DNB PEDIATRICS QUESTION BANK 2018 PART 1

dnb pediatrics question papers 2018

THEORY QUESTION PAPER JUNE 2015 - 2018 


PART 1: All questions 2016 AND 2015

For question papers bank till 2016 here

JUNE 2016 PAPER 1

1) A. Outline the steps involved in the synthesis of steroid hormones.
   B. Clinical features and management of classical congenital adrenal hyperplasia.(3+(4+3)

2) Classification, etiopathogenesis and management of haemolytic uraemic syndrome. (3+4+3)

3) A. Munchausen syndrome by proxy. 4
   B. Meta-analysis.3
   C. Forest Plot graph.3

4) Mechanism of action, therapeutic usage, dosages and adverse effects in children of:
   A. Low molecular weight heparins 5
   B. Magnesium sulphate. 5

5) A. Pathophysiology of regulation of plasma osmolality. 5
   B. Diagnosis and management of distal renal tubular acidosis. 5

6) A. Pathophysiology of thrombophilia. 4
   B. Outline management of polycythemia. 4
   C. Enumerate the oncologic emergencies occurring in leukemia/lymphomas. 2

7) A. Biology and role of cytokines in newborn infants. 3
   B. Oxygenation index. 3
   C. ASHA. 4

8) A. Define fulminant hepatic failure.
   B. Stages of hepatic encephalopathy.
   C. Management of fulminant hepatic failure. (2+3+5)

9) A. Development of diaphragm, trachea and esophagus.
   B. Diagrammatically depict various types of tracheoesophageal fistulae. (2+2+2)+4

10) A. Give graphical picture and explanation of elastic volumepressure relationship of lung and chest wall in children.
   B. How would you distinguish restrictive vs obstructive lung disease based on PFT? ( (6+4)

JUNE 2016 PAPER 2

1) A 12-year-old female child presents with short stature and delayed puberty.
   A. Enumerate various possible causes. 2
   B. Approach to diagnosis and their management. 8

2) A. MDR and XDR tuberculosis: treatment strategies. 6
   B. AVNRT (AV Nodal Re-entrant Tachycardia). 4

3) A child with suspected diabetes insipidus is brought to hospital. How will you approach, investigate and manage this patient? (2+3+5)

4) A. Outline the physiology of Vitamin D. 4
   C. Diagnosis and treatment of Vitamin D dependent rickets. (3+3)

5) Management of:
   A. Post Traumatic Stress Disorder. 4
   B. Tourette’s disorder. 3
   C. PANDAS. 3

6) A. Management of steroid resistant & steroid dependent nephrotic syndrome.
   B. Metabolic syndrome: diagnosis & complications. (6+4)

7) A. Etiological classification of neonatal hypoglycemia. 2
   B. Clinical features and management of neonatal hypoglycemia. (3+5)

8) A. Management of infantile tremor syndrome. 4
   B. Clinical features of hypervitaminosis A. 3
   C. Clinical features of hypervitaminosis D. 3

9) A 2 year old child presents with history of regression of milestones for past 6 months and hepatomegaly. Discuss the differential diagnosis and diagnostic approach. (7+3)

10) A. Macrophage activation syndrome. 5
   B. Causes and investigations in a child with stroke. 5

JUNE 2016 PAPER 3

1) A. Define near drowning.
   B. Pathophysiology and management of near drowning. (2+(4+4)

2) Outline the diagnosis, differential diagnosis and treatment of: A. Familial dysautonomia 5
   B. Autonomic neuropathies 5

3) A. How will you classify childhood histiocytosis? 2
   B. Diagnostic criteria, clinical features and treatment for hemophagocytic lymphohistiocytosis. (2+3+3)

4) A. Obstructive sleep apnea: Diagnosis and management
   B. Clinical features and management of Hashimoto’s thyroiditis. (5+5)

5) A. How do you classify and treat lupus nephritis? 5
   B. Enumerate causes and management of adrenal crisis 5

6) A. Hypernatraemic dehydration. 5
   B. Hyperosmolar non ketotic diabetic coma. 5

7) Diagnosis and management of:
   A. Lead poisoning. 5
   B. Kerosene oil ingestion. 5

8) A. Neonatal pain. 5
   B. Fetal therapy. 5

9) Primary and secondary prevention of genetic disorders. (5+5)

