 4. What is nocturnal enuresis? Outline the causes for the same. Describe the modalities for managing a 6 year old child with enuresis. (08/2)10 5. Discuss evaluation and management of an 8 year old male with primary nocturnal enuresis. (10/2)4+6

3. SOCIAL ISSUES, CHILDREN WITH SPECIAL HEALTH NEEDS

FAILURE TO THRIVE

1. Approach to a child with Failure To Thrive (96/1)14 2. Causes of Failure to Thrive in infancy (96/2)15 3. Define failure to thrive. Outline a diagnostic approach for a child with failure to thrive. (04/2)2+8 4. Non organic failure to thrive (07/1)10 5. Define failure to thrive. Give its etiology, classification, clinical features and management. (09/2) 1+2+2+2+3 6. Define failure to thrive and tabulate its causes. Outline the approach to manage a child with failure to thrive. (10/2) 2+3+5 7. Failure to thrive (15/1) 6

ADOPTION 1. Role of Pediatrician in Adoption of a child (95/1)10 2. Adoption (03/2) 3. Role of pediatrician in adoption of a child (13/1)5 4. Laws of adoption in India 4(Apr 16) CHILD ABUSE

1. Management of the sex abused child (95/2)15 2. Define child abuse. List the etiology of child abuse in India. Outline strategies for prevention. (04/2) 3. Discuss Child maltreatment. What are the factors related with child abuse (05)5+5 4. Define Child Abuse. Describe clinical manifestations of Child Abuse. Discuss some useful investigations in a suspected case of Child Abuse (06)10 5. Define child abuse. Describe in brief the factors responsible for child abuse. Outline management of a child who is suspected of being abused. (11/1)2+3+5 6. Define child abuse and neglect. Discuss various clinical manifestations, diagnostic work up and management of physical abuse. (11/2)2+3+2+3 7. Write short notes on : (09/2) 5+5 a. Female infanticide (14/2) 5 b.karyotyping (14/2)5 8. Write short notes on :child abuse (14/2) 5 9. a)Define child abuse and child neglect 2+2 b) Outline the steps involved in managment of suspected child of sexual abuse 6 (15/2) 10. Steps to curb female infanticide. 5 (Apr 16) 11. Munchausen syndrome by proxy 4 (01/16)

MENTAL RETARDATION 1. Various physical features that are likely to be associated with specific syndromes of mental retardation (95/2)10 2. Preventable and treatable causes of Mental retardation (96/2)10 3. Enumerate the causes of mental retardation in children. Give an outline of management of a child with mental retardation. (10/1)4+6 4. Enumerate the criteria for diagnosis of mental retardation (MR). Classify MR and describe its evaluation. (14/1)2+2+6

4. NUTRITION

PEM

1. Discuss the influences of malnutrition on mental functions in relation to its onset, severity and type of functional losses with supportive advances. (93/1)25 2. Prevention of hypocalcaemia in PEM (93/1)15 3. Biochemical changes in PEM (96/2)10 4. Immunological changes that take place in PEM (98/2)10 5. Age independent Anthropometric criteria for assessment of PEM (06)5 6. Management of a 4 year old child with grade 4 PEM (07/2)10 7. Outline the initial management (in first 48 hours) of a 2 year old severely malnourished child (weight 5.5kg) who is cold to touch and has edema and poor peripheral pulses. (08/1)10 8. Discuss biochemical and metabolic derangements in a child with severe malnutrition. Discuss factors associated with high mortality in severe PEM. (08/2)10 9. Outline the 10 steps of management of severe malnutrition, as per WHO guidelines, in appropriate sequence. (10/2)10 10. Define ‘Severe Acute Malnutrition (SAM)’. Outline the tools for its diagnosis in the community and discuss their merits/ demerits. (12/1)2+4+4 11. Enlist the clinical and anthropometric criteria for diagnosis of Severe Acute Malnutrition (SAM). Discuss the principles of management of Sam in an 18 months old baby who also has watery diarrhea. (13/1)3+7 12. What are the different growth charts? Discuss the WHO growth chart. What is Sam (Severe Acute Malnutrition)? How do you manage a child with SAM? (14/1) 2+2+2+4 13. A) Clinical signs and symptoms of refeeding syndrome. 7 b) how will you manage such a case ? 3 (15/2) 14.a)What is Severe acute malnutrition (SAM) 2 b) What are clinical signs of SAM? 2 c) Management of SAM in an 1 year old child weighing 5 kg. 6(Apr 16)

VIT A 1. Hazards and virtues of Vitamin A in pediatric practice (96/2)10 2. Vitamin A supplementation (07/1) 5 3. Enumerate functions of vitamin A in human body. Tabulate the WHO classification of vitamin A deficiency. Outline the treatment schedule for managing Xerophthalmia in children. (10/2)2+3+5 4. Describe WHO classification of eye manifestation of vitamin A deficiency. Discuss prevention & mgmt of Vit. A deficiency in children (14/2) 4+6 5. Hypervitaminosis A 4 (Apr16)Rpt 3marks (1/16)

VIT B 1. Discuss the etiopathogenesis, clinical features, diagnosis and management of cobalamine deficiency. (12/1) 2+3+1+4

VIT D 1. Clinical manifestations of Rickets (93/2)10 2. Vitamin D Resistant Rickets (96/2)12 3. Renal Rickets (97/2) 15 4. Functions of vitamin D (98/2) 10 5. Resistant Rickets 15 6. Outline the metabolism and function of Vitamin D in human body. Describe in detail the etiology and pathological changes in rickets (99/2)25 7. What are the causes of non nutritional rickets? How will you manage such a child? (04/2)3+7 8. Classify the various causes of rickets and outline how to differentiate them (05)5+5 9. Diagnostic approach to a child with resistant rickets (06)10 10. Resistant Rickets (06/1)10 11. Discuss calcium and vitamin D metabolism. Outline an approach to a case of Resistant Rickets (07/1)10 12. Discuss the pathophysiological basis of clinical and radiological manifestations of nutritional rickets. (09/1)10 13. Describe vitamin D metabolism. Describe diagnostic approach to a 3 year old child with rickets who has shown no response to treatment with 6 lac I.U. of vitamin D. (09/2) 4+6 14. Outline the clinical features, radiological changes, diagnosis and treatment of nutritional vitamin D deficiency rickets. (10/2) 2+2+2+4 15. Write in brief the role of vitamin D in health and disease in children. Outline the management of Vitamin D deficiency disorder. (12/1) 6+4 16. Hypervitaminosis D 4(Apr16)Rpt 3marks (1/16) 17. a. Outline the physiology of vitamin D 4 b. Diagnosis and treatment of vitamin D dependent Rickets.3+3 (1/16) VIT C 1. Scurvy- radiological changes. How are they produced? What is the role of Blood Level of Vit C in the diagnosis (05)10 VIT E 1. Enumerate the functions and therapeutic uses of Vit E (98/1)15 2. Vitamin E and its role in human nutrition (92/2)15

