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Paediatrics Questions

Tribhuvan university mbbs pediatrics questions

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243 views19 pages

Paediatrics Questions

Tribhuvan university mbbs pediatrics questions

Uploaded by

Nivedita Mishra
Copyright
© © All Rights Reserved
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Umno lenate eek, MBBS Final Year {285 Scabies : 8 4 Furunculosts ee Wiccan * Cellulitis ' ' © Goneral Pedianiess Enumerate problems that can occur in an adolescent? List © Candidiasis a programs associated with adolescent health in Nepal Allergic Conditions Diagnose and manage : 443-7 (2067) + Urticaria Impactof violence in the child healt. 220.2064) + Steven Johnson Syndrome Write shostnoteson:....,..” i |, (2081) Nutritional Disorders a. Integrated management of childhood iiness(IMCD. 8 What are the important cayses of high infant mortality rate In our country? Discuss, the ,possible, measures that can be adopted to reduce it =, 102057) ‘Write short notes on: je. (2056) a. Assessment of sick child betwoen 2 & 11 months of age 5 Diagnose and manage + PEM and its management + Vitamin deficiencies + Nutritional anemia in infant and childhood Diarrheal Diseases " Diagnose and manage __b, Child abuse ..., t 4 > Acute diarrhea and management : { + Write short nates on: _ (2055) Dysentery Yo costa. Rights ofthe child. we 4 + Persistent diarrhea { Baby friendly hospital initiative cldhood Malignancies vs | "6 (Growth Developments) Diagnose and manage iba agaist + A4 year old boy was brought to pediatric OPD with complain * Neuroblastoma an oa of not gaining adequate weight: 143+4=8 (2075/9) © Wilnr's tumor sow A a. Define failure to thrive. Lymphoma Brain tumor Leukemia- ALL b. What important'history you pond Mie: ‘to ask i find the “underlying etiology?“ a ‘6, Enlist’ acute‘life threatening’ complications in ‘severely \indernourished child and outline its management.” | "eA father of a-24 month old boy isiconcerned about the ee siteneinai 4 development of his baby. He has just stited to stand without : ji ‘Support, speaks bisyllable words. *~ =" (2074/8) 9%) What would be devélopmentalf eof this child? 1 “| “2 Go yy enlist Common causes of developmental delay. ** 2 7 @) what do you expect the child of this chronological age to : ‘lo? ‘y : 4) On examination, he has hoarse voice and dry'skin: How do you confirm the diagnosis? 2 + An 8 year old girl is evaluated for short statute. 3434258 (2073/9) a, What are the most important measurements to be performed for the child and parents? b. What are two most important differential diagnoses for this problem? List the characteristics of each condition. ¢. List the investigations required for this girl: ‘+ An 18 months old boy was brought by a mother‘as she is worried as he is not able to stand til date. ’4+2+2-8 (2072/9) a. Enumerate appropriate development milestone for this child. : b. How will you investigate above child? List few causes for his delayed milestone of development. * Acchild was brought by his mother with’ history’ of delayed milestone of development. On examination, he Walks with one hand held, rises independently, and takes several steps. He speaks few words besides ‘mama’, dada-and plays simple ball game. i (2071/11) a. What is the age of the child? veut Botany oh b. List the principles of development 4 . Write the milestone of development at the age of 18 months. 3 ‘+ A child was brought by his mother with history of delayed milestone of development. On assessment, he walks alone; makes tower of 3 cubes, follow simple, commands and may name a familiar object. He indicates some desires or needs by pointing. 1+3+428 (2071/1) a. Write age of the child. b, List the milestone of development of 40 weeks infant. List the factors éffecting normal milestone of development. ‘+ A 12 months old infant is brought to Paediatrics OPD with history of delayed milestones of development. On examination you find global delay in his milestones. List the common causes of global delay milestone. Enumerate the normal stint nella MBBS Final Year_|287 development of milestone a 12 months old infant should have achieved. What are red flag signs in child development? 243+3=8 (2069/11) ‘An 18 months old boy has been brought to you for consultation. The parents are worried about his feeding. On examination, you find that the child weighs 11 kg and is able to Walk and he speaks a few words with meaning. What is your assessment of the child's growth and development? What advice will you give the parents about feeding of the child? 2+2=4 (2066) How do you evaluate the physical growth of a child? Write down the developmental milestones of an infant in a sequential manner. 2#8=10 (2065) ‘Approach to a child presented with delayed milestones of development. 10 (2064) Enumerate milestones of development in a 9-month old infant. 10 (2063) Write short answers of the following: (2082) a. Milestones of development in one year old male child. 8 b. Causes of failure to thrive and management of kwashiorkor. 8 (2054) ‘Write short notes on: a. Development milestones at 18 months of age. 8 (2061) ¢. Principles of growth and development. 8 (2059) d. Approach toa child with failure to thrive. 8 (2058) e. Developmental assessment of an infant of 9 months and a child of 2 years, 8 (2058) Write short answers: (2057) a. Developmental milestone of child aged 1% yrs. 5 Write short notes on: (2056) a, Motor milestones achieved by 12 months of age. 5 Write short notes on: : (2056) 'b. Developmental milestones. 4 Write short notes on: (2055) a. Developmental milestones ofa nine months old infant. 4 | Clinical Phase Q-Book _ + Assessment of developmental milestones ina child of one year. (2054) * Developmental milestones of a child with 6 months age. (2053) * Pattern of weight gain in children. (2052) ‘~ Tnumunization: * Answer the following regarding the immunization program of Government of Nepal. (o71/11) a, How does it help to reduce infant morbidity and mortality? 3 b. Mention the absolute contra indications oflive vaccine. 2 © What is the schedule of newer vaccines that have been incorporated in EPI program? 3 * Write short notes on: (2065) a. BCGtest 4 +. Immunization for children. 8 (2059) + Write short notes on: (2056) a. National Immunization Schedule and its justification 4 + Write short notes on: (2055) a. National EPI schedule. 4 © Genetic diseases: © List the signs seen in skull, GI system and palm of a child whose karyotyping shows three 21st chromosome. What it s the risk ofhaving another child? 34124 (2067) ‘+ Differentiate between Turner's syndrome and Noonan Syndrome. 3 (2065) © Write short notes on: (2056) a. Features of Down's syndrome. 5 b. Down's syndrome. 4 (2055) ‘* Write short notes on: (2054, 52) a. Turner's syndrome = © PM rete Eergy Main): + A2 year old boy was brought to pediatric OPD with complain of poor weight gain, His weight was 6 kg and length was 80cm. 143+242=8 (2073/9) a. Write WHO classification of undernutrition. <. MBBS Final Year | |289 ’b.: How do you clinically evaluate this boy?) + 60 00s . How do you assess dehydration in this child? 