Download DNB 2017 Dec EMG MED EM PAPER IV Question Paper

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NATIONAL BOARD OF EXAMINATIONS

DECEMBER 2017

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EMERGENCY MEDICINE

PAPER - IV

EM.MED/D/17/52/IV

Time : 3 hours

Max. Marks :100

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Important instructions:

• Attempt all questions in order.
• Each question carries 10 marks.
• Read the question carefully and answer to the point neatly and legibly.
• Do not leave any blank pages between two answers.

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• Indicate the question number correctly for the answer in the margin space.
• Answer all the parts of a single question together.
• Start the answer to a question on a fresh page or leave adequate space between two answers.
• Draw table/diagrams/flowcharts wherever appropriate.

Write short notes on:

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1. 1. Name three recent trials on control of blood pressure in patients with intracranial hemorrhage. (3+4+3)
   2. Discuss anyone of them.
   3. Discuss briefly about drugs to control blood pressure in patients with intracranial hemorrhage.
2. 1. Triage of a victim of sexual assault (2+5+3)

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   2. Assessment of female victim of sexual assault
   3. Treatment of female victim of sexual assault
3. 1. Discuss various steps to prepare a neonate for transport to other hospitals (4+6)
   2. Special considerations in neonates when preparing for transport

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4. A 7-year school-going boy came to ED with one day fever of 102.6°F and cold. Several cases of H1N1 influenza infection were reported during that period. (2+4+2+2)
   1. What standard precautions would you take in ED while examining a patient with suspected influenza infection?
   2. Define categories of patients with suspected H1N1 infection.
   3. Discuss briefly the drugs used to treat a case of influenza infection.
   4. How will you manage this child?

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5. 1. Epidemiology of recent outbreak of Zika virus infection (3+3+3+1)
   2. Clinical features of Zika infection
   3. Complications of Zika infection
   4. Recent observation about transmission of Zika virus through sexual contact

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6. Regarding ocular ultrasonography in the emergency department: (3+3+2+2)
   1. Discuss the uses of this technology in ED
   2. Define normal values of optic nerve sheath diameter in adults
   3. List the pitfalls of this examination
   4. What are the precautions and contraindications of this test?

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7. 1. Diagnostic criteria and severity assessment for Substance use disorders based on the Diagnostic and Statistical Manual of Mental Disorders (4+2+4)
   2. Enumerate different alcohol withdrawal syndromes
   3. ED management of alcohol withdrawal syndrome

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8. A 2 year old child was brought to ED with complaints of fever for 6 days associated with rash over the trunk and extremities. On examination, there is conjunctival congestion without any discharge and cervical lymphadenopathy. (1+4+3+2)
   1. What is the most probable diagnosis?
   2. What are the diagnostic criteria for this illness?
   3. What are the complications?
   4. How will you manage this child?

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9. Discuss the following in a child with sickle cell disease: (4+3+3)
   1. Vaso-occlusive crisis
   2. Fever
   3. Neurologic complaints
10. 1. Discuss briefly about mechanical CPR (Cardiopulmonary resuscitation) devices. (2+2+2+2+2)

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    2. What is impedance threshold device in CPR?
    3. Discuss the techniques used in extracorporeal cardiopulmonary resuscitation
    4. What do you understand by CPR feedback devices?
    5. What are the recommendations about use of feedback devices during CPR?

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