PEDIATRICS

FLUID AND ELECTROLYTES

● Causes of hyponatremia? Outline management

● Causes, clinical picture and management of hypocalcemia

● Definition, management, etiology, ECG changes and management of

hyperkalemia, hypokalemia
● What is hypernatremic dehydration? How will you manage it?

● Define shock. Etiology and management of a child with hypovolemic

shock
GROWTH AND DEVELOPMENT

● Developmental milestones of a 3 yr old child

● Growth charts and its utility in Indian children

● Mention 4 developmental milestones attained at 1 yr of age

● Name 4 sys. Diseases that can be associated wiyth severe short stature

● Evaluation of child with short stature with definition of short stature

● Causes for delayed puberty in girl child

● Principles/ laws of growth and development and fetal origin hypothesis

● Outline normal development milestones for a 10 month old infant

● Red flag signs in development assessment of a child< 5 yr old

● Enlist the developmental milestones upto 1 yr in children in social,

language, motor quadrants
● Drawing skills at various ages and developmental quotient

● Social, adaptive, personal development of children with key milestones

for various ages
 ● The normal development milestones from 0-3 yrs of age in all domains.
What are the domains of development?
● Height velocity and bone age assessment

● Enumerate various skull shapes caused by abnormal closure of sutures

● Define growth and development. Write briefly on the factors affecting

growth. Graphically represent the growth of various tissue with relation
to age. Differentiate constitutional growth delay from familial short
stature
● Note on fine motor development especially w.r.t. block skills with age

● Early stimulation w.r.t. development delay

CNS

● Management of febrile convulsions with diagnosis

● Management of status epilepticus

● Describe briefly pathophysiology of hypoxic ischemic encephalopathy

● How to evaluate a floppy infant?

● 11 month old child presented with fever with 2 episodes of generalised

seizure within first 24 hrs of fever. How will you evaluate and manage
the child
● Diagramatically represent CSF pathway and write 5 causes of
hydrocephalus
● Signs of meningeal irritation

● Differentiate the CSF picture in various types of meningitis and justify

the use of steroids in bacterial meningitis
● Clinical stages and CSF picture in tubercular meningitis
 ● Investigations and outline management of acute bacterial meningitis in 5
yr old child
● Management if 1 yr old child with spastic diplegic cerebral palsy

MALNUTRITION

● Classification of malnutrition- WHO and IAP

● Outline the management of SAM

● Management of severe PEM who is hospitalised

● Ready to therapeutic diet

● Nutritional recovery syndrome

● WHO classification of SAM under 5 yrs

● Define SAM. How to differentiate between kwashiorkor and marasmus

● 15 month old baby complains lethargy since morning. Wt. for ht. is
-4SD. Blood sugar-50mg/dl( normal-54mg/dl)
o WHO definition of SAM
o How to approach hypoglycemia in this case?
o 10 steps for management of SAM
o Discharge criteria for SAM
● Age dependent anthropometric indices

● Criteria to diagnose SAM

● 2.5 yr female from poor socioeconomic background came with a h/o of

progressively increasing shortness of breath, decreased activity, swelling
of feet and abdomen all of which have been gradually increasing over the
past 6 months. Child received breast feeding for 3 months and after that
has been on bottle feed of half diluted goat milk over past 2 yrs. On
examination, she is irritable, severe pallor, no icterus, cyanosis,clubbing,
pitting edema on both legs till midcalf. She has platynoichia with
hyperpigmented knuckles otherwise her skin and hair appear normal. HR-
148/min, RR-52/min, WT.-11kg, P/A-mild fullness positive, liver
 palpable 5 cm below costal margin, soft and firm, tender, spleen just
palpable, no petechiae or bony tenderness.
o Nutritional possibilities you may consider in this child
o Which of the above would you primarily consider and why?
o Investigations would you plan for the child
o Treatment
RESPIRATORY SYSTEM