VITAMINS 1. Hypervitaminosis in Children (96/1) 12

COPPER 1. What are the dietary sources of copper? What are the diseases associated with abnormal copper metabolism? Describe investigat., clinical features and treatment of any one of them. (09/2)1+2+7 ZINC 1. Relevance of Zinc in human nutrition (92)15 2. Role of Zinc in health and diseases of children (97/1)10 3. Effects of Zinc supplementation in persistent diarrhea (98/2)10 4. Give dietary requirements of Zinc in children and discuss its role in childhood immunity and infections (07/1) 10 5. Write short notes on: Zinc supplementation – when and how? (11/2) 5

MAGNESIUM 1. Sources, deficiency state and uses of magnesium in children. (10/1)3+3+4 2. Magnesium in therapy 3(14/1) 3. Mechanism of action, therapeautic dose, and adverse effects in children of magnesium sulphate. 5(1/16)

MILK 1. Anti-infective properties of Human milk (95/2)10 2. Differences in the composition of Milk secreted by mothers delivering Term and Preterm babies (96/2)10 3. Bioactive factors in Human Milk (98/1)15 4. Discuss the physiology of Breast Milk secretion and advantages of breast feeding with special reference to metabolic aspects. What are the causes of lactation failure (99/1) 25 5. Enlist the problems of breastfeeding and outline the management of the same (05) 4+6 6. Explain the occurrence of low prevalence of Hypoglycemia and iron deficiency anemia in breast fed infants (05)10 7. How would you assess the adequacy of breast milk for a 2 months old baby. Enumerate 4 features of good attachment of a baby to the breast. What can be the problems with poor attachment (06)10 8. Compare the composition of human milk with cow’s milk. Outline the difference in the milk composition of a mother with a premature neonate from that of a term neonate. Describe the immunological factors present in human milk. (08/2) 10 IODINE 1. Prevention of Iodine deficiency (95/1)15

FLUORINE 1. Prevention of Fluoride toxicity (95/1)15 2. Fluoride and disease 2 (Apr16) OBESITY 1. Approach to a child with obesity (99/1)15 2. Define obesity in childhood. List the causes of obesity in children. Outline strategies for its prevention. (04/2)2+3+5 3. What is Obesity? Discuss the management in children (05)3+7 4. Approach to a child with Obesity (06/1)(07/2)10 5. Outline the diagnostic measures and clinical manifestations of obesity. Enlist the differential diagnosis of childhood obesity. (09/2) 2+3+5 6. Define syndrome X. Outline the diagnostic criteria and laboratory work up for obese children. (10/1)2+3+5 7. Define obesity. List causes of obesity. Discuss approach to a child with obesity. (11/1)2+3+5 8. A 2 year old toddler presents with a weight of 25 kg. Discuss the possible causes, evaluation and treatment for this child. (14/1)3+4+3 MISCELLANEOUS 1. Metabolism of fat absorption along with role of MCT in nutrition (03/1)15 2. What is Complimentary Feeding? Discuss the feeding problems in first year of life (05)5+5 3. How would you assess the nutritional status of a child whose age is not known (05)10 4. Describe the attributes of complimentary feeding. What is the safe age of introduction of complementary feeding in your opinion – Justify. Describe some foods appropriate for complimentary feeding. (08/2)10 5. Daily nutritional requirements as recommended Daily Allowance (RDA) in infants and children. (10/1)5+5 6. Define complimentary feeding. Outline the attributes of complimentary foods. Enumerate the recommendations on complimentary feeding, as per the National guidelines on Infant and Young Child Feeding (IYCF) (10/2) 2+2+6 7. Name the micronutrients required for various body functions. Discuss briefly their dietary sources and the effects of deficiency of mineral micronutrients (trace elements). (11/2)3+2+5 8. Outline the nutritional support of a critically ill child. List the complications during management of such a child. (12/1)7+3 9. Enteral feeding in the sick child 4(14/1) 10. Role of micronutrient in pediatric health and diseases. 5(Apr16)

5. PATHOPHYSIOLOGY OF BODY FLUIDS AND FLUID THERAPY ACUTELY ILL CHILD

SHOCK

1. Define Shock. Describe the pathophysiology and management of septic shock in children (94/2)25 Rpt(04/2)5+5 2. Management of Cardiogenic shock (96/1)12 3. Discuss the classification and causes of shock in children (97/1)15 4. Shock-pathogenesis of different types and pathological changes in different organs (03/1)25 5. Discuss the management of an infant with Shock (00/1)25 6. How do you classify Shock in children? Write its etiopathogenesis and management (06)10 7. Discuss the pathophysiology of cardiogenic shock. How are the various hemodynamic parameters affected in cardiogenic shock? Discuss steps in monitoring and treatment of cardiogenic shock. (08/2)10 8. Define fluid refractory shock. Describe the management strategy for a 2 year old child with fluid refractory shock. (10/1) 3+7 9. Define septic shock. Describe the etiopathogenesis and clinical features in a 15 month old child presenting with septic shock. (11/2)2+4+4 10. Discuss the pathophysiology of septic shock. Describe the international consensus definition for pediatric sepsis. (13/1)5+5 11. Define SIRS, sepsis, severe sepsis and septic shock. Discuss the management of septic shock. (13/2) 1+1+1+1+6 12. Etiology and management of cardiogenic shock. (14/2) 3+7 13. Pathophysiology and management of Refractory shock 5(15/2) 14. What is the defining criteria of systemic inflammatory response syndrome (SIRS).Name the mediators involved and their mode of action. 5+5(15/2) 15. Etiology , pathogenesis, clinical features and management of cardiogenic shock? 2+3+2+3 (15/2)

POTASSIUM 1. List the causes of Hypokalemia. Discuss the clinical features, laboratory diagnosis and management of Hypokalemia (06)10 2. Define hypokalemia. Enlist its causes and outline clinical features and its treatment (09/2) 1+3+2+4 3. Discuss the diagnostic algorithm for investigating persistent hypokalemia in a child. (13/2)10 4. Define hyperkalemia. Discuss management of hyperkalemia (14/2)2+8 5. Hyperkalemia 3 (Apr16)

SODIUM 1. List the causes of Hyponatremia. Discuss the clinical features, lab diagnosis and management of Hyponatremia . (05)3+4+3 2. Enumerate common causes of Hyponatremia (06)5 3. Define hypernatremia. Describe the pathophysiological changes and steps of management of hypernatremia. (10/1)2+4+4 4. Define hyponatremia. Enumerate the etiology of hyponatremia. Describe the management of hypovolemic hyponatremia. (10/2) 2+3+5 5. Define hypernatremia. Enumerate the etiology of hypernatremia. Describe the management of hypernatremic dehydration.(11/1) 3+4+3 6. Write short notes on: Causes and management of hypernatremia in children. (13/2)5 7. Hypernatremia 3 (Apr 16) 8. Hypernatremic dehydration 5(1/16) PHOSPHATE 1. Etiology, pathogenesis, clinical features and management of Hypophosphatemia 2+3+2+3(Apr 16)

