Theory question bank update 2016: Part 2


Theory question bank in three parts reorganized and updated till 2016

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

6. ACUTELY ILL CHILD

DROWNING

1. Near drowning in children (06)10 Rpt (15/1) 4 marks
2. An 18 month old child was brought to you after he fell upside down in a tub filled with water. Briefly describe the possible injuries and preventive strategies to avoid similar situation in future. (08/1)10
3. Describe the pathogenetic mechanism of injury in near drowning. Discuss the steps of initial resuscitation and subsequent hospital management. (08/2)10
4. Discuss the pathophysiology of submersion injury. A 4 year old boy was rescued 10 min back from a pond and rushed to the hospital emergency. Mention the basic principles of management. (12/1) 5+5
5. A. Define near drowning 2
B.Pathophysiology and management of near drowning 4+4 (1/16)

PAIN

1. Pain management in infants and children (98/1)15
2. Pathogenesis and management of pain in children (06)10
3. Enumerate various sedatives and analgesics recommended for children undergoing painful procedures. Describe their main action, indication in pediatric practice and important side – effects in a tabular format. (08/1)10
4. Write short notes: (12/1) 5+5
a)Non-pharmacological methods in pain management.
(Rpt 4 marks)(Apr16)
b) Drug therapy in neonatal pain management.

BURN

1. How is the degree of Burns classified? Write the initial fluid therapy for a one year old child weighing 10 kg with 20% 2ND degree burns (06)10
2. Provide classification of burns injury. Describe the clinical manifestation of electrical burns. Outline emergency management of a child with 20% burns. (11/2)2+3+5

COLD INJURIES

1. Cold Injury (07/1) 10

BRAIN DEATH

1. Brain Death (98/1) (99/2) 15
2. Define Brain Death. Write age specific criteria for Brain Death in children. (11/2)2+8

P.A.L.S.

1. Draw an algorithm for managing pulseless ventricular tachycardia and ventricular fibrillation. (08/1) 10
2. How will you assess that a 10 year old child who has fallen unconscious in front of you required basic life support. What are the steps for basic life support to such a child (as per American Heart Association Guidelines for CPR) (09/1) 3+7
3. What is Rapid sequence intubation (RSI)? Outline the steps involved. Discuss the indications and advantages of RSI. (14/2) 2+5+3

MECHANICAL VENTILATION

1. Describe the various pressures which are used or varied during mechanical ventilation. What is ‘Cycling’ and ‘Control’ in mechanical ventilator? Describe the differences in pressure controlled and volume controlled ventilation. Illustrate with suitable indication use of these forms of ventilation. (08/2)10
2.Write short notes on: Central hypoventilation syndrome. (13/2) 5
3.A) High frequency oscillatory ventilation (HFOV) 5(15/1)
  B) pulmonary graphics 5

MISCELLANEOUS

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

7. GENETICS

1. Early stimulation in Down syndrome (92/2)15
2. Genetic counseling of a case of Down Syndrome (99/1)15
3. Prenatal diagnosis of Down syndrome and Duchenne Muscular Dystrophy 15
4. Briefly discuss the principles of genetic counseling. Outline the counseling of a family with a child with Down’s syndrome. (04/2)5+5
5. Gene Therapy in Children (06/1)10
6. Gene therapy (07/1)5
7. Enumerate and describe the structural abnormalities of autosomes. Illustrate with suitable examples. (08/1)10
8. What are trisomies? What are predisposing factors? Discuss clinical features of 3 common trisomies seen in clinical practice? (08/1)10
9. A couple has a child with Down Syndrome. Outline the principles of genetic counseling and antenatal management for the subsequent pregnancy. (09/1)10
10. Write a short note: Karyotyping (09/2)5 Rpt (14/2)
11. What are mutations? Describe their consequences. (10/1)5+5
12. Discuss the genotypic and phenotypic features of Turner’s syndrome (11/1) 4+6
13. What are mitochondrial genes? How are they transmitted? Briefly discuss diseases transmitted by them? (11/2)2+2+6
14. Enumerate classic and non-classic forms of genetic inheritance. Discuss in brief the characteristics of autosomal recessive inheritance. Illustrate with a pedigree chart. (13/1) 5+3+2 (13/2) 2+2+6
15. Describe the symbols used in pedigree chart. Draw pedigree charts over 4 generations depicting a) X – linked dominant disease b) X – linked recessive disease. 4+3+3 (Apr16)
16. Define transloction.Write the inheritance pattern for translocations. Describe clinical features of any one translocation disorder. 6(Apr16)
17. Primary and secondary prevention of genetic disorders 5+5 (1/16)


