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DNB PEDIATRICS THEORY QUESTION BANK (updated Oct 2014)

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DNB PEDIATRICS 
THEORY 
QUESTION BANK 
(Updated Oct 2014) 
HOW TO INTERPRET THE QUESTIONS 
1. Questions are divided based ...
1 GROWTH AND DEVELOPMENT 
1. Approach to a child with Delayed Speech (02/1) 15 
2. Discuss the causes and approach to a Pr...
age in children and adolescents. Outline the differential diagnosis of a child 
with short stature on the basis of bone ag...
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DNB PEDIATRICS THEORY QUESTION BANK (updated Oct 2014)

  1. 1. DNB PEDIATRICS THEORY QUESTION BANK (Updated Oct 2014) HOW TO INTERPRET THE QUESTIONS 1. Questions are divided based on Chapters of Nelsons Textbook of Pediatrics 2. Questions contain two numbers at the end. Numbers within bracket indicates the year. For example (97/1)- 97 means year 1997 1 means June (2 means December) Thus (06/1) means June 2006 3. Number at the end of the question(not within bracket) indicates marks DR KAUSIK SUR / Updated by DR. NOELLA PEREIRA D.C.H, DNB D.C.H., DNB ASSISTANT PREOFESSOR ASSISTANT PREOFESSOR DEPARTMENT OF PEDIATRICS B .J. WADIA HOSPITAL FOR VIVEKANANDA INSTITUTE CHILDREN. MUMBAI OF MEDICAL SCIENCES KOLKATA e-mail- kausiksur@gmail.com
  2. 2. 1 GROWTH AND DEVELOPMENT 1. Approach to a child with Delayed Speech (02/1) 15 2. Discuss the causes and approach to a Preschool child with Developmental Regression (02/1) 25 3. Growth Monitoring (98/1) 15 4. What are the developmental disorders in preschool years? Discuss the management (97/1) 15 5. Velocity and cross-sectional standards as applied to Human Growth (95/2) 15 6. Discuss the basis for use of Growth Standards. What should be taken as a reasonable approach for India (94/2) 25 7. Principles of Growth and Development (00/1) 15 8. Importance of Bone age assessment in children 15 9. Growth Factors (99/1) 15 10. Sexual Maturity Rating in female adolescents (95/2) 15 11. Describe the events of sexual development in relation to physical growth. Name the most important regulatory factors (94) 25 12. Gessel Developmental schedule (93/1) 15 13. Define Growth, Development, Velocity of growth mean, median, percentiles. Enumerate causes of retarded growth. Briefly outline a schedule for investigation of such a case (92/2) 25 14. Factors affecting Development of children (92) 15 15. SMR (03/2) 16. What is SMR? Discuss the secular trend in Children (05/2) 5+5 17. How would you assess sexual maturity of a female adolescent (06) 10 18. Factors affecting Adolescent health and development (06) 10 19. 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 20. Approach to a child with short stature (06/1) (07/2) 10 21. Bone age assessment and its usefulness (07/2) 10 22. Growth and development in second year of life in children (07/1) 10 23. Outline the basic principles of sleep hygiene for children and adolescents (09/1) 10 (12/1) 5+5 24. Describe: (09/2) 5+5 a) Factors affecting child development b) Developmental screening tests available and suitable for use in Indian children. 25. Developmental milestones in first two years of life. (10/1) 10 26. 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 27. 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 28. Enumerate the available methods and indications for determination of bone
  3. 3. 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 29. Describe Tanner’s Sexual Maturity Rating (pubertal staging) in boys based on a) Genitalia and b) Pubic hair development. (11/2) 5+5 30. Describe in detail the physical growth and development in all domains from birth till completion of first year. (11/2) 5+5 31. What is developmental delay? Describe different tools used for screening of developmental delay. (11/2) 3+7 32. 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 33. What is developmental screening? Enumerate common developmental screening test. What issues they identify in a child? (12/1) 2+4+4 34. Principles of sleep hygiene in children (13/1) 5 35. Define developmental delay and developmental dissociation. Outline the screening and definitive tests for diagnosis of developmental delay. (13/1) 5+5 36. 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 37. Enumerate the criteria for diagnosis of mental retardation (MR). Classify MR and describe its evaluation. (14/1) 2+2+6 2 PSYCHOLOGIC DISORDERS PSYCHOSOMATIC ILLNESS 1. Management of Conversion reactions (98/1) 15 VEGETATIVE DISORDER 1. Sleep Disorders in children (99/2) 10 2. Encopresis (99/2) 15 3. What is Vegetative Disorder (05) 5 4. What is vegetative disorder? Discuss management of a child with injuries (05) 5+5 5. Rumination (06/1) 5 6. Pica (07/1) 5 HABIT DISORDER 1. Habit Disorders in children (07/1) 10 MOOD DISORDER 1. Childhood Depression (06) 10 DISRUPTIVE BEHAVIORAL DISORDERS 1. Common Behavioral problems in children (97/2) 15
  4. 4. 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. Discuss the management of a child with schizophrenia (04/2) 5 4. Autistic spectrum disorder (07/2) 10 5. Autistic Disorder (07/1) 10 6. Etiology, clinical manifestations and treatment of Autistic Disorder (06/1) 10 7. Discuss the management of a child with Schizophrenia (05) 5 8. Describe the etiology, clinical manifestations and management of autistic spectrum disorders in children. (09/2) 2+3+5 9. Discuss briefly the diagnostic features and management of Pervasive Developmental Disorders/ autistic spectrum disorders. (11/2) 4+6 10. Enumerate various pervasive developmental disorders and autism spectrum disorders. Outline one core feature of each of them. (12/1) 5+5 11. Define autistic spectrum disorders. Enumerate their clinical features and discuss their managements (13/2) 2+4+4 12. What are Autistic Spectrum Disorders? Discuss the differential diagnosis and management of a child with Autism. (14/1) 3+3+4 NEURODEVELOPMENTAL DYSFUNCTION IN THE SCHOOL AGED CHILD 1. Attention Deficit Disorders (97/1) (95/2) (00/1) 15 2. ADHD (03/1) 15 3. Describe clinical manifestations, diagnosis and management of ADHA (06) 10 MISCELLANEOUS 1. Juvenile Delinquency (06/1) 5 3 SOCIAL ISSUES, CHILDREN WITH SPECIAL HEALTH NEEDS FAILURE TO THRIVE 1. Causes of Failure to Thrive in infancy (96/2) 15 2. Approach to a child with Failure To Thrive (96/1) 14 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. 