Theory question bank update 2016: Part 4


Theory question bank in parts, reorganized and updated till 2016: Part 4

What new in this update
1. All questions organised.
2. Questions arranged chapter wise 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 down 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

15. DIGESTIVE SYSTEM

BASIC SCIENCE

1. A) Embryology and antomy of pancreas
    B) Physiology of exocrine pancreas
    C) How would you assess the pancreatic functions. (15/1) 3+3+4
2. Liver function tests (15/1)5
3. Tracheoesophageal Fistula and Esophageal atresia (06/1)10
4. Enlist the functions of pancreas. Outline the pancreatic function tests and their implications in pediatric practice. (10/2)4+6
5. A. Development of diaphragm,trachea,and esophagus 2+2+2
    b. Diagrammatically depict various types of trachea esophageal fistulae 4(1/16)

GERD

1. Gastro esophageal Reflux (94/2)15
2. Describe physiological basis of Gastroesophageal reflux. Discuss clinical features and management of GERD (14/2) 3+(2+5)
3. Define gastro – esophageal reflux disease (GERD). Describe its clinical features, diagnosis and treatment. (12/1)1+3+3+3
4. Gastroesophageal reflux disease (GERD) in pediatric population 5(15/2)

DIARRHOEA

1. Pathogenesis of Persistent Diarrhea of infancy (96/2)10
2. Persistent Diarrhea (99/1)15
3. Chronic Diarrhea in Infancy (00/1)15
4. 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
5. Write management of Persistent Diarrhea (06)5
6. Approach and management of a child with Persistent Diarrhea (06)10
7. Describe the etiology, pathogenesis, diagnosis and treatment of antibiotic associated diarrhoea. (10/2)1+2+3+4
8. Discuss the management of acute diarrhea with particular reference to low osmolarity ORS, zinc, probiotics and antibiotics. (10/2)3+2+3+2
9. Outline the etiopathogenesis of chronic diarrhea and provide a scheme of investigating for a child with chronic diarrhea. (11/1)5+5
10. Describe the types of diarrhoea with examples. Discuss their pathophysiological mechanisms. (11/2)5+5
11. 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
12. 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

CHRONIC ABDOMINAL PAIN

1. What is H.Pylori Bacillus? How is it associated with chronic abdominal pain (98/2)10
2. Discuss the treatment of the following: Persistent constipation (14/1) 3

MALABSORPTION

1. Diagnosis of carbohydrate intolerance (95/1)15
2. Define malabsorption. Enlist the generalized and specific malabsorption states. Discuss the investigative plan for a child with generalized malabsorption. (08/1)10
3. 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
4. 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
5 .a) Recurrent abdominal pain in children 5
    b) chronic pancreatitis in children 5(14/2)

CELIAC DISEASE

1. Pathogenesis of Celiac Disease (97/2)15
2. Diagnosis and management of a child with Celiac Disease (06/1)10
3. Aetiopathogenesis and diagnosis of celiac disease (07/2)10
4. 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
5. Pathophysiology ,clinical manifestations and management of gluten sensitive enteropathy. 3+4+3(15/2)

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
3. Define probiotics and prebiotics and enumerate their essential characteristics. Outline the effects of probiotic in various gastrointestinal disorders. (09/1)(5+5)
4. 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
5. Write short notes on: Prebiotics, probiotics and symbiotics (13/2)(5)
6. Write short notes on Probiotics (14/1)


HEPATOBILIARY

BASIC SCIENCE

1. Differential Diagnosis of Ascites in children (93/1)10
2. Describe clinical, laboratory and radiologic evaluation of possible liver dysfunction in children. (11/2)3+4+3
3. Enumerate the causes and discuss the types, pathogenesis and evaluation of ascites in children. (11/2)2+2+3+3

HEPATITIS

1. Diagnosis and management of Acute Viral Hepatitis (96/2)12

HEPATIC FAILURE

1. Describe Biochemical and Pathological changes in various organs in Hepatic Encephalopathy. How will you manage a case (93/2)10
2. Laboratory Finding of Fulminant Hepatic Failure (98/2)10
3. Hepatic Encephalopathy- pathophysiology and management (03/2)25
4. Discuss the management of Fulminant Hepatic Failure. Add a note on Liver Transplantation (06)
5. Define Fulminant Hepatic Failure and outline the staging of severity of Hepatic encephalopathy. Discuss the steps in its management. (09/1)4+6
6. Outline the management of an 8 year old child with acute liver cell failure and hepatic encephalopathy. (10/2)10
7. Define fulminant hepatic failure. Discuss factors precipitating hepatic encephalopathy and management of hepatic encephalopathy. (14/2)2+(3+5)
8. a) define chronic liver disease 1
    b) causes clinical approach and management of a case of chronic liver disease. 2+3+4 (15/1)
9. Define Fulminant Hepatic Failure.Write stages of Hepatic encephalopathy. Outline steps in its management. 2+3+5 (Apr 16) Rpt (1/16)

CHOLESTASIS

1. Cholestatic Jaundice 15
2. Biliary Atresia (95)15
3. List the causes of infantile cholestasis. Provide an algorithm for the diagnosis of infantile cholestasis. (04/2)3+7
4. Persistent Jaundice in neonates (06)10
5. Clinical approach, investigations and management of a neonate with Cholestatic jaundice (06/1)10
6. 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
7. Define neonatal cholestasis. Outline clinical features and scheme for evaluation of a neonate with cholestasis. (11/1)2+3+5

LIVER ABSCESS

1. Outline the differential diagnosis of tender hepatomegaly. Describe the management of liver abscess. (10/1)5+5

WILSONS DISEASE

1. 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
2. Discuss the pathogenesis, clinical presentations, diagnosis and treatment of Wilson’s disease. (13/1)2+3+3+2

PORTAL HYPERTENSION

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. 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

PANCREATITIS

1. Etiology, pathogenesis, clinical features and management of acute pancreatitis in children. (10/1)2+2+2+4

GI BLEEDING

1. Hematemesis (94)15
2. 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
3. Management of Acute Upper GI Bleeding (06)10
4. Discuss the management of acute upper gastrointestinal bleeding in a 5 year old child. (08/1)10
5. 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
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