DNB Theory question bank 2022 | The Endocrine system

This is a 2022 update on previously asked questions in the DNB pediatrics theory exam. The questions are arranged topic-wise.

1. Questions are arranged in chronological order, latest first
2. Each question is followed by a Numbers.
3. Numbers in bracket are Year followed by session, 1 is June session, 2 is December session eg. (2022/1) is a question from June 2022 question paper
4. The number after the bracket is Marks allotted for eg. 5+5 is 5 marks for each subquestion.

Section I. Disorders of the hypothalamus and pituitary gland

Hormones of the Hypothalamus and Pituitary

1. A) Enumerate hormones secreted by the anterior pituitary.
   B) Factors stimulating and inhibiting the secretion of growth hormone (2015/1) 3+7
2. Enumerate the hormones secreted by the anterior pituitary and list the factors stimulating and inhibiting the secretion of growth hormone. (2010/2)3+7

Hypopituitarism

1. Discuss the endocrine causes and its evaluation of short stature. (2020/2) 5+5
2. Enumerate the various functions of growth hormone and describe indications of growth hormone therapy (2020/1) 5+5
3. Growth Hormone in Pediatric practice (2019/2)5
4. Indication of growth hormone therapy in pediatrics (2017/1) 5
5. What are the causes of Dwarfism? How will you investigate such a case (1997/2)15
6. Indications of Growth Hormone Therapy (1993/2)10

Diabetes Insipidus

1. A child with suspected diabetes insipidus is brought to the hospital. How will you approach, investigate and manage this patient? 2+3+5 (1/2016)
2. Causes, clinical presentation, investigations, and management of diabetes insipidus (2015/1) 1+2+3+4
3. Discuss approach to the diagnosis of a child presenting with polyuria and polydipsia (2013/2)10
4. Outline the diagnostic criteria of diabetes insipidus. Discuss the management of nephrogenic diabetes insipidus. (2010/2) 4+6
5. Diagnostic approach for a child who presented with polyuria and polydipsia. (2010/1)10
6. A 4-year-old child presents with polydipsia and polyuria. How will you establish a diagnosis of diabetes insipidus in this case? Discuss its management. (2008/1)10
7. How will you assess a child presenting with features of Diabetes Insipidus (2006)10

Other Abnormalities of Arginine Vasopressin Metabolism and Action

1. Diagnostic criteria for SIADH (2017/2) 4
2. Write short notes on the evaluation and treatment for a child with SIADH 5(2014/1)
3. Outline the diagnostic criteria for SIADH. Discuss its etiopathogenesis. (2012/1)6+4
4. How will you diagnose and treat SIADH in a child (2006)5
5. SIADH (1999/1), (1999/2)10

Hyperpituitarism, Tall Stature, and Overgrowth Syndromes

1. A 5-year-old boy has attained a height of 137 cm. What could be the cause(s) for this situation and which specific clinical pointers may be useful for determining the cause? How will you evaluate this child for an underlying endocrinological disorder? (2013/2) 6+4

Physiology of Puberty

1. Physiology of puberty in boys and girls (2010/1)10
2. Discuss the normal physiology of puberty and its relation to sexual development. (2009/1)4+6

Disorders of Pubertal Development

1. Precocious puberty. (2020/01)5
2. Investigation and management of delayed puberty (2019/2)5
3. Premature thelarche (2018/1)4
4. Diagnostic approach to precocious puberty in girls (2018/2)5
5. Approach to delayed puberty (2017/2)5
6. Define precocious puberty in boys. Enumerate causes of precocious puberty in boys (2014/2)5
7. Write short notes on the evaluation and treatment for a child with Virilisation (2014/1)
8. Define delayed puberty. Describe its etiology and diagnostic evaluation. (2013/2)2+4+4
9. Define and classify precocious puberty in boys according to its etiology. Outline the approach for investigating a boy with precocious puberty. (2011/1)2+4+4
10. Outline the diagnostic approach to a 14 years old boy with infantile genitalia. (2010/1)10
11. Define delayed puberty in a male child. List the possible causes. Describe changes in male genitals in different stages of sexual maturation. (2008/2)10

