Download DNB 2020 June Hematology Paper I Question Paper

FINAL EXAM
NATIONAL BOARD OF EXAMINATIONS
JUNE 2020
HEMATOLOGY
PAPER-I

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Time: 3 hours
HEMAT/J/20/48/I
Max. Marks:100
Important Instructions:
Attempt all questions in order.

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Each question carries 10 marks.
Read the question careful y 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.

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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 56-year-old patient is admitted with chest pain, decreased saturation and 2+4+4
is diagnosed to have acute promyelocytic leukemia. Cardiac enzymes are

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normal. He also has raised D dimer levels; he does not have fever.
a) What do you think his ECG wil show?
b) What tests wil you do to confirm your suspicion?
c) How wil you manage this complication?
2. a) What is hematopoietic niche?

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3+3+4
b) Role of mesenchymal stem cells in the bone marrow stroma.
c) Role of the bone marrow stroma in stem cel mobilization and
engraftment.
3. Megakaryocytes:

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3+4+3
a) What is the molecular defect and presentation of congenital
amegakaryocytic thrombocytopenia?
b) What are micro-megakaryocytes?
c) What bone marrow picture is found in immune thrombocytopenia?

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4. Hereditary spherocytosis:
3+4+3
a) What structural defects occur in the red cel s?
b) What is the basis of the incubated osmotic fragility test?
c) What is Nestroft test?

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5. a) What is the need for randomization in a clinical trial?
4+3+3
b) What is the reason for blinded assessments?
c) What is block randomization? What does it achieve?
6. a) Why do some clinical trials have a crossover design?

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2+4+4
b) What information is needed to calculate the sample size and power of a
study?
c) What is intention to treat analysis? How does it help the researcher?
P.T.O

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-1-
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.

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FINAL EXAM
NATIONAL BOARD OF EXAMINATIONS

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JUNE 2020
HEMATOLOGY
PAPER-I
7. a) Inherited bone marrow failure syndrome - list diseases and main 5+3+2
features.

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b) What tests are required to diagnose dyskeratosis congenital (DKC)?
c) How wil you work up a case of Diamond-Blackfan anemia?
8. A 3-year-old child with short stature, hyperpigmentation, horse shoe kidney 3+4+3
and thrombocytopenia comes to see you. Elder sibling died because of
chronic anemia and development of acute myeloid leukemia.

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a) What work up wil you do?
b) What is the therapy you wil plan?
c) What counsel ing wil you give to the parents?
9. Sickle cell disease:
3+4+3

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a) How is the diagnosis made in the new born period?
b) What are the evidence based practices recommended for therapy in
children and adults with sickle cel disease?
c) What is a veno-occlusive crisis? How should it be managed? What are
the pain medicines indicated?

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10. Describe, discuss rational and give examples for:
4+3+3
a) Primary prophylaxis.
b) Secondary prophylaxis.
c) Post exposure prophylaxis.

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-2-
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.

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