Theory question bank update 2016: Part 9


Theory question bank in parts, reorganized and updated till 2016: Part 9

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

23. NERVOUS SYSTEM

BASIC SCIENCES

1. Newer antiepileptic drugs (13/1) 5 rpt 15/1 (4),(15/2) (5marks)
2. Tabulate the mechanism of action ,dosage, indications and side effects of the following
a) Zonisamide
b) Rufinamide
c) Stiripentol
d) Levetricetam
e) Lacosamide 2x5(15/2)
2. a) CSF formation and CSF circulation 4
   b) Enumerate the causes and management of
         i) Communicating hydrocephalus 3
         ii) Non - communicating hydrocephalus 3(Apr 16)

NEUROLOGICAL EVALUATION

1. Newer Antiepileptic drugs (99/1)15
2. Modified Glasgow Coma Scale in a 1 year old Child (03/1)15
3. Outline the pathway of seventh cranial. Discuss the diagnosis and management of Bell’s palsy. (04/2)4+3+3
4. Briefly discuss the role of electrophysiological studies in pediatric neurological disorders. (04/2)10
5. What are the signs of meningeal irritation in a 2 year old child? How do you elicit them? How will you rule out Pseudo-neck rigidity(05)10
6. Give 5 examples each of UMN and LMN lesion. How do you clinically differentiate between UMN and LMN lesions? What is the importance of fundus examination in a child with Para paresis (05)10
7. Clinical significance of Postural Reflexes (06)10
8. A). What are the demyelinating disorders of CNS? 2
B). Etiopathogenesis, clinical features, investigations and management of ADEM (Acute demyelinating encephalomyelitis) (15/1) (2+2+2+2)
8.Utility of newer Neuro-imaging modalities in pediatric age group and their cost-effectiveness. 5+5(15/2)
9. a) Modified Glasgow Coma Scale for children and infants 5
b) Its advantages and disadvantages 2
c) What is AVPU pediatric response Scale 3(Apr 16)

CONGENITAL ANOMALIES OF CNS

1. Hydrocephalus in infancy (96/2)14
2. Prevention of Neural Tube Defects (97/2)15
3. Role of Folic Acid in prevention of Neural Tube Defects (98/2)10
4. Normal CSF circulation in Newborns and the changes that take place in Aqueductal Stenosis (98/2)10
5. Etiology and pathophysiology of hydrocephalus (99/2)15
6. Dandy Walker Malformation (03/1)15
7. List the causes of Hydrocephalus in children. What is the pathogenesis and discuss the management (05)10
8. Discuss briefly the possible predisposing factors, types of open Neural Tube Defects in children and its prevention (07/1)10
9. Describe the normal cerebrospinal fluid pathway with the help of a diagram. Define and classify hydrocephalus and enlist its causes. (09/1)4+6
10. List the neurocutaneous syndromes. Describe the genetics, cellular defect, clinical manifestation and diagnosis of tuberous sclerosis. (09/2) 3+1+1+3+2
11. What are the causes of congenital hydrocephalus? Describe clinical features and management of an infant with Arnold Chiari malformation. (09/2)4+6
12. Describe growth velocity of head size from birth till 5 years of age. Define microcephaly. Enumerate its etiology and approach to diagnosis in a child with microcephaly. (10/1)3+2+2+3
13. Enumerate various types of neural tube defects and discuss their embryogenesis. Outline in brief management of meningomyelocele. (11/1) 3+3+4
14. Describe briefly cerebrospinal fluid formation, circulation, absorption and enumerate causes of hydrocephalus. (11/2)3+2+2+3
15. Define microcephaly. Enumerate causes of primary and secondary microcephaly. Outline the diagnostic approach of a 2 years old child brought to the hospital with small sized head. (12/1)1+4+5
16. Define craniosynostosis and its types. Name specific syndromes associated with craniosynostosis. Describe the clinical characteristics of common types of craniosynostosis. (13/2)3+3+4
17. Enumerate common types of neural tube defects .Discuss prevention and management of neural tube defects. (14/2)4+(2+4)
18. Enumerate 4 common neuronal migration disorders and their clinical features in brief. 6(Apr 16)

CNS INFECTIONS

1. Discuss diagnosis and management of Viral Encephalitis (97/1)15
2. Chronic Meningitis – clinical approach and management (02/1)15
3. Pathophysiology of Acute Encephalitis (03/1)15
4. Pathogenesis, management and prognosis of H.Influenzae Meningitis in children (06)10
5. Discuss briefly epidemiology, investigations and management of Viral Meningoencephalitis (07/1)10
6. Enumerate risk factors for brain abscess. Outline a scheme for investigating and treatment a 10 year old child with brain abscess. (08/1)10
7. Discuss the etiology, clinical presentation, diagnosis and treatment of Acute Disseminated Encephalomyelitis (ADEM) (09/1)4+6
8. Enumerate risk factors for brain abscess. Outline investigations and treatment of brain abscess in children. (09/2)4+2+4
9. Acute demyelinating encephalomyelitis (13/1)5