ACID-BASE BALANCE 1. Define pH and base excess. Discuss briefly regulation of Acid-base homeostasis and management of Respiratory Acidosis (93/1)15 2. Physiological compensatory mechanisms during Metabolic Acidosis (97/1)15 3. Describe briefly how the acid-base balance of body is maintained in health (98/1) 25 4. Anion Gap (98/2) (00/1)10 5. Pathophysiology of Acid-base disorders (03/1)15 6. Anion Gap (03/2)15 7. 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 8. Outline the normal mechanism of acid-base regulation in children. What is anion-gap? Describe the causes and management of a child with metabolic acidosis (07/2)10 9. List the causes of metabolic alkalosis. Describe the pathophysiology, clinical features and treatment. (08/2)10 10. Classify metabolic acidosis based on anion gap. Mention the various causes of lactic acidosis. Describe the approach to diagnosis of inborn error of metabolism in an infant. (08/2)10 11. Classify and enlist the causes of metabolic alkalosis. Outline the treatment modalities. (10/1)3+3+4 12. Define anion gap. Enlist causes of increased anion gap acidosis and discuss its management in brief. (11/1)2+3+5 13. What is anion gap? Discuss the acid base distribution in metabolic acidosis. Enumerate the causes of increased anion gap and normal anion gap metabolic acidosis. 1+5+(2+2)(15/2)

DEHYDRATION

1. Why children are more vulnerable to develop dehydration (96/2)10 2. One year old infant with AGE develops Abdominal Distension. Discuss the differential diagnosis (97/1)10 3. Pathogenesis and Management of Hypernatremic Dehydration (97/2) 15 4. Management of Acute Diarrhea in children (98/1)15 5. Management of Hypernatremic Dehydration (02/1)15 6. Hypernatremic Dehydration (03/1)15 7. Hyponatremic Dehydration (03/2) 15 8. Steps in management of patient with Hypernatremic Dehydration (06)10 9. A one year old infant weighing 5.5kg presents with Acute Dysentery and severe dehydration. Discuss its complete management (06/1)10 10. A one year old baby weighing 5.5kg comes in severe dehydration. Discuss complete management (07/2)10 11. Discuss causes, predisposing factors and pathophysiology of Hypernatremic dehydration in young children (07/1)10 12. Describe the pathophysiology of hyponatremic dehydration. Briefly discuss the management of a child with serum sodium of 110meq/liter presenting with moderate dehydration and seizures (08/2) 10

MISCELLANEOUS 1. Pathophysiology of regulation of Plasma Osmolality (06)10 2. Discuss etiopathogenesis, clinical manifestations and management of Bartter Syndrome. (13/2) 2+4+4 3. Define osmolarity. Discuss the mechanism of regulation of plasma osmolarity in the human body. (14/2) 2+8 4. How is plasma osmolality calculated?Discuss its determinants.What are the diagnostic criteri of SIADH? 3+4+3 (Apr 16) 5. Pathophysiology and regulation of plasma osmolality 5(1/16)

6. ACUTELY ILL CHILD

DROWNING

1. Near drowning in children (06)10 Rpt (15/1) 4 marks

2. An 18 month old child was brought to you after he fell upside down in a tub filled with water. Briefly describe the possible injuries and preventive strategies to avoid similar situation in future. (08/1)10

3. Describe the pathogenetic mechanism of injury in near drowning. Discuss the steps of initial resuscitation and subsequent hospital management. (08/2)10

4. Discuss the pathophysiology of submersion injury. A 4 year old boy was rescued 10 min back from a pond and rushed to the hospital emergency. Mention the basic principles of management. (12/1) 5+5

5. A. Define near drowning 2

B.Pathophysiology and management of near drowning 4+4 (1/16)

PAIN

1. Pain management in infants and children (98/1)15

2. Pathogenesis and management of pain in children (06)10

3. Enumerate various sedatives and analgesics recommended for children undergoing painful procedures. Describe their main action, indication in pediatric practice and important side – effects in a tabular format. (08/1)10

4. Write short notes: (12/1) 5+5

a)Non-pharmacological methods in pain management.

(Rpt 4 marks)(Apr16)

b) Drug therapy in neonatal pain management.

BURN

1. How is the degree of Burns classified? Write the initial fluid therapy for a one year old child weighing 10 kg with 20% 2ND degree burns (06)10

2. Provide classification of burns injury. Describe the clinical manifestation of electrical burns. Outline emergency management of a child with 20% burns. (11/2)2+3+5

COLD INJURIES

1. Cold Injury (07/1) 10

BRAIN DEATH

1. Brain Death (98/1) (99/2) 15

2. Define Brain Death. Write age specific criteria for Brain Death in children. (11/2)2+8

P.A.L.S.

1. Draw an algorithm for managing pulseless ventricular tachycardia and ventricular fibrillation. (08/1) 10

2. How will you assess that a 10 year old child who has fallen unconscious in front of you required basic life support. What are the steps for basic life support to such a child (as per American Heart Association Guidelines for CPR) (09/1) 3+7

3. What is Rapid sequence intubation (RSI)? Outline the steps involved. Discuss the indications and advantages of RSI. (14/2) 2+5+3

MECHANICAL VENTILATION

1. Describe the various pressures which are used or varied during mechanical ventilation. What is ‘Cycling’ and ‘Control’ in mechanical ventilator? Describe the differences in pressure controlled and volume controlled ventilation. Illustrate with suitable indication use of these forms of ventilation. (08/2)10

2.Write short notes on: Central hypoventilation syndrome. (13/2) 5

3.A) High frequency oscillatory ventilation (HFOV) 5(15/1)

B) pulmonary graphics 5

MISCELLANEOUS

1. Discuss the management of a 3 year old unconscious child (99/1)25

7. GENETICS

1. Early stimulation in Down syndrome (92/2)15

2. Genetic counseling of a case of Down Syndrome (99/1)15

3. Prenatal diagnosis of Down syndrome and Duchenne Muscular Dystrophy 15

4. Briefly discuss the principles of genetic counseling. Outline the counseling of a family with a child with Down’s syndrome. (04/2)5+5

5. Gene Therapy in Children (06/1)10

6. Gene therapy (07/1)5

7. Enumerate and describe the structural abnormalities of autosomes. Illustrate with suitable examples. (08/1)10

8. What are trisomies? What are predisposing factors? Discuss clinical features of 3 common trisomies seen in clinical practice? (08/1)10

9. A couple has a child with Down Syndrome. Outline the principles of genetic counseling and antenatal management for the subsequent pregnancy. (09/1)10

10. Write a short note: Karyotyping (09/2)5 Rpt (14/2)

11. What are mutations? Describe their consequences. (10/1)5+5

12. Discuss the genotypic and phenotypic features of Turner’s syndrome (11/1) 4+6

13. What are mitochondrial genes? How are they transmitted? Briefly discuss diseases transmitted by them? (11/2)2+2+6

14. Enumerate classic and non-classic forms of genetic inheritance. Discuss in brief the characteristics of autosomal recessive inheritance. Illustrate with a pedigree chart. (13/1) 5+3+2 (13/2) 2+2+6

15. Describe the symbols used in pedigree chart. Draw pedigree charts over 4 generations depicting a) X – linked dominant disease b) X – linked recessive disease. 4+3+3 (Apr16)

16. Define transloction.Write the inheritance pattern for translocations. Describe clinical features of any one translocation disorder. 6(Apr16)

