1. DNB PEDIATRICS THEORY QUESTION BANK (UPDATED TILL JUNE 2012)DR KAUSIK SUR / Updated by DR. NOELLA PEREIRA JOHND.C.H, DNB D.C.H. (Mumbai)ASSISTANT PROFESSORDEPARTMENT OF PEDIATRICSVIVEKANANDA INSTITUTE OF MEDICAL SCIENCESKOLKATAe-mail- kausiksur@gmail.comHOW 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

2. 1 GROWTH AND DEVELOPMENT 1. Approach to a child with Delayed Speech (02/1) 15 2. Discuss the causes and approach to a Preschool child with Developmental Regression (02/1) 25 3. Growth Monitoring (98/1) 15 4. What are the developmental disorders in preschool years? Discuss the management (97/1) 15 5. Velocity and cross-sectional standards as applied to Human Growth (95/2) 15 6. Discuss the basis for use of Growth Standards. What should be taken as a reasonable approach for India (94/2) 25 7. Principles of Growth and Development (00/1) 15 8. Importance of Bone age assessment in children 15 9. Growth Factors (99/1) 15 10. Sexual Maturity Rating in female adolescents (95/2) 15 11. Describe the events of sexual development in relation to physical growth. Name the most important regulatory factors (94) 25 12. Gessel Developmental schedule (93/1) 15 13. Define Growth, Development, Velocity of growth mean, median, percentiles. Enumerate causes of retarded growth. Briefly outline a schedule for investigation of such a case (92/2) 25 14. Factors affecting Development of children (92) 15 15. SMR (03/2) 16. What is SMR? Discuss the secular trend in Children (05/2) 5+5 17. How would you assess sexual maturity of a female adolescent (06) 10 18. Factors affecting Adolescent health and development (06) 10 19. Write the height velocity curves of girls and boys from birth to adolescence, describe the principles and factors governing the growth and development in children (06) 10 20. Approach to a child with short stature (06/1) (07/2) 10 21. Bone age assessment and its usefulness (07/2) 10 22. Growth and development in second year of life in children (07/1) 10 23. Outline the basic principles of sleep hygiene for children and adolescents (09/1) 10 (12/1) 5+5 24. Describe: (09/2) 5+5 a) Factors affecting child development b) Developmental screening tests available and suitable for use in Indian children. 25. Developmental milestones in first two years of life. (10/1) 10 26. Outline the fine motor milestones along with their normal age of achievement in sequence attained between birth and 5 years of age. (10/2) 10 27. Discuss the evolution and characteristics of WHO growth charts. Discuss their implications on the magnitude of malnutrition in Indian setting. (11/1) 3+4+3 28. Enumerate the available methods and indications for determination of bone

3. age in children and adolescents. Outline the differential diagnosis of a child with short stature on the basis of bone age. (11/1) 3+3+4 29. Describe Tanners Sexual Maturity Rating (pubertal staging) in boys based on a) Genitalia and b) Pubic hair development. (11/2) 5+5 30. Describe in detail the physical growth and development in all domains from birth till completion of first year. (11/2) 5+5 31. What is developmental delay? Describe different tools used for screening of developmental delay. (11/2) 3+7 32. Define growth velocity. Draw a typical height velocity curve from birth to puberty for boys and girls. Discuss the utility of determining growth velocity. (12/1) 2+4+4 33. What is developmental screening? Enumerate common developmental screening test. What issues they identify in a child? (12/1) 2+4+42 PSYCHOLOGIC DISORDERSPSYCHOSOMATIC ILLNESS 1. Management of Conversion reactions (98/1) 15VEGETATIVE DISORDER 1. Sleep Disorders in children (99/2) 10 2. Encopresis (99/2) 15 3. What is Vegetative Disorder (05) 5 4. What is vegetative disorder? Discuss management of a child with injuries (05) 5+5 5. Rumination (06/1) 5 6. Pica (07/1) 5HABIT DISORDER 1. Habit Disorders in children (07/1) 10MOOD DISORDER 1. Childhood Depression (06) 10DISRUPTIVE BEHAVIORAL DISORDERS 1. Common Behavioral problems in children (97/2) 15PERVASIVE DEVELOPMENTAL DISORDER AND CHILDHOODPSYCHOSIS 1. Autism (03/2) 15 2. Define autism. Outline its etiology. Outline the clinical markers of autism and its prognosis. (04/2) 2+3+3+2 3. Discuss the management of a child with schizophrenia (04/2) 5 4. Autistic spectrum disorder (07/2) 10

4. 5. Autistic Disorder (07/1) 10 6. Etiology, clinical manifestations and treatment of Autistic Disorder (06/1) 10 7. Discuss the management of a child with Schizophrenia (05) 5 8. Describe the etiology, clinical manifestations and management of autistic spectrum disorders in children. (09/2) 2+3+5 9. Discuss briefly the diagnostic features and management of Pervasive Developmental Disorders/ autistic spectrum disorders. (11/2) 4+6 10. Enumerate various pervasive developmental disorders and autism spectrum disorders. Outline one core feature of each of them. (12/1) 5+5NEURODEVELOPMENTAL DYSFUNCTION IN THE SCHOOL AGED CHILD 1. Attention Deficit Disorders (97/1) (95/2) (00/1) 15 2. ADHD (03/1) 15 3. Describe clinical manifestations, diagnosis and management of ADHA (06) 10MISCELLANEOUS 1. Juvenile Delinquency (06/1) 53 SOCIAL ISSUES, CHILDREN WITH SPECIAL HEALTH NEEDSFAILURE TO THRIVE 1. Causes of Failure to Thrive in infancy (96/2) 15 2. Approach to a child with Failure To Thrive (96/1) 14 3. Define failure to thrive. Outline a diagnostic approach for a child with failure to thrive. (04/2) 2+8 4. Non organic failure to thrive (07/1) 10 5. Define failure to thrive. Give its etiology, classification, clinical features and management. (09/2) 1+2+2+2+3 6. Define failure to thrive and tabulate its causes. Outline the approach to manage a child with failure to thrive. (10/2) 2+3+5ADOPTION 1. Adoption (03/2)CHILD ABUSE 1. Define child abuse. List the etiology of child abuse in India. Outline strategies for prevention. (04/2) 2. Discuss Child maltreatment. What are the factors related with child abuse (05) 5+5

5. 3. Define Child Abuse. Describe clinical manifestations of Child Abuse. Discuss some useful investigations in a suspected case of Child Abuse (06) 10 4. Management of the sex abused child (95/2) 15 5. Define child abuse. Describe in brief the factors responsible for child abuse. Outline management of a child who is suspected of being abused. (11/1) 2+3+5 6. Define child abuse and neglect. Discuss various clinical manifestations, diagnostic work up and management of physical abuse. (11/2) 2+3+2+3 7. Write short notes on : (09/2) 5+5 a. Female infanticide b. KaryotypingMENTAL RETARDATION 1. Preventable and treatable causes of Mental retardation (96/2) 10 2. Various physical features that are likely to be associated with specific syndromes of mental retardation (95/2) 10 3. Enumerate the causes of mental retardation in children. Give an outline of management of a child with mental retardation. (10/1) 4+64 NUTRITIONPEM 1. Immunological changes that take place in PEM (98/2) 10 2. Biochemical changes in PEM (96/2) 10 3. Discuss the influences of malnutrition on mental functions in relation to its onset, severity and type of functional losses with supportive advances (93/1) 25 4. Prevention of hypocalcaemia in PEM (93/1) 15 5. Age independent Anthropometric criteria for assessment of PEM (06) 5 6. Management of a 4 year old child with grade 4 PEM (07/2) 10 7. Outline the initial management ( in first 48 hours) of a 2 year old severely malnourished child (weight 5.5kg) who is cold to touch and has edema and poor peripheral pulses. (08/1) 10 8. Discuss biochemical and metabolic derangements in a child with severe malnutrition. Discuss factors associated with high mortality in severe PEM. (08/2) 10 9. Outline the 10 steps of management of severe malnutrition, as per WHO guidelines, in appropriate sequence. (10/2) 10 10. Define Severe Acute Malnutrition (SAM). Outline the tools for its diagnosis in the community and discuss their merits/ demerits. (12/1) 2+4+4

