Theory question bank update 2016: Part 1


Theory question bank in multiple parts reorganized and updated till 2016. Each part has one or two related systems. So easy to keep and carry in bag for day today preparation before exams.

What new in this update
1. All questions reorgnaised.
2. Questions arranged chapterwise as per appearance in Nelson’s textbook of Pediatrics.
3. Arranged in chronological order old first and latest last.
4. Adequate space and gaps given to take side notes and jot doin points for last minute revision.
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

1. GROWTH AND DEVELOPMENT

DELAYED SPEECH

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

DEVELOPMENTAL REGRESSION

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

GROWTH CHARTING AND MONITORING

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

SHORT STATURE

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

DEVLOPMENTAL DELAY

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

2. PSYCHOLOGIC DISORDERS

PSYCHOSOMATIC ILLNESS

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

HABIT DISORDER

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

DISRUPTIVE BEHAVIORAL DISORDERS

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

SLEEP MEDICINE

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

ENURESIS

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

3. SOCIAL ISSUES, CHILDREN WITH SPECIAL HEALTH NEEDS


FAILURE TO THRIVE

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

ADOPTION

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

CHILD ABUSE

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

MENTAL RETARDATION

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


4. NUTRITION

PEM


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

VIT A

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

VIT B

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

VIT D

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

VIT C

1. Scurvy- radiological changes. How are they produced? What is the role of Blood Level of Vit C in the diagnosis (05)10

VIT E

1. Enumerate the functions and therapeutic uses of Vit E (98/1)15
2. Vitamin E and its role in human nutrition (92/2)15

VITAMINS

1. Hypervitaminosis in Children (96/1) 12

COPPER

1. What are the dietary sources of copper? What are the diseases associated with abnormal copper metabolism? Describe investigat., clinical features and treatment of any one of them. (09/2)1+2+7

ZINC

1. Relevance of Zinc in human nutrition (92)15
2. Role of Zinc in health and diseases of children (97/1)10
3. Effects of Zinc supplementation in persistent diarrhea (98/2)10
4. Give dietary requirements of Zinc in children and discuss its role in childhood immunity and infections (07/1) 10
5. Write short notes on: Zinc supplementation – when and how? (11/2) 5

MAGNESIUM

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

MILK

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

IODINE 

1. Prevention of Iodine deficiency (95/1)15

FLUORINE

1. Prevention of Fluoride toxicity (95/1)15
2. Fluoride and disease 2 (Apr16)

OBESITY

1. Approach to a child with obesity (99/1)15
2. Define obesity in childhood. List the causes of obesity in children. Outline strategies for its prevention. (04/2)2+3+5
3. What is Obesity? Discuss the management in children (05)3+7
4. Approach to a child with Obesity (06/1)(07/2)10
5. Outline the diagnostic measures and clinical manifestations of obesity. Enlist the differential diagnosis of childhood obesity. (09/2) 2+3+5
6. Define syndrome X. Outline the diagnostic criteria and laboratory work up for obese children. (10/1)2+3+5
7. Define obesity. List causes of obesity. Discuss approach to a child with obesity. (11/1)2+3+5
8. A 2 year old toddler presents with a weight of 25 kg. Discuss the possible causes, evaluation and treatment for this child. (14/1)3+4+3

MISCELLANEOUS

1. Metabolism of fat absorption along with role of MCT in nutrition (03/1)15
2. What is Complimentary Feeding? Discuss the feeding problems in first year of life (05)5+5
3. How would you assess the nutritional status of a child whose age is not known (05)10
4. Describe the attributes of complimentary feeding. What is the safe age of introduction of complementary feeding in your opinion – Justify. Describe some foods appropriate for complimentary feeding. (08/2)10
5. Daily nutritional requirements as recommended Daily Allowance (RDA) in infants and children. (10/1)5+5
6. Define complimentary feeding. Outline the attributes of complimentary foods. Enumerate the recommendations on complimentary feeding, as per the National guidelines on Infant and Young Child Feeding (IYCF) (10/2) 2+2+6
7. Name the micronutrients required for various body functions. Discuss briefly their dietary sources and the effects of deficiency of mineral micronutrients (trace elements). (11/2)3+2+5
8. Outline the nutritional support of a critically ill child. List the complications during management of such a child. (12/1)7+3
9. Enteral feeding in the sick child 4(14/1)
10. Role of micronutrient in pediatric health and diseases. 5(Apr16)

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

SHOCK

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

POTASSIUM

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

SODIUM

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

PHOSPHATE

1. Etiology, pathogenesis, clinical features and management of Hypophosphatemia 2+3+2+3(Apr 16)

ACID-BASE BALANCE

1. Define pH and base excess. Discuss briefly regulation of Acid-base homeostasis and management of Respiratory Acidosis (93/1)15
2. Physiological compensatory mechanisms during Metabolic Acidosis (97/1)15
3. Describe briefly how the acid-base balance of body is maintained in health (98/1) 25
4. Anion Gap (98/2) (00/1)10
5. Pathophysiology of Acid-base disorders (03/1)15
6. Anion Gap (03/2)15
7. Define anion gap and its utility. Outline the major causes of metabolic acidosis in children. Outline the treatment of renal tubular acidosis. (04/2)2+4+4
8. Outline the normal mechanism of acid-base regulation in children. What is anion-gap? Describe the causes and management of a child with metabolic acidosis (07/2)10
9. List the causes of metabolic alkalosis. Describe the pathophysiology, clinical features and treatment. (08/2)10
10. Classify metabolic acidosis based on anion gap. Mention the various causes of lactic acidosis. Describe the approach to diagnosis of inborn error of metabolism in an infant. (08/2)10
11. Classify and enlist the causes of metabolic alkalosis. Outline the treatment modalities. (10/1)3+3+4
12. Define anion gap. Enlist causes of increased anion gap acidosis and discuss its management in brief. (11/1)2+3+5
13. What is anion gap? Discuss the acid base distribution in metabolic acidosis. Enumerate the causes of increased anion gap and normal anion gap metabolic acidosis. 1+5+(2+2)(15/2)

DEHYDRATION

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

MISCELLANEOUS

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