17. Primary and secondary prevention of genetic disorders 5+5 (1/16)

8. METABOLIC DISEASES

1. Homocysteinuria (94/2)15

2. Screening tests for Inborn Errors Of Metabolism (96/2)10

3. Metachromatic Leukodystrophy (96/1)12

4. Discuss the diet plan in various metabolic disorders (99/1)15

5. Write briefly about glucose metabolism in body. Describe briefly glycogen storage disorders. (04/2)4+6

6. Laboratory Screening tests for metabolic Disorders (06/1)10

7. Provide a diagrammatic representation of urea cycle. Indicate and name related disorders of urea cycle metabolism at each step. (08/1) (Rpt 15/2) 10

8. Discuss the enzymes replacement therapy and substrate reduction strategies in management of metabolic disease. (08/2)10

9. Enlist the inborn errors of metabolism (IEM) with their associated peculiar odor. Provide the investigative approach for an infant with suspected IEM. Describe the treatment of phenylketonuria. (09/2) 4+4+2

9. NEONATOLOGY

ANTENATAL DIAGNOSIS

1. Amniocentesis in prenatal diagnosis (92)15

2. Intrauterine Diagnosis (93/2)10

3. Discuss the methods of detection of congenital malformations in the fetus and their prevention (95/1)25

4. Antenatal Diagnosis (98/2)10

5. Methods to diagnose fetal disorder. Fetal medical therapy (05)5+5

6. List various methods for Fetal diagnosis and assessment along with indications (06)5

7. Prenatal Diagnosis and Fetal therapy (06/1)10

8. Treatment and prevention of fetal diseases (07/1)10

9. Medical management of Fetal Problems (07/2)10

10. What are the methods of diagnosis of fetal disorders? Describe the fetal medical and surgical therapeutic options for various fetal disorders. (09/2) 10

11. Antenatal screening for Down syndrome (13/1) 5

12. Outline the methods of assessing fetal well being with their clinical indications. (13/2 10

13. Fetal therapy 5(1/16)

FETUS

1. Describe in detail tests for antepartum and intrapartum monitoring of fetal distress (06)5

2. Fetal monitoring (06) 10

3. Discuss the complications in the fetus and newborn of a mother with diabetes during pregnancy. (08/1)10

RESPIRATORY DISTRESS

1. Pathophysiology of RDS of newborn (94)15

2. Tests for pulmonary maturity and surfactant therapy for RDS (94/2)15

3. Surfactant therapy (98/2)10

4. Surfactant therapy for HMD 15

5. Discuss RDS with special reference to surfactant therapy (98/2)15

6. Describe the surgical causes of Respiratory difficulty in newborn (02/1)25

7. HMD- pathophysiology and management (03/1)25

8. List the causes of respiratory distress in preterms. Outline the principles of surfactant therapy in preterms. Outline the manifestations of oxygen therapy in newborns. (04/2)2+4+4

9. Etiology, pathogenesis and management of a neonate with RDS (06/1) 10

10. CPAP (06/2)10

11. Briefly discuss normal fetal development of Surfactant. List the uses of Surfactant in newborn (07/2)10

12. Discuss the pathophysiology of hyaline membrane disease in premature newborns. (10/2)10

13. Describe the pathophysiology of hyaline membrane disease (HMD) in newborns. Outline important available strategies to prevent HMD.

(11/1) 5+5

14. A)CPAP for neonatal RDS 5

B) Surfactant replacement therapy 5 (15/1)

14. Silverman Anderson scoring system 5 (15/2)

MECONIUM ASPIRATION SYNDROME

1. Meconium Aspiration Syndrome (97/2)15

2. Discuss the pathogenesis and management of MAS (00/1)25

BPD

1. BPD (97/1)15

2. Outline and discuss the strategies to prevent lung injury and bronchpulmonary dysplasia in a preterm baby. (13/1) 10

PPHN

1. Describe in brief PPHN (or PFC) with regard to Pathology, pathophysiology, Diagnosis and management (94/2)25

2. What is the etiopathogenesis of PPHN of Newborn. Outline the

diagnosis and management (05)3+3+4

3. PPHN (06/1)10

4. Discuss the diagnosis and management of PPHN (07/2)

5. Enumerate causes of persistent pulmonary hypertension in neonates and discuss its pathophysiology. (08/1)10

6. Discuss the approach to diagnosis of Persistent Pulmonary Hypertension of Newborn (PPHN). Outline the available modalities of management, highlighting their key features in a tabular format.

(10/2)4+6

7. Etiology and management of persistent pulmonary hypertension. (14/2) 3+7

8. Pathophysiology of persistent fetal circulation. (15/1) 3

SURGICAL

1. Enumerate congenital anomalies presenting as severe respiratory distress in a newborn. Describe the pre-operative and post operative care of a neonate with trachea-esophageal fistula. (10/1)4+3+3

2. Enumerate causes of persistent vomiting in a 4 week old child.

Describe clinical features and management of hypertrophic pyloric stenosis. (12/1)3+3+4

3. Describe the development of the midgut. Enumerate the causes for bilious vomiting in a two week neonate and discuss its management. (14/1) 3+2+5

RESUCITATION

1. Steps in Neonatal Resuscitation 15

2. Fetal circulation and changes at birth (00/1)15

3. How do you assign APGAR score to a neonate. In which 5 conditions will you get a low score without associated hypoxia? What are

fallacies of APGAR score. (06)10

4. What is the sequence of events leading to the first breath after

Delivery ? What is the significance of establishment of Functional

Residual Capacity? (06)10

5. A term baby is apnoeic. What information of the perinatal events you would like to know? What are the initial steps of management in the labor room? What are the possible complications in the next 48 hours? (08/2)10

6. Describe the changes taking place in circulation at birth and their

implications in neonatal resuscitation. (09/1)5+5

7. Enumerate the newer recommendations of neonatal resuscitation by American Academy of Pediatrics 2010 guidelines. Comment on the level of evidence for each of the changes. (12/1) 6+4

8. Discus the recent changes in guidelines for resuscitation of new born and older children with the rationale for the change. (13/1)10

9. Cyanosis in newborn 5 (Apr16)

BIRTH ASPHYXIA

1. HIE (93/1) (92/2)15

2. Prognosis of Birth Asphyxia (93/1)10

3. HIE in newborn (95/1)10

4. Discuss the etiopathology and management of birth asphyxia (96/2)25

5. HIE (97/2)15

6. Clinical and laboratory correlates of neuromotor outcome in Birth asphyxia (97/1)10

7. Discuss briefly pathophysiology and recent modalities of management of HIE (99/2)25

8. Perinatal asphyxia- clinical features and management (02/1)15

9. What are the etiological causes of Fetal Hypoxia? Write

pathophysiology of Fetal Hypoxia. Describe stages of HIE (06)10

10. Pathophysiology of Hypoxic Brain injury in neonate (06/1)10

11. Discuss the pathophysiology of hypoxic Ischemic Encephalopathy (HIE) in neonates.(09/1)10

12. Discuss etiology, pathophysiology, clinical manifestations and management of Hypoxic- Ischemic Encephalopathy. (13/2) 2+2+2+4

13. Neuroprotective strategies in CNS injuries in neonates 5(15/2)

NEONATAL SEIZURES

1. Etiopathogenesis of neonatal seizures (02/1)15

2. Management of Resistant Neonatal Seizure (03/2)15

3. Classify neonatal seizures. Outline their etiology and provide a brief clinical description. Provide general principles of management of a seizure in neonate. (12/1) 2+2+3+3

IVH

1. IVH (03/1)15

2. Outline the risk factors, pathophysiology and principles of management of intraventricular hemorrhage in preterm neonates. (10/2)3+3+4

3. Discuss the pathogenesis of intracranial hemorrhage in newborn

infants. Outline the possible promoters and protectors for occurrence of subsequent white matter disease. (12/1)6+2+2

4. Pathophysiology and managment of intraventricular hemorrhage. 5(15/2)

PAIN

1. Discuss the impact of pain on a preterm neonate. Identify common procedures associated with pain in a newborn. Describe the strategies for pain management in a newborn. (08/2)10

2. Write short notes: (12/1)5+5

a) Non-pharmacological methods in pain management.

b) Drug therapy in neonatal pain management.

