27-01-2025
III-MBBS (Part-II) RUHS 1431A3+1431A4
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Third Professional M.B.B.S. Part-II (Main) Examination (New Scheme)
January 2025
Paediatrics
Paper-I
Time: Three Hours
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Maximum Marks: 100
Attempt all questions in both sections.
Section-A
Q.1 Write correct answer. (6x1=6)
A. Triad of congenital rubella syndrome is __________.
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B. __________ is the most common cause of acute epiglottitis in children.
C. Oliguria in children is defined as urine output less than __________.
D. In nephritic syndrome urinary protein to creatinine ration should be more than __________.
E. Normal value of serum Na level in children is __________.
F. The precocious puberty is defined as appearance of secondary sexual characteristics before __________ Years of age in girls and before __________ Years of age in boys.
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Q.2 Write correct answer. Multiple choice questions. (4x1=4)
1. Commonest enzyme defect in congenital adrenal hyperplasia is:
a. 21-hydroxylase b. 11-beta hydroxylase
c. 3-hydroxylase d.17-alpha hydroxylase
2. Best investigation for assessment of iron stores is:
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a. Hemoglobin b. Serum iron
c. Ferritin d. Transferrin
3. A 6-month old infant present with severe pallor and hepatosplenomegaly. Similar history is present in older brother. What is the investigation of choice:
a. Bone marrow biopsy b. Hb electrophoresis
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c. Hb estimation d. Platelet count
4. Signs of good latch are all, except:
a. Complete nipple and areola inside baby's mouth b. Lower lip exerted
c. Rapid and shallow suck d. Chin of the baby touching mother's breast
Q.3 Anant is a 3-year-old boy. He is referred to the hospital as his mother has noticed that his face is swollen. His mother was concerned that he had an allergic reaction to some peanuts he ate at a party. Examination reveals abdominal distension, bilateral scrotal swelling and pitting edema of his lower limbs. Urine dipstick had 4+ protein, 2+ blood, nitrite and leukocyte negative. His blood pressure is normal for his age. You perform renal function tests, which reveal normal levels of sodium, potassium, urea and creatinine. His complements levels (C3 and C4) are normal. (2+3+4+4+2=15)
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a) What is the most likely diagnosis?
b) What are the common causes of generalized body swelling?
c) How you will manage the case?
d) What are the common complications of the disease?
e) Which vaccines you will essentially suggest to this patient?
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Q.4 Write briefly on the following. (Any Five) (5x2=10)
a) Management of cyanotic spells?
b) Cause of respiratory distress in newborn?
c) Radiological changes of Rickets
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d) Criteria of acute kidney injury
e) Catch-up vaccination of 10-year-old unimmunized girl child.
f) Differential diagnosis of acute flaccid paralysis.
Q.5 Explain why (Any three) (3x5=15)
a. Animal milk can cause hypo-calcemic seizures in infant.
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b. Iron is not given during stabilization phase of management of SAM.
c. Early initiation of breast feeding is emphasized after birth.
d. Correction of hypernatremia is done slowly.
Section-B
6. Clinical features, lab diagnosis and management of Tuberculous Meningitis. (5+5+5+5=20)
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7. Write briefly on (Any five) (3x5=15)
a) What is MDR TB?
b) Modified Jones Criteria for Acute Rheumatic Fever.
c) Clinical features of Kawasaki's disease
d) Chelation therapy in thalassemia major
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f) Which tests are included in quadruple screen for Down syndrome?
g) Management of Hyperkalemia
8. Write short notes on. (5x4=20)
a) Define Seizure and status epilepticus. Write management of status epilepticus
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b) Define short stature and enumerate causes of short stature.
c) Hemorrhagic Disease of Newborn (HDN)
d) Management of Enuresis
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