4. Outline management of dehydration on hi ‘4.2 year old girl was brought to pediatric OPD with complain ‘of not gaining adequate weight * 143+4=8(2072/9) ‘a. Write WHO classification of PEM in children . ..b. What important history you would like to ask to find the underlying ‘etiology? c Enlist acute life threatening complications | in severely undernourished | child and outline its ‘management. How does. the WHO define Protein Energy Malnutrition (PEM)? List important points, for, initial assessment of severe malnutrition. a 'T+3=4 (2067) List four pathophysical changes in gastrointestinal “system during protein energy malnutrition. ‘List «five. important heading in which you treat a.child with severe protein energy malnutrition, List five causes of failure to gain weight in spite of adequate calorie intake in malnutrition. _.2+2+2=6 (2066) Define PEM. How will you approach a child of 13 ‘year classified as PEM grade III by IAP who is severely wastéd’and severely stunted and has severe dehydration? 2+8=10 (2065) What are the complications’ of severe protein “energy malnutrition? . 24 10 (2064) What are the differences between Marasmus & Kwashlorkor? Describe the management of complications‘of.severe protein energy malnutrition. eshidtng ation 10 (2063) Write short notes on: (2061) a. Investigations in a severely malnourished child, and thelr justification. 8 Approach to a child with, proiein energy malnutrition 8 (2059) Write short notes on: (2056) a. Causes of hypothermia in amatasmicehilds 7 |S How does protein energy malnutrition prese in our country? Give an account of the short and long term management of such a case: 10 (2056) ‘Write short notes on: . a a, Marasmus‘and Kwashiorkor: ot Book * Management of child with protein energy malnutrition. | (2054) * List the acute complications of severe malnutrition. Discuss the steps for their prevention and management. How will you Prepare a high energy meal based on skimmed milkpover, whlch all provide 135 keal/100 ml and 35 gms of protein per l. (2052) /Vitamin+Minerals: * Define trace elements. Write down the clinical features of Zinc- deficiency. Weston ito: eee) a. Common micronutrient deficiencies in children. : * Write short notes oi a. Vitamin A deficiency and treatment (2055) b. Vitamin A deficiency (2053) * Write short notes on: (2052) a: ‘Acrodermatitis enteropathica ‘| “b. Scurvy ‘ Neonatology: "Miscellaneous: 7 * What are the mu can orally nthecounty? nn Oconee © Write short notes on: 1. (2056) a. Hemorrhagic disease of the newborn. o 4 + Write short notes on: “"(@2055) a. Rh & ABO incompatibility and managemerit. 4 “Temperature: ; * writ (2073/9) a. Define and classify hypothermia in a newborn. 2 b. How én you prevent hypottiermia in a newborn? 2 ‘¢. How will you manage a case of severe hypothermia? # + 436 hours old preterm 2.2 kilos baby was found to have cold stress and gitteriness duiring clinical examination, i 2a2e24: (2072/9) a. Define cold stress and hypothermia ’b. Write 4 steps of warm chain management in this baby e BS Final Yor [294 ‘c. Write 4 causes of gitteriness in the neonates. d. Despite adequate management of hypothermia this neonate is unresponsive to temperature stability. What investigation will you like to do? «During routine morning rounds in the maternity ward you happen to see a 12 hours old full term newborn with cold feet. How will you classify hypothermia? Describe the preventive measures to hypothermia in newborns. How will you manage cold stress? 1+443=8 (2069/11) “Essential Neirborn Care: ‘© Youare called to see a newborn just born in labor room who is. © not breathing well: 4434128 (2071/1) 5 a. How will you proceed for resuscitation? "p. After succéssful resuscitation, how will you proceed history taking? ‘ cc. List drugs that can be given via endotracheal tube? ‘+ What do you understand by essential newborn care? 10 (2064) List the newborn danger’ signs. Outline the steps in newborn resuscitation. 110 (2063) (°.. Write short answers: (2057, 55) ‘a. High risk neonate 5 ‘Maturity Assessment: * Write short notes on: (2056) " a. Physical criteria for assessment of gestational age in a newborn. 5 "Low Birth Weight Babies: * A32 week baby with birth weight of 1500gm is delivered at your hospital. . , . 143+2+2=8 (2073/9) a., Enlist important problems that may arise in this new born. b. Describe in brief about the alternative methods of feeding. c., What are the common methods to prevent hypothermia in this new born? \d. Write criteria for discharge for such new born. ‘ooo, What are the problems of LBW babies and what steps you will take to prevent them? 10 (2064) 292 | Clinical Phase Q-Book + Write short notes on: (2060) a, Problems and management of LBW. i 8 | Birth Injuries: 7 + Write short notes on: a. Birth injuries. . 4(2056) b. Cephalhematoma "" (2052) ‘+ A newborn baby at 30 week period of gestation, develops respiratory distress and cyanosis after 30 minutes of birth, (2074/8) a) What are the likely causes of respiratory difficulty, in this newborn? 2 b) What investigations will you do to confirm your diagnosis? What will be the findings? : 2 ©) Write the treatment planofthisnewborn.... ,.; , .- 2 4) How can you prevent this condition? swedWy.s 2 + You are called to see a two hours old preterm newborn who is, not well. You examine and found him in obvious respiratory distress, 2442-8 (2072/9) a. List the differential diagnosis of respiratory distress in newborns. b. How will you manage such cases? 5 © How can you prevent respiratory distress in premature babies? ‘+ You are called to see one hour old newborn hiving difficulty in breathing. On examination the baby’is term and is in obvious respiratory distress. 0 too £(2071/11) a. What signs will you examine to reach to a diagnosis?’ 3 b. Write down the steps of iianagément of ‘aewborn with respiratory distress. © | seis tg How can” you. prevent’ respiratory distress in’ premature babies? i “i 2 + ANewborn weighing 2.8 kg develops respiratory distress noticed scat 30 minutes of live, What are the causes of respiratory distress? MBBS Final Year :|293 Mention the broad headings of management. of respiratory distress according to the cause in such babes. __,2+6=8 (2068) 2) List the causes of respiratory distress in neonates. Enumerate | the problems in preterm baby. 34326 (2066) *) Write short notes on: (2065) a. Meconium aspiration syndrome 4 +, Assessment ofa neonate with respiratory distress. 6 (2058) _Meqnatal 4 +: A3 days old newborn develops yellowish discoloration of eyes and body. Parents rush the baby to emergency because they “had a previous baby who died of hyperbilirubinemia. You are ‘the medical officer in emergency. (2071/11) = ‘What other important history and ‘examination findings should you’ ‘obtain to come to diagnosis? 3 b. The mother asks you why her baby has developed jaundice ‘so early. Explain the reasons that you are aware on why most neonates develop jaundice. . 2 c. What are different treatment ‘options available? Describe “&-* the principlé“of most important and effective treatment ( available. 23 * Twelve days old baby brought by her mother with complain of yellowish discoloration of whole body..On examination, she ., » 1 has coarse facies and hoarse cry. 144+3=8 (2069/11) 1x; aWhatis the most likely diagnosis? (©). How the physiological jaundice differ from pathological £ jaundice? o , 1 What are the causes of unconjugated: hhyperbilirubinemia? & © AS days newborn was brought by his mother with history of yellow discoloration of skin and sclera for.the last 3 days. He 5 by Was full term normal, delivery. with, normal sucking.. Mother blood. group was A.