Section II. Disorders of the Thyroid gland

Thyroid Development and Physiology

1. Interpretation of thyroid function tests (2019/2)5
2. Thyroid hormone synthesis and its derangements. (2010/1) 6+4
3. What are the changes seen in Thyroid Hormone levels around birth? Describe the salient features of Neonatal Thyroid Screening programme (2006)10

Hypothyroidism

1. Clinical features, investigation and treatment of congenital hypothyroidism (2016/2) 10, (2018/2) 5
2. Screening and treatment of congenital hypothyroidism (2018/1) 6
3. Enlist common causes of acquired hypothyroidism in a 12-year-old girl. Discuss in brief the clinical manifestations and laboratory findings. (2012/1)3+4+3
4. Discuss the synthesis of thyroid Hormones. Outline the causes of congenital hypothyroidism and a brief comment on neonatal thyroid screening. (2009/1)3+7
5. Discuss causes, clinical features and management of Acquired Hypothyroidism (2007/2)10
6. Neonatal Thyroid Screening (2007/2)10
7. Congenital Hyperthyroidism (2007/1)10
8. Etiopathology of Congenital Hypothyroidism 15
9. Congenital Hypothyroidism (2000/1)15
10. Endemic Cretinism (1999/2)15
11. Diagnosis of Congenital Hypothyroidism (1995/1)15

Thyroiditis

1. Hashimoto’s thyroiditis. (2020/01)5
2. Clinical features and management of Hashimoto’s thyroiditis (1/2016) 5
3. Briefly list the various thyroid function tests. Describe clinical presentation and management of autoimmune thyroiditis. (2004/2)6+4

Goitre

1. Goitrogenic Hypothyroidism (2003/2)15
2. Management of Puberty Goiter (1998/2)15
3. Management of Puberty Goiter (1993/1)15

Section III. Disorders of the parathyroid gland

Hormones and Peptides of Calcium Homeostasis and Bone Metabolism

1. DEXA in children | (2021/1) 5
2. Calcium homeostasis | (2021/1) 5
3. Calcium regulation in humans (2018/2)5
4. Define hypocalcemia. Enumerate hormones affecting calcium balance in the body. Describe the respective roles in calcium homeostasis (2013/1)2+3+5
5. Outline the calcium metabolism. Discuss the causes and management of Hypocalcaemia in 3 years old. (2007/2)10
6. Role of hormones in calcium balance (2003/2)15

Hypoparathyroidism

1. Differentiate between the laboratory features of hypoparathyroidism, pseudohypoparathyroidism and hyperparathyroidism (2008/1)(2012/1)10

Pseudohypoparathyroidism

1. Describe the calcium metabolism in a child. Detail the clinical manifestation, diagnosis and treatment of a child with pseudohypoparathyroidism (2008/2)10

Hyperparathyroidism

1. Discuss the etiopathogenesis, clinical manifestations, diagnosis, and treatment of hypercalcemia (2009/1)10

Section IV. Disorder of the Adrenal gland

Physiology of the Adrenal Gland

1. Steroidogenic pathway (2018/2)5
2. Steroid biosynthesis pathway (2017/2) 4
3. a) Adrenal steroid hormone synthesis 5 (April 2016)
   b) Outline steps involved in the synthesis of steroid hormones. (01/2016)3

Adrenocortical Insufficiency

1. Enumerate causes and management of adrenal crisis 5(1/2016)
2. Enumerate the causes of adrenal crisis. Provide key features of clinical presentation and discuss its management. (2008/1)10
3. Causes of Adrenal Crises and discuss its management (2006)10

Congenital Adrenal Hyperplasia and Related Disorders

1. Diagnosis and prevention of congenital adrenal hyperplasia (CAH). (2020/01)5
2. Management of CAH (2017/1) 5
3. Clinical features of CAH (2017/2) 6
4. Clinical features & management of classical congenital hyperplasia. (4+3)(01/2016)
5. Outline biochemical consequences of defects in the classical 21- hydroxylase deficiency and its management (2+3) (April 2016)
6. Diagnosis and management of a child with CAH (2006/1)10
7. Salt losing CAH (2003/1)15
8. Management of adrenogenital syndrome (1996/2)15