6. VIT A 1. Hazards and virtues of Vitamin A in pediatric practice (96/2) 10 2. Vitamin A supplementation (07/1) 5 3. Enumerate functions of vitamin A in human body. Tabulate the WHO classification of vitamin A defiency. Outline the treatment schedule for managing Xerophthalmia in children. (10/2) 2+3+5VIT B 1. Discuss the etiopathogenesis, clinical features, diagnosis and management of cobalamine deficiency. (12/1) 2+3+1+4VIT D 1. Functions of vitamin D (98/2) 10 2. Renal Rickets (97/2) 15 3. Vitamin D Resistant Rickets (96/2) 12 4. Resistant Rickets 15 5. Outline the metabolism and function of Vitamin D in human body. Describe in detail the etiology and pathological changes in rickets (99/2) 25 6. Clinical manifestations of Rickets (93/2) 10 7. What are the causes of non nutritional rickets. How will you manage such a child. (04/2) 3+7 8. Classify the various causes of rickets and outline how to differentiate them (05) 5+5 9. Diagnostic approach to a child with resistant rickets (06) 10 10. Resistant Rickets (06/1) 10 11. Discuss calcium and vitamin D metabolism. Outline an approach to a case of Resistant Rickets (07/1) 10 12. Discuss the pathophysiological basis of clinical and radiological manifestations of nutritional rickets. (09/1) 10 13. Describe vitamin D metabolism. Describe diagnostic approach to a 3 year old child with rickets who has shown no response to treatment with 6 lac I.U. of vitamin D. (09/2) 4+6 14. Outline the clinical features, radiological changes, diagnosis and treatment of nutritional vitamin D deficiency rickets (10/2) 2+2+2+4 15. Write in brief the role of vitamin D in health and disease in children. Outline the management of Vitamin D deficiency disorder. (12/1) 6+4VIT C 1. Scurvy- radiological changes. How are they produced? What is the role of Blood Level of Vit C in the diagnosis (05) 10VIT E 1. Enumerate the functions and therapeutic uses of Vit E (98/1) 15 2. Vitamin E and its role in human nutrition (92/2) 15VITAMINS 1. Hypervitaminosis in Children (96/1) 12

7. COPPER 1. What are the dietary sources of copper? What are the diseases associated with abnormal copper metabolism? Describe investigations, clinical features and treatment of any one of them. (09/2) 1+2+7ZINC 1. Effects of Zinc supplementation in persistent diarrhea (98/2) 10 2. Role of Zinc in health and diseases of children (97/1) 10 3. Relevance of Zinc in human nutrition (92) 15 4. Give dietary requirements of Zinc in children and discuss its role in childhood immunity and infections (07/1) 10 5. Write short notes on: Zinc supplementation when and how? (11/2) 5MAGNESIUM 1. Sources, deficiency state and uses of magnesium in children. (10/1) 3+3+4MILK 1. Bioactive factors in Human Milk (98/1) 15 2. Differences in the composition of Milk secreted by mothers delivering Term and Preterm babies (96/2) 10 3. Discuss the physiology of Breast Milk secretion and advantages of breast feeding with special reference to metabolic aspects. What are the causes of lactation failure (99/1) 25 4. Anti-infective properties of Human milk (95/2) 10 5. Enlist the problems of breastfeeding and outline the management of the same(05) 4+6 6. Explain the occurrence of low prevalence of Hypoglycemia and iron deficiency anemia in breast fed infants (05) 10 7. How would you assess the adequacy of breast milk for a 2 months old baby. Enumerate 4 features of good attachment of a baby to the breast. What can be the problems with poor attachment (06) 10 8. Compare the composition of human milk with cows milk. Outline the difference in the milk composition of a mother with a premature neonate from that of a term neonate. Describe the immunological factors present in human milk. (08/2) 10IODINE 1. Prevention of Iodine deficiency (95/1) 15FLUORINE 1. Prevention of Fluoride toxicity (95/1) 15OBESITY 1. Approach to a child with obesity (99/1) 15

8. 2. Define obesity in childhood. List the causes of obesity in children. Outline strategies for its prevention. (04/2) 2+3+5 3. What is Obesity? Discuss the management in children (05) 3+7 4. Approach to a child with Obesity (06/1) (07/2) 10 5. Outline the diagnostic measures and clinical manifestations of obesity. Enlist the differential diagnosis of childhood obesity. (09/2) 2+3+5 6. Define syndrome X. Outline the diagnostic criteria and laboratory work up for obese children. (10/1) 2+3+5 7. Define obesity. List causes of obesity. Discuss approach to a child with obesity. (11/1) 2+3+5MISCELLANEOUS 1. Metabolism of fat absorption along with role of MCT in nutrition (03/1) 15 2. What is Complimentary Feeding? Discuss the feeding problems in first year of life (05) 5+5 3. How would you assess the nutritional status of a child whose age is not known (05) 10 4. Describe the attributes of complimentary feeding. What is the safe age of introduction of complementary feeding in your opinion Justify. Describe some foods appropriate for complimentary feeding. (08/2) 10 5. Daily nutritional requirements as recommended Daily Allowance (RDA) in infants and children. (10/1) 5+5 6. Define complimentary feeding. Outline the attributes of complimentary foods. Enumerate the recommendations on complimentary feeding, as per the National guidelines on Infant and Young Child Feeding (IYCF) (10/2) 2+2+6 7. Name the micronutrients required for various body functions. Discuss briefly their dietary sources and the effects of deficiency of mineral micronutrients (trace elements). (11/2) 3+2+5 8. Outline the nutritional support of a critically ill child. List the complications during management of such a child. (12/1) 7+35 PATHOPHYSIOLOGY OF BODY FLUIDS AND FLUIDTHERAPY ACUTELY ILL CHULDSHOCK 1. How do you classify Shock in children? Write its aetiopathogenesis and management (06) 10 2. Discuss the classification and causes of shock in children (97/1) 15 3. Management of Cardiogenic shock (96/1) 12 4. Define Shock. Describe the pathophysiology and management of septic shock in children (94/2) 25 (04/2) 5+5