8. METABOLIC DISEASES

1. Homocysteinuria (94/2)15
2. Screening tests for Inborn Errors Of Metabolism (96/2)10
3. Metachromatic Leukodystrophy (96/1)12
4. Discuss the diet plan in various metabolic disorders (99/1)15
5. Write briefly about glucose metabolism in body. Describe briefly glycogen storage disorders. (04/2)4+6
6. Laboratory Screening tests for metabolic Disorders (06/1)10
7. Provide a diagrammatic representation of urea cycle. Indicate and name related disorders of urea cycle metabolism at each step. (08/1) (Rpt 15/2) 10
8. Discuss the enzymes replacement therapy and substrate reduction strategies in management of metabolic disease. (08/2)10
9. Enlist the inborn errors of metabolism (IEM) with their associated peculiar odor. Provide the investigative approach for an infant with suspected IEM. Describe the treatment of phenylketonuria. (09/2) 4+4+2


9. NEONATOLOGY


ANTENATAL DIAGNOSIS

1. Amniocentesis in prenatal diagnosis (92)15
2. Intrauterine Diagnosis (93/2)10
3. Discuss the methods of detection of congenital malformations in the fetus and their prevention (95/1)25
4. Antenatal Diagnosis (98/2)10
5. Methods to diagnose fetal disorder. Fetal medical therapy (05)5+5
6. List various methods for Fetal diagnosis and assessment along with indications (06)5
7. Prenatal Diagnosis and Fetal therapy (06/1)10
8. Treatment and prevention of fetal diseases (07/1)10
9. Medical management of Fetal Problems (07/2)10
10. What are the methods of diagnosis of fetal disorders? Describe the fetal medical and surgical therapeutic options for various fetal disorders. (09/2) 10
11. Antenatal screening for Down syndrome (13/1) 5
12. Outline the methods of assessing fetal well being with their clinical indications. (13/2 10
13. Fetal therapy 5(1/16)

FETUS

1. Describe in detail tests for antepartum and intrapartum monitoring of fetal distress (06)5
2. Fetal monitoring (06) 10
3. Discuss the complications in the fetus and newborn of a mother with diabetes during pregnancy. (08/1)10

RESPIRATORY DISTRESS

1. Pathophysiology of RDS of newborn (94)15
2. Tests for pulmonary maturity and surfactant therapy for RDS (94/2)15
3. Surfactant therapy (98/2)10
4. Surfactant therapy for HMD 15
5. Discuss RDS with special reference to surfactant therapy (98/2)15
6. Describe the surgical causes of Respiratory difficulty in newborn (02/1)25
7. HMD- pathophysiology and management (03/1)25
8. List the causes of respiratory distress in preterms. Outline the principles of surfactant therapy in preterms. Outline the manifestations of oxygen therapy in newborns. (04/2)2+4+4
9. Etiology, pathogenesis and management of a neonate with RDS (06/1) 10
10. CPAP (06/2)10
11. Briefly discuss normal fetal development of Surfactant. List the uses of Surfactant in newborn (07/2)10
12. Discuss the pathophysiology of hyaline membrane disease in premature newborns. (10/2)10
13. Describe the pathophysiology of hyaline membrane disease (HMD) in newborns. Outline important available strategies to prevent HMD.
(11/1) 5+5
14. A)CPAP for neonatal RDS 5
B) Surfactant replacement therapy 5 (15/1)
14. Silverman Anderson scoring system 5 (15/2)

MECONIUM ASPIRATION SYNDROME

1. Meconium Aspiration Syndrome (97/2)15
2. Discuss the pathogenesis and management of MAS (00/1)25

BPD

1. BPD (97/1)15
2. Outline and discuss the strategies to prevent lung injury and bronchpulmonary dysplasia in a preterm baby. (13/1) 10

PPHN

1. Describe in brief PPHN (or PFC) with regard to Pathology, pathophysiology, Diagnosis and management (94/2)25
2. What is the etiopathogenesis of PPHN of Newborn. Outline the
diagnosis and management (05)3+3+4
3. PPHN (06/1)10
4. Discuss the diagnosis and management of PPHN (07/2)
5. Enumerate causes of persistent pulmonary hypertension in neonates and discuss its pathophysiology. (08/1)10
6. Discuss the approach to diagnosis of Persistent Pulmonary Hypertension of Newborn (PPHN). Outline the available modalities of management, highlighting their key features in a tabular format.
(10/2)4+6
7. Etiology and management of persistent pulmonary hypertension. (14/2) 3+7
8. Pathophysiology of persistent fetal circulation. (15/1) 3