5. 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 ADOPTION 1. Adoption (03/2) 2. Role of pediatrician in adoption of a child (13/1) (5) CHILD ABUSE 1. Define child abuse. List the etiology of child abuse in India. Outline strategies for prevention. (04/2) 2. Discuss Child maltreatment. What are the factors related with child abuse (05) 5+5 3. Define Child Abuse. Describe clinical manifestations of Child Abuse. Discuss some useful investigations in a suspected case of Child Abuse (06) 10 4. Management of the sex abused child (95/2) 15 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 b. Karyotyping MENTAL RETARDATION 1. Preventable and treatable causes of Mental retardation (96/2) 10 2. Various physical features that are likely to be associated with specific syndromes of mental retardation (95/2) 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 NUTRITION PEM 1. Immunological changes that take place in PEM (98/2) 10 2. Biochemical changes in PEM (96/2) 10
  6. 6. 3. 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 4. Prevention of hypocalcaemia in PEM (93/1) 15 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 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 VIT B 1. Discuss the etiopathogenesis, clinical features, diagnosis and management of cobalamine deficiency. (12/1) 2+3+1+4 VIT D 1. Functions of vitamin D (98/2) 10 2. Renal Rickets (97/2) 15 3. Vitamin D Resistant Rickets (96/2) 12 4. Resistant Rickets 15 5. Outline the metabolism and function of Vitamin D in human body. Describe in detail the etiology and pathological changes in rickets (99/2) 25 6. Clinical manifestations of Rickets (93/2) 10 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
  7. 7. 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 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 investigations, clinical features and treatment of any one of them. (09/2) 1+2+7 ZINC 1. Effects of Zinc supplementation in persistent diarrhea (98/2) 10 2. Role of Zinc in health and diseases of children (97/1) 10 3. Relevance of Zinc in human nutrition (92) 15 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 MILK 1. Bioactive factors in Human Milk (98/1) 15 2. Differences in the composition of Milk secreted by mothers delivering Term and Preterm babies (96/2) 10
  8. 8. 3. 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 4. Anti-infective properties of Human milk (95/2) 10 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 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
  9. 9. 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 5 PATHOPHYSIOLOGY OF BODY FLUIDS AND FLUID THERAPY ACUTELY ILL CHULD SHOCK 1. How do you classify Shock in children? Write its etiopathogenesis and management (06) 10 2. Discuss the classification and causes of shock in children (97/1) 15 3. Management of Cardiogenic shock (96/1) 12 4. Define Shock. Describe the pathophysiology and management of septic shock in children (94/2) 25 (04/2) 5+5 5. Shock-pathogenesis of different types and pathological changes in different organs (03/1) 25 6. Discuss the management of an infant with Shock (00/1) 25 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 POTASSIUM 1. List the causes of Hypokalemia. Discuss the clinical features, laboratory diagnosis and management of Hypokalemia (06) 10
  10. 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 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 ACID-BASE BALANCE 1. Anion Gap (98/2) (00/1) 10 2. Describe briefly how the acid-base balance of body is maintained in health (98/1) 25 3. Physiological compensatory mechanisms during Metabolic Acidosis (97/1) 15 4. Define pH and base excess. Discuss briefly regulation of Acid-base homeostasis and management of Respiratory Acidosis (93/1) 15 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 DEHYDRATION
  11. 11. 1. Steps in management of patient with Hypernatremic Dehydration (06) 10 2. Management of Hypernatremic Dehydration (02/1) 15 3. Management of Acute Diarrhea in children (98/1) 15 4. Pathogenesis and Management of Hypernatremic Dehydration (97/2) 15 5. One year old infant with AGE develops Abdominal Distension. Discuss the differential diagnosis (97/1) 10 6. Why children are more vulnerable to develop dehydration (96/2) 10 7. Hypernatremic Dehydration (03/1) 15 8. Hyponatremic Dehydration (03/2) 15 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 110 meq/liter presenting with moderate dehydration and seizures. (08/2) 10 MISCELLANEOUS 1. Discuss etiopathogenesis, clinical manifestations and management of Bartter Syndrome. (13/2) 2+4+4 6 ACUTELY ILL CHILD DROWNING 1. Near drowning in children (06) 10 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 PAIN 1. Pathogenesis and management of pain in children (06) 10 2. Pain management in infants and children (98/1) 15 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
  12. 12. a)Non-pharmacological methods in pain management. 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 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 7 GENETICS 1. Genetic counseling of a case of Down Syndrome (99/1) 15 2. Early stimulation in Down syndrome (92/2) 15 3. Prenatal diagnosis of Down syndrome and Duchenne Muscular Dystrophy 15 4. Gene Therapy in Children (06/1) 10 5. Gene therapy (07/1) 5 6. Enumerate and describe the structural abnormalities of autosomes. Illustrate with suitable examples. (08/1) 10