3. Neonatal pain 5 (1/16)

NEONATAL HYPOGLYCEMIA

1. Management of neonatal hypoglycemia (98/2)(92/2)10

2. Define Hypoglycemia in newborn. List its causes. Describe stepwise treatment if hypoglycemia in a newborn (06)10

3. Define hypoglycemia. Describe clinical features and management of hypoglycemia in newborn and children. (11/2)1+4+5

4. A. Etiological classification of neonatal hypoglycemia 2

B. Clinical features & mgmt. of neonatal hypoglycemia 3+5(1/16)

TEMPERATURE

1. Thermoregulation peculiarities in newborn (94/2)15

2. Hypothermia in the newborn (97/1)15

3. Thermal regulation in newborn (98/2)10

4. Prevention of Hypothermia in the newborn (98/2)15

5. Physiological and biochemical consequences of Hypothermia in Neonate (99/1)15

6. Thermal balance in Neonates (03/2)15

7. Discuss management of Neonatal Hypothermia (06)5

8. Write the components, pre-requisites and benefits of Kangaroo Mother care. (08/2) 10, (11/2)5+2+3

9. Discuss the principles of care of the skin in neonates. Outline the role of touch and massage therapy in newborn infants. (10/2)4+3+3

10. Describe the advantages and methods of giving Kangaroo Mother Care (KMC). Enlist metabolic consequences of hypothermia. (13/1) (4+4)+2

NUTRITION

1. Write short notes on: Trophic feeding (13/1)5

2. Discuss attributes, complications and monitoring of total parenteral nutrition in a newborn (13/1)5

3. Write short notes on: (14/1)4+3+3

a) Human Milk Fortifiers

b) Vitamin D supplementation in neonates

c) Medium chain triglycerides in neonatal nutrition

RENAL

1. Kidney functions in neonate (98/2)(99/2)10

INFECTIONS

1. Antibiotic treatment of Neonatal Meningitis (93/2)10

2. Early diagnosis of Neonatal Septicemia (94/2)15

3. Infants of HIV seropositive mothers (95/1)15

4. Infants of HBV seropositive mothers (95/1)15

5. Rapid diagnostic tests in a suspected case of Neonatal Septicemia (95/2) 10

6. Congenital toxoplasmosis (97/2)15

7. Infection control in neonatal intensive care (98/2)10

8. Newer modalities in the management of neonatal sepsis (99/2)15

9. Screening tests for neonatal sepsis 15

10. Prevention of Mother to Child transmission of Hep B 15

11. Sepsis Screen in neonates (06/1)10

12. Candidiasis in Neonates (06)10

13. Adjuvant therapy in Neonatal sepsis (06)10

14. Differential Diagnosis of Neonatal sepsis (07/1)10

15. Discuss various adjunct therapies in neonatal sepsis. (08/1)10

16. Discuss the risk factors for vertical transmission of HIV infection and methods to prevent parent to child transmission of HIV. (09/1)4+6

17. Discuss the predisposing factors, causative agents, methods of diagnosis and treatment of neonatal osteomyelitis. (09/1)4+6

18. A 3 day old home delivered boy (Weight 1450g, Gestation 36 wk) is brought to you with abnormal body movements and not accepting feeds. The child is cold to touch and capillary filling time is 5 sec. Outline the immediate, short term and long term management of this child. (09/1) 4+6

19. Enumerate the clinical features that indicate presence of a possible intrauterine infection in a neonate. Describe the interpretation of TORCH screen. (09/2)6+4

20. Clinical features, investigations and prevention of Congenital Rubella Syndrome. (10/1)3+3+4

21. Outline the clinical presentation, diagnosis and management of a neonate with intrauterine CMV infection. (11/1)3+4+3

22. Discuss the available strategies for prevention of mother to child transmission of HIV. (12/1)10

23. Write short notes on: Various adjunctive therapies in the management of overwhelming sepsis in neonates. (13/2) 5

24. A three days old neonate is brought to the Emergency woth history of not accepting feeds for one day. He is found to be lethargic with a HR of 180/min, and capillary filling time of 4 secs and cold extremities. Outline your approach to this neonate along with management of the case. (14/1) 4+6

25. Newer diagnostic tests for neonatal sepsis (15/1) 5

26. Congenital varicella (15/2)4

SFD

1. Factors associated with IUGR (93/1)10

2. Immune status of SFD babies (98/1)15

3. List the principles of community care of LBW infants. Define Kangaroo Mother care. Outline its advantages and disadvantages. (04/2)4+2+4

4. Outline the handicaps in enteral feeding of LBW newborns. Briefly discuss the feeding strategies for LBW babies. (04/2)3+4+4

5. Enumerate the etiology of fetal or intrauterine growth retardation (IUGR). Describe the screening and diagnosis of IUGR. (11/2) 3+4+3

6. Immediate and late problems due to low birth weight (13/1)5

APNEA OF PREMATURITY

1. Pathophysiology of Apnea Of Prematurity (97/2)15

2. A 10 day old preterm neonate has recurrent cessation of breathing lasting for more than 20 seconds with bradycardia. Classify and enumerate causes for this condition. Discuss in brief the management of this condition. (12/1)4+6

3. Management of neonatal apnea. (13/1) 5

4. Apnea Of Prematurity 5(Apr16)

RETINOPATHY OF PREMATURITY

1. ROP (07/1) 10 Rpt (Apr 16 )5mrks

OSTEOPENIA OF PREMATURITY

1. Osteopenia of prematurity (06)10

NEONATAL JAUNDICE

1. Pathogenesis of kernicterus (96/2)10

2. A 3 week old infant brought to the hospital with moderate jaundice. Discuss the Diagnosis (97/2)10

3. Kernicterus (97/1)15

4. Discuss the Bilirubin metabolism and list the causes and approach to Diagnosis of Hyperbilirubinemia in a neonate (00/1)25

5. Discuss reasons for Physiological Jaundice in a Newborn. Define and list causes of pathological jaundice in a newborn. Discuss clinical manifestations (acute and chronic)of kernicterus (06)10

6. Outline the normal metabolism of bilirubin. Outline the principle of phototherapy for treatment of neonatal jaundice. List factors that influence efficacy of phototherapy. (08/1)10(09/1)10,(10/2)4+3+3

7. Critically describe the role of various treatment modalities for treating neonatal unconjugated hyperbilirubinemia. (11/2)10

