DNB Pediatrics Theory Question Paper Dec 2015

Theory question paper for DNB final exam held by National Board of Examination in .

Links to relevant answers are given where available.

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. 7+3
   (b) How will you manage such a case?
3. (a) Mention the anatomical and functional factors responsible for obstructive sleep apnoea in children. 5+2+3
   (b) Mention the anatomical and functional factors responsible for obstructive sleep apnoea in children. 5+2+3
4. Characteristic hematological features, laboratory findings and treatment of congenital hypoplastic anaemia. (Dlamond 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+(4+4)
   (b) Common types of bias and the methods to minimize bias inanalytical studies.
7. Define child abuse and child neglect. Outline the steps involved in management of a suspected child of sexual abuse. (2+2)+6
8. (a) Attention-Deficit Hyperactivity Disorder (ADH
   d)
   (b) Gastroesophageal Reflux Disease (GER
   d) in paediatric population. 5+5
9. (a) What is relative risk (RR) and discuss its implications? 1+3
   (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 toburden/deficiencies, risks, technique, handling and disposal. 2x5

Paper – II

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
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) Treatment strategies for acute and chronic hepatitis B. 4+(3+3)
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.
   b) Complications of unconjugated hyperbilirubinemia in a neonate. 5+5
8. (a) Algorithmic approach to a neonate with suspected I.E.M.
   b) Silverman Anderson Scoring system. 5+5
9. Tabulate the mechanism of action, dosage, indications and side effects of the following. 2*5
   a) Zonisamde
   b) Rufinamide
   c) Stiripental
   d) levetiracetam
   e) Lacosamide
10. What are the defining criteria of Systemic Inflammatory Response Syndrome (SIRS) Name the mediators involved and their mode of action.

Paper – III

1. Pathophysiology, clinical manifestations, and management of salicylate poisoning. 3+3+4 2.
2. a) Classification of Spinal Muscular Atrophies (SMA). 5+5
   b) Major distinguishing features amongst various forms of SMA.
3. (a) Free Radicals. 5
   (b) Febrile neutropenia - Definition & management. 1+4
4. (a) What is Developmentally Supportive Care?
   (b) Components of Developmentally Supportive Care in neonates.
5. Algorithmic approach to a suspected case of Kawasaki disease. 3+7. 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 Vs 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.
   b) Child with pulmonary involvernent with cystic fibrosis. 5+5
10. a) Congenital varicella.
    b) Complications of Pertussis.
    c) Roseola Infantum. 4+3+3