  13. 13. 7. What are trisomies? What are predisposing factors? Discuss clinical features of 3 common trisomies seen in clinical practice? (08/1) 10 8. Describe the symbols used in pedigree chart. Draw pedigree charts over 4 generations depicting a) X – linked dominant disease b) X – linked recessive disease. 9. Briefly discuss the principles of genetic counseling. Outline the counseling of a family with a child with Down’s syndrome. (04/2) 5+5 10. A couple has a child with Down Syndrome. Outline the principles of genetic counseling and antenatal management for the subsequent pregnancy.(09/1)10 11. Write a short note: Karyotyping (09/2) 5 12. What are mutations? Describe their consequences. (10/1) 5+5 13. Discuss the genotypic and phenotypic features of Turner’s syndrome (11/1) 4+6 14. What are mitochondrial genes? How are they transmitted? Briefly discuss diseases transmitted by them? (11/2) 2+2+6 15. 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 8 METABOLIC DISEASES 1. Screening tests for Inborn Errors Of Metabolism (96/2) 10 2. Metachromatic Leukodystrophy (96/1) 12 3. Homocysteinuria (94/2) 15 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) 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 10. Define hypoglycemia. Describe clinical features and management of hypoglycemia in newborn and children. (11/2) 1+4+5 9 NEONATOLOGY RESPIRATORY DISTRESS
  14. 14. 1. Describe the surgical causes of Respiratory difficulty in newborn (02/1) 25 2. Surfactant therapy (98/2) 10 3. Meconium Aspiration Syndrome(97/2) 15 4. BPD (97/1) 15 5. Surfactant therapy for HMD 15 6. Tests for pulmonary maturity and surfactant therapy for RDS (94/2) 15 7. Discuss RDS with special reference to surfactant therapy (98/2) 15 8. Discuss the pathogenesis and management of MAS (00/1) 25 9. Pathophysiology of RDS of newborn (94) 15 10. HMD- pathophysiology and management (03/1) 25 11. 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 12. What is the etiopathogenesis of PPHN of Newborn. Outline the diagnosis and management (05) 3+3+4 13. Describe in brief PPHN (or PFC) with regard to Pathology, pathophysiology, Diagnosis and management (94/2) 25 14. 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 15. Etiology, pathogenesis and management of a neonate with RDS (06/1) 10 16. PPHN (06/1) 10 17. Briefly discuss normal fetal development of Surfactant. List the uses of Surfactant in newborn (07/2) 10 18. Discuss the diagnosis and management of PPHN (07/2) 19. Enumerate causes of persistent pulmonary hypertension in neonates and discuss its pathophysiology. (08/1) 10 20. 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 21. Discuss the pathophysiology of hyaline membrane disease in premature newborns. (10/2) 10 22. Describe the pathophysiology of hyaline membrane disease (HMD) in newborns. Outline important available strategies to prevent HMD. (11/1) 5+5 23. Outline and discuss the strategies to prevent lung injury and bronchpulmonary dysplasia in a preterm baby. (13/1) 10 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 tracheo – 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
  15. 15. 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. 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 2. 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 3. Describe the changes taking place in circulation at birth and their implications in neonatal resuscitation. (09/1) 5+5 4. 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 5. Discus the recent changes in guidelines for resuscitation of new born and older children with the rationale for the change. (13/1) 10 BIRTH ASPHYXIA 1. Perinatal asphyxia- clinical features and management (02/1) 15 2. HIE (97/2) 15 3. Clinical and laboratory correlates of neuromotor outcome in Birth Asphyxia (97/1) 10 4. Discuss the etiopathology and management of birth asphyxia (96/2) 25 5. HIE in newborn (95/1) 10 6. Discuss briefly pathophysiology and recent modalities of management of HIE (99/2) 25 7. HIE (93/1) (92/2) 15 8. Prognosis of Birth Asphyxia (93/1) 10 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 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
  16. 16. IVH 1. IVH (3/1) 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 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. 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 TEMPERATURE 1. Thermal regulation in newborn (98/2) 10 2. Hypothermia in the newborn (97/1) 15 3. Thermoregulation peculiarities in newborn (94/2) 15 4. Prevention of Hypothermia in the newborn (98/2) 15 5. Physiological and biochemical consequences of Hypothermia in Neonate3 (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: (14/1) 4+3+3 a) Human Milk Fortifiers b) Vitamin D supplementation in neonates c) Medium chain triglycerides in neonatal nutrition 2. Write short notes on: Trophic feeding (13/1) (5)
  17. 17. 3. Discuss attributes, complications and monitoring of total parenteral nutrition in a newborn (13/1) (5) ANTENATAL DIAGNOSIS 1. Antenatal Diagnosis (98/2) 10 2. Discuss the methods of detection of congenital malformations in the fetus and their prevention (95/1) 25 3. Intrauterine Diagnosis (93/2) 10 4. Amniocentesis in prenatal diagnosis (92) 15 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. Medical management of Fetal Problems (07/2) 10 9. Treatment and prevention of fetal diseases (07/1) 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 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 RENAL 1. Kidney functions in neonate (98/2) (99/2) 10 INFECTIONS 1. Infection control in neonatal intensive care (98/2) 10 2. Congenital toxoplasmosis (97/2) 15 3. Infants of HIV seropositive mothers (95/1) 15 4. Infants of HBV seropositive mothers (95/1) 15 5. Early diagnosis of Neonatal Septicemia (94/2) 15 6. Newer modalities in the management of neonatal sepsis (99/2) 15 7. Screening tests for neonatal sepsis 15 8. Prevention of Mother to Child transmission of Hep B 15 9. Rapid diagnostic tests in a suspected case of Neonatal Septicemia (95/2) 10 10. Sepsis Screen in neonates (06/1) 10
