Theory question bank update 2016: Part 6

Theory question bank in parts, reorganized and updated till 2016: Part 6

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.
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. Fetal Circulation and cardiovascular adjustments after birth (06/1)10
2. Outline Fetal Circulation (07/2)
3. Draw a labeled diagram of fetal circulation. Indicate partial pressure of oxygen (PaO2) and oxygen saturation (SaO2) values at key points in this circulation. (08/1)10
4. Fetal circulation and changes after birth (10/1)5+5Rpt (15/1) 4+3
5. Depict diagrammatically fetal circulation. Highlight its unique features differentiating it from neonatal circulation. Outline important changes occurring at birth. (11/1)4+3+3


1. Significance of S2 in clinical practice (98/1)15
2. Enumerate the conditions where you can get
a. Loud S2
b. Wide splitting S2
Explain the pathophysiology of fixed splitting of S2 (05)10
3. Discuss the various minimally surgical invasive devices and procedures available for the management of common congenital heart diseases in children. (07/1)10
4. A one year old child is referred for an asymptomatic cardiac murmur. Outline the likely causes. How will you differentiate an innocent murmur from that of a congenital heart disease, on clinical grounds? (09/1)3+7
5. A 3 year old child having fever for 2 days suddenly develops breathlessness, tachycardia and sweating. Describe the differential diagnosis of this case and its treatment. (09/2)5+5
6. 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 systolic murmur is noted. Discuss differential diagnosis, investigations and management. 4+3+3(15/2)


1. Newer approaches in management of CCF (93/1)15
2. Treatment of Intractable CCF (93/2)10
3. Describe briefly the Pathophysiology of CCF and management of Refractory Failure (98/2)25
4. Intractable congestive heart failure- management approach (02/1) 15
5. ACE inhibitors in CCF with congenital heart disease (03/1)15
6. CCF- Pathophysiology and management (03/2)25
7. How will you manage a child in Refractory CCF (06)5
8. Discuss the pathogenesis of Congestive Heart failure and the role of vasodilators in its management (06)10
9. Refractory congestive heart failure- causes and management (07/2)10
10. Discuss the role of vasodilator therapy in congestive heart failure. Enumerate various vasodilator agents used in CHF and their
respective mechanisms of action. (08/1)10
11. List the causes of congestive heart failure in a 2 years old child. Describe different types of VSD according to position and size. Write indicators for surgical intervention/ device closure. (08/1)10


1. Cyanotic Spell (94/2)15
2. How do you classify congenital cyanotic heart disease? Discuss their investigations (97/2)15
3. Complications of Fallot’s Tetralogy and their management (99/2)10
4. Management of Paroxysmal Hypercyanotic spell (99/2)15
5. Pathophysiology of Cyanotic spells (02/1)15
6. What are the congenital heart diseases associated with cyanotic spells. Write clinical presentation and management of cyanotic spell. (04/2)2+3+5
7. How will you manage a child in cyanotic spell (06)5
8. Pathophysiology, diagnosis and treatment of Eisenmenger Syndrome (07/1)10
9. Discuss the hemodynamics and pathophysiology of Tetralogy of Fallot. Outline management of cyanotic spell in a 2 year old child. (12/1)4+3+3
10. Describe the hemodynamics and clinical features of tricuspid atresia in a neonate. Outline the expected findings on ECG and chest X-ray. (13/1) 3+3+2+2
11. Describe the development of ventricular septum. Discuss the clinical features and management of VSD, and enumerate the indications for surgical intervention. (14/1)3+3+2+2


1. Classification of cardiac arrythmias and management of WPW Syndrome (92)15
2. Arrythmias- pathogenesis, diagnosis and management of different types (03/2)15
3. Describe the etiopathogenesis of supraventricular tachycardia in children. Discuss the diagnosis and management of a child with supraventricular tachycardia. (04/2)3+3+4
4. What are the causes, manifestations and management of a young child with SVT (06)10
5. Classify stable and unstable arrythmias. Discuss the types of SVT (Supra Ventricular Tachycardia) with their ECG changes. Outline the approach to manage unstable arrythmias. (08/2)10
6. Classify anti – arrhythmic drugs used in children. Describe the mechanism of action and uses of Amiodarone. (10/1)5+5
7. Enumerate the causes and outline the characteristics and treatment of Supraventricular Tachycardia (SVT) in an infant (10/2)3+3+4
8. Enumerate life threatening tachyarrhythmias in childhood. How would you diagnose them? Briefly outline their emergency interventions. (12/1) 2+4+4
9. AVNRT (AV Nodal Re-Entrant tachycardia) 4(1/16)