● WHO classification of pneumonia. Management of severe pneumonia in

a 2 yr old child
● 4 causes of wheezing in children

● Revised WHO classification of community acquired pneumonia in a

child aged > 2 months – 5 years. Define CAP( categories with c/f and
management)
● Mention 4 classes of drugs used as controller medications in childhood
asthma
● 3 yr old girl presents with cough, running nose and noisy breathing for 5
days. On examination she is irritable, has suprasternal retractions, a
banking cough, inspiratory stridor at rest. She is alert, accepting oral
feeds and has a saturation at 99% room air.
o Clinical diagnosis
o Commonest organism causing this
o 2 therapeutic measures that can help her
● 6 months old infant previously well developed running nose and cough 5
days back. 2 days later he developed mild fever, irritability, rapid
breathing. Tachycardia, tachypnea, intercostal retractions, hyperinflated
chest and bilateral wheeze present. CXR shows patchy infiltrates and
bilateral hyperinfiltration
o Most probable diagnosis
o M.C. organism causing this
o Therapeutic measures to be undertaken
o Drug used if child was immunocompromised
● Classify severity of childhood asthma. Management of acute severe
asthma
 ● Causes of resp. distress in a term neonate. Discuss clinic-radiological
picture and management of transient tachypnea of newborn
● Management of mild asthma

● Pathophysiology of childhood asthma

● Various devices used in management of bronchial asthma

● D/d of a 3 yr child with stridor and management of acute epiglottitis

● Enumerate the causes of stridor in a 2 yr old child. How will you manage
a child with moderate croup?
● 1 yr old completely vaccinated child presented to casualty with h/o cough
for 3-4 days which suddenly worsened for past 6-8 hrs and since 2 hrs he
has difficulty in breathing as well. On examination child is anxious but
consolable, having bouts of intermittent cough with audible intermittent
stridor. He has minimal suprasternal and sternal recession. Chest has
equal air entry with very harsh bronchovescicular breath sounds and
prolonged expiration and ronchii++
o Probable diagnosis and likely offending organism
o Management
● Approach to diagnosis and management of a 3 yr old with severe
pneumonia
HEMATOLOGY

● Outline causes of microcytic hypochromic anemia

● Management of iron deficiency anemia in 2 yr old child

● Approach to petechiae in child presented to OPD

● Idiopathic thrombocytopenic purpura

● Approach to child with anemia

● Management of child with classical hemophilia

● Various types of crisis associated with SCD

 ● Define anemia in children. Enlist causes of anemia in children and outline
the plan of management
● Enlist the causes of bleeding diathesis in children and enumerate
management plan
● 7 yr old male with history of hemarthroses since early childhood has
presented after fall from bicycle. Child is drowsy with right hemiparesis
o How to confirm diagnosis of hemophilia in this patient?
o Classification of hemophilia severity
o Most probable cause for CNS symptoms and how to confirm it?
o Specific management of hemophilia A in this child weighing 20
kgs and its duration. Also enumerate principles of supportive
management in this child
● 1 yr male child 8 kg presents with anemia and hepatosplenomegaly.
Developmental milestones normal
o Approach
o Management
● Chelation therapy in thalassemia

● Iron deficiency anemia

● Lab diagnosis of iron deficiency anemia in 1 yr old

CVS

● 4 yr old boy presents with cyanosis noted from early infancy, clubbing,
failure to thrive. No h/o recurrent chest infections. On examination
precordial bulge, systolic murmur, soft single second heart sound. After
admission he develops sudden onset of severe cyanosis, restlessness and
gasping respiration
o Underlying diagnosis
o Reason for acute complication
o 2 therapeutic measures used to manage this acute complication
● Causes of cyanotic heart disease with decreased pulm. Blood flow

● Management of cyanotic spells in a 2 yr old child

 ● Jones criteria. Management of acute rheumatic fever

● Classification of acyanotic congenital heart disease and management of

VSD
● Revised Jones criteria for diagnosis of ARF

● How will you manage a 1 yr old child presenting with large VSD and
failure to thrive?
● Clinical signs you will look for in a child diagnosed with infective
endocarditis
● Patent ductus arteriosus

● 6 wk old male complaints of poor feeding, poor activity, fats breathing,

decreased urine output for past 6 days. Birth wt-2.9 kg and neonatal
period was uneventful. On examionation child was looking sick,
tachypneic with intercostal and subcostal recession. Wt-3.1 kg,
PR-160/min, low volume with cold peripheries. Resp. system
examination showed tachypnea with crackles heard in posterior lung
fields. CVS- grade-4/6 pansystolic murmur heard best in lt. lower sternal
border. Abdominal examination revealed a palpable liver 6 cm below and
spleen 1 cm below costal margin.
o Most probable diagnosis
o Investigations done and probable findings to expect
o 4 complications of main diagnosis
o Management
● WHO criteria for diagnosis of RF & RHD