9. 5. Shock-pathogenesis of different types and pathological changes in different organs (03/1) 25 6. Discuss the management of an infant with Shock (00/1) 25 7. Discuss the pathophysiology of cardiogenic shock. How are the various hemodynamic parameters affected in cardiogenic shock? Discuss steps in monitoring and treatment of cardiogenic shock. (08/2) 10 8. Define fluid refractory shock. Describe the management strategy for a 2 year old child with fluid refractory shock. (10/1) 3+7 9. Define septic shock. Describe the etiopathogenesis and clinical features in a 15 month old child presenting with septic shock. (11/2) 2+4+4POTASSIUM 1. List the causes of Hypokalemia. Discuss the clinical features, laboratory diagnosis and management of Hypokalemia (06) 10 2. Define hypokalemia. Enlist its causes and outline clinical features and its treatment (09/2) 1+3+2+4SODIUM 1. List the causes of Hyponatremia. Discuss the clinical features, lab diagnosis and management of Hyponatremia (05) 3+4+3 2. Enumerate common causes of Hyponatremia (06) 5 3. Define hypernatremia. Describe the pathophysiological changes and steps of management of hypernatremia. (10/1) 2+4+4 4. Define hyponatremia. Enumerate the etiology of hyponatremia. Describe the management of hypovolemic hyponatremia. (10/2) 2+3+5 5. Define hypernatremia. Enumerate the etiology of hypernatremia. Describe the management of hypernatremic dehydration. (11/1) 3+4+3ACID-BASE BALANCE 1. Anion Gap (98/2) (00/1) 10 2. Describe briefly how the acid-base balance of body is maintained in health (98/1) 25 3. Physiological compensatory mechanisms during Metabolic Acidosis (97/1) 15 4. Define pH and base excess. Discuss briefly regulation of Acid-base homeostasis and management of Respiratory Acidosis (93/1) 15 5. Pathophysiology of Acid-base disorders (03/1) 15 6. Anion Gap (03/2) 15 7. Define anion gap and its utility. Outline the major causes of metabolic acidosis in children. Outline the treatment of renal tubular acidosis. (04/2) 2+4+4 8. Outline the normal mechanism of acid-base regulation in children. What is anion-gap? Describe the causes and management of a child with metabolic acidosis (07/2) 10

10. 9. List the causes of metabolic alkalosis. Describe the pathophysiology, clinical features and treatment. (08/2) 10 10. Classify metabolic acidosis based on anion gap. Mention the various causes of lactic acidosis. Describe the approach to diagnosis of inborn error of metabolism in an infant. (08/2) 10 11. Classify and enlist the causes of metabolic alkalosis. Outline the treatment modalities. (10/1) 3+3+4 12. Define anion gap. Enlist causes of increased anion gap acidosis and discuss its management in brief. (11/1) 2+3+5DEHYDRATION 1. Steps in management of patient with Hypernatremic Dehydration (06) 10 2. Management of Hypernatremic Dehydration (02/1) 15 3. Management of Acute Diarrhea in children (98/1) 15 4. Pathogenesis and Management of Hypernatremic Dehydration (97/2) 15 5. One year old infant with AGE develops Abdominal Distension. Discuss the differential diagnosis (97/1) 10 6. Why children are more vulnerable to develop dehydration (96/2) 10 7. Hypernatremic Dehydration (03/1) 15 8. Hyponatremic Dehydration (03/2) 15 9. A one year old infant weighing 5.5kg presents with Acute Dysentery and severe dehydration. Discuss its complete management (06/1) 10 10. A one year old baby weighing 5.5kg comes in severe dehydration. Discuss complete management (07/2) 10 11. Discuss causes, predisposing factors and pathophysiology of Hypernatremic dehydration in young children (07/1) 10 12. Describe the pathophysiology of hyponatremic dehydration. Briefly discuss the management of a child with serum sodium of 110 meq/liter presenting with moderate dehydration and seizures. (08/2) 106 ACUTELY ILL CHILDDROWNING 1. Near drowning in children (06) 10 2. An 18 month old child was brought to you after he fell upside down in a tub filled with water. Briefly describe the possible injuries and preventive strategies to avoid similar situation in future. (08/1) 10 3. Describe the pathogenetic mechanism of injury in near drowning. Discuss the steps of initial resuscitation and subsequent hospital management. (08/2) 10 4. Discuss the pathophysiology of submersion injury. A 4 year old boy was rescued 10 min back from a pond and rushed to the hospital emergency. Mention the basic principles of management. (12/1) 5+5

11. PAIN 1. Pathogenesis and management of pain in children (06) 10 2. Pain management in infants and children (98/1) 15 3. Enumerate various sedatives and analgesics recommended for children undergoing painful procedures. Describe their main action, indication in pediatric practice and important side effects in a tabular format. (08/1) 10 4. Write short notes: (12/1) 5+5 a)Non-pharmacological methods in pain management. b) Drug therapy in neonatal pain management.BURN 1. How is the degree of Burns classified? Write the initial fluid therapy for a one year old child weighing 10 kg with 20% 2ND degree burns (06) 10 2. Provide classification of burns injury. Describe the clinical manifestation of electrical burns. Outline emergency management of a child with 20% burns. (11/2) 2+3+5COLD INJURIES 1. Cold Injury (07/1) 10BRAIN DEATH 1. Brain Death (98/1) (99/2) 15 2. Define Brain Death. Write age specific criteria for Brain Death in children. (11/2) 2+8P.A.L.S. 1. Draw an algorithm for managing pulseless ventricular tachycardia and ventricular fibrillation. (08/1) 10 2. How will you assess that a 10 year old child who has fallen unconscious in front of you required basic life support. What are the steps for basic life support to such a child (as per American Heart Association Guidelines for CPR) (09/1) 3+7MECHANICAL VENTILATION 1. Describe the various pressures which are used or varied during mechanical ventilation. What is Cycling and Control in mechanical ventilator? Describe the differences in pressure controlled and volume controlled ventilation. Illustrate with suitable indication use of these forms of ventilation. (08/2) 107 GENETICS 1. Genetic counseling of a case of Down Syndrome (99/1) 15 2. Early stimulation in Down syndrome (92/2) 15 3. Prenatal diagnosis of Down syndrome and Duchenne Muscular Dystrophy 15

12. 4. Gene Therapy in Children (06/1) 10 5. Gene therapy (07/1) 5 6. Enumerate and describe the structural abnormalities of autosomes. Illustrate with suitable examples. (08/1) 10 7. What are trisomies? What are predisposing factors? Discuss clinical features of 3 common trisomies seen in clinical practice? (08/1) 10 8. Describe the symbols used in pedigree chart. Draw pedigree charts over 4 generations depicting a) X linked dominant disease b) X linked recessive disease. 9. Briefly discuss the principles of genetic counseling. Outline the counseling of a family with a child with Downs syndrome. (04/2) 5+5 10. A couple has a child with Down Syndrome. Outline the principles of genetic counseling and antenatal management for the subsequent pregnancy.(09/1)10 11. Write a short note: Karyotyping (09/2) 5 12. What are mutations? Describe their consequences. (10/1) 5+5 13. Discuss the genotypic and phenotypic features of Turners syndrome (11/1) 4+6 14. What are mitochondrial genes? How are they transmitted? Briefly discuss diseases transmitted by them? (11/2) 2+2+68 METABOLIC DISEASES 1. Screening tests for Inborn Errors Of Metabolism (96/2) 10 2. Metachromatic Leukodystrophy (96/1) 12 3. Homocysteinuria (94/2) 15 4. Discuss the diet plan in various metabolic disorders (99/1) 15 5. Write briefly about glucose metabolism in body. Describe briefly glycogen storage disorders. (04/2) 4+6 6. Laboratory Screening tests for metabolic Disorders (06/1) 10 7. Provide a diagrammatic representation of urea cycle. Indicate and name related disorders of urea cycle metabolism at each step. (08/1) 10 8. Discuss the enzymes replacement therapy and substrate reduction strategies in management of metabolic disease. (08/2) 10 9. Enlist the inborn errors of metabolism (IEM) with their associated peculiar odor. Provide the investigative approach for an infant with suspected IEM. Describe the treatment of phenylketonuria. (09/2) 4+4+2 10. Define hypoglycemia. Describe clinical features and management of hypoglycemia in newborn and children. (11/2) 1+4+5