1. Cardiomyopathy (95/1)15
2. Diagnosis of Cardiomyopathy (96/2)12
3. Discuss in brief the etiopathogenesis, clinical features and management of dilated cardiomyopathy. (12/1)3+3+4


1. Diagnosis and management of Constrictive Pericarditis (99/2)10


1. Treatment of Acute Rheumatic carditis (97/1)15


1. Pathogens, clinical features and management of infective endocarditis. (10/1)2+4+4
2. Enumerate common pathogens of infective endocarditis. List conditions/ interventions which require prophylaxis for infective endocarditis in a child with underlying heart disease. Oultine antibiotic therapy for a child with RHD and infective endocarditis. (11/1)2+3+5
3. Outline Duke criteria for diagnosis of bacterial endocarditis. Discuss its application in clinical setting. (13/1)6+4


1. Diagnosis of Essential Hypertension in children (93/1)10
2. Investigations in a child with Hypertension (95/1)10
3. Treatment of Hypertension (97/2)12
4. Discuss etiology, diagnosis and management of Childhood Hypertension (00/1)25
5. Severe Hypertension in infancy (00/1)15
6. Discuss the causes of Hypertension in a 7 year old child. Approach of investigation and management of such a case (02/1)25
7. A 8 year old child is brought with a history of convulsions and altered sensorium. On examination her BP was 180/110 mm Hg. Discuss the D/D and laboratory investigations in this child. Discuss the management of Hypertensive Encephalopathy in this child. Add a note on fundus changes in hypertension. (06)10
8. Recent advances in management of Hypertension (06/1)10
9. Essential Hypertension in children (07/1)10
10. Discuss the treatment of Hypertension in children. Classify the drugs used to treat hypertension and briefly mention their mechanism of action (07/2)10
11. A 10 year old boy is brought with a history of convulsions and altered sensorium. On examination, his BP was 180/110 mm of Hg. Describe differential diagnosis, laboratory investigations and treatment of this case. (09/2)3+4+3
12. Describe the causes and pathogenesis or renal and renovascular hypertension. Outline principles of management. (12/1)3+3+4
13. Define Hypertension in children. Enumerate the causes and discuss the management of an 8 years old boy presenting with a blood pressure of 210/160 mm Hg with seizures. (14/1)2+3+5
14. An 8 year old child is brought with a history of convulsions and altered sensorium. His BP is 180/110 mm Hg. Discuss the D/D and laboratory investigations and management of this patient. 3+3+4(Apr16)


1. Cardiovascular Risk factors in children (96/1)15
2. Primary Endocardial Fibroelastosis (98/1)15
3. A 13 year old male is brought with an H/o progressive Dyspnea on exertion. He has past H/o recurrent joint pain. What is the most likely diagnosis? How will you investigate and manage the child. Add a note on Refractory CCF in a child (05)5+5
4. What advice will you give to a 35 year old patient with coronary artery disease regarding its prevention in his adolescent son? (06)10
5. Preventive cardiology in adolescents (07/2)10



1. Discuss the etiology and investigations in a case of Anemia (94)25
2. Describe laboratory investigations in an infant with anemia and briefly outline the interpretation of test results (95/1)25
3. Severe anemia in the first year of life (02/1)15
4. What is peripheral smear finding in (05)2+2+2+2+2
· Thalassemia Major
· Lead poisoning
· Megaloblastic anemia
· Malaria
5. List the causes of microcytic hypochromic anemia. How will you differentiate between iron deficiency anemia and thalassemia? Discuss briefly the oral iron chelators. (08/1)10


1. Discuss the etiology and management of Autoimmune Hemolytic Anemia (09/1)3+7
2. Discuss the etiology, pathogenesis and diagnostic workup of Acute
autoimmune hemolytic anemia. (10/2)3+3+4
3. Diagnosis and management of Autoimmune Hemolytic Anemia 3(15/1)