+ve. On.examination the baby was active with, yellowish discoloration of face and sclera. 1+4+3=8 (2068) a. What is the most likely diagnosis? b. What are the causes of unconjugated hyperbilirubinemia? c. List the differences between physiological and pathological Jaundice. (2065) ‘+ Write short notes on: a. Phototherapy and its complications 4 ‘+ Write short answers of the following: (2062) a. Investigations in a neonate with persistent jaundice for 3 weeks. 8 ‘+ Write short notes on: a. Approach to a neonate with jaundice. 8 (2061) b. Causes of jaundice in the first 24 hours of life and its management. 8 (2060) ¢. Jaundice in the first week of life. 8 (2059) 4. Jaundice in the first week of life. 4 (2056, 53) / Congenital Malformations: What are the non pulmonary causes of rapid breathing? What are the clinical features and complications of TEF (Tracheoesophageal fistula)? 242415 (2065) «Write short answers of: (2057, 53) a, Tracheo-esophageal fistula 5 ‘+ Write short note on: Diaphragmatic hernia. (2054) ‘+ Write short notes o1 (2052) ‘a. Causes of vomiting in first week of life. ‘Metabolic disorders: + “A 2:kg newborn delivered at home is brought to hospital for poor feeding & lethargy. You witnessed convulsion in emergency room. (2074/8) a) How will you manage this condition? 3 b) What important history & clinical examination would you like to do on this newborn? +3 ©) His blood sugar is 25 mg/dl. What do you do hext? 2 + During thé morning'réunds in the maternity ward you find a baby who was born 12 hours back who is not active? 3424328 (2071/1) a. What important points will you ask to find the cause or the problem? b. List the possible cause. c. How will you manage symptomatic hypoglycemia? MBBS Final Year [295 ——___ BS Final Year [295 Neonatal infectto + You are called in the maternity ward for a 24 hours old newborn with poor feeding and lethargy. . 2+3+3=8 (2075/9) a. What could be the important causes for this problem? b. You are suspecting sepsis on this newborn. Write important Positive history and clinical examination findings that you expect on him? . Write important investigations with positive findings that confirm sepsis. + Wnite short notes on: (2054) a. Sepsisin neonates ‘+ Write short notes on: (2054) ‘a. Congenital syphil Z * A 12 years boy came in OPD with fever and swelling of neck for 4 days. On examination, he has stridor and bull neck. 3424328 (2075/9) a._ Enlist differential diagnosis for him. b. What laboratory investigations you would perform in this child to come to diagnosis? © Outline the management prophylaxis for close contacts. + A 12 year old boy was brought with complain of fever for 1 ‘week. On examination, he has recorded temperature of 102°F. of diphtheria including (2074/8) a) What other important history & clinical examination you would like to elicit in this child. 4 ») Enlist differential diagnosis for him. : 2 ~ ¢) His widal test is 1:60. How do you treat this child? 2 * Steps taken by Government of Nepal for eradication of pollomyelitis from the country. 10 (2064) *' Write short notes on: (2061) a. Diagnosis & drug therapy in kala-azar, 296 | Clinical Phase Q-Book ‘© How do you Approach to a child with fever? 8 (2059) + Write short answers oft (2056, 53) ‘a. Complications of pertusis, 4 + Write short notes on: (2055) ‘a. Multidrug therapy (MDT) for lenrosy. 4 | Mumps: + An 8 year old boy develops swelling of both the cheeks and the hollow space beneath the ears associated with fever for last 3 days, Many of his friends in school also had similar problem over last 2 weeks. He presents to you with repeated episodes of vomiting and headache for last 12 hours. 2+2+4=8 (2073/9) a. What is your diagnosis? What is the mode of transmission of this disease among his friends? b. List the diagnostic testing required for this boy and ways to confirm the etiological diagnosis. . How would you manage him? What are common complications and their long term health risks? + Mother brought a 3 years old male child with high fever, cough and difficulty in swallowing, There is history of excessive salivation. Examination of throat shows multiple red ulcers in the mouth. (2071/1) a, Whats the most likely diagnosis? b. List the complications of Mumps. . List the drugs used in septic shock = Write short answers: , (2057) a. Complications of mumps 5 Measles: . : + A two years girl presented with fever and maculopapular rashes. What is the differential diagnosis. of such.rashes with fever? List the complications of measles. How can you prevent measles and rubella? 3434258 (2069/11) = You see a gil aged 7 years brought by her mother in OPD with complains of rashes in her body which she noticed two days _ back. This girl has maculopapular rashes. What are “the” ~ <..Complications of measles. MBBS Final Year [297 conditions in which you get such rashes List the complications of measles. 44428 (2068) + What are the causes of maculopapular rash in a 3 year old child? Which of these are prevented by immunization? Write the Clinical Features of any one ofthem. . - 2+1+2=5 (2065) 1») “An eighteen: months old child has presented with complaints of fever of 4 days duration. Mother further reported noticing rashes con the face and body. List the questions you will sk to reach the ‘most likely diagnosis you suspect in such a case. List the common. diseases that the child might be suffering from. (2061) 8 (2060, 2055- 4 marks) + How will you approach to a child with generalized rash? 8 (2060) + Complications of measles and its management. 8 (2058) + Write short ariswers of: (2056) 1a‘ Measies and its complications. , 4, Write shért notes on: (2056) ‘a, Vitamin A deficiency in measles. : 5 + Write short notes on: (2055) a. Complications of measles and their management. 8 ‘A 10 years old boy presented with history of low gradé fever for 1 day followed by appearance of rashes, in the form of macules, papules & fluid filled vesicles in the body. (2074/8) __, 8) What is the most likely diagnosis? 1 'b) How can you confirm your diagnosis?., 2 ©) What treatment will you offer to this boy?» 2 ) What are the likely complications of this disease?. 3 Meningitis: - «A 8 year old boy presented with H/O:low grade fever and headache for last 2 weeks. For last 2 days he started vomiting and he also, has neck stiffness. Tubercular meningitis .was suspected, 2+24242=8 (2073/9) a, How will you proceed to confirm the diagnosis? Phase Q-Book b. Describe stages of tubercular meningitis. ¢. How will you treat this child? d. What are the complications? Write short notes on: (2061) . Comiplications of pyogenic meningitis. 8 Write about Bacterial meningitis and its complications. 8 (2059) Write short answers: (2057) ‘a. Complications of lumbar puncture 5 ‘A2 year old male child has been brought to the emergency room of Kanti Children Hospital with complaints of high fever, convulsions and repeated vomiting of 2 days’ duration. Discuss ‘the possible causes for the child’s condition. What more information would you try to elicit from the caretakers of the child? List the physical findings you would like to look for in order to arrive at the diagnosis. What investigations will you order? How will you proceed to manage the child? 