● What is Fallot’s physiology? Write components of TOF

● Hemodynamics of VSD

LIVER, GALLBLADDER, GIT

● Causes of cholestatic jaundice in an infant. Briefly discuss management

of same
● How will you evaluate a child with malabsorption syndrome?
 ● 2 month old boy presented with progressive yellowish discoloration of
eye along with high colored urine since birth. h/o passing clay colored
stools. On examination; baby stable, jaundice ++, abdomen distended,
liver palpable 5cm below costal margin, firm in consistency and spleen 2
cm below costal margin. LFT: Bilirubin( Total- 14mg/dl, direct-7.4
mg/dl, indirect-6.6 mg/dl), AST- 54, ALT-36 and serum ALP-1284 IU,
PT INR 2.1
o D/d
o Investigation to confirm diagnosis
o Management
● Pathophysiology of physiological jaundice of newborn. Approach to
jaundice case of newborn explaining the relevance of investigations.
Mechanism of action and problems with use of phototherapy
NEPHROLOGY

● Management of steroid dependent nephrotic syndrome

● Grade vesicoureteric reflux and write about antibiotic prophylaxis in

VUR
● Define steroid resistant nephrotic syndrome. Write the management plan
for 4 yr old child diagnosed to have 1st episode of nephrotic syndrome
● Lab findings and management of acute glomerulonephritis

● How will you approach a 2 yr male child with recurrent UTI?

● Discuss diagnosis and subsequent evaluation for 1st episode fo UTI in a

3yr old boy
● 1 yr child present with excessive cry during urination associated with
vomiting and fever. How will you evaluate and manage the child?
● 3 yr old female with c/o puffiness of face and limbs for past 7 days with
decreased urine output. A urine examination done shows significant
proteinuria
o D/d
o Approach to clinical scenario
o Investigations required
 o Management of the most probable D/d
INFECTIONS

● Define acute flaccid paralysis. Write a note on FAP surveillance.

Differentiate between common causes of AFP in tabular manner. Briefly
write about polio end game strategy
● Discuss the management of child with complicated or severe malaria

● C/f, diagnosis and treatment of uncomplicated scrub typhus

● 9 yr old male complains of not gaining weight and inactivity/ lethargy in

evening hours after he returns from school since last 2 months. Mother
gives a h/o cough with/ without sputum for a month. Fever wasn’t
perceptible by parents. Child has good BCG scar.
o How to diagnose the case?
o In case of pulmonary TB, how will you manage the case as per
current guidelines?
● Antimicrobial therapy in management of enteric fever

● Management of severe dengue

● Classify dengue fever. Algorithmic approach for management of dengue

fever with warning signs
● Management of dengue shock syndrome

● Etiopathogenesis, c/f, prevention and management of tetanus

● Screening of neonate born to HIV positive mother

● Opportunistic infection in HIV

● PPTCT in HIV

● ART in HIV

● Draw structure of C. diphtheriae. Management of a child diagnosed with

faucial diphtheria with airway compromise
● Life cycle of malaria, c/f, management
 ● Lab diagnosis of enteric fever. How to manage the case with special
mention to prevention?
● Define response to therapy, treatment failure, recrudescence and relapse
with regard to malaria and write about rapid diagnostic tests in malaria.
● Discuss diagnosis of childhood TB

● Describe guidelines on management of newly diagnosed pulmonary TB.