  18. 18. 11. Antibiotic treatment of Neonatal Meningitis (93/2) 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 intra -uterine 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 SFD 1. Immune status of SFD babies (98/1) 15 2. Factors associated with IUGR (93/1) 10 3. Enumerate the etiology of fetal or intrauterine growth retardation (IUGR). Describe the screening and diagnosis of IUGR. (11/2) 3+4+3 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) RETINOPATHY OF PREMATURITY 1. ROP (07/1) 10 OSTEOPENIA OF PREMATURITY
  19. 19. 1. Osteopenia of prematurity (06) 10 NEONATAL JAUNDICE 1. A 3 week old infant brought to the hospital with moderate jaundice. Discuss the Diagnosis (97/2) 10 2. Kernicterus (97/1) 15 3. Pathogenesis of kernicterus (96/2) 10 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),(10/2) 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) NEC 1. NEC (97/2) 15 2. Pathogenesis of NEC (97/1) (92) 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. Desccribe 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
  20. 20. 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. Management of Neonatal Thrombocytopenic Purpura (00/1) 15 2. Hemorrhagic Disease of The Newborn (95/2) 15 3. Causes of Anemia in the Newborn (93/1) 10 4. Discuss etiopathogenesis, diagnosis and management of a Bleeding Neonate (06/2) 10 5. Anemia in newborn infant (07/1) 10 6. 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 7. Outline the classification, clinical manifestations, laboratory findings and differential diagnosis of vitamin K deficiency bleeding. (12/1) 3+3+2+2 FLUID THERAPY 1. Fluid therapy in special situations in neonates (06/1) 10 HIGH RISK INFANT 1. 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 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 MISCELLANEOUS 1. Role of O2 free radicals in the pathogenesis of neonatal disorders (96/2) 10 2. Bullous skin eruptions in newborn babies (95/2) 15 3. Endocrine problems that can be diagnosed on the first day of life (95/1) 10 4. Prenatal steroid therapy (99/2) 15 5. Steps in Neonatal Resuscitation 15 6. Fetal circulation and changes at birth (00/1) 15 7. Placental dysfunction syndrome (95/2) 15 8. Scheme for identifying High Risk Fetuses (92/2) 15 9. Hydrops Fetalis (03/1) 15 10. Non immune hydrops fetalis (03/2) 15, (07/1) 10 11. Fetal Therapy (03/2) 15 12. List the principles of community care of LBW infants. Define Kangaroo Mother care. Outline its advantages and disadvantages. (04/2) 4+2+4
  21. 21. 13. Outline the handicaps in enteral feeding of LBW newborns. Briefly discuss the feeding strategies for LBW babies. (04/2) 3+4+4 14. 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 15. Biology and role of cytokines in Newborn Infants (06/1) 10 16. ECMO (06/1) 10 17. CPAP (06/2) 10 18. Organization and levels of Newborn care (06/1) 10 19. Complications of infants born to diabetic mothers (07/2) 10 20. Steroid in neonatal care (07/1) 5 21. Enumerate common peripheral nerve injuries in neonates. Describe their clinical characteristics and outline the management. (09/1) 2+3+5 22. Discuss the proposed hypothesis on ‘fetal origins of adult disease’ and its implications on burden of diseases. (11/1) 5+5 23. Immediate and late problems due to low birth weight (13/1) (5) 24. Discuss the principles of safe and stable transport of a sick newborn. (13/1) 10 25. Write short notes on: (14/1) 5+5 a) Insure therapy in neonates b) Developmentally supportive care in neonates 10 SPECIAL HEALTH PROBLEMS DURING ADOLESCENCE 1. Juvenile Delinquency (02/1) 15 2. Etiological factors in Juvenile Delinquency (98/2) 15 3. Role of health education to Adolescents (98/2) 10 4. Discuss the special health problems of Adolescents (98/1) 25 5. Health education of adolescent girls 15 6. Adolescent Violence (03/1) 15 7. Health problems of adolescents(03/2) 15 8. What are the common problems in Adolescence (05) 5 9. Problems of adolescence (07/2) 10 10. What are the common problems in adolescence (05) 5 11. Discuss briefly Adolescent Health Problems (07/2) 10 11 IMMUNOLOGY 1. Prenatal Diagnosis of Primary Immunodeficiency diseases (94/2) 10 2. Graft versus host disease (99/1) 15 3. Indications for various organ and tissue transplants in Pediatric practice and common considerations in selection of donors (95/2) 10 4. Laboratory investigation of a child suspected to have T-cell immunity Disorder (92) 15
  22. 22. 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. Discuss various components of primary immune deficiency, their clinical characteristics and investigations of a suspected predominant B-cell defect. (13/2) 2+3+5 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 NEPHROLOGY GLOMERULAR FILTRATION 1. Outline the development of glomerular filtration. Outline the methods for evaluating GFR in children. (08/1) 10 2. 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 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 RENAL TUBULAR ACIDOSIS
  23. 23. 1. Classify types of RTA and their management principles (02/1) 15 2. Diagnosis and management of RTA (92/2) 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 PROTEINURIA 1. Persistent asymptomatic proteinuria (98/2) (07/1) 10 2. Proteinuria (96/2) 15 HEMATURIA 1. Diagnosis and management of recurrent Hematuria (96/1) 12 2. A 3 year old child was brought for Hematuria. Discuss the differential diagnosis and management (94/2) 25 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. Enumerate the principles of management of Idiopathic Nephrotic syndrome (98/2) 10 2. Pathophysiology of Nephrotic Syndrome (96/2) 10 3. What factors will you consider in deciding the prognosis of a child with Nephrotic syndrome (95/1) 15 4. Relapse in Nephrotic Syndrome (94) 15 5. Frequently relapsing steroid resistant Nephrotic Syndrome (03/2) 15