13. 9 NEONATOLOGYRESPIRATORY DISTRESS 1. Describe the surgical causes of Respiratory difficulty in newborn (02/1) 25 2. Surfactant therapy (98/2) 10 3. Meconium Aspiration Syndrome(97/2) 15 4. BPD (97/1) 15 5. Surfactant therapy for HMD 15 6. Tests for pulmonary maturity and surfactant therapy for RDS (94/2) 15 7. Discuss RDS with special reference to surfactant therapy (98/2) 15 8. Discuss the pathogenesis and management of MAS (00/1) 25 9. Pathophysiology of RDS of newborn (94) 15 10. HMD- pathophysiology and management (03/1) 25 11. List the causes of respiratory distress in preterms. Outline the principles of surfactant therapy in preterms. Outline the manifestations of oxygen therapy in newborns. (04/2) 2+4+4 12. What is the etiopathogenesis of PPHN of Newborn. Outline the diagnosis and management (05) 3+3+4 13. Describe in brief PPHN (or PFC) with regard to Pathology, pathophysiology, Diagnosis and management (94/2) 25 14. What is the sequence of events leading to the first breath after delivery? What is the significance of establishment of Functional Residual Capacity? (06) 10 15. Etiology, pathogenesis and management of a neonate with RDS (06/1) 10 16. PPHN (06/1) 10 17. Briefly discuss normal fetal development of Surfactant. List the uses of Surfactant in newborn (07/2) 10 18. Discuss the diagnosis and management of PPHN (07/2) 19. Enumerate causes of persistent pulmonary hypertension in neonates and discuss its pathophysiology. (08/1) 10 20. Discuss the approach to diagnosis of Persistent Pulmonary Hypertension of Newborn (PPHN). Outline the available modalities of management, highlighting their key features in a tabular format. (10/2) 4+6 21. Discuss the pathophysiology of hyaline membrane disease in premature newborns. (10/2) 10 22. Describe the pathophysiology of hyaline membrane disease (HMD) in newborns. Outline important available strategies to prevent HMD. (11/1) 5+5SURGICAL 1. Enumerate congenital anomalies presenting as severe respiratory distress in a newborn. Describe the pre-operative and post operative care of a neonate with tracheo esophageal fistula. (10/1) 4+3+3 2. Enumerate causes of persistent vomiting in a 4 week old child. Describe clinical features and management of hypertrophic pyloric stenosis. (12/1) 3+3+4

14. RESUCITATION 1. How do you assign APGAR score to a neonate. In which 5 conditions will you get a low score without associated hypoxia? What are fallacies of APGAR score. (06) 10 2. A term baby is apnoeic. What information of the perinatal events you would like to know? What are the initial steps of management in the labor room? What are the possible complications in the next 48 hours? (08/2) 10 3. Describe the changes taking place in circulation at birth and their implications in neonatal resuscitation. (09/1) 5+5 4. Enumerate the newer recommendations of neonatal resuscitation by American Academy of Pediatrics 2010 guidelines. Comment on the level of evidence for each of the changes. (12/1) 6+4BIRTH ASPHYXIA 1. Perinatal asphyxia- clinical features and management (02/1) 15 2. HIE (97/2) 15 3. Clinical and laboratory correlates of neuromotor outcome in Birth Asphyxia (97/1) 10 4. Discuss the etiopathology and management of birth asphyxia (96/2) 25 5. HIE in newborn (95/1) 10 6. Discuss briefly pathophysiology and recent modalities of management of HIE (99/2) 25 7. HIE (93/1) (92/2) 15 8. Prognosis of Birth Asphyxia (93/1) 10 9. What are the etiological causes of Fetal Hypoxia? Write pathophysiology of Fetal Hypoxia. Describe stages of HIE (06) 10 10. Pathophysiology of Hypoxic Brain injury in neonate (06/1) 10 11. Discuss the pathophysiology of hypoxic Ischemic Encephalopathy (HIE) in neonates. (09/1) 10NEONATAL SEIZURES 1. Etiopathogenesis of neonatal seizures (02/1) 15 2. Management of Resistant Neonatal Seizure (03/2) 15 3. Classify neonatal seizures. Outline their etiology and provide a brief clinical description. Provide general principles of management of a seizure in neonate. (12/1) 2+2+3+3IVH 1. IVH (3/1) 15 2. Outline the risk factors, pathophysiology and principles of management of intraventricular hemorrhage in preterm neonates. (10/2) 3+3+4

15. 3. Discuss the pathogenesis of intracranial hemorrhage in newborn infants. Outline the possible promoters and protectors for occurrence of subsequent white matter disease. (12/1) 6+2+2PAIN 1. Discuss the impact of pain on a preterm neonate. Identify common procedures associated with pain in a newborn. Describe the strategies for pain management in a newborn. (08/2) 10 2. Write short notes: (12/1) 5+5 a)Non-pharmacological methods in pain management. b) Drug therapy in neonatal pain management.NEONATAL HYPOGLYCEMIA 1. Management of neonatal hypoglycemia (98/2) (92/2) 10 2. Define Hypoglycemia in newborn. List its causes. Describe stepwise treatment if hypoglycemia in a newborn (06) 10TEMPERATURE 1. Thermal regulation in newborn (98/2) 10 2. Hypothermia in the newborn (97/1) 15 3. Thermoregulation peculiarities in newborn (94/2) 15 4. Prevention of Hypothermia in the newborn (98/2) 15 5. Physiological and biochemical consequences of Hypothermia in Neonate3 (99/1) 15 6. Thermal balance in Neonates (03/2) 15 7. Discuss management of Neonatal Hypothermia (06) 5 8. Write the components, pre-requisites and benefits of Kangaroo Mother care. (08/2) 10 , (11/2) 5+2+3 9. Discuss the principles of care of the skin in neonates. Outline the role of touch and massage therapy in newborn infants. (10/2) 4+3+3ANTENATAL DIAGNOSIS 1. Antenatal Diagnosis (98/2) 10 2. Discuss the methods of detection of congenital malformations in the fetus and their prevention (95/1) 25 3. Intrauterine Diagnosis (93/2) 10 4. Amniocentesis in prenatal diagnosis (92) 15 5. Methods to diagnose fetal disorder. Fetal medical therapy (05) 5+5 6. List various methods for Fetal diagnosis and assessment along with indications (06) 5 7. Prenatal Diagnosis and Fetal therapy (06/1) 10 8. Medical management of Fetal Problems (07/2) 10 9. Treatment and prevention of fetal diseases (07/1) 10 10. What are the methods of diagnosis of fetal disorders? Describe the fetal medical and surgical therapeutic options for various fetal disorders. (09/2) 10