10) A. What are the biochemical criteria for the diagnosis of diabetic ketoacidosis? 3
   B. What are the goals of therapy? 2
   C. How will you manage a child with DKA ? 5

APRIL 2016 PAPER 1

1) A. Adrenal steroid hormone synthesis. 5
   B. Outline the biochemical consequences of defects in the classical 21-hydroxylase deficiency and its management. (2+3)

2) A. Structure of glomerulus with diagrammatic representation.
   B. What are the glomerular changes in rapidly progressive glomerulonephritis? 6+4

3) Enumerate the five high impact activities under RMNCH+A programme. 10

4) How is plasma osmolality calculated? Discuss its determinants. What are the diagnostic criteria of SIADH (Syndrome of inappropriate ADH secretion)? (3+4)+3)

5) A. Steps to curb female infanticide.
   B. Role of micronutrients in pediatric health and disease. (5+5)
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6) A. Virology and epidemiology of Swine-flu.
   B. How is the disease categorized according to Govt. of India guidelines?
   C. Mention which children need to be immunized and who need to be given medication for the disease. (1+2)+3+(2+2)

7) A. Evidence based medicine. 6
   B. Forest plot in meta-analysis. 4

8) A. Clinical trials – Phase I, Phase II, Phase III & Phase IV. 5
   B. Ethics in biomedical research. 5

9) A. Laws of adoption in India.
   B. Define translocation. Write the inheritance pattern for translocations. Describe clinical features of any one translocation disorder. (4+6)

10) A. Enumerate 4 common neuronal migration disorders and their clinical features in brief. 6
   B. Millennium Development Goals (MDG). 4

APRIL 2016 PAPER 2

1) A. Causes of neonatal anaemia.
   B. Cyanosis in newborn. (5+5)

2) Aetiology, pathogenesis, clinical features and management of hypophosphataemia. (2+3+2+3)

3) A. What is Severe Acute Malnutrition (SAM)?
   B. What are the clinical signs of SAM?
   C. Management of SAM in an one year old child weighing 5 kg. (2+2+6)

4) An 8 year old child is brought with history of convulsions and altered sensorium. His BP is 180/110 mmHg. Discuss the differential diagnosis, laboratory investigations and management of this patient. (3+3+4)

5) A. Apnoea of prematurity.
   B. Retinopathy of prematurity. (5+5)

6) Management of steroid resistant and steroid dependent nephrotic syndrome. (5+5)

7) Management of:
   A. Acute myeloid leukaemia
   B. Aplastic anaemia. 5+5

8) A. Diagnosis and management of pertussis.
   B. VAPP (Vaccine Associated Paralytic Poliomyelitis) 5+5

9) A. Fluoride and disease. 2
   B. Hypervitaminosis A. 4
   C. Hypervitaminosis D. 4

10) A. CSF formation and CSF circulation.
   B. Enumerate the causes and management of:
   C. i. Communicating hydrocephalus and; ii. Non-communicating hydrocephalus. ( (4+(3+3)

APRIL 2016 PAPER 3

1) Pathophysiology and management of:
   A. Organophosphorus poisoning.
   B. Scorpion bite. (5+5)

2) What are the biochemical criteria for the diagnosis of Diabetic Ketacidosis (DKA)?
What are the goals of therapy? How will you manage a 7 year child with DKA? (3+3+4)

3) Etiology, pathogenesis, clinical features and management of cardigenic shock? (2+3+2+3)

4) Describe the symbols used in pedigree chart. Draw pedigree charts over four generation depicting:
   a) X-linked dominant disease.
   b) X-linked recessive disease. 4+(3+3)

5) Define severe dengue. Describe the WHO guidelines for its management. Enumerate the complications of severe dengue. (2+4+4)

6) A. Bioterrorism
   B. Radiation sickness
   C. Congenital cataract (3+3+4)
 
7) A. Modified Glasgow Coma Scale for children and infants.
   B. Its advantages and disadvantages.
   C. What is AVPU Pediatric Response Scale? (5+2+3)

8) Define fulminant hepatic failure. Write stages of hepatic encephalopathy. Outline steps of its management. 2+3+5)

9) A. Autistic spectrum disorders.
   B. Wiskott-Aldrich syndrome.
   C. Graft versus host disease. (3+3+4)