  24. 24. 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 RENAL FAILURE 1. Biochemical and endocrinal changes in CRF 2. What are the causes of ARF in children? How will you investigate such a case? Discuss management. (97/1) 25 3. Describe the pathogenesis of CRF and outline important principles in the management of such a case (95/2) 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 1. Define Chronic kidney Disease (CKD) and its stages. What are the clinical manifestations of CKD. Outline its treatment. (13/2) 3+4+3
  25. 25. HUS 1. HUS- etiopathogenesis and diagnosis (98/1) 15 2. Diagnostic features of HUS (93/2) 15a 3. Classify Haemolytic Uremic Syndrome. Discuss its pathogenesis, clinical features and management. (13/2) 2+3+3+2 MISCELLANEOUS 1. Nephrogenic Diabetes Insipidas (98/2) 15 14 RHEUMATIC DISEASES KAWASAKI DISEASE 1. Phases and complications of Kawasaki’s disease (06) 10 2. Kawasaki Syndrome (00/1) 15 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 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
  26. 26. 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 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 15 INFECTIOUS DISEASES PUO 1. Discuss definition, etiology and 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
  27. 27. 11. Enumerate opportunistic infections in HIV infected children. How will you treat and prevent pneumocystis jiroveci infection. (12/1) 5+3+2 11. Briefly discuss the pulmonary disorders seen in children with HIV/ AIDS. (13/1) 10 12. Discuss the key issues in the management of an HIV exposed infant. (13/2) 10 TB 1. Diagnosis and management of a child with resistant TB (02/1) 15 2. Short course chemotherapy for TB (98/2) 10 3. Prevention and early detection of TB (96/2) 15 4. CNS changes in Tubercular meningitis(Pathological only) 15 5. Discuss the pathogenesis, clinical symptomatology and diagnosis of NeuroTB (06) 10 6. 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 7. Newer diagnostic modalities for TB (06) 10 8. Describe clinical manifestations, diagnosis and management of Neuro – tuberculosis. (11/2) 3+4+3 8. Discuss the recent guidelines for diagnosis and management of childhood tuberculosis. (13/1) 10 9. Describe aetiopathogenesis, diagnosis and management of different types of neurotuberculosis. (13/2) 3+4+3 ENTERIC FEVER 1. Interpretation of Widal test in immunized children (98/2) 10 2. Nontyphoidal salmonellosis (95/2) 15 3. Management of typhoid fever (95/2) 15 4. Treatment of typhoid fever (93/1) 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. Pathogenesis of bleeding and shock in Dengue fever (98/2) 10 2. Discuss the management of Dengue Shock Syndrome (97/1) 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)
  28. 28. 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 E COLI 1. Classification of E coli and pathogenesis of Invasive Diarrhoea (95/1) 15 2. Discuss the pathogenesis of E. coli diarrhea (94/2) 15 POLIO AND AFP 1. AFP Surveillance (99/2) 15 2. Approach to a child with AFP and components of AFP surveillance (00/1) 15 3. AFP- Definition, Differential Diagnosis in details, how help in polio eradication (03/2) 25 4. Discuss the differential diagnosis and management of acute flaccid paralysis in a 2 year old child. (04/2) 5+5 5. What is AFP? Discuss the differential diagnosis and management of a child with AFP. Discuss AFP surveillance (05) 2+3+2+3 6. 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 7. Pulse Polio programme (02/1) (98/1) 15 8. Define AFP. Enlist the causes and investigations of a case of AFP (06) 10 9. 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 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. Drug resistant Malaria (03/1) 15 4. What are management guidelines of malaria under the national programme. How will you manage a case of cerebral malaria. (04/2) 4+6
  29. 29. 5. Enumerate manifestations of Severe Malaria and their management (06/2) 10 6. 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 7. 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) 8. Define complicated malaria. Describe the management strategies of complicated malaria. (09/2) 3+7 9. 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 management of a child with cerebral malaria. (13/1) 4+6 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 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
  30. 30. 11. Discuss prevention and prophylaxis against meningococcal infection (05) 5+5 12. Prophylaxis of Meningococcemia (06/1) 10 SYPHILIS 1. Radiological features and confirmatory laboratory tests for congenital syphilis (07/1) 10 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. Comment on clinical features, diagnosis and treatment of Swine flu in children. (09/2) 2+3+5 5. 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. 6. Describe the etiology, mode of transmission, clinical features and management of viral hemorrhagic fever in children. (12/1) 2+2+3+3 16 DIGESTIVE SYSTEM GIT 1. What is H.Pylori Bacillus? How is it associated with chronic abdominal pain (98/2) 10 2. Pathogenesis of Celiac Disease (97/2) 15 3. Pathogenesis of Persistent Diarrhea of infancy (96/2) 10 4. Diagnosis of carbohydrate intolerance (95/1) 15 5. Gastro esophageal Reflux (94/2) 15 6. Persistent Diarrhea (99/1) 15 7. Chronic Diarrhea in Infancy (00/1) 15 8. Immunological features associated with cow milk allergy 15 9. 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 10. Write management of Persistent Diarrhea (06) 5 11. Approach and management of a child with Persistent Diarrhea (06) 10 12. Diagnosis and management of a child with Celiac Disease (06/1) 10 13. Tracheoesophageal Fistula and Esophageal atresia (06/1) 10 14. Aetiopathogenesis and diagnosis of celiac disease (07/2) 10 15. Define malabsorption. Enlist the generalized and specific malabsorption states. Discuss the investigative plan for a child with generalized malabsorption. (08/1) 10