10+10+10+2+8=40 (2056) A 10 year old female child was brought to the outpatient department with history of high fever and severe headache for. 4 days followed by vomiting for 1 day. (2052) a. List the possible causes. b. What investigations would you like to do and why? c. Suggest the line of treatment for the most likely cause. d. What are the likely complications ini such case? Childhood TB: + What do you understand by preventive chemotherapy in Tuberculosis? List the features that suggest neuro- tuberculosis. Which specific investigations help to make the diagnosis? 2+3+3=8 (2067) Write short notes on: (2061) a. Approach to a child with cervical lymphadenopathy. Write short notes on: 4 a, Short course chemotherapy (SCC) for tuberculosis. ‘A9 years old child has beni brought to outpatient fd with history of fever for 2: months, gradual weight loss for 1.) months and gradual swelling of abdomen for 1 month. On | MBBS Final Year [299 tis less than 60% of expected body 4-cm palpable and free fluid is examination, child's wei weight, pallor and liver present in abdomen. (2054) a. What more information you would like to have from the parents? b. What are the possible causes? ¢. What investigations you would like to do and why? . Suggest plan of management for one of the most likely /-HIVin children: Anewborn is born to HIV positive mother. 2+3+3-8 (2075/9) a. How do you confirm HIV disease in this newborn? b. What advice will you give regarding breast feeding? ¢. How can the risk of transmission of HIV infection to ' newborn be minimized? What are the common opportunistic infections in children with HIV infection? What are the indications of staring antiretroviral therapy in infants and children? What drug _ Tesimen ‘will you use? 3#3+2=8 (2068) How will you prevent mother to child transmission of HIV? How will you make a definitive diagnosis of HIV in an infant who is two month old? What are the indications of anti- retroviral therapy in children? 342+3=8 (2087) A two months old infant Is brought to OPD born to a HIV aie mother. How will you counsel the mother on infant feeding? What investigation will you order to confirm the diagnosis? Does this infant need to be on any medication? 3434228 (2066) Write about HIV infections in children, 10 (2064) Write short answers: (2087) a. Prevention of AIDS in children 5 ‘+ A.10 years old child comes to you with history of hematemesis. ‘On examination the child has splenomegaly with ascites. What 300 | Clinicat Phase Q-Book a: are the D/D? How. will you. proceed to. reach for your diagnosis? 3+3=6 (2065) ‘+ What are the causes of pain abdomen in‘children and what investigations you will do to come at diagnosis.’ "10 (2064) + Write short answers of the following: (2062) a. Approach to a child with recurrent abdominal pain. 8 + Write short notes on: “ (2061) a. Medical management of acute abdomen in childhood. 8 + Abdominal tuberculosis in children, 8 (2058) ‘+ Write short notes on: (2056) a. Intussusceptions- presentation and treatment. 4 b. Hirschsprung's disease presentation and management "Hepatobiliary diseases: : +S year old boy was brouight for evaluation of jaundice.(2074/8) a) Enlist important causes of jaundice in children. 2 b) What important history & clinical examination you would like to do to reach at the underlying etiological diagnosis? 3 ©) Write investigations for a child with acute viral hepatitis. 3 + 4.10 years old boy was brought for evaluation of jaundice for the last 2 months. » 3424328 (2072/9) a. What important history in this child could guide to a diagnosis? b. Enlist causes of chronic liver diseases in children. c. Write the management of hepatic encephalopathy. | ‘+ 410 years old boy was seen in emergency with history of pain abdomen and vomiting. On examination he was found to be lethargic and icteric. (2071/11) a How will you evaluate such patients by history and examination to come to diagnosis? 4 b. How will you manage fulminant liver failure? : + A child was admitted in pediatric inpatient department with history of repeated vomiting for 24 hours. On examination, he was icteric with enlarged tender liver. 1+3+4=8 (2071/1) a. What is the most likely diagnosis? b. List the causes of tender hepatomegaly. wa MBBS Firial Year [301 ——____»_ MBs Final Year 301- ci" List the stages ‘and signs and symptoms of hepatic encephalopathy in children.’ 3 > Write short answers of the following: ' (2062, 61) a! “Approach to a child with hepatospleriémegaly. “8 (2° Signs of portal hypertension. 2 (2055) “eA 2 year old child is brought in emergency with history of passing blodd and mucus tn stool. On examination he is febrile {(8i2.-with history of tenesmus during defecation. 343+2-8 (2075/9) ou ra. Enumerate the causes of blood in stool. b. \What features in-the'history and examination of this child ‘ ‘owill help to differentiate: between bacillary and amebic ‘dysentery?.: vibe a '*e. Eriumerate the complications of bacillary dysentery. + A7 Year‘old child‘ with ‘history of profuse watery diarrhea \"Ctreated outside has now come with complaints of weakness and abdominal distension. ‘He is passing urine but has not Passed stool since: the: past’24 hours. On’ examination, his abdomen is distended and.non-tender-with sluggish bowel sounds. v 4#4=8 (2073/9) tal: Whats: the diagnosis and which:tests will-you order-to forge twiconfirm tt? i 7 fe ,. b-:DéSeribe how will you maiiage this condition. +” A2 year old girl weighs 7 kg. She was born with a weight of 3.25 Kg. She has edema, of both feet and looks pale with angular stomatitis on both sides. She presents to hospital with _ diarrhea and vomiting for 2 days, ~" o7as11) sia % How would you assess dehydration in this child? 2 > 'b; What are the most important complications that can cause vin hospital mortality for these type of patients? 2 © Outline the management of this patient. 4 * List the five causes that may lead to chronic and persistent diarrhea. How will you differentiate chronic diarrhea from persistent, dysentery and acute water diarrhea? 2+5=7 (2067) 302 | Clinical Phase Q-Book * Classify clinical types of diarrhea. Write one complication for each type of diarthea. List three constituents of ReSoMal that isnot present in normal ORS. 1+2+2=5 (2066) + List the causes of acute diarrhea. Outline the management of persistent diarrhea, 10 (2063) ‘+ Write short notes on: Management of different types of clinical diarthea. 8 (2060) ‘+ Write about nutritional therapy in a child with diarrhea. 8 (2058) + A2 years old girl has been brought to the hospital with the ‘complaints of dysentery for 7. days, with moderate grade of fever. On further questioning, the mother gives the history of diminution in urine output and few reddish spots on the skin. On examination, the child looks markedly pale and slightly puffy. She has been on ORS since the onset of her illness. (2052) a. What further questions you will ask? b. What are the diagnostic possibilities? ¢. How will you proceed to manage the child? | Fluld & Electrolyte Balance: + An 11 months old child was brought in emergency with fever and loose motion of 2 days duration. On examination his eyes were sunken and skin pinch goes very slowly. His weight was 10kg, 1+3+4=8(2072/9) a. What is your diagnosis? b, How can you treat this child? . List the complications of diarrhea. + A4 years child was brought in emergency with history of blood in stool with tenesmus. On examination, he was febrile: His blood examination reveals toxic granules in Neutrophil. 