16. FETUS 1. Describe in detail tests for antepartum and intrapartum monitoring of fetal distress (06) 5 2. Fetal monitoring (06) 10 3. Discuss the complications in the fetus and newborn of a mother with diabetes during pregnancy. (08/1) 10RENAL 1. Kidney functions in neonate (98/2) (99/2) 10INFECTIONS 1. Infection control in neonatal intensive care (98/2) 10 2. Congenital toxoplasmosis (97/2) 15 3. Infants of HIV seropositive mothers (95/1) 15 4. Infants of HBV seropositive mothers (95/1) 15 5. Early diagnosis of Neonatal Septicemia (94/2) 15 6. Newer modalities in the management of neonatal sepsis (99/2) 15 7. Screening tests for neonatal sepsis 15 8. Prevention of Mother to Child transmission of Hep B 15 9. Rapid diagnostic tests in a suspected case of Neonatal Septicemia (95/2) 10 10. Sepsis Screen in neonates (06/1) 10 11. Antibiotic treatment of Neonatal Meningitis (93/2) 10 12. Candidiasis in Neonates (06) 10 13. Adjuvant therapy in Neonatal sepsis (06) 10 14. Differential Diagnosis of Neonatal sepsis (07/1) 10 15. Discuss various adjunct therapies in neonatal sepsis. (08/1) 10 16. Discuss the risk factors for vertical transmission of HIV infection and methods to prevent parent to child transmission of HIV. (09/1) 4+6 17. Discuss the predisposing factors, causative agents, methods of diagnosis and treatment of neonatal osteomyelitis. (09/1) 4+6 18. A 3 day old home delivered boy (Weight 1450g, Gestation 36 wk) is brought to you with abnormal body movements and not accepting feeds. The child is cold to touch and capillary filling time is 5 sec. outline the immediate, short term and long term management of this child. (09/1) 4+6 19. Enumerate the clinical features that indicate presence of a possible intra -uterine infection in a neonate. Describe the interpretation of TORCH screen. (09/2) 6+4 20. Clinical features, investigations and prevention of Congenital Rubella Syndrome. (10/1) 3+3+4 21. Outline the clinical presentation, diagnosis and management of a neonate with intrauterine CMV infection. (11/1) 3+4+3 22. Discuss the available strategies for prevention of mother to child transmission of HIV. (12/1) 10

17. SFD 1. Immune status of SFD babies (98/1) 15 2. Factors associated with IUGR (93/1) 10 3. Enumerate the etiology of fetal or intrauterine growth retardation (IUGR). Describe the screening and diagnosis of IUGR. (11/2) 3+4+3APNEA OF PREMATURITY 1. Pathophysiology of Apnea Of Prematurity (97/2) 15 2. A 10 day old preterm neonate has recurrent cessation of breathing lasting for more than 20 seconds with bradycardia. Classify and enumerate causes for this condition. Discuss in brief the management of this condition. (12/1) 4+6RETINOPATHY OF PREMATURITY 1. ROP (07/1) 10OSTEOPENIA OF PREMATURITY 1. Osteopenia of prematurity (06) 10NEONATAL JAUNDICE 1. A 3 week old infant brought to the hospital with moderate jaundice. Discuss the Diagnosis (97/2) 10 2. Kernicterus (97/1) 15 3. Pathogenesis of kernickterus (96/2) 10 4. Discuss the Bilirubin metabolism and list the causes and approach to Diagnosis of Hyperbilirubinemia in a neonate (00/1) 25 5. Discuss reasons for Physiological Jaundice in a Newborn. Define and list causes of pathological jaundice in a newborn. Discuss clinical manifestations (acute and chronic)of kernickterus (06) 10 6. Outline the normal metabolism of bilirubin. Outline the principle of phototherapy for treatment of neonatal jaundice. List factors that influence efficacy of phototherapy. (08/1) 10 (09/1),(10/2) 4+3+3 7. Critically describe the role of various treatment modalities for treating neonatal unconjugated hyperbilirubinemia. (11/2) 10NEC 1. NEC (97/2) 15 2. Pathogenesis of NEC (97/1) (92) 15 3. Etiology and pathology of NEC 15 4. Etiology of NEC, staging and management. (04/2) 10 5. Discuss management of NEC (06) 5 6. Discuss the clinical features, diagnosis and management of neonatal necrotizing enterocolitis. (09/1) 3+7 7. Discuss the pathophysiology, classification and diagnostic features of necrotizing enterocolitis. (10/2) 4+3+3

18. 8. A 6 day old preterm neonate presents with abdominal distension, feed intolerance, vomiting and blood in stools. Discuss the differential diagnosis, diagnostic approach and principles of initial stabilization. (12/1) 4+3+3NEONATAL HYPOTHYROIDISM 1. Clinical features of Cretinism in newborn babies (97/1) 10 2. Desccribe in brief the etiology, clinical features, diagnostic investigations and management of congenital hypothyroidism. (11/1) 2+2+3+3PRETERM 1. Enumerate the socio-demographic factors associate with Low birth weight babies. Discuss the clinical problems of Preterm babies (96/1) 25 2. Pharmacotherapy in prematurity clinical decisions- salient features (03/1) 15 3. Management of Patent Ductus Asteriosus (PDA) in preterm neonates(10/1)10HAEMATOLOGY 1. Management of Neonatal Thrombocytopenic Purpura (00/1) 15 2. Hemorrhagic Disease of The Newborn (95/2) 15 3. Causes of Anemia in the Newborn (93/1) 10 4. Discuss aetiopathogenesis, diagnosis and management of a Bleeding Neonate (06/2) 10 5. Anemia in newborn infant (07/1) 10 6. Define polycythemia in a newborn. What are the factors predisposing to it? Describe the impact of polycythemia on various systems and their clinical presentation. Describe the management of polycythemia in newborn. (08/2) 10 7. Outline the classification, clinical manifestations, laboratory findings and differential diagnosis of vitamin K deficiency bleeding. (12/1) 3+3+2+2FLUID THERAPY 1. Fluid therapy in special situations in neonates (06/1) 10HIGH RISK INFANT 1. Discuss the basic elements of the At Risk concept with regard to their advantages and disadvantages and fallacies if any as they relate to health care of mothers and children (95/2) 25 2. Define High risk infant. Discuss the long term management of such infants with emphasis on detection and early intervention of infants with developmental disabilities (95/1) 25MISCELLANEOUS 1. Role of O2 free radicals in the pathogenesis of neonatal disorders (96/2) 10 2. Bullous skin eruptions in newborn babies (95/2) 15 3. Endocrine problems that can be diagnosed on the first day of life (95/1) 10 4. Prenatal steroid therapy (99/2) 15