  31. 31. 16. 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 17. Etiology, pathogenesis, clinical features and management of acute pancreatitis in children. (10/1) 2+2+2+4 18. Describe the etiology, pathogenesis, diagnosis and treatment of antibiotic associated diarrhoea. (10/2) 1+2+3+4 19. Enlist the functions of pancreas. Outline the pancreatic function tests and their implications in pediatric practice. (10/2) 4+6 20. Outline the etiopathogenesis of chronic diarrhea and provide a scheme of investigating for a child with chronic diarrhea. (11/1) 5+5 21. Describe the types of diarrhoea with examples. Discuss their pathophysiological mechanisms. (11/2) 5+5 22. 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 23. Define gastro – esophageal reflux disease (GERD). Describe its clinical features, diagnosis and treatment. (12/1) 1+3+3+3 24. 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 25. 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 26. 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 27. Discuss the treatment of the following: Persistent constipation (14/1) 3 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 13. Define probiotics and prebiotics and enumerate their essential characteristics. Outline the effects of probiotic in various gastrointestinal disorders. (09/1) (5+5) 14. Discuss the management of acute diarrhea with particular reference to low osmolarity ORS, zinc, probiotics and antibiotics. (10/2) 3+2+3+2 15. 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 16. Write short notes on: Prebiotics, probiotics and symbiotics (13/2) (5)
  32. 32. 17. Write short notes on: (14/1) 3+4+3 a) Probiotics b) Enteral feeding in the sick child c) Magnesium in therapy HEPATOBILIARY 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. Laboratory Finding of Fulminant Hepatic Failure (98/2) 10 4. Diagnosis and management of Acute Viral Hepatitis (96/2) 12 5. Cholestatic Jaundice 15 6. Biliary Atresia (95) 15 7. Describe Biochemical and Pathological changes in various organs in Hepatic Encephalopathy. How will you manage a case (93/2) 10 8. Hepatic Encephalopathy- pathophysiology and management (03/2) 25 9. List the causes of infantile cholestasis. Provide an algorithm for the diagnosis of infantile cholestasis. (04/2) 3+7 10. Persistent Jaundice in neonates (06) 10 11. Clinical approach, investigations and management of a neonate with Cholestatic jaundice (06/1) 10 12. Discuss the management of Fulminant Hepatic Failure. Add a note on Liver Transplantation (06) 13. 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 14. 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 15. Define Fulminant Hepatic Failure and outline the staging of severity of Hepatic encephalopathy. Discuss the steps in its management. (09/1) 4+6 16. Outline the differential diagnosis of tender hepatomegaly. Describe the management of liver abscess. (10/1) 5+5 17. Outline the management of an 8 year old child with acute liver cell failure and hepatic encephalopathy. (10/2) 10 18. 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 19. Define neonatal cholestasis. Outline clinical features and scheme for evaluation of a neonate with cholestasis. (11/1) 2+3+5 20. Describe clinical, laboratory and radiologic evaluation of possible liver dysfunction in children. (11/2) 3+4+3 21. Enumerate the causes and discuss the types, pathogenesis and evaluation of ascites in children. (11/2) 2+2+3+3
  33. 33. 22. Discuss the pathogenesis, clinical presentations, diagnosis and treatment of Wilson’s disease. (13/1) 2+3+3+2 MISCELLANEOUS 1. Hematemesis (94) 15 2. Differential Diagnosis of Ascites in children (93/1) 10 3. 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 4. Management of Acute Upper GI Bleeding (06) 10 5. Discuss the management of acute upper gastrointestinal bleeding in a 5 year old child. (08/1) 10 6. 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 17 RESPIRATORY SYSTEM CLINICAL EXAMINATION 1. 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 2. Outline the pulmonary function testing in children with emphasis on performance and interpretation of spirometry. (08/1) 10 3. Briefly discuss the non invasive estimation of gas exchange in children.(04) 10 4. Discuss Pulmonary Function Tests and their clinical utility. (13/2)7+3 BRONCHIAL ASTHMA 1. Describe the pathogenesis of Bronchial Asthma. Give an outline for prevention and treatment of recurrent episodes (02/1) 25 2. Treatment of Bronchial asthma (96/2) 3. Discuss briefly the recent advances in the management of Bronchial Asthma (99/1) 15 4. Use of Nebulizers in Pediatric practice (95/2) 10 5. Aerosol therapy in children (95/2) 15 6. Management of Acute Severe Asthma (92/2) 15 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
  34. 34. 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 step – wise management of chronic asthma in children . (11/2) 3+7 PNEUMONIA 1. Discuss briefly the Differential diagnosis and management of a case of Persistent Pneumonia in a 3 month old infant (99/2) 15 2. Treatment of Staphylococcal pneumonia (93/1) 10 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 STRIDOR 1. A 2 year old child presents to the hospital with fever and Stridor of 12 hour duration. Discuss the diagnosis (97/1) 10 2. Management of Acute Stridor in a Preschool child (93/1) 15 3. List the common causes of stridor in children. How will you diagnose and manage a case of stridor. (04/2) 3+4+3
  35. 35. 4. 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 5. Clinical Evaluation and management of a child with stridor (06/1) 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 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 TONSILITIS 1. Management of Acute Tonsillitis in children (98/1) 15 2. Discuss the treatment of the following: 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 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