1+4+3=8(2071/1) a. Whatis the most likely diagnosis? b. List the signs and symptoms of hypokalemia. ©. Write the composition of ORS MBRSFinal Year [303 + An eleven months (8 kg) child was brought in Emergency with history of acute onset of watery diarrhea, On assessment, she ‘was found to have severe dehydration. 2+3+3=8 (2069/11) a. Enumerate the causes: b, Describe the steps in management. Enumerate the complications of diarrhea. © A. years old boy was brought to Pediatric OPD by her grandmother with complaint of five episodes of vomiting since » this morning and two episodes of loose stool. You examine him and ‘found some signs of dehydration. List the causes of © vomiting. How’ will’ manage him? Mention the physiological basis prescribing ORS. 2434328 (2068) + How will you classify a dehydration based on sodium content of plasma? How will you manage a child whose serum sodium is 160mmol/L?> > 245=7 (2067) ‘© Write short answers: a, Management of hypernatremic dehydration. 5 (2057,52) . Signs of dehydration and management. 4 (2056) c. Degree and signs of dehydration. 4 (2055) , Managetiient’ of child “with severe dehydration having metabolic acidosis: €. Management of severe dehydration. (2054) (2053) romaualeseg + A3 years old child with complaints of frequently turning blue has been brought to emergency with complaints of excessive breathlessness for the last few minutes. — 3+2+3=8 (2075/9) a, What finding on examination will help you make a diagnosis of congenital cyanotic heart disease? ‘b. What are the common cyanotic heart diseases? ¢. How will you treat a cyanotic spell? * A 10 year old boy presented with history of sorethroat and fever followed by multiple joint pain after 2 weeks of onset of sorethroat. (2074/8) a) Enumerate additional points in history and examination findings to support diagnosis of acute rheumatic fever. 4 b) Outline the treatment for acute rheumatic fever. 4 304 | Clinical Phase Q-Book + A3 month old infant presents with poor weight, gain, fast breathing and excessive sweating especially during feeding. 3+342=8 (2073/9) ‘a, Describe additional symptoms and signs that will. suggest is infant has heart disease. b, Which is the commonest congenital cardiac lesion? List the diagnostic tests with expected findings to confirm this condition in this infant. ¢. What are the indications for surgical treatment of this lesion? i + A child was brought in, emergency with history. of fast breathing and rapid pulse. On examination, his pulse rate was high with diffuse cardiac impulse on precordium. Auscultation of the heart reveals systolic murmur. (2071/11) a. List the causes of systolic murmur in children. 2 b. List the grading of systolic murmur. 163 c. What is. the ‘natural history of VSD (ventricular septal defect)? 4.3 + AvG-year-old male child..was brought in emergency, with history of breathlessness & cyanosis. On examination he had. * _ both central and peripheral cyanosis with clubbing. There is systolic murmur on auscultation ofheart. 3+3+2=8 (2071/1) a. List the causes of cyanotic heart diseases in children... b. List the complications of Tetralogy of fallot (TOF). ¢. Enumerate the components of TOF. ‘ ‘+ A 2 year. old child: came in emergency with tachypnea, tachycardia, On examination, he was, stunted, cyanosed with clubbing, There was history of cyanotic spells in the past. 1444328 (2068) a, What is the most likely diagnosis? . Outline the treatment of Congestive Cardiac Failure (CCF). ¢. List the causes of cyanotic heart disease in children. ‘+ List cardiac disease that may present as congestive ‘cardiac failure without cyanosis. Enumerate key points that you will consider in treating congestive cardiac failure, 3+5=8 (2067) MBBS Final Year_[305, a _ MBS Final Year_|305. ich is the single most common cardiac defect in children? What special clinical sign will be present in this defect? What is your advice to parent when this is diagnosed at 6 months of age? 1424255 (2066) Write stiort notes ont: oe =" “* 065) ‘a Nadas criteria : 4 ‘+ Write short notes on: , a. Diagnosis of acute rheumatic fever. 8 (2061) + Clinical manifestations of bacterial endocarditis, 8 (2060) ‘+ Write about Congenital cyanaticheart diseases. - 8 (2059) + Writeshort answersof: ' (2057, 54) ‘a, Management of rheumatic fever’ t 5 ‘+ Whiat are'the common forms of streptococcal infection? What “smay ‘be the ‘complications? Give ‘the. treatment and ‘management of one of such complications." - - 10 (2055) '-”Write short notes‘on::*. Mer ties oa a eatures of congestive heart fallure ina 6 month old eile aoe 5 (2056) tlhe “tetilog oat 7 4 (2056, 55, 52) . “Approach to a child with cyanotic spells. (2055) a. Mahagemént o cdnigestive cardiac failure. “3054, 53) &. Erythema nodosum ‘(2082) (tw AG years oid boy presented in Emergency. with complaints of bluish discoloration and swelling of right. ankle joint and ‘miltiple “uncle. ‘a.’ What’ other sidan additional points"in history and clinical examinatjon will help to arrive at a diagnosis? b. How will you confirm the diagnosis? ©. What treatment will you provide for this baby? . Enlist long term complications of this condition. + A3 years old boy is admitted for blood transfusion. He comes for regular blood transfusions. 2+343=8 (2072/9) 306 | Clinical Phase Q-Book ‘a. What could be the possible illness? . Entimerate the complications of repeated blood transfusions ¢. How will you diagnose Thalassemia? ‘A-12 year old girl is admitted to pediatric ward for bluish red spots in skin of one-week duration. Your examination confirms that she has multiple petechiae, purpura and ecchymoses. (2071/11) a. List the most important differential diagnosis. 1 . Describe the ‘findings’ expected in ‘a’ blood smear ‘examination in each of your differential diagnosis: 3 © Your consultant asks you to perform’ a bone marrow examination. What abnormalities do you expect in bone ‘marrow examination in each of your differential diagnoses?3 4. While this patient is in ward, what are the most important clinical signs to monitor? 1 One and half years old boy was seen in the OPD with history of increasing pallor. What are the symptoms in the history you will ask the parents to come to a diagnosis? Enumerate the signs.in the physical examination that will point towards the different diagnosis. : 444-8 (2069/11) You examine a one-year-old girl and found moderate pallor and liver of 4 cm and palpable spleen tip. There is history of blood transfusion once. List the causes of anemia. How will you investigate suspected ‘case of thalassemia? Describe the ‘matiagemient of thalassemia major. "2434358 (2068) Nine months old child who is’on cow’s milk and rice lito presented with pallor. The peripheral bload smear. shows hypochromic microcytic red blood cells. List two conditions that can present with this. What further two: investigations differentiate between these two conditions. Write one specific treatment for these conditions. 2424236 (2066) Write short notes on: (2065) ‘a, Radiological changes seen in thalassemia. 