SURGICAL

1. Enumerate congenital anomalies presenting as severe respiratory distress in a newborn. Describe the pre-operative and post operative care of a neonate with trachea-esophageal fistula. (10/1)4+3+3
2. Enumerate causes of persistent vomiting in a 4 week old child.
Describe clinical features and management of hypertrophic pyloric stenosis. (12/1)3+3+4
3. Describe the development of the midgut. Enumerate the causes for bilious vomiting in a two week neonate and discuss its management. (14/1) 3+2+5

RESUCITATION

1. Steps in Neonatal Resuscitation 15
2. Fetal circulation and changes at birth (00/1)15
3. How do you assign APGAR score to a neonate. In which 5 conditions will you get a low score without associated hypoxia? What are
fallacies of APGAR score. (06)10
4. What is the sequence of events leading to the first breath after
Delivery ? What is the significance of establishment of Functional
Residual Capacity? (06)10
5. A term baby is apnoeic. What information of the perinatal events you would like to know? What are the initial steps of management in the labor room? What are the possible complications in the next 48 hours? (08/2)10
6. Describe the changes taking place in circulation at birth and their
implications in neonatal resuscitation. (09/1)5+5
7. Enumerate the newer recommendations of neonatal resuscitation by American Academy of Pediatrics 2010 guidelines. Comment on the level of evidence for each of the changes. (12/1) 6+4
8. Discus the recent changes in guidelines for resuscitation of new born and older children with the rationale for the change. (13/1)10
9. Cyanosis in newborn 5 (Apr16)

BIRTH ASPHYXIA

1. HIE (93/1) (92/2)15
2. Prognosis of Birth Asphyxia (93/1)10
3. HIE in newborn (95/1)10
4. Discuss the etiopathology and management of birth asphyxia (96/2)25
5. HIE (97/2)15
6. Clinical and laboratory correlates of neuromotor outcome in Birth asphyxia (97/1)10
7. Discuss briefly pathophysiology and recent modalities of management of HIE (99/2)25
8. Perinatal asphyxia- clinical features and management (02/1)15
9. What are the etiological causes of Fetal Hypoxia? Write
pathophysiology of Fetal Hypoxia. Describe stages of HIE (06)10
10. Pathophysiology of Hypoxic Brain injury in neonate (06/1)10
11. Discuss the pathophysiology of hypoxic Ischemic Encephalopathy (HIE) in neonates.(09/1)10
12. Discuss etiology, pathophysiology, clinical manifestations and management of Hypoxic- Ischemic Encephalopathy. (13/2) 2+2+2+4
13. Neuroprotective strategies in CNS injuries in neonates 5(15/2)

NEONATAL SEIZURES

1. Etiopathogenesis of neonatal seizures (02/1)15
2. Management of Resistant Neonatal Seizure (03/2)15
3. Classify neonatal seizures. Outline their etiology and provide a brief clinical description. Provide general principles of management of a seizure in neonate. (12/1) 2+2+3+3

IVH

1. IVH (03/1)15
2. Outline the risk factors, pathophysiology and principles of management of intraventricular hemorrhage in preterm neonates. (10/2)3+3+4
3. Discuss the pathogenesis of intracranial hemorrhage in newborn
infants. Outline the possible promoters and protectors for occurrence of subsequent white matter disease. (12/1)6+2+2
4. Pathophysiology and managment of intraventricular hemorrhage. 5(15/2)

PAIN

1. Discuss the impact of pain on a preterm neonate. Identify common procedures associated with pain in a newborn. Describe the strategies for pain management in a newborn. (08/2)10
2. Write short notes: (12/1)5+5
a) Non-pharmacological methods in pain management.
b) Drug therapy in neonatal pain management.
3. Neonatal pain 5 (1/16)

NEONATAL HYPOGLYCEMIA

1. Management of neonatal hypoglycemia (98/2)(92/2)10
2. Define Hypoglycemia in newborn. List its causes. Describe stepwise treatment if hypoglycemia in a newborn (06)10
3. Define hypoglycemia. Describe clinical features and management of hypoglycemia in newborn and children. (11/2)1+4+5
4. A. Etiological classification of neonatal hypoglycemia 2
   B. Clinical features & mgmt. of neonatal hypoglycemia 3+5(1/16)

