Download DNB 2016 Dec EMERGENCY MEDICINE PAPER 4 Question Paper

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FINAL EXAM

DECEMBER 2016

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EMERGENCY MEDICINE

PAPER - IV

NATIONAL BOARD OF EXAMINATIONS

EM.MED/D/16/52/1V

Time : 3 hours

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Max. Marks : 100

Important instructions:

1. Attempt all questions in order.
2. Each question carries 10 marks.
3. Read the question carefully and answer to the point neatly and legibly.

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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.
8. Draw table/diagrams/flowcharts wherever appropriate.

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Write short notes on:

1. 1. List 6 common symptoms and signs of increased intracranial pressure in infants.
   2. What is an impact seizure?
   3. Setting-sun sign.
   4. Outline the management of hydrocephalus in infants.

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   3+1+2+4

2. 1. What are the indications for intraosseous access?
   2. Different sites available for it and outline its procedure.
   3. What are the complications?

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   4. What drugs can be given through intraosseous route?

   2+3+3+2

3. 1. What are the recent clinical trials done on management of hypertensive intracerebral haemorrhage?
   2. Discuss briefly anyone of the trials:

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   3. Latest guidelines for the management of hypertensive intracerebral haemorrhage:

   3+3+4

4. 1. Mention changes in the 2015 AHA guidelines from 2010 guidelines for CPR-in an adult with cardiac arrest.
   2. What are H’s and T’s?

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   3. What is high quality CPR?

   4+3+3

5. A 2 year old child is brought with drooling and noisy breathing.

   1. Mention the differential diagnosis.

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   2. How will you prepare to secure the airway if needed?
   3. Drug treatment of this child.

   2+5+3

6. 1. Name newer anti-epileptic drugs.

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   2. Dose and advantages of levetiracetam.
   3. Give algorithm for management of status epilepticus.

   3+3+4

7. 1. What is targeted temperature management (TTM)?

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   2. Methods of lowering temperature in the post-Return of spontaneous circulation (ROSC) patient.
   3. Mention trials done on TTM.

   3+4+3

8. 1. Define multiple casualty and mass casualty.

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   2. How would you develop a hospital disaster plan?
   3. Triaging during mass casualty.

   2+5+3

9. 1. Recent definitions for sepsis and septic shock.

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   2. Role of different vasopressors in septic shock.
   3. What are the goals in first 6 hours of its management?

   2+4+4

10. 1. Define randomized clinical trial.

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    2. Compare prospective and retrospective studies.
    3. Which common statistical methods are employed for categorical variables? Discuss any one of them.

    2+2+(3+3)

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