8. Outline and discuss various strategies to mange hyperbilirubinemia in newborns (13/1)10

9. Short note on side effects of phototherapy (14/2)5

10. Complications of unconjugated hyperbilirubinemia in a neonate (15/2)5

NEC

1. Pathogenesis of NEC (97/1) (92)15

2. NEC (97/2)15

3. Etiology and pathology of NEC 15

4. Etiology of NEC, staging and management. (04/2)10

5. Discuss management of NEC (06)5

6. Discuss the clinical features, diagnosis and management of neonatal necrotizing enterocolitis. (09/1)3+7

7. Discuss the pathophysiology, classification and diagnostic features of necrotizing enterocolitis. (10/2)4+3+3

8. A 6 day old preterm neonate presents with abdominal distension, feed intolerance, vomiting and blood in stools. Discuss the differential diagnosis, diagnostic approach and principles of initial stabilization. (12/1)4+3+3

NEONATAL HYPOTHYROIDISM

1. Clinical features of Cretinism in newborn babies (97/1)10

2. Describe in brief the etiology, clinical features, diagnostic investigations and management of congenital hypothyroidism. (11/1) 2+2+3+3

PRETERM

1. Enumerate the socio-demographic factors associate with Low birth weight babies. Discuss the clinical problems of Preterm babies (96/1)25

2. Pharmacotherapy in prematurity clinical decisions salient features (03/1)15

3. Management of Patent Ductus Arteriosus (PDA) in preterm neonates (10/1)10

4. Enumerate the factors associated with prematurity and low birth weight. Discuss the potential pathways by which infection plays a role in

premature delivery. (13/1)4+6

5. Describe the development of the ductus arteriosus. Enumerate the duct dependent lesions in the newborn and outline their management. (14/1)3+2+5

HAEMATOLOGY

1. Hemorrhagic Disease of The Newborn (95/2)15

2. Management of Neonatal Thrombocytopenic Purpura (00/1)15

3. Hydrops Fetalis (03/1)15

4. What is Hydrops fetalis. Discuss etiology of Non immune hydrops fetalis. What is the management of a case of Non immune hydrops fetalis (05)2+5+3

5. Discuss etiopathogenesis, diagnosis and management of a Bleeding Neonate (06/2)10

6. Anemia in newborn infant (07/1)10

7. Non immune hydrops fetalis (03/2)15, (07/1)10

8. Define polycythemia in a newborn. What are the factors predisposing to it? Describe the impact of polycythemia on various systems and their clinical presentation. Describe the management of polycythemia in newborn. (08/2)10

9. Outline the classification, clinical manifestations, laboratory findings and differential diagnosis of vitamin K deficiency bleeding. (12/1)3+3+2+2

10. A)Anemia of prematurity 5

B)Treatment options for a 3 month old preterm who has Hb of 6gm%. 5(15/2)

11. Causes of Anemia in the Newborn (93/1)10 Rpt 5marks(Apr16)

12. Outline management of polycythemia 4(1/16)

FLUID THERAPY

1. Fluid therapy in special situations in neonates (06/1)10 HIGH RISK INFANT 1. Scheme for identifying High Risk Fetuses (92/2)15 2. Define ‘High risk infant’. Discuss the long term management of such infants with emphasis on detection and early intervention of infants with developmental disabilities (95/1)25 3. Discuss the basic elements of the ‘At Risk’ concept with regard to their advantages and disadvantages and fallacies if any as they relate to health care of mothers and children . (95/2)25

MISCELLANEOUS 1. Endocrine problems that can be diagnosed on the first day of life(95/1)10 2. Bullous skin eruptions in newborn babies (95/2)15 3. Placental dysfunction syndrome (95/2)15 4. Role of O2 free radicals in the pathogenesis of neonatal disorders (96/2)10 5. Prenatal steroid therapy (99/2)15 6. Fetal Therapy (03/2)15 7. Biology and role of cytokines in Newborn Infants (06/1)10 8. ECMO (06/1)10 9. Organization and levels of Newborn care (06/1)10 10. Steroid in neonatal care (07/1)5 11. Complications of infants born to diabetic mothers (07/2)10 12. Enumerate common peripheral nerve injuries in neonates. Describe their clinical characteristics and outline the management. (09/1)2+3+5 13. Discuss the proposed hypothesis on ‘fetal origins of adult disease’and its implications on burden of diseases. (11/1)5+5 14. Discuss the principles of safe and stable transport of a sick newborn. (13/1)10 15. Write short notes on: (14/1)5+5 a) Insure therapy in neonates b) Developmentally supportive care in neonates Rpt (15/1) 3 c) Issues related to transport of sick newborn (14/2)5 16. A)Feeding of low birth weight babies 5 B) probiotics in neonates (15/1)5 17. A)What is Developmentally supportive care. 3 B)Components of developmentally supportive care in neonates (15/2)7 18. Neonatal hemochromatosis (15/1)5 19. Biology and role of cytokines in newborn infants (1/16)3

10. SPECIAL HEALTH PROBLEMS DURING ADOLESCENCE

1. Discuss the special health problems of Adolescents (98/1)25 2. Etiological factors in Juvenile Delinquency (98/2)15 3. Role of health education to Adolescents (98/2)10 4. Adolescent Violence (03/1)15 5. Health problems of adolescents (03/2)15 6. Health education of adolescent girls 15 7. What are the common problems in Adolescence (05)5 8. What are the common problems in adolescence (05)5 9. Factors affecting Adolescent health and development (06)10 10. Juvenile Delinquency (02/1)15, Rpt(06/1)5 11. Problems of adolescence (07/2)10 12. Discuss briefly Adolescent Health Problems (07/2)10

11. IMMUNOLOGY

1. Laboratory investigation of a child suspected to have T-cell immunity Disorder (92)15 2. Prenatal Diagnosis of Primary Immunodeficiency diseases (94/2)10 3. Indications for various organ and tissue transplants in Pediatric practice and common considerations in selection of donors (95/2)10 4. Graft versus host disease (99/1)15 5. Approach to a child with suspected immune dysfunction (06/1)10 6. numerate functions of the Phagocytes and briefly describe defects of their functions. (09/1)4+6 7. Enlist the humoral immunodeficiency disorders. Outline the diagnostic approach and treatment. (10/1)4+6 8. Outline the characteristic features of primary immunodeficiency. Write in detail about pathogenesis and clinical features of chronic granulomatous disease. (11/1)4+3+3 9. Enumerate the methods of harvesting/ storing stem cells. Outline the indications of stem cell therapy. Discuss in brief the patient preparation required for stem cell therapy. Enlist important potential complications of stem cell therapy. (11/1)2+3+3+2 10. Discuss various components of primary immune deficiency, their clinical characteristics and investigations of a suspected predominant B-cell defect. (13/2)2+3+5 11. Discuss pathogenesis of Graft Versus Host Diseases (GVHD) Discuss clinical manifestations, staging and grading and management of acute GVHD. (13/2)2+3+2+3 12. Discuss the indications for stem cell transplantation therapy in children. What is its rationale and sources for stem cells. (13/2) 5+3+2 13. Stem cell therapy (14/2)5 14. A) Components of immune system B) Difference between innate and acquired immunity. C) Role of T and B lymphocytes and the killer cells (15/1) 4+3+3 15. What is the pathogenesis of graft vs host disease? What are its clinical manifestations? What measures can be taken to prevent it in case of stem cell transplantation? 4+3+3(15/2) 13. Wiscott-Aldrich Syndrome 3(Apr 16) 14. Graft vs Host Disease 4(Apr 16) 15. Immunological features associated with cow milk allergy 15