4 List the causes of purpuric rash in children, 10 (2063) MBPS Final Year [307 ——____________ MBPs Final Year_|307 Describe the clinical features, laboratory investigations and ‘management of iron deficiency anemia, 10 (2063) ‘+ Write short answers of the following: a, Approach to a child with purpuric spots all over the body. 8 (2062) b. Purpuric rashes in a 4 yrs old child. (2061) © Diagnosis and management of pallor in children. (2061) d. Approach toa child with purpura. 8 (2059) e. Differéntial diagnosis of thrombocytopenia and its investigations. 8 (2058) + Write short answers: (2057) a, Hazards of blood transfusion 5 * Write short notes on: (2055) a. Thalassaemia. 4 + Approach to a child with thrombocytopenia. (2054) ‘+ Write short note on: Aplastic anemia, (2054, 52) + A7 years old.male child presented, with bleeding gum and Purpuric spots all over the body. (2051) ‘a. Whatare the possible causes? 'b. What investigations you will do? © Give clinical features and line of treatment of one of the most likely cause? ‘© Childhood malignancies: + ATyear old boy presented with fever and increasing pallor for last 10 days. Treating physician suspects acute leukemia. (2074/8) ) What other symptoms this boy might have and what clinical signs will you look for? 2 1b) How will you confirm the diagnosis? 3 ©) Discuss the treatment protocol in brief for acute lymphoblastic leukemia, 3 * Acchild was admitted in pediatric ward with history of fever for 10 days and cervical lymphadenopathy for 1 month duration. On examination he was severely pale with purpura and ecchymosis. He had generalized lymphadenopathy with blood picture . shows '=109%, L=90% with. blast 1+4#3=8 (2071/1) hepatosplenomegaly. His ‘TC=200,000/cmm of blood with cells in peripheral blood smear. a. What is the most likely diagnosis?, b. List the causes of severe pallor in children. © List the indications of bone marrow in children, ‘+ Outline the management of ALL. (2063) ‘+ What is the commonest type.of leukemia seen in children? What may be the presenting signs and clinical picture? Give broad guidelines of management? 10 (2055) + A2 year old girl was brought for cough with hoarseness of voice for 2 days. On examination, you noticed that she is in respiratory distress with noisy breathing during inspiration. 1444328 (2073/9) @. What are important causes for this problem? | ° b. Write important history ‘and clinical examination that would help you to identify possible underlying cause. ©. Write the immediate management for this child. + A4year old girl has fever, cough, chest pain, fast breathing and shortness of breath for 4 days, 1+4+3=8 (2072/9) @ List the most common’ organisins responsible ‘for this condition, ; b. A chest X-ray shows pleural effusion on-his'left side! How” can you classify pleural effusion and what is the importance of this classification? % it sat © Whatare other complications that can develop in this girl? + AS months old male infant was admitted in pediatrics ward with history of cold and cough with low grade fever of 2 days duration. On examination, his respiratory rate was 60/min, with rhonchi and crepts on auscultation. (2071/11) a, List the causes of respiratory distress in infancy. 2 », How can you differentiate between bronchopneumonia and bronchiolitis? 3 . List the complications of pneumonia. 3 MBBS Final Year [309 ——________Mbs Final Year [309 + AB years old child was rushed to emergency with difficulty in . breathing, » 2434328 (2071/1) a. What important history will you take to guide to a diagnosis? ‘ b. What signs will you look for to find out the causes? ¢. How will you treat acute asthma?. + ASyrs old child presented with breathlessness and fever of 4 days duration. On examination, his trachea is shifted towards Jeft side of the chest with decreased vocal fremitus on right side of the chest. Percussion note on right side is dull with diminished breath sound, 143+4=8 (2069/11) ‘a. What is the most likely diagnosis? ~ b, Enumerate the complications of pneumonia in children. c/Enumerate the causes of pleural effusion. + AS-year-old child canie in emergency with history of fever and pain on the right side of the chest. On examination, he was in respiratory distress with normal position of trachea and bronchial breath sound on right side of the chest: 2 1+4+3=8 (2068) a. What is'the most likely clinical diagnosis? b, List the catises of pleural effusion: List the complications of pneumonia in children. +A two year old child presented in the ER because of difficulty In breathing and high fever for two days. List four important key signs that you will look for respiratory distress, What are the World Health Organization age related definitions for tachypnoea? List the medicines you will use for complicated pneumonia. 3+1+2=6 (2067) + A three years old girl has presented to emergency of your hospital with complaints of fever and cough of three days’ duration. What questions will ask the parents that will help you to decide whether the child is suffering from a mild disease or. from, a. life threatening condition requiring hospitalization? 3 (2066) 310 | Clinical Phase Q-Book + Define croup. How will you differentiate acute layngotracheobronchitis and epiglottitis? List three drigs that are used for the treatment of severe’ acute laryngotracheobronchitis. 1434256 (2066) + List three salient features that diagnoses asthma clinically? Which plan of action is used for children whe~ cannot afford inhalers and other costly medicines for asthma? How will you classify a child who has symptoms of asthma more than 2 times a week and less than 1 times a day and exacerbations may affect activity and the FEV1 is more than 80% predicted? 3414125 (2066) ‘+ A 2years old child comes to you with the history of high fever. On Examination you find that the child has toxic look; there is also central cyanosis and respiratory distress with saliva drooling from the mouth. Write three differential diagnosis and. the investigations you will do to confirm each of your diagnosis. 3+3=6 (2065) ‘+ Describe in brief the pathophysiology of bronchial asthma and management of acute asthma. 110 (2063) ‘+ A.16 months old child has presented with the complaints of fever, cough and poor feeding for 2 days. What are the ‘common conditions causing these symptoms? State the steps you will take to help this infant. (2061) + Causes of stridor and approach to a child with this symptom, 8 (2060) + How would you manage achild with pneumonia? _8 (2059) + Diagnosis and management of pneumonia in under 5 years children in the community. 8 (2058) + Write short answers of: (2057) a. WHO classification of ARI 5 ‘+ Write short notes on: a. ARI-WHO guidelines and management. 4 (2056) b. Management of ARI- WHO guidelines. 4 (2055) wo dane c. Management of ARI in an 11 month old infant in the ‘community. 