Theory question bank update 2016: Part 5


Theory question bank in parts, reorganized and updated till 2016: Part 5

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

16. RESPIRATORY SYSTEM

BASIC SCIENCES

1. Write notes on embryological development of abdominal diaphragm and types of congenital diaphragmatic hernia (06)10
2. Name the steps in morphogenesis of respiratory system .Enumerate congenital lung malformations. Describe natural course of congenital cystic adenomatous malformations. (14/2) 3+3+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

CLINICAL APPLICATION

1. Indications to use antibiotics in children with Upper Respiratory Infections (97/1)10
2. Pulse Oximetry and its limitations (98/1)15
3. Briefly discuss the non invasive estimation of gas exchange in children. (04)10
4. 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
5. Outline the pulmonary function testing in children with emphasis on performance and interpretation of spirometry. (08/1)10
6. Discuss Pulmonary Function Tests and their clinical utility. (13/2)7+3
7. Write short notes: (14/1)3+4+3
a) End – Tidal carbon dioxide monitoring
b) Pulse oximetry
c) Amplitude integrated EEG.
8. Utility of Blood gas (ABG) in localosing pathology and severity of disease in respiratory problems (15/1)5+5
9. Pulseoxymetry 2 (15/1)
10. A.Give graphical picture and explaination of elastic volume-pressure relationship of lung and chest wall in children 6
b. How would you distinguish restrictive vs obstructive lung disease based on PFT? 4 (1/16)

STRIDOR

1. Management of Acute Stridor in a Preschool child (93/1)15
2. A 2 year old child presents to the hospital with fever and Stridor of 12 hour duration. Discuss the diagnosis (97/1)10
3. List the common causes of stridor in children. How will you diagnose and manage a case of stridor. (04/2)3+4+3
4. Clinical Evaluation and management of a child with stridor (06/1)10
5. 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
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

TONSILITIS

1. Management of Acute Tonsillitis in children (98/1)15
2. Discuss the treatment of 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

BRONCHIAL ASTHMA

1. Management of Acute Severe Asthma (92/2)15
2. Use of Nebulizers in Pediatric practice (95/2)10
3. Aerosol therapy in children (95/2)15
4. Treatment of Bronchial asthma (96/2)
5. Discuss briefly the recent advances in the management of Bronchial Asthma (99/1)15
6. Describe the pathogenesis of Bronchial Asthma. Give an outline for prevention and treatment of recurrent episodes. (02/1)25
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
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 stepwise management of chronic asthma in children . (11/2)3+7

PNEUMONIA

1. Treatment of Staphylococcal pneumonia (93/1)10
2. Discuss briefly the Differential diagnosis and management of a case of Persistent Pneumonia in a 3 month old infant (99/2)15
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

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
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
2. Diagnostic work up of a child with cystic fibrosis(CF). Describe management of a child with CF. (14/2) 4+6
3. Outline management of pulmonary involvement with cystic fibrosis. 5(15/2)

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. Diagnosis of Bronchial Foreign Body (93/2)10
2. Differential diagnosis of Hemoptysis in children (95/2)10
3. Describe the etiology, stages of evolution, clinical manifestations, diagnostic investigations and management of empyema thoracis (11/1)1+2+2+2+3
4. 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
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
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