PEDIATRIC SURGERY (FINAL / PART 2}

FINAL EXAMDECEMBER 2011

NATIONAL BOARD OF EXAMINATIONS

PEDIATRIC SURGERY (FINAL / PART 2}

PAPER- I

PED SURG-2IDI11I29IITime :3 hoursMax. Marks : 100

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

1. How will you define 'hyponatremia' and 'hypernatremia' in asurgical neonate? What are the important causes ofderanged serum sodium concentrations in differenthydration states hypovolumic, euvolumic andhypervolumic. What is the significance of measuringurinary sodium?

2. Briefly mention the principles behind newer imagingtechniques of functional MRI and Positron EmissionTomography (PET). Briefly mention clinical uses of thesetwo technologies in Paediatic Surgery.

3. Enumerate the macronutrients and micro nutrientsavailable in parenteral nutrition formulas. Briefly mentionthe volume, concentration, caloric value etc. of eachmacronutrient. Briefly mention major complications of totalparenteral nutrition (TPN)

4. Briefly mention the different modes used in mechanicalventilation. Enumerate the complications of mechanicalventilation.

5. Draw schematic representation of coagulation cascade.Enumerate the blood tests used to detect bleedingdisorders stating parameters used by each test.

6. Briefly mention the limitations of standard minimal accesssurgery techniques and technology that have paved pathfor introduction of robotic technology- What are the differenttypes 'of robotic surgical systems that are presentlyavailable? Discuss briefly their advantages, limitations andapplications in Paediatric Surgery.

7. Briefly rnention the antenatal diagnosis and fetalmanagement of myelomeningocele. Mention the rationalebehind the clinical trial the Management ofMyelomeningocole Study (MOMS) and enumerate itsprimary objectives

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POSSESSION/ASE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED, INSIaE THE EXAMINATION HALL

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8. 'Enumerate the different energy sources used for open and 2.5+2.5+2.5+2.sminimally invasive surgery. Mention their mechanism ofaction, advantages and disadvantages.

' 9. Enumerate the fetal conditions in which maternar serum 4+2+4and amniotic fluid alfa fetoprotein levels are raised. At whatgestation the fetalAFP levels reach their peak? What otherbio-chemical markers are useful for fetal screening?

10. Enumerate modern immunosuppresants used in liver 2.5+2.5+2.5+2.5transplantation. Mention their action, principal use andcommon toxicities.

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M d o D d o r i r

FINAL EXAM NATIONAL BOARD OF EXAMINATIONSDECEMBER 2011

PEDIATRIC SURGERY (FINAL / PART 2}

Time :3hours PAPER' l l

PED SURG.2IDI11I29IIIMax. Marks : 100

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

1. Draw schematic representations of 3 commonly performed 3+2+Ssurgical procedures for Hirschsprungs disease. How do youdiagnose total colonic aganglionosis? List the variousoperative procedures for total colonic aganglionosis.

2. Briefly describe the various prognostic indices for Congenital 4+3+3Diaphragmatic Hernia (CDH). Briefly mention the paradigmshift that has taken place in the management of CDH. Brieflymention the various pharmacological agents used in CDHassociated pulmonary hypertension.

3' What are the indications of liver transplantation in children? 3+4+3Briefly describe PELD score. Enumerate the posttransplantation complications.

4. Define MKI in context of neuroblastoma. Give details of 2a4+4modified Shimada pathologic classification of neuroblastoma.Briefly describe risk based management of neuroblastoma.

5. Discuss the predisposing factors, clinical feature and 2+3+5management of liver abscesses in children.

6.' Describe the diagnosis medical and surgical management of 4+3+3/ neonatal hyperinsulinemic hypoglycemia of infancy.

7. Discuss the classification, diagnosis and surgicar 2+2+6management of choledochal cyst mentioning the pros andcons of different operative modalities.

8. Describe the different congenital anomalies involving the 4+6umbilicus with their embryological explanation with the helpof schematic diagrams.

9. Enumerate the antenatal sonographic features suggestive of 2+2+6uretero-pelvic junction obstruction. Cite Society of FetalUrology grading of hydronephrosis. Briefly mention themanagement algorithm for antenatally detectedhydronephrosis. P.T.O

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10. Define overactive bladder syndrome. Briefly mention the 2+B+snon-pharmocologic management of the syndrome, citingdoses, common side effects and formulations available.

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FINAL EXAMDECEMBER 20{1

NATIONAL BOARD OF EXAMINATIONS

POSSESSION/ASE OF CELL PHONES OR AIVY SUCH ELECTRONIC GADGETS IS NNT PFNMIT'TFN

FINAL EXAMDECEMBER 2011

NATIONAL BOARD OF EXAMINATIONS

PAPER. IIITime : 3 hoursMax. Marks : 100

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

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1. Briefly describe development of cleft lip and cleft palate.What do you understand by the cleft 'team' approach andwhat do these individual team members contribute to themanagement of the cleft patient.

2. Enumerate the indicators of augmentation of urinary bladder.What are the goals of such of a surgery? Briefly mention the-merits and demerits of different procedures used for bladderaugmentation.

3. Briefly mention the characteristic features of bladderexstrophy epispadias complex with schematic diagrams.Enumerate the various variants of BEEC. Briefly mention thedifferent philosophies of operative management of BEECwith their pros and cons.

4. Briefly mention the three common congenital cystic lesions ofthe lung as regards to the embryology, pathology, diagnosis,treatment and prognosis.

5. Briefly discuss management of anastomotic leak in anoperated patient of esophageal atresia and tracho-esphagealfistula in regard to incidence, etiology, diagnosis and

- management.

6. What is androgen insensitivity syndrome (AlS)? Brieflydiscuss the types, clinical features, diagnosis and treatmentof AlS.

7. Briefly mention the treatment options, indications for surgery,surgical procedures with their merits and demerits and followup strategy for vesico-ureteral reflux.

8. Briefly mention the prognostic factors affecting final outcomein subjects of biliary atresia. Briefly mention the diagnosisand various treatment strategies for biliary atresia.

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POSSESSIONruSE OF CELL PHONES OR ANY SACH ELECTRONIC GADGETS IS NOT PERMITTEDINSIDE THE EXAMINATION HALL

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FINAL EXAMDECEMBER 2OI1

NATIONAL BOARD OF EXAMINATIONS

9.

10.

Briefly discuss management of Wilm's tumor as regards todiagnosis, staging, various treatment strategies that haveevolved of clinical trials and their merits and demerits.

Briefly discuss management of antenatally diagnosedventriculomegaly as regard to definition, diagnostic iriteria,investigative modalities; different types of postnatalmanagement and outcome.

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