19. 5. Steps in Neonatal Resuscitation 15 6. Fetal circulation and changes at birth (00/1) 15 7. Placental dysfunction syndrome (95/2) 15 8. Scheme for identifying High Risk Fetuses (92/2) 15 9. Hydrops Fetalis (03/1) 15 10. Non immune hydrops fetalis (03/2) 15, (07/1) 10 11. Fetal Therapy (03/2) 15 12. List the principles of community care of LBW infants. Define Kangaroo Mother care. Outline its advantages and disadvantages. (04/2) 4+2+4 13. Outline the handicaps in enteral feeding of LBW newborns. Briefly discuss the feeding strategies for LBW babies. (04/2) 3+4+4 14. What is Hydrops fetalis. Discuss etiology of Non immune hydrops fetalis. What is the management of a case of Non immune hydrops fetalis (05) 2+5+3 15. Biology and role of cytokines in Newborn Infants (06/1) 10 16. ECMO (06/1) 10 17. CPAP (06/2) 10 18. Organization and levels of Newborn care (06/1) 10 19. Complications of infants born to diabetic mothers (07/2) 10 20. Steroid in neonatal care (07/1) 5 21. Enumerate common peripheral nerve injuries in neonates. Describe their clinical characteristics and outline the management. (09/1) 2+3+5 22. Discuss the proposed hypothesis on fetal origins of adult disease and its implications on burden of diseases. (11/1) 5+510 SPECIAL HEALTH PROBLEMS DURING ADOLESCENCE 1. Juvenile Delinquency (02/1) 15 2. Etiological factors in Juvenile Delinquency (98/2) 15 3. Role of health education to Adolescents (98/2) 10 4. Discuss the special health problems of Adolescents (98/1) 25 5. Health education of adolescent girls 15 6. Adolescent Violence (03/1) 15 7. Health problems of adolescents(03/2) 15 8. What are the common problems in Adolescence (05) 5 9. Problems of adolescence (07/2) 10 10. What are the common problems in adolescence (05) 5 11. Discuss briefly Adolescent Health Problems (07/2) 1011 IMMUNOLOGY 1. Prenatal Diagnosis of Primary Immunodeficiency diseases (94/2) 10 2. Graft versus host disease (99/1) 15 3. Indications for various organ and tissue transplants in Pediatric practice and common considerations in selection of donors (95/2) 10

20. 4. Laboratory investigation of a child suspected to have T-cell immunity Disorder (92) 15 5. Approach to a child with suspected immune dysfunction (06/1) 10 6. numerate functions of the Phagocytes and briefly describe defects of their functions. (09/1) 4+6 7. Enlist the humoral immunodeficiency disorders. Outline the diagnostic approach and treatment. (10/1) 4+6 8. Outline the characteristic features of primary immunodeficiency. Write in detail about pathogenesis and clinical features of chronic granulomatous disease. (11/1) 4+3+312 ALLERGIC DISORDERS 1. Pathogenesis and management of anaphylaxis (97/1) 15 2. Mechanism, manifestations and management of anaphylaxis (92) 15 3. Allergic Rhinitis (07/1) 5 4. Enumerate the chemical mediators of allergic reactions and describe the important actions of histamine. (08/1) 10 5. Clinical features, differential diagnosis and treatment of atopic dermatitis in infants. (10/1) 3+3+4 6. What is atopic dermatitis? Describe the clinical features and differential diagnosis of atopic dermatitis. (11/2) 2+5+3 7. What is atopic dermatitis? Describe clinical features, differential diagnosis and treatment of atopic dermatitis. (12/1) 1+3+3+313 NEPHROLOGYGLOMERULAR FILTRATION 1. Outline the development of glomerular filtration. Outline the methods for evaluating GFR in children. (08/1) 10 2. List the children to be selected for assessing renal function. Briefly discuss the tests used to assess the renal function in children. (04) 3+7RENAL REPLACEMENT THERAPY 1. Renal replacement therapy in ESRD (00/1) 15 2. Peritoneal dialysis (03/1) 15 3. Renal replacement therapy (06/1) 10 4. Discuss renal replacement therapy (07/1) 10RTA 1. Classify types of RTA and their management principles (02/1) 15 2. Diagnosis and management of RTA (92/2) 15PROTEINURIA 1. Persistent asymptomatic proteinuria (98/2) (07/1) 10

21. 2. Proteinuria (96/2) 15HEMATURIA 1. Diagnosis and management of recurrent Hematuria (96/1) 12 2. A 3 year old child was brought for Hematuria. Discuss the differential diagnosis and management (94/2) 25 3. Evaluation of a child with Hematuria 15 4. Outline the differential diagnosis of an abdominal lump with hematuria in a 3 year old child. Describe its investigations and treatment. (09/2) 3+3+4 5. Write the common causes and differential diagnosis of gross symptomatic hematuria. Provide an algorithm for its laboratory and radiological evaluation. (10/2) 2+2+6 6. Outline the causes of red coloured urine. Provide an approach for evaluation of a child with red colored urine. (11/1) 3+7 7. Discuss the pathology, clinical manifestations, diagnosis and treatment of infantile polycystic kidney. (11/2) 2+2+3+3PSGN 1. Discuss the pathogenesis, clinical features and management of acute PSGN 2. Enumerate the complications of acute post streptococcal glomerulonephritis. Describe their management in brief. (10/2) 3+7NEPHROTIC SYNDROME 1. Enumerate the principles of management of Idiopathic Nephrotic syndrome (98/2) 10 2. Pathophysiology of Nephrotic Syndrome (96/2) 10 3. What factors will you consider in deciding the prognosis of a child with Nephrotic syndrome (95/1) 15 4. Relapse in Nephrotic Syndrome (94) 15 5. Frequently relapsing steroid resistant Nephrotic Syndrome (03/2) 15 6. What factors help you to clinically decide non-minimal nature of Nephrotic Syndrome? Enumerate the steps to test urine for albumin using heat methods (05) 10 7. Histopathological changes in RPGN 15 8. Write the management of a 6 year old child with Nephrotic syndrome who is frequently relapsing. Enumerate complications that can occur (06/2) 10 9. Management of steroid dependent nephrotic syndrome (07/2) 10 10. Describe the diagnostic approach and management in a case of frequently relapsing and steroid dependent nephritic syndrome. (09/2) 4+6 11. Management of steroid resistant nephrotic syndrome. (10/1) 10 12. Define steroid dependent and frequently relapsing nephrotic syndrome. Describe management of an 8 year old child with frequent relapsing nephrotic syndrome. (11/1) 2+2+6

22. RENAL FAILURE 1. Biochemical and endocrinal changes in CRF 2. What are the causes of ARF in children? How will you investigate such a case? Discuss management. (97/1) 25 3. Describe the pathogenesis of CRF and outline important principles in the management of such a case (95/2) 25 4. What are the causes of acute renal failure in a 4 year old child. How will you investigate such a case. Discuss the management of acute renal failure. (04/2) 4+3+3 5. Outline the etiopathogenesis of ARF in children. Discuss briefly the management (05) 5+5 6. List the causes of renal failure in a 3 month old child. Discuss the clinical features, laboratory diagnosis and treatment of acute renal failure in children. Discuss the indications of renal biopsy in children (06) 10 7. Discuss the etiology of cortical necrosis in newborns and older children, separately. State the most important clinical manifestations of cortical injury and factors governing prognosis. (08/1) 10 8. Discuss the role of recombinant human erythropoietin therapy (indication, dose, aim, precaution, benefits and complications) in management of chronic renal failure. List reasons of resistance to such therapy. (08/1) 10 9. What is acute renal failure? List the common causes leading to it. Tabulate the laboratory indices used to differentiate pre-renal and intrinsic acute renal failure. Outline the medical management of acute renal failure. (08/1) 10 10. Define renal osteodystrophy. Enumerate its clinical features and outline the management. (09/2) 2+3+5HUS 1. HUS- etiopathogenesis and diagnosis (98/1) 15 2. Diagnostic features of HUS (93/2) 15TUBULAR DISORDERS 1. Nephrogenic Diabetes Incipidas (98/2) 15 2. Pathogenesis, clinical features and management of Distal Renal Tubular disorder (07/2) 10 3. Define anion gap and its utility. Outline the major causes of metabolic acidosis in children. Outline the treatment of renal tubular acidosis. (04/2) 2+4+4