10) A. Hypernatremia.
   B. Hyperkalemia.
   C. Non-pharmacoglogic strategies for pain management. (3+3+4)

DECEMBER 2015 PAPER 1

1) Give a diagrammatic representation of urea cycle. Indicate and name related disorders of urea cycle metabolism at each step.(10)

2) A. Clinical signs and symptoms of refeeding syndrome.
   B. How will you manage such a case?( 7+3)
 
3) A. Mention the anatomical and functional factors responsible for obstructive sleep apnoea in children.
   B. How do you diagnose and treat this condition? 5+(2+3)

4) Characteristic hematological features, laboratory findings and treatment of congenital hypoplastic anaemia (Diamond-Blackfan anaemia). (3+3+4)

5) Pathophysiology, clinical manifestations and management of carbon monoxide poisoning. (3+3+4)

6) A. What is bias in medical research? 2
   B. Common types of bias and the methods to minimize bias in analytical studies.(4+4)

7) A. Define child abuse and child neglect. 2
   B. Outline the steps involved in management of a suspected child of sexual abuse.(2+6)

8) A. Attention-Deficit Hyperactivity Disorder (ADHD). 5
   B. Gastroesophageal Reflux Disease (GERD) in paediatric population. 5

9) A. What is relative risk (RR) and discuss its implications? 4
   B. What is the usefulness of confidence interval? 3
   C. Implications of sensitivity and specificity. 3

10) Safe injection practices at level III care with respect to burden/deficiencies, risks, technique, handling and disposal. (2x5)

DECEMBER 2015 PAPER 2

1) What is Anion gap? Discuss the acid-base disturbance in metabolic acidosis.
Enumerate the causes of increased anion gap and normal anion gap metabolic acidosis. (1+5+(2+2)

2) Utility of newer Neuro-imaging modalities in paediatric age group and their cost effective benefits. (5+5)
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3) Pathophysiology and management of: A. Refractory shock. B. Intraventricular hemorrhage. (5+5)

4) What is ‘Developmental delay’? Describe different tools used for screening and for diagnosis of developmental delay. 2+(4+4)

5) A. Serologic course of acute hepatitis B. (4)
   B. Treatment strategies for acute and chronic hepatitis B. (6)

6) A. Anaemia of Prematurity.
   B. Treatment options for a 3 month old preterm who has Hb of 6 gm%. (5+5)

7) A. Neuroprotective strategies in CNS injuries in neonates. 5
   B. Complications of unconjugated hyperbilirubinemia in a neonate. 5

8) A. Algorithmic approach to a neonate with suspected I.E.M. 5
   B. Silverman Anderson Scoring System. 5

9) Tabulate the mechanism of action, dosage, indications and side effects of the following:
   A. Zonisamide B. Rufinamide
   C. Stiripentol
   D. Levetricacetam
   E. Lacosamide

10) What are the defining criteria of Systemic Inflammatory Response Syndrome
(SIRS)? Name the mediators involved and their mode of action. (5+5)

DECEMBER 2015 PAPER 3

1) Pathophysiology, clinical manifestations and management of salicylate poisoning.(3+3+4)

2) A. Classification of Spinal Muscular Atrophies (SMA). 5
   B. Major distinguishing features amongst various forms of SMA. 5

3) A. Free Radicals.5
   B. Febrile neutropaenia - Definition & management. 5

4) A. What is Developmentally Supportive Care? 3
   B. Components of Developmentally Supportive Care in neonates. 7

5) Algorithmic approach to a suspected case of Kawasaki disease. Enumerate its complications and outline the management. 5+(2+3)

6) Pathophysiology, clinical manifestations and management of Gluten sensitive enteropathy. 3+4+3

7) 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 a systolic murmur is noted. Discuss differential
diagnosis, investigations and management. (4+3+3)

8) What is the pathogenesis of graft v/s host disease? What are its clinical manifestations? What measures can be taken to prevent it in case of stem-cell transplantation? (4+3+3)

9) Outline management of:
   A. Steroid resistant nephrotic syndrome. 5
   B. Child with pulmonary involvement with cystic fibrosis. 5

10) A. Congenital varicella. 4
   B. Complications of Pertussis. 3
   C. Roseola Infantum. 3

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