1. Classify causes of acquired pancytopenia. Write briefly about the
management of acquired aplastic anemia. (09/1)3+7
2. Define pancytopenia. Enlist the causes and assessment of severity of aplastic anemia in children. (10/1)2+4+4
3. Define pancytopenia. Enumerate common causes in children. How will you assess severity of acquired anemia in children? (11/2)2+3+5
4. Characteristic hematological features ,laboratory findings and treatment of congenital hypoplastic anemia (Diamond Blackfan Anemia) 3+3+4 (15/2)
5. Management of Aplastic anemia 5 (Apr 16)


1. Current management of Thalassemia Major (96/2)15
2. Newer modalities in the management of β Thalassemia Major (99/2)10
3. Antenatal diagnosis of Thalassemia (99/2)15
4. Genetic basis of Thalassemia syndromes (02/1)15
5. In relation to Thalassemia write a note on the following (05)10
a. Alkali desaturation test
b. NESTROFT test
c. Peripheral smear
e. BMD
6. Alpha Thalassemia (07/1)10
7. Outline the antenatal management of a mother with an earlier child with thalasemia major (07/2)10
8. List the causes of microcytic hypochromic anemia. Provide diferentiating features between iron deficiency anemia and beta thalassemia trait. Describe the management of thalassemia major. (11/1)3+3+4
9. Outline the long term complications of thalassemia major. How will you monitor for such complications in a child with thalassemia major? (13/1)5+5
10. Describe the foetal hemoglobins. Discuss the transfusion therapy for Thalassemia major and its long term follow up plan. (14/1)3+4+3
11. Recent concepts/advances for treatment /managment of Thalassemia major in children (95/2)10 Rpt (14/2)5


1. Prevention of Iron Deficiency Anemia in children (95/2)15
2. Management of Iron Deficiency anemia (98/2)10
3. Enlist the causes and outline the Differential Diagnosis and treatment of iron deficiency anemia (05)3+3+4
4. Outline the etiology of iron deficiency in children. Describe the clinical features and approach to diagnosis of a child suspected to be having nutritional anemia. (13/1)3+(2+5)
5. Describe the sequential pathological changes seen with iron deficiency states. What laboratory studies can be used to differentiate common microcytic anemias? (13/2) 5+5


1. Pathogenesis of anemia in G6PD Deficiency (99/1)15
2. G6PD deficiency (99/2)10
3. 3yr old child-H/O Jaundice since 2 months, H/O Exchange transfusion at D2. Discuss the D/D. Classify Hemolytic Anemia. Add a note on management of Intravascular hemolysis in G6PD deficiency (05)4+4+2
4. Briefly outline normal erythropoiesis. Describe the diagnosis and treatment of G6PD deficiency (07/2)10
5. Enlist the red blood cell metabolic enzyme pathways and the enzymes
responsible for hemolysis. Discuss the pathogenesis involved in these
hemolytic anemias. (11/1)3+7


1. Megaloblastic anemia (03/2)15
2. List the common causes of macrocytic anaemia. Describe the laboratory diagnosis of megaloblastic anaemia and treatment of juvenile pernicious anaemia. (04/2)4+3+3
3. Clinicohematological profile of Megaloblastic Anaemia (06/1)10
4. Discuss causes, clinical manifestations, laboratory findings and treatment of Folate Deficiency anaemia in children (07/2)10
5. Enlist the common causes of macrocytic anemia. Describe the laboratory diagnosis and treatment of megaloblastic anemia. (09/2)2+3+5
6. Write short note on: Peripheral smear findings in iron deficiency and B12 deficiency anemia (10/2)2.5+2.5


1. Diagnosis and management of Congenital Hereditary Spherocytosis (97/1)15
2. Hereditary Spherocytosis (06)10


1. Management of acute sickle cell crisis (99/1)15


1. Outline the functions of Spleen. Describe the indications and complication of splenectomy and post –operative management. (09/1)3+7
2. Describe the functions of spleen. Describe clinical manifestations and management of asplenia/ polysplenia. (10/1)4+3+3