4 (2054) ‘Write short notes on: a. Approach toa child with acute respiratory failure. (2055) ‘+ Write short notes on: Management of a child with pneumonia and their complications, (2054) «Write short notes on: Management of severe pneumonia. (2053) «AB years old male child has been brought to emergency room with a history of sudden respiratory distress for last few hours. On examination, respiration is @0/min intercostals recession is present, child is cyanosed. (2052) a, What more information you would like to have from the parents? b. What other information you would like to have regarding clinical findings? c. Whatare the investigations you would like to do? 4. Suggest the plan of management for one of the most Ii cause. @ Renal diseases:; + A2year old girl has presented with high grade fever, vomiting and abdominal pain. On examination she looks dehydrated and hhaslointenderness. = * 142424328 (2075/9) a. Whats the diagnosis? b. Whatare the predisposing factors of this condition? ©. What is the laboratory investigation to support your diagnosis? . How will you treat this condition? What imaging modality will you suggest for further evaluation of this patient? + Nephrotic syndrome is suspected for a 4 year old boy who presented with swelling of body forlast 1week. (2074/8) a) How do you confirm the diagnosis in this case? 3 'b) How do you treat this condition? 2 9 ‘AS year old gitl complains of red urine for 2 days. 244428 (2073/9) a. Enlist common causes for this problem. b. How do you evaluate this child? ¢. On examination you found edema and hypertension on her. What complications might occur on her? + A7 year old boy presents with reddish urine for 1 week, (2071/11) a. Discuss an approach to a child with red urine. 3 hat complication cain occur? b. On examination of urine, the laboratory reports that he also has ++++ urine proteins. Describe the, importance of this finding and its implications. 3 © What other investigations are important to make a diagnosis in this child? 2 + A 12 years old girl presented in OPD with history of generalized swelling of few days duration. 2+3+3=8 (2071/1) a. What relevant history will you take to come to a diagnosis? b. What signs will look to come to specific diagnosis? c. How will you treat hypertensive encephalopathy? + A years old baby was admitted in the paediatric with history of swelling of face and then legs for last 12 days. List the differential diagnosis of such swelling How will you investigate? Describe in brief management of acute renal failure, 2+2+4=8 (2069/11) ‘A4 years old child was brought by his care-giver with history of swelling of the whole body for the last 10 days with passage of scanty urine. On examination, he looks pufly with pedal edema and ascites. His urine shows Albumin++++ without RBCs in urine. 143+4=8 (2068) a. The most likely diagnosis is? b. List 5 common causes of hematuria in children, ¢. List complications of prednisolone. =~ MBBS Final Year" [313 List three hypothesis that have been postulated for the pathogenesis of ) PostStreptococcal’ Glomerulonephritis? Enumerate the five differential diagnosis. Which investigations are done when follow-up is required? 242+2=6 (2067) A 7 years old boy, presents,;with..edema, Enumerate. the ‘common causes of edema in children, He also gives history of red colored urine. List the clinical signs you will see in this patient. How will you manage this patient? 2+3+3-B (2066) What are the causes,of hematuria in a child? Write down the clinical features and management of a child suffering from acute post streptococcal glomerulonephritis, 2+1+2=5 (2065) How will you manage a case of acute renal failure?,10 (2064) Enumerate the causes.of nephritic syndrome and describe the ‘management of minimal change glomerulonephritis. 10(2063) Write short answers of the following:, (2062, 54) a. Classification. and treatment of nephrotic syndrome in children. 8 b. Management of acute renal failure, 8 ‘What are the complications of nephrotic syndrome? 8 (2060) Write short answers of: : (2057) a. Managementofnephriticsyndrome. 7 iy, 5 Write short notes opi. yor ophie) aeons Bre any (2056) a. Daily: assessment of a child admitted with nephritic syndrome in the hospital... : 5 What are the causes of edema .in- children?)\Give clinical features and management of a case-of Nephrotic Syndrome. als} innig 20 (2056) How do you approach toa child with bilateral edema of feet?(2055) What are the.common forms of streptococcaliinfection? What may be the complications? Give the. treatment and management of one of such complications. 10 (2055) ‘Aten years old male presented in emergency department with sudden hematuria, (2053) a, Whatare the possible causes? b: "What investigations you would like to suggest and why? ‘c. Suggest line of treatment for one of the most likely cause. Diagnos ‘of nephrotic Syiidromi (2052) Meningitis has been listéd indér Infectious’ Diseases ‘aS per the syllabus. if * A110 years boy has history of repéated falling while walking or Tunning ‘on even surface. On examination, he has positive Gower sign. 3+2+3=8 (2075/9) a. What important history and physical examination would you like to do'in this child? 'b. What investigations will you do to confirm your diagnosis? ‘¢: What complications cani occur in the child? + A’2 year old girl presented With sudden loss'of conscious with jerky movements of her limbs that lasted for about 5 minutes. (2074/8) ‘a) List few differential diagnosis. 2 'b) How will you approach for the diagnosis? 4 “Q) What are the criteria for diagnosing febrilé seiziites? “2 ‘+ 14 months old male’ child presents with’ fever of one day duration and abnormal jerky movemeit of body that lasted for ‘Sminutes. 342424128 (2072/9) a. What further history and clinical examination will help you to maké a diagnosis? . b. What sre the’ characteristic differetices betvréen typical and ~ atypical febrile seizures? His CSF . analysis’ is ‘riormal ‘and other’ findings unremarkable. How will you council the parents? . Enlist the types of generalized epilepsy. + A five years old boy ‘was rushed to’ emérgency with generalized convulsion and then later went to coma. List the MBBS Final Year [345 ‘causes that may lead this condition in emergency. Is this condition preventable and ifsohow? _-3+3+2=8 (2069/11) Ten years old boy wes rushed to ER and found him having generalized tonic clinic convulsion. How will you manage him now? List the causes of such events. and how will you investigate. 2+343=8 (2068) List the findings that suggest lower motor neuron in a floppy child, How will you diagnose child who is floppy and has degeneration of anterior horn cells? 34225 (2067) List five important, clinical signs that differentiate peripheral nervous system from central nervous system lesion. List five ‘signs of severely raised intracranial pressure. List two drugs for the treatment of raised intracranial pressure, 2+2+1=5 (2066) Define AFP(Acute Flaccid Paralysis). Write down the clinical features of Guillain Barre Syndrome with its management. 1+4=5 (2065) What are the immediate steps you will take to manage a child presented with convulsion at emergency? 110 (2064) Describe the differential diagnosis of acute flaccid paralysis/limping. 10 (2063) Approach to a child with hypotonia. 8 (2062, 58, 54) Write short answers of the following: (2062, 61, 60, 54) a. Febrile convulsion, 8 Write short notes on: (2061) a. Limping in children ‘b. Management of 2 years child with convulsion ‘A male child aged 5 years was brought to emergency ina state of convulsions. 3444815 (2057) ‘a. What are the important information on history you would like to know from the parents? b. What immediate measure will you take to manage the patient? 