Download DNB 2016 Dec EMERGENCY MEDICINE PAPER 1 Question Paper

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FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2016
EMERGENCY MEDICINE
PAPER - I
EM.MED/D/16/52/

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Important instructions:

1. Attempt all questions in order.
2. Each question carries 10 marks.

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3. Read the question carefully and answer to the point neatly and legibly.
4. Do not leave any blank pages between two answers.
5. Indicate the question number correctly for the answer in the margin space.
6. Answer all the parts of a single question together.
7. Start the answer to a question on a fresh page or leave adequate space between two answers.

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8. Draw table/diagrams/flowcharts wherever appropriate.

Write short notes on:

1. a) Illustrate with the help of a labelled diagram the conducting system of the heart. 3+3+4
   b) What are the different mechanisms of tacharrhythmias?
   c) Classification of anti-arrhythmic agents.

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2. a) Sodium homeostasis. 4+3+3
   b) Mention various causes of hypernatremia.
   c) Pathophysiology of clinical effects of hypernatremia.
3. a) Anatomy of wrist and hand as relevant to emergency physician. 4+3+3
   b) Nerve supply of various muscles of hands.
   

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   c) Action of various muscles of hand.
4. a) Kassirer-Bleich equation. 2+3+2+3
   b) How does the kidney regulate acid-base balance?
   c) Define anion gap and mention its clinical use.
   d) Enumerate cause of metabolic acidosis.

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5. a) Non-invasive oxygen-and carbon dioxide monitoring. 4+3+3
   b) Oxygen-hemoglobin dissociation curve.
   c) What is the ‘utility of end-tidal CO2 during cardio-pulmonary resuscitation?
6. a) Name three low-molecular heparins alongwith their doses. 3+3+4
   b) Mechanism of action of unfractionated and low-molecular weight heparin.
   

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   c) Methods to monitor therapy with unfractionated heparin.
7. Classify various antimicrobial agents. 4+2+2+2
   a) Adverse effects of penicillins.
   b) Mechanism of action of penicillins.
   c) What are the adverse effects of aminoglycosides?

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8. a) What are the diseases produced by various species of Clostridium? 3+4+3
   b) Pathogenesis of tetanus.
   c) Tetanus prophylaxis following an injury.
9. a) Common causes and pathophysiology of anaphylaxis. 5+3+2
   b) Clinical criteria for its diagnosis.
   

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   c) Write about 2 drugs used as first-line therapy.
10. a) Pathophysiology and diagnostic criteria of diabetic ketoacidosis. (4+3)+3
    b) Mention important laboratory tests to be done in a case of suspected diabetic ketoacidosis.

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