1. DIC (96/2)15
2. Antenatal diagnosis and carrier detection of Hemophilia (98/2)15
3. Explain coagulation cascade. A 4 year old child with h/o recurrent epistaxis and gum bleeding. Discuss laboratory diagnosis and management of this condition. Add a note of differentiating a bleeding disorder from a coagulation disorder (05)5+3+2
4. A 5 year old male child comes with a history of trivial fall and swelling of right knee. He has history of easy brusiability. Discuss the laboratory diagnosis and management of this child. Add a note on antenatal diagnosis and counseling (06)10
5. Discuss the various aspects of management of a child with
Hemophilia A (07/2)10
6. Discuss the pathogenesis of disseminated intravascular coagulation (DIC) and relate it to the laboratory abnormalities observed in this entity. (08/1)10
7. Diagrammatically outline the Normal Coagulation Cascade. Outline diagnosis and management of disseminated Intravascular Coagulation (DIC) (09/1)4+6
8. A 10 year old boy with hemophilia A, weighing 30 kg has come with bleeding in both knee joints. Discuss briefly the specific, supportive and prophylactic management of this child. (11/1)4+3+3
9. An 8 year old girl has presented with epistaxis, bleeding gum and ecchymotic patches over trunk. Her platelet count is 20,000/cumm. Discuss the differential diagnosis with specific clinic-investigative pointers. Plan the diagnostic work up for this child. (13/2) 3+3+2+2
6. Draw the coagulation cascade. Describe the Hess capillary test and enumerate the screening tests for a bleeding and a clotting disorder. (14/1)4+6
7. Pathophysiology of thrombophilia 4(1/16)


1. Write differential diagnosis of a 5 year old child with petechial rash with fever. How will you manage a child with idiopathic thrombocytopenic purpura. (04/2)4+6
2. Various treatment modalities in acute ITP (06)10
3. Write in brief regarding the etiology and management of idiopathic
Thrombocytopenic purpura (ITP). (11/1)4+6
4. Discuss the treatment options for acute ITP in a 14 year old girl child. (13/1)10


1. Pathogenesis ,clinical features and diagnostic criteria of autoimmune lymphoproliferative syndrome (14/2) 4+3+3


1. Describe the risks and benefits of bone marrow transplantation in children (94/2)15
2. Bone marrow transplantation for children (06/1)10
3. Define febrile neutropenia and describe the treatment and care of a child with febrile neutropenia. (08/1)10
4. Febrile neutopenia- definition and management (15/2)1+4


1. Transfusion of Blood fractions 10
2. Discuss the inherent hazards of Blood Transfusion in children and the necessary measures to avoid and minimize them (07/1)10
3. Outline the method of extracting various blood components. What are the indications of usage of Fresh Frozen Plasma (FFP) and cryoprecipitate? (09/2)5+5
4. Discuss briefly the risks associated with blood transfusion therapy. (13/2)10



1. Treatment and prognosis of ALL (97/2)15
2. Management of CNS Leukemia (96/1)14
3. Management of a case of ALL in a 3 year old (03/1)25
4. Discuss management of a child with acute leukemia (06/1)10
5. Management of a child with acute leukemia (06/2)10
6. Prognostic indicators in Acute Leukemia (07/2)10
7. Define tumour lysis syndrome. Enlist its important constituents. Outline its etiology and describe the management. (08/1)10
8. Utility of immunophenotyping in the diagnosis of leukemia in children. Outline the treatment of acute lymphoblastic leukemia. (09/2)4+6
9. Outline the essential components and pathophysiology of tumor lysis syndrome. Describe its management. (11/1)2+4+4
10. Define tumour lysis syndrome. Describe the pathophysiology of tumour lysis syndrome. How will you prevent occurrence of tumour lysis syndrome? (11/2)2+4+4
11. A)classification of childhood leukemias
b)management of Tumour lysis syndrome (14/2)5+5
12. Managment of Acute Myeloid Leukemia 5(Apr 16)
13. Enumerate the oncological emergencies occurring in leukmia/lymphomas 2(1/16)


1. Different types of Lymphomas in children and their Histopathological classification (93/2)15


1. Write in brief the clinical manifestations, laboratory findings and management principles of Langerhans Cell Histocytosis. (09/1)10
2. Classify childhood histiocytosis. Describe the clinical manifestations, diagnosis and treatment of Langerhan’s cell histiocytosis. (10/1)3+3+2+2
3. A) Classify childhood histiocytosis. 3
B) Clinical features and management of a case of Langerhan’s cell histiocytosis. (15/1)3+4
4. How will you classify childhood Histiocytosis? Describe the diagnostic criteria, clinical manifestations and treatment for hemophagocytic lymphohistiocytosis. What are the infections associated with it? (11/2) 2+2+2+2+2
10. a. How will you classify childhood Histiocytosis? 2
b.Describe the diagnostic criteria, clinical manifestations and treatment for hemophagocytic lymphohistiocytosis. 2+3+3 (1/1
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