Theory question paper: Dec 2015

Dr Hemang Mendpara
Read the questions carefully and answer to the point neatly and legibly.
Do not leave any blank pages between two answers
Indicate the question number correctly for the answer in the margin space.
Answer the parts of a Single question together.
Start the answer to a question on a fresh page or leave adequate space  between two answers.
Draw table/diagrams/flowcharts wherever appropriate.
Time        : 3 hours
Max. Marks    : 100
Paper – 1

1. Give a diagrammatic representation of urea cycle. Indicate and name related disorders of urea cycle metabolism at each step. 10

(a) Clinical  signs  and  symptoms  of refeeding  syndrome. 7+3

(b) How will you manage such a case? 

(a) Mention  the  anatomical  and functional  factors  responsible for obstructive  sleep  apnoea  in children. 5+2+3

(b) Mention  the  anatomical  and functional  factors  responsible for obstructive  sleep  apnoea  in children. 5+2+3

4. Characteristic hematological features, laboratory findings and treatment of congenital    hypoplastic anaemia. (Dlamond Blackfan  anaemia). 3+3+4

5. Pathophysiology clinical  manifestations   and  management   of carbon  monoxide  poisoning. 3+3+4

(a) What  is bias in medical  research? 2+(4+4)

(b) Common  types  of bias  and the methods  to minimize  bias  in
analytical  studies. 

(a) Define child  abuse  and child  neglect. (2+2)+6

(b) Outline  the  steps  involved  in  management   of  a  suspected child of sexual  abuse.

(a) Attention-Deficit   Hyperactivity  Disorder  (ADHD).              5

(b) Gastroesophageal    Reflux   Disease   (GERD)   in  paediatric 
population. 5

(a) What  is relative risk (RR) and discuss  its implications? 1+3

(b) What  is the usefulness  of confidence  interval? 3

(c) Implications  of sensitivity and specificity. 3

10. Safe   injection   practices   at   level   III   care   with   respect   to
burden/deficiencies,   risks, technique,  handling and disposal. 2x5

Paper – II

1. What   is  Anion   gap?   Discuss   the   acid-base   disturbance    in metabolic  acidosis.   Enumerate  the causes  of increased  anion gap  and normal  anion  gap metabolic  acidosis. 1+5+(2+2)

2. Utility   of  newer   Neuro-imaging   modalities   In  paediatric   age group  and their  cost-effective- benefits. 5+5

3. Pathophysiology   and  managernent  of:
a) Refractory  shock.  5
b) Intraventricular   hemorrhage.  5

4. What  is 'Developmental   delay'?   Describe  different  tools  used for screening  and for diagnosis  of developrnental  delay. 2+(4+4)

a) Serologic  course  of acute  hepatitis  B.
b) Treatment  strategies  for  acute and chronic  hepatitis  B. 4+(3+3)

a) Anaemia   of  Prematurity.
b) Treatment   options  for  a 3 month  old  preterm  who has  Hb  of 6 gm% 5+5

a) Neuraprotective    strategies  in CNS  injuries  in neonates.  5
b) Camplications   of   unconjugated  hyperbihrubinemia  in   a neonate. 5

(a) Algorithmic   approach   to a neonate with  suspected   I.E.M.       5
(b) Silverman  Anderson   Scoring system.     5

9. Tabulate    the   mechanism    of  action, dosage, indications  and side  effects  of the  following. 2*5

a) Zonisamde b) Rufinamide c) Stiripental d) levetiracetam  e) Lacosamide

10. What are the definining    criteria    of   Systemic    Inflammatory Response Syndrome (SIRS)? Name the mediators involved and their mode of action.

Paper – III

1. Pathophysiology, clinical manifestations and  management   of salicylate  poisoning. 3+3+4 

a) Classification  of Spinal Muscular  Atrophies  (SMA). 5+5
b) Major   distinguishing   features   amongst   various   forms   of SMA.

(a) Free  Radicals. 5
(b) Febrile neutropaenia  - Definition  & management. 1+4

(a) What  is Developmentally  Supportive  Care?
(b) Components of Developmentally Supportive Care in neonates.                                                                                      
5. Algorithmic approach to a suspected case of Kawasaki disease. 3+7 Enumerate its complications  and outline the management. 5+(2+3)

6. Pathophysiology,   clinical  manifestations  and  management  of
Gluten sensitive  enteropathy. 3+4+3

7. A  2  month  old  baby  presents  with  history  of  failure  to  gain weight, tachypnea, tachycardia,  difficulty in  taking  feed  and excessive perspiration. On examination - no cyanosis, hepatomegaly and   a   systolic   murmur is noted.   Discuss differential  diagnosis,  investigations and management. 4+3+3

8. What is the pathogenesis of graft Vs host disease? What are its clinical   manifestations? What measures can be taken to prevent it in case of stem-cell transplantation? 4+3+3

9. Outline management of:
a) Steroid  resistant  nephrotic syndrome.  5
b) Child with pulmonary  involvernent with cystic fibrosis. 5

a) Congenital  varicella.  4
b) Complications  of  Pertussis.  3
c) Roseola  Infantum.  3

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