12. ALLERGIC DISORDERS

1. Pathogenesis and management of anaphylaxis (97/1)15 2. Mechanism, manifestations and management of anaphylaxis (92)15 3. Allergic Rhinitis (07/1)5 4. Enumerate the chemical mediators of allergic reactions and describe the important actions of histamine. (08/1)10 5. Clinical features, differential diagnosis and treatment of atopic dermatitis in infants. (10/1)3+3+4 6. What is atopic dermatitis? Describe the clinical features and differential diagnosis of atopic dermatitis. (11/2)2+5+3 7. What is atopic dermatitis? Describe clinical features, differential diagnosis and treatment of atopic dermatitis. (12/1)1+3+3+3 8. What are the types of Atopic Dermatitis (AD) in children? Discuss in detail the clinical features of AD. Describe the differential diagnoses in a case of suspected AD. (13/2) 2+4+4

13. RHEUMATIC DISEASES

KAWASAKI DISEASE 1. Kawasaki Syndrome (00/1)15 2. Phases and complications of Kawasaki’s disease (06)10 3. Discuss the presentation, diagnostic criteria for Kawasaki Disease. What is the management strategy? What are the complications? (08/1)10 4. Discuss the pathogenesis, differential diagnosis and echocardiography findings in Kawasaki Disease (KD). How is the classical KD different from Atypical KD? (09/1)6+4 5. Describe clinical manifestations of classical and atypical Kawasaki disease. Provide algorithmic approach to a suspected case of Kawasaki disease. Enumerate various treatment modalities. (11/1)4+4+2 6. Write short notes on:Diagnostic criteria for Kawasaki Disease.(13/2) 5 7. Algorithmic approach to a suspected case of Kawasaki disease. Enumerate its complications and outline the management.5+(2+3)(15/2)

JRA 1. Classification and features of JRA (96/2)14 2. What are the clinical manifestations of juvenile rheumatoid arthritis. Discuss the differential diagnosis and management. (04/2)3+3+4 3. Write the current classification used in JRA. Outline the management plan for JRA (06)10 4. Tabulate differentiating features of various types of juvenile Rheumatoid arthritis. (08/1)10 5. Tabulate the classification of Juvenile Idiopathic arthritis and state principles of its treatment. (10/2)4+6 6. Outline the diagnostic criteria of juvenile rheumatoid arthritis. Tabulate the differentiating features of various types of JRA. Outline a scheme of investigation for a child with suspected JRA.(11/1)3+4+3 7. Tabulate the differentiating clinical features and the diagnostic approach of Juvenile Idiopathic Arthritis (JIA). Outline the principles of management of polyarticular JIA. (12/1)4+3+3 8. Define Juvenile Idiopathic Arthritis (JIA). Outline the classification of JIA. Discuss the mimickers of rheumatic diseases in children. (13/1)2+4+4 9. A six year old boy presents with painful swelling of his right knee. Enumerate the likely causes. Define Juvenile Idiopathic arthritis and discuss its management. (14/1)2+2+6 10. A)disease modifying agents used for JIA B)Biological anti-TNF agents for JIA (14/2) 5+5 11. a) ILAR classification of juvenile idiopathic arthritis 4 b) clinical features of systemic onset disease and give the differential diagnosis thereof (15/1) 4+2 12. Macrophage activation syndrome 5(1/16) H S PURPURA

1. Discuss briefly clinical presentation and management of H S Purpura (07/1) 10 2. Describe the diagnostic approach and management of a six year old child presenting with purpuric rash and pedal edema following an episode of acute diarrhoea. (11/2)4+6

MISCELLANEOUS 1. Classify vasculitis based on size of involved vessels and give examples of each category. Describe etiology, clinical features and management of Takayasu’s arteritis. (09/2)5+5

14. INFECTIOUS DISEASES

PUO 1. Discuss definition,etiology & approach to investigation of PUO (07/1)10 2. Outline the approach to management of a 2 month old infant having fever without focus. (09/1)10 3. Enumerate the common causes of pyrexia of unknown origin in a 5 year old child. Discuss diagnostic approach to fever with rash. (11/2)4+6

HIV 1. Prevention of HIV infection during childhood (02/1)15 2. HIV and Pediatrics (98/2)10 3. Post exposure HIV prophylaxis (03/2)15 4. An HIV positive mother has been admitted in labour. What will you do to prevent transmission of infection to the baby (05)10 5. Factors involved in perinatal transmission of HIV infection and the various preventive measures (06)10 6. Prevention of Childhood AIDS (07/2)10 7. Clinical Presentations requiring screening for HIV (07/1)5 8. HIV and TB (07/1)5 9. Outline clinical and immunological criteria for starting anti-retroviral treatment (ART) in a HIV infected child. How will you monitor a child initiated on ART? (09/2)6+4 10. Enlist the common opportunistic infections in HIV infected children. Describe the clinical features, diagnosis and management of herpes simplex infection in HIV infected children (11/2)3+2+2+3 11. Enumerate opportunistic infections in HIV infected children. How will you treat and prevent pneumocystis jiroveci infection. (12/1)5+3+2 12. Briefly discuss the pulmonary disorders seen in children with HIV/AIDS. (13/1)10 13. Discuss the key issues in the management of an HIV exposed infant. (13/2)10

TUBERCULOSIS 1. Failure in control of Tuberculosis (93/1)15 2. Prevention and early detection of TB (96/2)15 3. Short course chemotherapy for TB (98/2)10 4. DOTS chemotherapeutic management of Tuberculosis in National TB Control Programme (00/1)15 5. Diagnosis and management of a child with resistant TB (02/1)15 6. CNS changes in Tubercular meningitis(Pathological only) 15 7. Discuss the pathogenesis, clinical symptomatology and diagnosis of NeuroTB (06)10 8. How do you perform and interpret Mantoux Test. Enumerate 3 conditions each in which you can get a false positive and a false negative result. (06)10 9. Newer diagnostic modalities for TB (06)10 10. DOTS regimen and the problems involved in the implementation in childhood TB (06)10 11. 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 12. 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 c) What are the components of DOTS strategy as defined by WHO? (09/2) 4 13. Describe clinical manifestations, diagnosis and management of Neurotuberculosis. (11/2 3+4+3 14. Describe the flow chart for diagnosis of childhood tuberculosis under RNTCP. Write briefly on DOT PLUS program. (12/1)6+4 15. Discuss the recent guidelines for diagnosis and management of childhood tuberculosis. (13/1)10 16. Describe aetiopathogenesis, diagnosis and management of different types of neurotuberculosis. (13/2) 3+4+3 17. Clinical presentation, investigations and treatment of multidrug resistant TB. (14/2) 3+2+5 18. A) Define DOTS, DOTS agents and DOTS plus. 3 b) List at least 4 important components Of DOTS 2 C) Give the categorization of treatment strategy in DOTS (15/1)5 19. MDR and XDR tuberculosis treatment strategies. 3+3 (1/16)