23. 14 RHEUMATIC DISEASESKAWASAKI DISEASE 1. Phases and complications of Kawasakis disease (06) 10 2. Kawasaki Syndrome (00/1) 15 3. Discuss the presentation, diagnostic criteria for Kawasaki Disease. What is the management strategy? What are the complications? (08/1) 10 4. Discuss the pathogenesis, differential diagnosis and echocardiography findings in Kawasaki Disease (KD). How is the classical KD different from Atypical KD? (09/1) 6+4 5. Describe clinical manifestations of classical and atypical Kawasaki disease. Provide algorithmic approach to a suspected case of Kawasaki disease. Enumerate various treatment modalities. (11/1) 4+4+2JRA 1. Classification and features of JRA (96/2) 14 2. What are the clinical manifestations of juvenile rheumatoid arthritis. Discuss the differential diagnosis and management. (04/2) 3+3+4 3. Write the current classification used in JRA. Outline the management plan for JRA (06) 10 4. Tabulate differentiating features of various types of juvenile rheumatoid arthritis. (08/1) 10 5. Tabulate the classification of Juvenile Idiopathic arthritis and state principles of its treatment. (10/2) 4+6 6. Outline the diagnostic criteria of juvenile rheumatoid arthritis. Tabulate the differentiating features of various types of JRA. Outline a scheme of investigation for a child with suspected JRA. (11/1) 3+4+3 7. Tabulate the differentiating clinical features and the diagnostic approach of Juvenile Idiopathic Arthritis (JIA). Outline the principles of management of polyarticular JIA. (12/1) 4+3+3H S PURPURA 1. Discuss briefly clinical presentation and management of H S Purpura (07/1) 10 2. Describe the diagnostic approach and management of a six year old child presenting with purpuric rash and pedal edema following an episode of acute diarrhoea. (11/2) 4+6MISCELLANEOUS 1. Classify vasculitis based on size of involved vessels and give examples of each category. Describe etiology, clinical features and management of Takayasus arteritis. (09/2) 5+5

24. 15 INFECTIOUS DISEASESPUO 1. Discuss definition, etiology and approach to investigation of PUO (07/1) 10 2. Outline the approach to management of a 2 month old infant having fever without focus. (09/1) 10 3. Enumerate the common causes of pyrexia of unknown origin in a 5 year old child. Discuss diagnostic approach to fever with rash. (11/2) 4+6HIV 1. Prevention of HIV infection during childhood (02/1) 15 2. HIV and Pediatrics (98/2) 10 3. Post exposure HIV prophylaxis (03/2) 15 4. An HIV positive mother has been admitted in labour. What will you do to prevent transmission of infection to the baby (05) 10 5. Factors involved in perinatal transmission of HIV infection and the various preventive measures (06) 10 6. Prevention of Childhood AIDS (07/2) 10 7. Clinical Presentations requiring screening for HIV (07/1) 5 8. HIV and TB (07/1) 5 9. Outline clinical and immunological criteria for starting anti-retroviral treatment (ART) in a HIV infected child. How will you monitor a child initiated on ART? (09/2) 6+4 10. Enlist the common opportunistic infections in HIV infected children. Describe the clinical features, diagnosis and management of herpes simplex infection in HIV infected children (11/2) 3+2+2+3 11. Enumerate opportunistic infections in HIV infected children. How will you treat and prevent pneumocystis jiroveci infection. (12/1) 5+3+2TB 1. Diagnosis and management of a child with resistant TB (02/1) 15 2. Short course chemotherapy for TB (98/2) 10 3. Prevention and early detection of TB (96/2) 15 4. CNS changes in Tubercular meningitis(Pathological only) 15 5. Discuss the pathogenesis, clinical symptomatology and diagnosis of NeuroTB (06) 10 6. How do you perform and interpret Mantoux Test. Enumerate 3 conditions each in which you can get a false positive and a false negative result. (06) 10 7. Newer diagnostic modalities for TB (06) 10 8. Describe clinical manifestations, diagnosis and management of Neuro tuberculosis. (11/2) 3+4+3ENTERIC FEVER 1. Interpretation of Widal test in immunized children (98/2) 10 2. Nontyphoidal salmonellosis (95/2) 15

25. 3. Management of typhoid fever (95/2) 15 4. Treatment of typhoid fever (93/1) 10 5. Define multidrug resistant (MDR) salmonella typhi (MDR ST) and nalidixic acid resistant salmonella typhi (NARST). Discuss the mechanism of development of drug resistance for salmonella typhi. (08/1) 10 6. Detail the various complications of enteric fever and briefly outline the specific management. (08/2) 10DENGUE FEVER 1. Pathogenesis of bleeding and shock in Dengue fever (98/2) 10 2. Discuss the management of Dengue Shock Syndrome (97/1) 10 3. Dengue Fever (03/2) 15 4. Define DHF and DSS and outline the treatment of DSS (05) 10 5. Diagnosis and management of DHF and DSS (06/1) 10 6. Outline the WHO criteria for diagnosis of dengue hemorrhagic fever. Draw an algorithm for volume replacement for a child with DHF and > 20% increase in hematocrit. (09/1) (3+7) 7. Define DHF and DSS. How does DHF differ from dengue fever with hemorrhage? Describe treatment of DSS. (09/2) 2+2+1+5 8. Classify severity of dengue hemorrhagic fever. Write in brief the management of dengue shock syndrome. (11/1) 4+6E COLI 1. Classification of E coli and pathogenesis of Invasive Diarrhoea (95/1) 15 2. Discuss the pathogenesis of E. coli diarrhea (94/2) 15POLIO AND AFP 1. AFP Surveillance (99/2) 15 2. Approach to a child with AFP and components of AFP surveillance (00/1) 15 3. AFP- Definition, Differential Diagnosis in details, how help in polio eradication (03/2) 25 4. Discuss the differential diagnosis and management of acute flaccid paralysis in a 2 year old child. (04/2) 5+5 5. What is AFP? Discuss the differential diagnosis and management of a child with AFP. Discuss AFP surveillance (05) 2+3+2+3 6. Define criteria for declaring a country Polio free. What is the present status of wild polio virus transmission and strategies being used for its control in India? Elaborate on AFP surveillance (06) 5+5 7. Pulse Polio programme (02/1) (98/1) 15 8. Define AFP. Enlist the causes and investigations of a case of AFP (06) 10

