Download DNB 2017 Dec EMG MED EM PAPER II Question Paper

FirstRanker.com

NATIONAL BOARD OF EXAMINATIONS

DECEMBER 2017 FirstRanker.com

--- Content provided by‍ FirstRanker.com ---

EMERGENCY MEDICINE

PAPER - II

EM.MED/D/17/52/II

Time : 3 hours Max. Marks :100

Important instructions:

--- Content provided by‌ FirstRanker.com ---

• 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.
• Indicate the question number correctly for the answer in the margin space.

--- Content provided by‍ FirstRanker.com ---

• 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:

1. A 32 year old is brought to the ED one hour after an accident. On arrival, he is talking in incomprehensible words. His vitals are: RR- 32/min and SpO2 — 92% on room air, PR- 118/min, and BP- 88/60mmHg. He is opening his eyes to painful stimulus. He withdraws right upper and lower extremities on painful stimulus with no movement of left side. The right pupil is fixed and dilated. (2+5+3)

   --- Content provided by FirstRanker.com ---

   1. What is his Glasgow Coma Scale?
   2. Describe step-wise approach to the patient in the ED.
   3. How will you prevent further-deterioration in brain injury?

2. A 16 year old boy presents to ED complaining of shortness of breath and pain on right side of chest. He informs being beaten by hockey sticks in playground 30 minutes ago. His vitals are: Respiratory rate — 28/minute, oxygen saturation — 80% on room air;, pulse — 110/min, blood pressure — 90/50 mmHg. His Glasgow Coma Scale is 15/15 with normal pupils and no deficits. (3+3+2+2)

   --- Content provided by​ FirstRanker.com ---

   1. What are the possible chest injuries in this patient?
   2. How will you detect various chest injuries in the ED?
   3. How will you relieve him of his pain?
   4. The patient was intubated by an intern and put on ventilator. However, the boy suddenly collapsed with unrecordable blood pressure. Enumerate the probable causes of his deterioration?

--- Content provided by‌ FirstRanker.com ---

3. A 56 year old male has been wheeled into your ED with deep second degree burns involving both upper limbs. He had an unsuccessful attempt trying to save his wife from fire within a closed compartment having wool garments. He is highly agitated and coughing black sputum. (2+5+3)

   1. What are your initial concerns in managing this patient?
   2. How will you manage various inhalational injuries produced by smoke?
   3. Discuss Parkland’s formula for fluid resuscitation of burn in adults.

--- Content provided by‌ FirstRanker.com ---

4. 1. Enumerate common causes of acute pancreatitis. (2+3+3+2)
   2. How do you assess severity of acute pancreatitis in ED?
   3. Diagnostic studies in a patient with suspected acute pancreatitis.
   4. What are the local complications seen in acute pancreatitis?

--- Content provided by FirstRanker.com ---

5. A 25 year old female presents with sudden loss of vision in her right eye. (5+5)

   1. Describe briefly various causes of painless vision loss.
   2. Describe briefly various causes of painful vision loss.
6. 1. List the incomplete spinal cord syndromes. (2+3+5)

   --- Content provided by‍ FirstRanker.com ---

   2. Management of neurogenic shock.
   3. Mechanisms of injuries encountered in cervical spine trauma with an example in each category.
7. 1. Discuss briefly about various causes of acute scrotal pain. (4+4+2)
   2. How do you differentiate clinically among them?

   --- Content provided by‍ FirstRanker.com ---

   3. Discuss the treatment-options for testicular torsion in ED.
8. 1. Anatomy of knee relevant to trauma. (3+3+4)
   2. Discuss important neurovascular complications of injuries to knee.
   3. Meniscal and ligament injuries around knee joint.

   --- Content provided by⁠ FirstRanker.com ---

9. 1. Regional nerve entrapment syndromes of the hip (3+3+4)
   2. Bursal syndromes of the knee
   3. Knee myofascial syndromes

--- Content provided by⁠ FirstRanker.com ---

10. 1. Chest pain during third trimester of pregnancy (4+3+3)
    2. Severe preeclampsia
    3. Abruptio placentae

--- Content provided by⁠ FirstRanker.com ---