ENTERIC FEVER

1. Treatment of typhoid fever (93/1)10 2. Nontyphoidal salmonellosis (95/2)15 3. Management of typhoid fever (95/2)15 4. Interpretation of Widal test in immunized children (98/2)10 5. Define multidrug resistant (MDR) salmonella typhi (MDR – ST) and nalidixic acid resistant salmonella typhi (NARST). Discuss the mechanism of development of drug resistance for salmonella typhi.(08/1)10

DENGUE FEVER

1. Discuss the management of Dengue Shock Syndrome (97/1)10 2. Pathogenesis of bleeding and shock in Dengue fever (98/2)10 3. Dengue Fever (03/2)15 4. Define DHF and DSS and outline the treatment of DSS (05)10 5. Diagnosis and management of DHF and DSS (06/1)10 6. Outline the WHO criteria for diagnosis of dengue hemorrhagic fever. Draw an algorithm for volume replacement for a child with DHF and > 20% increase in hematocrit. (09/1)(3+7) 7. Define DHF and DSS. How does DHF differ from dengue fever with hemorrhage? Describe treatment of DSS. (09/2) 2+2+1+5 8. Classify severity of dengue hemorrhagic fever. Write in brief the management of dengue shock syndrome. (11/1)4+6 9. What are the fluid, metabolic and biochemical changes in a child with severe dengue? Discuss the underlying pathophysiology. (13/1)10 10. Define severe dengue and describe the WHO guidelines for its management. Enumerate the indications for transfusion in dengue. (14/1)2+6+2 11. Define severe dengue . Describe the WHO guidelines for its management. Enumerate complications of Severe Dengue 2+4+4(Apr16) E COLI 1. Discuss the pathogenesis of E. coli diarrhea (94/2)15 2. Classification of E coli and pathogenesis of Invasive Diarrhoea (95/1)15

POLIO AND AFP

1. Pulse Polio Immunization (96/1)15 2. AFP Surveillance (99/2)15 3. Approach to a child with AFP and components of AFP surveillance (00/1)15 4. Pulse Polio programme (02/1)(98/1)15 5. AFP- Definition, Differential Diagnosis in details, how help in polio eradication (03/2)25 6. Discuss the differential diagnosis and management of acute flaccid paralysis in a 2 year old child. (04/2)5+5 7. What is AFP? Discuss the differential diagnosis and management of a child with AFP. Discuss AFP surveillance (05)2+3+2+3 8. Define criteria for declaring a country Polio free. What is the present status of wild polio virus transmission and strategies being used for its control in India? Elaborate on AFP surveillance (06)5+5 9. Define AFP. Enlist the causes and investigations of a case of AFP (06)10 10. What is acute flaccid paralysis? Describe the differential diagnosis and management of a child with flaccid paralysis. Describe AFP surveillance. (09/2)2+2+4+2 11. a) define polio eradication 1 b) polio eradication in india. 2 c) immunisation issues following polio eradication. 3(15/1)

MALARIA

1. Define drug resistant malaria, what are the different types of drug resistance as per WHO criteria. Discuss the various management strategies of Drug resistant Malaria 25 2. Management of Cerebral Malaria 15 3. Malaria prophylaxis (94/2)15 4. Drug resistant Malaria (03/1)15 5. What are management guidelines of malaria under the national programme. How will you manage a case of cerebral malaria. (04/2)4+6 6. Enumerate manifestations of Severe Malaria and their management (06/2)10 7. A 4 year old girl presents with history of fever for 2 days associated with severe anemia, black colored urine and splenomegaly. Discuss the management of this patient. (08/2)10 8. Describe clinical manifestations of cerebral malaria. Enlist the differential diagnosis and investigations required. Write management of a case of cerebral malaria in high endemic area. (09/1)(2+3+5) 9. Define complicated malaria. Describe the management strategies of complicated malaria. (09/2)3+7 10. Provide algorithms for case-detection and treatment for a child with fever, suspected to have malaria, as per National Vector Borne Disease Control Program: (10/2)5+5 a) In an area where microscopy results are available within 24 hours; and b) In an area where microscopy results are not available within 24 hours 9. Write short notes on: Laboratory diagnosis of malaria (11/2)5 10. List the WHO criteria to diagnose severe malaria. Discuss the mangement of a child with cerebral malaria. (13/1)4+6 11. Newer antimalarial drugs (15/1) 4

HEPATITIS B

1. Viral markers of Hepatitis B 15 2. Immunological markers of Hepatitis B 15 3. Hepatitis B infection in children (03/1)15 4. A 3 year old child is brought with a history of jaundice since 2 months. She gives a history of blood transfusion at 18 months of age. Her HBsAg is positive. Discuss briefly other viral markers of HepB infection which will help in monitoring and treatment of child. Discuss the management of fulminant hepatic failure. Add a note on Liver Transplantation. (06)10 5. Discuss the modes of transmission of hepatotrophic viral infections. Outline the clinical features, diagnosis and treatment of hepatitis B infection in children. (13/1) 2+3+3+2 6. A)Serological course of Hepatitis B 4 b)Treatment strategies for acute and chronic hepatitis 3+3 (15/2)

MEASLES 1. Diagnosis and treatment of SSPE (95/2)10

PLAGUE

1. Management of Plague (95/2)10 GROUP A STREPTOCOCCUS 1. Management of acute Rheumatic Fever (93/2)10

CYSTICERCOSIS

1. Current management of Neurocysticercosis (92)15 MENINGOCOCCUS

1. Discuss prevention and prophylaxis against meningococcal infection (05)5+5 2. Prophylaxis of Meningococcemia (06/1)10 SYPHILIS 1. Radiological features and confirmatory laboratory tests for congenital syphilis (07/1)10

PERTUSSIS

1. Discuss the etiology, pathogenesis and prevention of pertussis in chidren. Write the differences in efficacy , duration of protection and adverse events between whole cell and acellular pertussis vaccine 6+4(1/14)

JAPANESE ENCEPHALITIS

1. Epidemology ,clinical features ,prognosis and prevention of Japanese Encephalitis (15/1) 2+3+2+3 SWINE FLU 1. Comment on clinical features, diagnosis and treatment of Swine flu in children. (09/2)2+3+5 2. A) Virology and epidemiology of Swine Flu 1+2 b) How is the disease categorized according to the government of India guidelines? 3 c) Mention which children need to be immunized and who need to be given medication for the disease 2+2(Apr 16) MISCELLANEOUS

1. Laboratory diagnosis of Viral diseases 2. Brain CT findings in a case of Congenital toxoplasmosis and cysticercosis (94)15 3. Nosocomial Infections (06)10 4. A seven year old girl is admitted with pain and swelling of right knee and left ankle joint of two weeks duration. Enumerate the likely causes. Discuss the differential diagnosis highlighting important pointers in history, examination and investigations. 5. Describe the etiology, mode of transmission, clinical features and management of viral hemorrhagic fever in children. (12/1)2+2+3+3 6. Roseola infantum 3(15/2)

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