Cushing Syndrome

1. A 1 ½ year old female is brought to you with obesity, short stature, hypertension and
   hypertrichosis of face and trunk. Provide differential diagnosis and approach to investigating and managing this child. (2009/1)3+7

Pheochromocytoma

1. Clinical features, investigations & treatment of pheochromocytoma. (2010/1)3+3+4

Section V. Disorders of the Gonads

Development and Function of the Gonads

1. Describe normal sexual differentiation in fetus. What is intersex? Describe the etiological Classification of disorders of Sex Development (DSD). (2011/2)2+2+6

Disorders of Sex Development

1. A) Define disorders of sexual differentiation (DSD ) in new born
   B) Nursery evaluation of a newborn with suspected DSD by history, physical examination and diagnostic tests.
   C) Issues in the management of DSD (2015/1)2+6+2
2. Describe the diagnostic approach in a 2-year-old child with ambiguous genitalia (2009/2)10
3. Discuss karyotype abnormalities, clinical features and management of true hermaphroditism (2008/1)10
4. Discuss the approach to a child with ambiguous Genitalia (2006/2)10
5. Explain the synthesis of Steroid Hormones. Discuss Briefly approach to a child born with ambiguous genitalia (2005)5+5
6. Outline human sex differentiation. Provide an outline of the approach to an infant with ambiguous genitalia. (2004/2)4+6
7. Short note on female with Ambiguous genitalia at birth (2002/1)15

Section VI- Diabetes Mellitus in children

1. DKA management. (2021/2) 5
2. Insulin analogues (2021/2) 5
3. Recent advances in insulin  | (2021/1) 5
4. Continuous blood sugar monitoring | (2021/1) 5
5. Glucose homeostasis (2021/1) 5
6. Approach to hypoglycemia in 1-year-old | (2021/1) 5
7. Pancreatic function test | (2021/1) 5
8. Long-term management of Type 1 diabetes mellitus. (2020/01)5
9. Management of diabetic ketoacidosis (2018/) 5
10. Management of treatment of diabetes at home (2019/1) 5
11. Commonly used insulin regimens for long-term treatment of DM type 1 (2017/2) 5
12. A. What are the biochemical criteria for the diagnosis of Diabetic Ketoacidosis (DKA)?
    B. What are the goals of therapy?
    C. How will you manage a child with DKA? 3+2+5(1/2016)
13. Diagnosis and complication of Metabolic syndrome 4(1/2016)
14. Hyperosmolar non ketotic diabetic coma 5(1/2016)
15. What are the biochemical criteria for the diagnosis of Diabetic Ketoacidosis (DKA)? What are the goals of therapy? How will you manage a 7-year-old child with DKA? (11/2)3+3+4
16. Discuss the pathophysiological abnormalities in diabetic ketoacidosis. Describe the management of diabetic ketoacidosis in a child weighing 20 kg. (2013/2) 4+6
17. A 10-year-old child (body weight 22kg) presents with severe diabetic ketoacidosis. Write down the expected clinical and investigate findings. Outline the plan of management in the first 24 hours. (2009/1)4+6
18. Discuss the metabolic changes associated with diabetic ketoacidosis with steps of treatment of diabetic ketoacidosis. (2008/2)10
19. Classify the severity of diabetic ketoacidosis on the basis of clinical and blood gas examination. Briefly describe Somogyi and Dawn phenomenon in type 1 diabetes. (2008/1)10
20. Write risk factors, pathogenesis and treatment of Type 2 Diabetes Mellitus in children (2007/2)10
21. Management of a child with IDDM (2006/2)10
22. Write management of DKA (2006)5
23. 8 years old with a history of vomiting, and severe abdominal pain for 2 days. Dehydrated, acidotic breathing, Blood glucose (random) is 400 mg/dl. Outline the management (2005)10
24. Describe briefly the biochemical changes and management of DKA (1998/1) 25
25. Complications of Juvenile Diabetes Mellitus and their management (1997/1)15
26. Management of DKA (1995/2)15
27. Emergency management of DKA (1993/1)15