  36. 36. 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 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. Differential diagnosis of Hemoptysis in children (95/2) 10 2. Diagnosis of Bronchial Foreign Body (93/2) 10 3. Write notes on embryological development of abdominal diaphragm and types of congenital diaphragmatic hernia (06) 10 4. Describe the etiology, stages of evolution, clinical manifestations, diagnostic investigations and management of empyema thoracis (11/1) 1+2+2+2+3 5. 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 6. 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 18 CARDIOVASCULAR SYSTEM HEART FAILURE 1. Intractable congestive heart failure- management approach (02/1) 15 2. Treatment of Intractable CCF (93/2) 10 3. Newer approaches in management of CCF (93/1) 15 4. ACE inhibitors in CCF with congenital heart disease (03/1) 15 5. CCF- Pathophysiology and management (03/2) 25 6. Describe briefly the Pathophysiology of CCF and management of Refractory Failure (98/2) 25
  37. 37. 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 HYPERTENSION 1. Discuss the causes of Hypertension in a 7 year old child. Approach of investigation and management of such a case (02/1) 25 2. Treatment of Hypertension (97/2) 12 3. Investigations in a child with Hypertension (95/1) 10 4. Discuss etiology, diagnosis and management of Childhood Hypertension (00/1) 25 5. Severe Hypertension in infancy (00/1) 15 6. Diagnosis of Essential Hypertension in children (93/1) 10 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. Discuss the treatment of Hypertension in children. Classify the drugs used to treat hypertension and briefly mention their mechanism of action (07/2) 10 10. Essential Hypertension in children (07/1) 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 CONGENITAL HEART DIAEASE 1. Pathophysiology of Cyanotic spells (02/1) 15 2. How do you classify congenital cyanotic heart disease? Discuss their investigations (97/2) 15 3. Cyanotic Spell (94/2) 15 4. Complications of Fallot’s Tetralogy and their management (99/2) 10 5. Management of Paroxysmal Hypercyanotic spell (99/2) 15
  38. 38. 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 various minimally surgical invasive devices and procedures available for the management of common congenital heart diseases in children (07/1) 10 10. 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 11. 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 12. 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 13. 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 ARRYTHMIA 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 CARDIOMYOPATHY 1. Diagnosis of Cardiomyopathy (96/2) 12 2. Cardiomyopathy (95/1) 15 3. Discuss in brief the etiopathogenesis, clinical features and management of dilated cardiomyopathy. (12/1) 3+3+4
  39. 39. PERICARDITIS 1. Diagnosis and management of Constrictive Pericarditis (99/2) 10 CLINICS 1. Significance of S2 in clinical practice (98/1) 15 2. Enumerate the conditions where you can get · Loud S2 · Wide splitting S2 Explain the pathophysiology of fixed splitting of S2 (05) 10 3. 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 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 MISCELLANEOUS 1. 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 2. Primary Endocardial Fibroelastosis (98/1) 15 3. Cardiovascular Risk factors in children (96/1) 15 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 6. Fetal Circulation and cardiovascular adjustments after birth (06/1) 10 7. Outline Fetal Circulation (07/2) 8. 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 9. Fetal circulation and changes after birth (10/1) 5+5
  40. 40. 10. Depict diagrammatically fetal circulation. Highlight its unique features differentiating it from neonatal circulation. Outline important changes occurring at birth. (11/1) 4+3+3 11. 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 19 DISEASES OF THE BLOOD ANAEMIA 1. Severe anemia in the first year of life (02/1) 15 2. Describe laboratory investigations in an infant with anemia and briefly outline the interpretation of test results (95/1) 25 3. Discuss the etiology and investigations in a case of Anemia (94) 25 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 6. Discuss the etiology and management of Autoimmune Hemolytic Anemia (09/1) 3+7 7. Classify causes of acquired pancytopenia. Write briefly about the management of acquired aplastic anemia. (09/1) 3+7 8. Define pancytopenia. Enlist the causes and assessment of severity of aplastic anemia in children. (10/1) 2+4+4 9. Discuss the etiology, pathogenesis and diagnostic workup of Acute autoimmune hemolytic anemia. (10/2) 3+3+4 10. List the causes of microcytic hypochromic anemia. Provide differentiating features between iron deficiency anemia and beta thalassemia trait. Describe the management of thalassemia major. (11/1) 3+3+4 11. 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 12. Define pancytopenia. Enumerate common causes in children. How will you assess severity of acquired anemia in children? (11/2) 2+3+5 THALASSEMIA 1. Genetic basis of Thalassemia syndromes (02/1) 15 2. Current management of Thalassemia Major (96/2) 15
  41. 41. 3. Newer modalities in the management of β Thalassemia Major (99/2) 10 4. Antenatal diagnosis of Thalassemia (99/2) 15 5. Recent concepts for treatment of Thalassemia in children (95/2) 10 6. 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 7. Outline the antenatal management of a mother with an earlier child with thalasemia major (07/2) 10 8. Alpha Thalassemia (07/1) 10 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 IRON DEF ANEMIA 1. Management of Iron Deficiency anemia (98/2) 10 2. Prevention of Iron Deficiency Anemia in children (95/2) 15 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. 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 2. G6PD deficiency (99/2) 10 3. Pathogenesis of anemia in G6PD Deficiency (99/1) 15 4. Briefly outline normal erythropoiesis. Describe the diagnosis and treatment of G6PD deficiency (07/2) 10 MEGALOBLASTIC ANEMIA 1. Megaloblastic anemia (03/2) 15