TEMPERATURE

1. Thermoregulation peculiarities in newborn (94/2)15
2. Hypothermia in the newborn (97/1)15
3. Thermal regulation in newborn (98/2)10
4. Prevention of Hypothermia in the newborn (98/2)15
5. Physiological and biochemical consequences of Hypothermia in Neonate (99/1)15
6. Thermal balance in Neonates (03/2)15
7. Discuss management of Neonatal Hypothermia (06)5
8. Write the components, pre-requisites and benefits of Kangaroo Mother care. (08/2) 10, (11/2)5+2+3
9. Discuss the principles of care of the skin in neonates. Outline the role of touch and massage therapy in newborn infants. (10/2)4+3+3
10. Describe the advantages and methods of giving Kangaroo Mother Care (KMC). Enlist metabolic consequences of hypothermia. (13/1) (4+4)+2

NUTRITION

1. Write short notes on: Trophic feeding (13/1)5
2. Discuss attributes, complications and monitoring of total parenteral nutrition in a newborn (13/1)5
3. Write short notes on: (14/1)4+3+3
a) Human Milk Fortifiers
b) Vitamin D supplementation in neonates
c) Medium chain triglycerides in neonatal nutrition

RENAL

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

INFECTIONS

1. Antibiotic treatment of Neonatal Meningitis (93/2)10
2. Early diagnosis of Neonatal Septicemia (94/2)15
3. Infants of HIV seropositive mothers (95/1)15
4. Infants of HBV seropositive mothers (95/1)15
5. Rapid diagnostic tests in a suspected case of Neonatal Septicemia (95/2) 10
6. Congenital toxoplasmosis (97/2)15
7. Infection control in neonatal intensive care (98/2)10
8. Newer modalities in the management of neonatal sepsis (99/2)15
9. Screening tests for neonatal sepsis 15
10. Prevention of Mother to Child transmission of Hep B 15
11. Sepsis Screen in neonates (06/1)10
12. Candidiasis in Neonates (06)10
13. Adjuvant therapy in Neonatal sepsis (06)10
14. Differential Diagnosis of Neonatal sepsis (07/1)10
15. Discuss various adjunct therapies in neonatal sepsis. (08/1)10
16. Discuss the risk factors for vertical transmission of HIV infection and methods to prevent parent to child transmission of HIV. (09/1)4+6
17. Discuss the predisposing factors, causative agents, methods of diagnosis and treatment of neonatal osteomyelitis. (09/1)4+6
18. A 3 day old home delivered boy (Weight 1450g, Gestation 36 wk) is brought to you with abnormal body movements and not accepting feeds. The child is cold to touch and capillary filling time is 5 sec. Outline the immediate, short term and long term management of this child. (09/1) 4+6
19. Enumerate the clinical features that indicate presence of a possible intrauterine infection in a neonate. Describe the interpretation of TORCH screen. (09/2)6+4
20. Clinical features, investigations and prevention of Congenital Rubella Syndrome. (10/1)3+3+4
21. Outline the clinical presentation, diagnosis and management of a neonate with intrauterine CMV infection. (11/1)3+4+3
22. Discuss the available strategies for prevention of mother to child transmission of HIV. (12/1)10
23. Write short notes on: Various adjunctive therapies in the management of overwhelming sepsis in neonates. (13/2) 5
24. A three days old neonate is brought to the Emergency woth history of not accepting feeds for one day. He is found to be lethargic with a HR of 180/min, and capillary filling time of 4 secs and cold extremities. Outline your approach to this neonate along with management of the case. (14/1) 4+6
25. Newer diagnostic tests for neonatal sepsis (15/1) 5
26. Congenital varicella (15/2)4

SFD

1. Factors associated with IUGR (93/1)10
2. Immune status of SFD babies (98/1)15
3. List the principles of community care of LBW infants. Define Kangaroo Mother care. Outline its advantages and disadvantages. (04/2)4+2+4
4. Outline the handicaps in enteral feeding of LBW newborns. Briefly discuss the feeding strategies for LBW babies. (04/2)3+4+4
5. Enumerate the etiology of fetal or intrauterine growth retardation (IUGR). Describe the screening and diagnosis of IUGR. (11/2) 3+4+3
6. Immediate and late problems due to low birth weight (13/1)5