316 | Clinical Phase Q-Book © What are the investigations you would take, to.do? Give reasons. + Write short notes on: 4 (2056) a. Features of typical febrile convulsions. sony + b. Hydrocephalus- cause and management * 4 + Approach toa child with convulsion ves" (2055) + Write short notes on: & wth (2052) a. Hydrocephalus Endocrine Diseases: le : * Which investigation’ can “diagnose hypothyroidism during neonatal period? List important signs'that will make’ suspicious ofthis disease during neonatal period?“ -* 1444s 5 (2067) + A male neonate is born with “ambiguous genitalia. Further examination reveals ‘signs “of dehydration. ‘List ‘two serum electrolyte abnormalities that are’found in this condition! List two investigations that confirm the diagnosis. Which two drugs are used forthis condition? - «0: . .24242=6 (2066) + Write short answers off (2057) a. Clinical features of cretinism’ "2 : + Write short notes on: a. Treatment of hypothyroid child. ‘+ Write short notes on: * 7 a. Cretinism, + AB years old child has been brought to outpatient departinent with history of irregular swelling in both side’ of Hat foF last: two months. On-examination; there-is some pallor; liver! and spleen not palpable, 3)" 6) 07 wis 1 2 Boge uluts susn(2083) @. What more information you would like to‘have' froin the parents? * » i b. What are the possible causes? 1 . What investigations should be done and why?" d. Suggest line of treatment of the most likely cause. "| SMBS Final Year |317 + so.08!A'S years old irl was brought for evaluation of joint pain: she saint < 3424328 (2072/9) sa pare history" you Would liké to reach at the “underlying etiological diagnosis? ». Enlist cases of arthitis in children. 1906 6° Wire inodialties16r treatment of'a child with JIA : + A7 yrs old female child admitted with ‘pain ‘nthe multiple joints. On the examination, both large & small ‘joints are +l yoligt and tender: ‘There 1s history of morning stiffness also: ba - 143648 8 (2069/11) a. What is the most likely diagnosis? b. List the investigations you will do. c.Outline the management of the condition. + Enumerate the clinical points for inborn errors of metabolism. ‘A9 months old child has history of hypoglycemia and has hepatosplenomegaly with hypotonia and cardiomegaly. What type of metabolic disease this child is likely to have? 34% (2067) + List six different diagnoses for juvenile rheumatoid arthritis GRA). List four investigations that help to diagnose JRA. List four disease modifying antirheumatic drugs for this disease. 3424227 (2066) + Write short answers of the following: (2062) ‘a. Causes of multiple joint swellings and plan of investigation + Write short notes on: a. Approach toa child with joint swelling. 8 (2060) b. Henoch-Schonlein purpura. 8 (2060) ¢. Approach to a child with joint pain. 8 (2059) 4. Diagnosis of Juvenile Rheumatoid Arthritis. 8 (2058) fe. Approach to a child with arthritis. (2054) 318 | Clinical Phase Q-Book ® Poisoning: + A 10 year old male boy is found to have excessive salivation, watery loose stools and slurring of speech after he had visited a vegetable garden which was recently sprayed with Insecticide. 2434328 (2075/9) a. Whatis the likely cause of these symptoms? ‘b. What other clinical features would you look in this patient? c. How will you treat this patient? Write short notes on: (2061) ‘a, Management of organophosphorous poisoning in children. 8 Write short answers: (2057, 54) 2. Kerosene poisoning 5 te 2075/9 Bachelor Level/MBBS(3"“Phase)S® Year/IOM ——_‘Time:3hours Paediatrics XVIII Full Maris: 0 ‘Candidates are required to give the answers in thelr own words as far as procticable, ‘The figures nthe margin indicate fall marks. Use ceparate answer copies for each frou. Atemptall the questions Group"A" 1. Ad year old boy was brought to pediatric OPD with complain of not gaining adequate weight. 1434428 a. Define failure to thrive. B. What important history you would like to ask to find the underlying etiology? c Enlist. acute life threatening complications in severely undernourished child and outline its management. 2. Anewborn is born to HIV positive mother. 2434328 a. How do you confirm HIV disease in this newborn? b, What advice will you give regarding breast feeding? ¢. How can the risk of transmission of HIV infection to this newborn be minimized? 3, You are called in the maternity ward for a 24 hours old newborn vwitth poor feeding and lethargy. 2434358 ‘a. What could be the important causes for this problem? 'b. You are suspecting sepsis on this newborn. Write important positive history and clinical examination findings that you expecton him? c Write important investigations with positive findings that confirm sepsis. 4, 4.10 year old male boy is found to have excessive salivation, watery loose stools and slurring of speech after he had visited a vegetable garden which was recently sprayed with insecticide. 2434328, ‘a. Whatis the likely cause of these symptoms? . What other clinical features would you look in this patient? ‘c. How will you treat this patient? 5. A 12 years boy came in OPD with fever and swelling of neck for 4 days, On examination, he has stridor and bull neck. 3424358 a. Enlist differential diagnosis for him. b. What laboratory investigations you would perform in this child to come to diagnosis? c Outline the management of diphtheria including prophylaxis for close contacts. 6. A2 year old child is brought in emergency with history of passing blood and mucus in stool. On examination he ig febrile with history of tenesmus during defecation. 343+2=8 a. “Enumerate the causes of blood in'stool. b. What features in the history and examination of this child will help to differentiate between. bacillary and amebic dysentery?, ¢. Enumerate the complications of bacillary dysentery. 7. 43 years old child with complaints of frequently turning blue has been brought to emergency with complaints of . excessive breathlessness for the last few minutes. saute? ante t2t3a8 2. What finding on examination will help you make a diagnosis of congenital cyanotic heart disease? 8 b. Whatare the common cyanotic heart diseases? ¢. How will youtreata cyanotic spell?" 8. A 2 year old girl has presented with high grade fever, vomiting and abdominal pain. On examination she looks dehydrated and has loin tenderness. 1+24+2+3=8 a. Whatis the diagnosis? — b, What are the predisposing factors of this condition? ¢. Whatis the laboratory investigation to support your diagnosis? d. How will you treat this condition? What imaging modality will you suggest for further evaluation of this patient? . 3. A 6 years old boy presented in Emergency with complaints of bluish discoloration and ‘swelling of right ankle. joint and multiple ecchymoses over chest. There is similar history in his uncle.3+2+1+2=8 a. What other significant additional points in history and clinical examination will help to arrive at a diagnosis? b. How will you confirm the diagnosis? c. What treatment will you provide for this baby? d. Enlist long term'complications of this condition, 0. A 10 years boy has history of repeated falling while walking or running on even surface. On examination, he has positive Gower sign. 3+2+3=8 a. What important history and physical examination would you like to do in this child? : : b. What investigations will you do to confirm your diagnosis? ¢. What complications can occur in the child? oe

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