  42. 42. 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 HEMRRHAGIC AND THROMBOTIC DISEASES 1. Antenatal diagnosis and career detection of Hemophilia (98/2) 15 2. DIC (96/2) 15 3. 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 4. 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 5. 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 6. Various treatment modalities in acute ITP (06) 10 7. Discuss the various aspects of management of a child with Hemophilia A (07/2) 10
  43. 43. 7. Discuss the pathogenesis of disseminated intravascular coagulation (DIC) and relate it to the laboratory abnormalities observed in this entity. (08/1) 10 8. Diagrammatically outline the Normal Coagulation Cascade. Outline diagnosis and management of disseminated Intravascular Coagulation (DIC) (09/1) 4+6 13. Write in brief regarding the etiology and management of idiopathic thrombocytopenic purpura.(ITP) (11/1) 4+6 14. 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 15. Discuss the treatment options for acute ITP in a 14 year old girl child. (13/1) 10 16. 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 17. 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 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. 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 5. 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 6. Discuss the indications for stem cell transplantation therapy in children. What is its rationale and sources for stem cells. (13/2) 5+3+2 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
  44. 44. 20 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. Utility of immunophenotyping in the diagnosis of leukemia in children. Outline the treatment of acute lymphoblastic leukemia. (09/2) 4+6 LYMPHOMA 1. Different types of Lymphomas in children and their Histopathological classification (93/2) 15 MISCELLANEOUS 2. Define tumour lysis syndrome. Enlist its important constituents. Outline its etiology and describe the management. (08/1) 10 3. Write in brief the clinical manifestations, laboratory findings and management principles of Langerhans Cell Histocytosis. (09/1) 10 4. Classify childhood histiocytosis. Describe the clinical manifestations, diagnosis and treatment of Langerhan’s cell histiocytosis. (10/1) 3+3+2+2 5. Outline the essential components and pathophysiology of tumor lysis syndrome. Describe its management. (11/1) 2+4+4 6. 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 7. 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 21 UROLOGIC DISORDERS IN INFANTS AND CHILDREN ENURESIS 1. Define Enuresis. Discuss its manifestations and management (06) 5 2. Enuresis (96/2) 15 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
  45. 45. 5. Discuss evaluation and management of an 8 year old male with primary nocturnal enuresis. (10/2) 4+6 UTI 1. Imaging studies indicated in a child with UTI (06) 10 2. Recurrent UTI in childhood (02/1) 15 3. Management of a 2 year old child with first attack of UTI (99/2) 10 4. Describe the etiological factors, clinical manifestations and management of children with UTI (95/2) 25 5. Investigation of a 7 year old boy with Recurrent UTI (93/2) 10 6. Recurrent UTI (03/2) 15 7. Classify UTI and provide an algorithm for management of a child with first episode of UTI (05) 3+7 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. Management of an infant with VUR (93/1) 15 2. Discuss criteria for diagnosis, staging and management of VUR (92) 25 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 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
  46. 46. 22 ENDOCRINE SYSTEM THYROID GLAND 1. Management of Puberty Goiter (98/2) 15 2. Diagnosis of Congenital Hypothyroidism (95/1) 15 3. Endemic Cretinism (99/2) 15 4. Congenital Hypothyroidism (00/1) 15 5. Etiopathology of Congenital Hypothyroidism 15 6. Management of Puberty Goiter (93/1) 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. Neonatal Thyroid Screening (07/2) 10 11. Discuss causes, clinical features and management of Acquired Hypothyroidism (07/2) 10 12. Congenital Hyperthyroidism (07/1) 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 DIABETES MELLITUS 1. Describe briefly the biochemical changes and management of DKA (98/1) 25 2. Complications of Juvenile Diabetes Mellitus and their management (97/1) 15 3. Management of DKA (95/2) 15 4. Emergency management of DKA (93/1) 15 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
  47. 47. 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 child with DKA? (11/2) 3+3+4 13. Discuss the pathophysiological abnormalities in diabetic ketoacidosis. Describe the management of diabetic ketoacidosis in a child weighing 20 kg. (13/2) 4+6 HYPOTHALAMUS AND PITUITARY 1. What are the causes of Dwarfism? How will you investigate such a case (97/2) 15 2. SIADH (99/1) (99/2) 10 3. Indications of Growth Hormone Therapy (93/2) 10 4. Define Short Stature. Discuss the approach to a child with short stature and the role of GH in Short Stature (05) 2+5+3 5. How will you diagnose and treat SIADH in a child (06) 5 6. How will you assess a child presenting with features of Diabetes Insipidus (06) 10 7. 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 8. Short stature – definition, differential diagnosis and management approach. (10/1) 2+3+5 9. Diagnostic approach for a child who presented with polyuria and polydipsia. (10/1) 10 10. Outline the diagnostic criteria of diabetes insipidus. Discuss the management of nephrogenic diabetes insipidus. (10/2) 4+6 11. Enumerate the hormones secreted by anterior pituitary and list the factors stimulating and inhibiting secretion of growth hormone. (10/2) 3+7 12. Outline the diagnostic criteria for Syndrome of Inappropriate ADH Secretion (SIADH). Discuss its etiopathogenesis. (12/1) 6+4 13. Define short stature. Outline the approach to clinical evaluation and management of a child with short stature. (13/1) 2+8 14. Discuss approach to the diagnosis of a child presenting with polyuria and polydipsia. (13/2) 10 15. 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 16. Write short notes on the evaluation and treatment for a child with: (14/1) a) SIADH 5 b) Virilisation 5

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