APNEA OF PREMATURITY

1. Pathophysiology of Apnea Of Prematurity (97/2)15
2. A 10 day old preterm neonate has recurrent cessation of breathing lasting for more than 20 seconds with bradycardia. Classify and enumerate causes for this condition. Discuss in brief the management of this condition. (12/1)4+6
3. Management of neonatal apnea. (13/1) 5
4. Apnea Of Prematurity 5(Apr16)

RETINOPATHY OF PREMATURITY

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

OSTEOPENIA OF PREMATURITY

1. Osteopenia of prematurity (06)10

NEONATAL JAUNDICE

1. Pathogenesis of kernicterus (96/2)10
2. A 3 week old infant brought to the hospital with moderate jaundice. Discuss the Diagnosis (97/2)10
3. Kernicterus (97/1)15
4. Discuss the Bilirubin metabolism and list the causes and approach to Diagnosis of Hyperbilirubinemia in a neonate (00/1)25
5. Discuss reasons for Physiological Jaundice in a Newborn. Define and list causes of pathological jaundice in a newborn. Discuss clinical manifestations (acute and chronic)of kernicterus (06)10
6. Outline the normal metabolism of bilirubin. Outline the principle of phototherapy for treatment of neonatal jaundice. List factors that influence efficacy of phototherapy. (08/1)10(09/1)10,(10/2)4+3+3
7. Critically describe the role of various treatment modalities for treating neonatal unconjugated hyperbilirubinemia. (11/2)10
8. Outline and discuss various strategies to mange hyperbilirubinemia in newborns (13/1)10
9. Short note on side effects of phototherapy (14/2)5
10. Complications of unconjugated hyperbilirubinemia in a neonate (15/2)5

NEC

1. Pathogenesis of NEC (97/1) (92)15
2. NEC (97/2)15
3. Etiology and pathology of NEC 15
4. Etiology of NEC, staging and management. (04/2)10
5. Discuss management of NEC (06)5
6. Discuss the clinical features, diagnosis and management of neonatal necrotizing enterocolitis. (09/1)3+7
7. Discuss the pathophysiology, classification and diagnostic features of necrotizing enterocolitis. (10/2)4+3+3
8. A 6 day old preterm neonate presents with abdominal distension, feed intolerance, vomiting and blood in stools. Discuss the differential diagnosis, diagnostic approach and principles of initial stabilization. (12/1)4+3+3

NEONATAL HYPOTHYROIDISM

1. Clinical features of Cretinism in newborn babies (97/1)10
2. Describe in brief the etiology, clinical features, diagnostic investigations and management of congenital hypothyroidism. (11/1) 2+2+3+3

PRETERM

1. Enumerate the socio-demographic factors associate with Low birth weight babies. Discuss the clinical problems of Preterm babies (96/1)25
2. Pharmacotherapy in prematurity clinical decisions salient features (03/1)15
3. Management of Patent Ductus Arteriosus (PDA) in preterm neonates (10/1)10
4. Enumerate the factors associated with prematurity and low birth weight. Discuss the potential pathways by which infection plays a role in
premature delivery. (13/1)4+6
5. Describe the development of the ductus arteriosus. Enumerate the duct dependent lesions in the newborn and outline their management. (14/1)3+2+5

HAEMATOLOGY

1. Hemorrhagic Disease of The Newborn (95/2)15
2. Management of Neonatal Thrombocytopenic Purpura (00/1)15
3. Hydrops Fetalis (03/1)15
4. What is Hydrops fetalis. Discuss etiology of Non immune hydrops fetalis. What is the management of a case of Non immune hydrops fetalis (05)2+5+3
5. Discuss etiopathogenesis, diagnosis and management of a Bleeding Neonate (06/2)10
6. Anemia in newborn infant (07/1)10
7. Non immune hydrops fetalis (03/2)15, (07/1)10
8. Define polycythemia in a newborn. What are the factors predisposing to it? Describe the impact of polycythemia on various systems and their clinical presentation. Describe the management of polycythemia in newborn. (08/2)10
9. Outline the classification, clinical manifestations, laboratory findings and differential diagnosis of vitamin K deficiency bleeding. (12/1)3+3+2+2
10. A)Anemia of prematurity 5
   B)Treatment options for a 3 month old preterm who has Hb of 6gm%. 5(15/2)
11. Causes of Anemia in the Newborn (93/1)10 Rpt 5marks(Apr16)
12. Outline management of polycythemia 4(1/16)

FLUID THERAPY

1. Fluid therapy in special situations in neonates (06/1)10

HIGH RISK INFANT

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

MISCELLANEOUS

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