SEIZURES IN CHILDHOOD & CONDITIONS MIMICKING SEIZURES

1. Benign Rolandic Epilepsy of Childhood (93/1)15
2. Definition, prognosis and management of Febrile Convulsion (93/1)15
3. Management of children with partial epilepsy (95/1)15
4. Management of Children with Partial Seizures (95/1)15
5. Treatment of Status Epilepticus in a 5 year old Child (95/2)10
6. Classification of Epilepsy and treatment of Simple Partial Seizures (96/2)12
7. Treatment of Breath Holding spells (97/1)10
8. What are the causes of convulsions in infancy and childhood How will you investigate such a case (97/2)15
9. Breath Holding spells (98/1)15
10. Etiology and management of Febrile Seizures (98/1)15
11. Pseudoseizures (98/2)10
12. Management of a case of Complex Partial Seizure (98/2)10
13. Infantile spasms (99/2)10
14. Conditions mimicking seizures (99/2)15
15. Partial Seizures 15
16. Approach to an infant with myoclonic seizures (00/1)15
17. Enumerate newer drugs for treatment of Epilepsy with their uses (02/1)15
18. What are the causes of Convulsions in children? Discuss the management of Status Epilepticus (05)5+5
19. Define Febrile Convulsions. Discuss the management of a 2 year old child who presents to the emergency room with first episode of Febrile Seizure. Add a note on anticonvulsant Prophylaxis in febrile seizure. (06)10
20. Diagnosis and management of a child with Partial Focal Seizure (06/2)10
21. Indications for the therapeutic use of newer anticonvulsants in childhood seizure states and their potential adverse effects (07/1)10
22. Discuss conditions that mimic seizures in children (07/2)10
23. An 8 year old apparently well boy presents with generalized seizures for the last one hour. How will you approach (including history and examination) this child? Discuss the management of this patient. (08/2)10
24. Write the characteristic features of febrile seizures in children. Enumerate the differentiating points for atypical febrile seizure. Outline the indications and regime for continuous prophylaxis in febrile seizures. (10/2)2+2+3+3
25. Define myoclonic epilepsy. Discuss in brief the characteristic features of different types of myoclonic epilepsies, with onset in infancy. (10/2)2+8
26. Enumerate the etiology of first episode of complex partial seizures in a 7 year old boy. Provide an approach to management of this child.(11/1)4+6
27. Describe the etiology, types and EEG changes of infantile spasms. Outline the treatment protocol. (12/1)2+3+1+4

ACUTE STROKE SYNDROMES

1. Stroke in childhood (00/1)15
2. Discuss the etiopathogenesis of acute onset hemiplegia in a 3 year old child. How will you manage this child. (04/2)4+6
3. Discuss the etiopathogenesis, clinical symptomatology and differential diagnosis of childhood stroke (06/2)10
4. Briefly discuss the arterial supply of Brain. Outline the causes of acute hemiplegia in a 2 year old child (07/2)10
5. Describe the causes of arterial thromboembolism in children. Outline the management of a child with acute hemiplegia. (08/1)10
6. What are the causes of hypercoagulable state in children? How will you manage a case of acute hemiplegia? (09/2)4+6
7. Enumerate the causes of stroke in children. Discuss the diagnostic approach for managing a child with stroke. (11/2)3+7
8. Causes and investigations in a child with stroke (1/16)5

HEADACHE

1. Define Migraine in children. Discuss the classification of Migraine and write its management (07/2)10
2. Classification and management of Migraine (07/1)10
3. List causes of headache in children. Outline an approach for a 10 year old child with headache. (11/1)4+6

MISCELLANEOUS

1. Discuss the diagnosis and investigation plan for a 2 year old child with regression of milestones and generalized seizures (93/1)25
2. Signs and symptoms of a tumor at CP angle, in relation to the anatomy of different structures at this point (93/2)15
3. Differential diagnosis of Floppy Infant (96/1)12
4. Pseudotumor Cerebri (99/2)10
5. Toxic Neuropathy 15
6. Discuss the pathophysiology and management of Raised Intracranial Tension 25
7. Pathophysiology of Cerebral Edema (00/1)15
8. Pseudoparalysis (06)5
9. Enlist the possible conditions which could result in a 24 month old child with history of regression of milestones for past 8 month. The child also has a liver enlargement. Detail the clinical manifestation of Tay Sach Disease? (08/1)10
10. Outline the steps in managing intracranial hypertension and provide rationale for each of these steps. (09/1)10
11. Describe evaluation of a child with cerebral palsy. (09/2)10
12. Define raised intracranial pressure. Describe its clinical features and management. (10/1)2+3+5
13. Enumerate the causes for ataxia in children. Discuss the investigations and treatment for a 7 year old boy presenting with acute onset ataxia. (14/1)4+3+3
14. Discuss pathophysiology and types of cerebral edema. Write the medical management of raised ICT (14/2) 4+6
15. Management of infantile tremor syndrome (1/16)4
16. Familial dysautonomia (1/16)5
17. Autonomic neuropathies (1/16)5

24. NEUROMUSCULAR DISORDERS

1. Family Genetic Counseling to parents with 2 boys having calf hypertrophy and progressive proximal leg muscle weakness (07/1)10
2. Describe the different types of hereditary neuropathies. Outline the diagnostic approach and management of type 1 hereditary motor and sensory neuropathy. (10/1)4+6
3. Clinical features, diagnostic evaluation and treatment of myasthenia gravis. (10/1)3+3+4
4. Discuss about the clinical features, types, diagnosis and management of Myasthenia Gravis. (11/2)3+2+2+3
5. Discuss differential diagnosis of a floppy infant. Write a short note on clinical and laboratory characteristics of Werdnig- Hoffman disease. (13/1) 4+3+3
6. Types ,clinical presentation and management of spinal muscular atrophies (14/2) 2+4+4
7. A)Classification of spinal muscular atrophies (SMA) 5
b)Major distinguishing features amongst various forms of SMA (15/2)5
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