Download DNB 2016 Dec EMERGENCY MEDICINE PAPER 2 Question Paper

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FINAL EXAM NATIONAL BOARD OF EXAMINATIONS

DECEMBER 2016

EMERGENCY MEDICINE

PAPER - I

EM.MED/D/16/52/11

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Time : 3 hours

Max. Marks :100

Important instructions:

• Attempt all questions in order.
• Each question carries 10 marks.

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• 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.
• 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.

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• Draw table/diagrams/flowcharts wherever appropriate.

1. Write short notes on:

   1. Mention 3 anatomical and 3 physiological changes in pregnancy.
   2. What is the importance of these changes in trauma management?
   3. What is supine hypotension syndrome and how do you correct it?

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   (3+3+4)

2. A 35-year-old multiparous woman presents with severe vaginal bleeding following vaginal delivery at 36 weeks.

   1. Define postpartum hemorrhage.
   2. Possible causes of severe bleeding in this patient

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   3. Initial management in the Emergency Department.
   4. Definitive management in case of continued bleeding.

   (2+3+3+2)

3. 1. Clinical features of anterior cord syndrome.

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   2. Clinical features of posterior cord syndrome.
   3. Differentiate spinal shock and neurogenic shock.
   4. How will you manage neurogenic shock?

   (3+3+2+2)

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4. 1. Classify facial fractures:
   2. Airway management in a patient with facial injury.
   3. Haemorrhage control in such a patient.

   (3+4+3)

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5. A 60 year old male patient comes to the Emergency Department with severe acute abdominal pain.

   1. Enumerate your differential diagnoses.
   2. How will you evaluate the patient clinically?
   3. How will you investigate the patient?

   (3+4+3)

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6. 1. Hypotensive resuscitation in haemorrhagic shock.
   2. Compare crystalloids and colloids for resuscitation.
   3. What is Massive Transfusion Protocol?

   (4+3+3)

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7. 1. Causes of compartment syndrome.
   2. Clinical features and diagnosis of compartment syndrome.
   3. How will you manage it in the Emergency Department?
   4. Complications of compartment syndrome.

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   (3+3+2+2)

8. 1. What is the classic triad of ruptured abdominal aortic aneurysm?
   2. External signs of acute aortic rupture.
   3. Management of acute aortic rupture.

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   (2+2+6)

9. 1. Differential diagnosis of acute scrotal pain.
   2. What is Prehn’s sign?
   3. How will you diagnose torsion testis?

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   4. How you will perform detorsion of the testis?

   (3+2+2+3)

10. 1. Mention the six killers in thoracic trauma.
    2. Clinical features of tension pneumothorax.

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    3. Procedure for needle decompression.
    4. Procedure for intercostal drain insertion.

    (3+3+2+2)

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