Write drug doses and A/E you will look for on follow up of this child.
ENDOCRINOLOGY

● Congenital hypothyroidism- screening and management

● Congenital hypothyroidism- c/f

● SMR and its clinical significance

● C/f and management of untreated congenital hypothyroidism

● SMR in adolescents

● Importance of screening of cong. Hypothyroidism in neonates

VACCINATION

● Short note on rota virus

● 1.5 yr old boy brought to you, other than BCG, OPV received at birth he
is unimmunised. Name 2 mandatory and optional vaccines that should be
offered to him
● Vaccination of adolescent girl

● Mission Indradhanush

● Swine flu vaccine

● A/E with MMR vaccine( SN on MMR vaccine)

● Pneumococcal vaccine
 ● Dose, route, A/E of measeles vaccine

● BCG vaccine

● MR vaccine and the MR vaccination campaign 2017

● Types of vaccines and write a note on any one subunit vaccine

● Milestones in vaccination programme

● Enumerate any 8 disease conditions that produce fever with rash. Note
any 1 disease causing fever with rash that has special vaccination
campaign that started in 2017
● DPT vaccine

● Pathophysiology and management of anaphylaxis

● Bivalent OPV vaccine

NUTRITION

● Mention 4 c/f of vit.A deficiency and management

● Mention 2 c/f and 2 radiological features of rickets

● 4 c/f of Zn deficiency

● C/f of management of nutritional rickets

● Describe metabolism of vit. A. Manifestations and severity of vit.A

deficiency. Also write a note on its management
● Note on clinical manifestations and treatment of rickets in a 4yr old child

● Approach a case with refractory rickets

● Classify xerophthalmia as per WHO. Write biochemical cycle for

metabolism of vit. A. How to treat a child diagnosed with vit.A
deficiency and write a note on vit. A prophylaxis program

RHEUMATOLOGY
 ● 10 yr old female child presented with polyarthiritis for 6 months. Outline
the management of this child
NEONATOLOGY

● Classify neonatal sepsis. Outline investigations, diagnosis and

management in newborn with sepsis
● C/f of Down’s syndrome. Evaluate a child with Down’s in OPD follow
up
● Kangaroo mother care

● JSSK

● Signs of good attachment and benefits of breastfeeding

● Advantages of breastfeeding, positioning and attachment signs during

breastfeeding
● Sepsis screening in a neonate in tertiary health centre

● Warm chain and prevention of hypothermia in neonates

● Define hypothermia in newborns. Sources of heat loss in children? Why

are newborns more susceptible to hypothermia?
● Discuss feeding a low birth weight neonate

● A term female neonate born via emergency LSCS to a mother with

gestational diabetes with APGAR score 3,5,7,8 at 1,5,10,15 mins
requiring active resuscitation. She was shifted to NICU and was noted to
be severly tachypneic with chest indrawing. Flaring of alae nasi and
grunting at 1 hr of life
o Possibilities to consider
o Reason and justification of possibilities considered
o Management
GENETIC DISORDERS

● Discuss briefly the complications you will assess in a child with Down’s
syndrome on regular follow up
 ● Galactosemia

● Down’s syndrome

DIARRHEA

● Management plan for a child of 10 kg presented with acute diarrhea with

some dehydration
● WHO management plan for 1 yr old child with acute diarrhea and no
dehydration
● Mention 4 important physical findings of acute diarrhea with some
dehydration
● Mention 2 clinical parameters used to assess degree of dehydration in a
malnourished child
● What is persistent diarrhea? How to evaluate a child with persistent
diarrhea?
● Dietary management of persistent diarrhea

● Describe composition of WHO ORS, physiological basis of ORT nad

plan A of rehydration in a 7 month old child weighing 6 kg with acute
diarrhea
● Enumerate the causes and discuss the management of chronic diarrhea in
a 2 yr old child
● Severity assessment of diarrhea

MISCELLANEOUS

● Importance of communication in pediatric practice

● Approach to case with suspected metabolic disorder

● Management of a child with atopic dermatitis

● RBSK
● 18 month girl complains of patchy hyperpigmentation, apathy, flaking of
skin, weakness. H/o recurrent illness over past 8-9 months. Parents aren’t
sure about her weight gain but feel that child is chubby. On examination
she was pale with sparse hair over her temple which was lustreless with
bilateral pitting pedal edema. Her MUAC was 11 cm.
o Most likely diagnosis and write 2 D/d
o Approach to evaluate the patient
o New problems you may encounter once you start therapy
● Management of snake bite with ptosis

● ICDS

● Interpret this ABG: pH-7.31, pCO2-39, pO2-25, HCO3-19, BE-7, Na+-

108, K+-6.2, Cl- 72. Justify your ABG interpretation. Write a possible
condition that may present with similar findings