26. 9. What is acute flaccid paralysis? Describe the differential diagnosis and management of a child with flaccid paralysis. Describe AFP surveillance. (09/2) 2+2+4+2MALARIA 1. Define drug resistant malaria, what are the different types of drug resistance as per WHO criteria. Discuss the various management strategies of Drug resistant Malaria 25 2. Management of Cerebral Malaria 15 3. Drug resistant Malaria (03/1) 15 4. What are management guidelines of malaria under the national programme. How will you manage a case of cerebral malaria. (04/2) 4+6 5. Enumerate manifestations of Severe Malaria and their management (06/2) 10 6. A 4 year old girl presents with history of fever for 2 days associated with severe anemia, black colored urine and splenomegaly. Discuss the management of this patient. (08/2) 10 7. Describe clinical manifestations of cerebral malaria. Enlist the differential diagnosis and investations required. Write management of a case of cerebral malaria in high endemic area. (09/1) (2+3+5) 8. Define complicated malaria. Describe the management strategies of complicated malaria. (09/2) 3+7 9. Provide algorithms for case-detection and treatment for a child with fever, suspected to have malaria, as per National Vector Borne Disease Control Program: (10/2) 5+5 a) In an area where microscopy results are available within 24 hours; and b) In an area where microscopy results are not available within 24 hours 9. Write short notes on: Laboratory diagnosis of malaria (11/2) 5HEPATITIS B 1. Viral markers of Hepatitis B 15 2. Immunological markers of Hepatitis B 15 3. Hepatitis B infection in children (03/1) 15 4. A 3 year old child is brought with a history of jaundice since 2 months. She gives a history of blood transfusion at 18 months of age. Her HBSAg is positive. Discuss briefly other viral markers of HepB infection which will help in monitoring and treatment of child. Discuss the management of fulminant hepatic failure. Add a note on Liver Transplantation. (06) 10MEASLES 1. Diagnosis and treatment of SSPE (95/2) 10PLAGUE 1. Management of Plague (95/2) 10

27. GROUP A STREPTOCOCCUS 1. Management of acute Rheumatic Fever (93/2) 10CYSTICERCOSIS 1. Current management of Neurocysticercosis (92) 15MENINGOCOCCUS 1. Discuss prevention and prophylaxis against meningococcal infection (05) 5+5 2. Prophylaxis of Meningococcaemia (06/1) 10SYPHILIS 1. Radiological features and confirmatory laboratory tests for congenital syphilis (07/1) 10MISCELLANEOUS 1. Laboratory diagnosis of Viral diseases 2. Brain CT findings in a case of Congenital toxoplasmosis and cysticercosis (94) 15 3. Nosocomial Infections (06) 10 4. Comment on clinical features, diagnosis and treatment of Swine flu in children. (09/2) 2+3+5 5. A seven year old girl is admitted with pain and swelling of right knee and left ankle joint of two weeks duration. Enumerate the likely causes. Discuss the differential diagnosis highlighting important pointers in history, examination and investigations. (11/2) 2+8 6. Describe the etiology, mode of transmission, clinical features and management of viral hemorrhagic fever in children. (12/1) 2+2+3+316 DIGESTIVE SYSTEMGIT 1. What is H.Pylori Bacillus? How is it associated with chronic abdominal pain (98/2) 10 2. Pathogenesis of Celiac Disease (97/2) 15 3. Pathogenesis of Persistent Diarrhea of infancy (96/2) 10 4. Diagnosis of carbohydrate intolerance (95/1) 15 5. Gastro esophageal Riflux (94/2) 15 6. Persistent Diarrhea (99/1) 15 7. Chronic Diarrhea in Infancy (00/1) 15 8. Immunological features associated with cow milk allergy 15 9. 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

28. 10. Write management of Persistent Diarrhea (06) 5 11. Approach and management of a child with Persistent Diarrhea (06) 10 12. Diagnosis and management of a child with Celiac Disease (06/1) 10 13. Tracheoesophageal Fistula and Esophageal atresia (06/1) 10 14. Aetiopathogenesis and diagnosis of celiac disease (07/2) 10 15. Define malabsorption. Enlist the generalized and specific malabsorption states. Discuss the investigative plan for a child with generalized malabsorption. (08/1) 10 16. 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 17. Etiology, pathogenesis, clinical features and management of acute pancreatitis in children. (10/1) 2+2+2+4 18. Describe the etiology, pathogenesis, diagnosis and treatment of antibiotic associated diarrhoea. (10/2) 1+2+3+4 19. Enlist the functions of pancreas. Outline the pancreatic function tests and their implications in pediatric practice. (10/2) 4+6 20. Outline the etiopathogenesis of chronic diarrhea and provide a scheme of investigating for a child with chronic diarrhea. (11/1) 5+5 21. Describe the types of diarrhoea with examples. Discuss their pathophysiological mechanisms. (11/2) 5+5 22. 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 23. Define gastro esophageal reflux disease (GERD). Describe its clinical features, diagnosis and treatment. (12/1) 1+3+3+3PREBIOTICS & 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. Discuss the management of acute diarrhea with particular reference to low osmolarity ORS, zinc, probiotics and antibiotics. (10/2) 3+2+3+2 5. 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+2HEPATOBILIARY 1. Pathophysiology of Portal Hypertension (98/2) 10

29. 2. Discuss the causes, clinical features and management of portal hypertension in children. (04/2) 3+3+4 3. Laboratory Finding of Fulminant Hepatic Failure (98/2) 10 4. Diagnosis and management of Acute Viral Hepatitis (96/2) 12 5. Cholestatic Jaundice 15 6. Biliary Atresia (95) 15 7. Describe Biochemical and Pathological changes in various organs in Hepatic Encephalopathy. How will you manage a case (93/2) 10 8. Hepatic Encephalopathy- pathophysiology and management (03/2) 25 9. List the causes of infantile cholestasis. Provide an algorithm for the diagnosis of infantile cholestasis. (04/2) 3+7 10. Persistent Jaundice in neonates (06) 10 11. Clinical approach, investigations and management of a neonate with Cholestatic jaundice (06/1) 10 12. Discuss the management of Fulminant Hepatic Failure. Add a note on Liver Transplantation (06) 13. 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 14. 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 15. Define Fulminant Hepatic Failure and outline the staging of severity of Hepatic encephalopathy. Discuss the steps in its management. (09/1) 4+6 16. Outline the differential diagnosis of tender hepatomegaly. Describe the management of liver abscess. (10/1) 5+5 17. Outline the management of an 8 year old child with acute liver cell failure and hepatic encephalopathy. (10/2) 10 18. Write in brief the etiopathogenesis, clinical manifestations of Wilsons disease. Outline the desired investigation helpful in making a diagnosis of Wilsons disease. (11/1) 3+3+4 19. Define neonatal cholestasis. Outline clinical features and scheme for evaluation of a neonate with cholestasis. (11/1) 2+3+5 20. Describe clinical, laboratory and radiologic evaluation of possible liver dysfunction in children. (11/2) 3+4+3 21. Enumerate the causes and discuss the types, pathogenesis and evaluation of ascites in children. (11/2) 2+2+3+3MISCELLANEOUS 1. Hematemesis (94) 15 2. Differential Diagnosis of Ascites in children (93/1) 10 3. 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

30. laboratory diagnosis would you do in this child. What is the Differential Diagnosis and treatment of this condition (05) 10 4. Management of Acute Upper GI Bleeding (06) 10 5. Discuss the management of acute upper gastrointestinal bleeding in a 5 year old child. (08/1) 10 6. 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) 1017 RESPIRATORY SYSTEMCLINICAL EXAMINATION 1. 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 2. Outline the pulmonary function testing in children with emphasis on performance and interpretation of spirometry. 3. Briefly discuss the non invasive estimation of gas exchange in children.(04) 10BRONCHIAL ASTHMA 1. Describe the pathogenesis of Bronchial Asthma. Give an outline for prevention and treatment of recurrent episodes (02/1) 25 2. Treatment of Bronchial asthma (96/2) 3. Discuss briefly the recent advances in the management of Bronchial Asthma (99/1) 15 4. Use of Nebulizers in Pediatric practice (95/2) 10 5. Aerosol therapy in children (95/2) 15 6. Management of Acute Severe Asthma (92/2) 15 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 (