FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2017

POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
PAEDIATRIC SURGERY
PAPER I
PED.SURG/J/17/29/I
Time 3 hours
Max. Marks 100
Important instructions:
• 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.
• 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. Define MKI.
Shimada prognostic classification of neuroblastoma.
Biochemical tests to be performed in neuroblastoma for
diagnosis and prognosis.

2. Enumerate any five trace elements.
Mention clinical manifestations of deficiency and their role in
metabolism (for any two trace elements).
How will you calculate TPN (Total Parenteral Nutrition) for a
surgical neonate?

3. Fetal circulation along with schematic representation.
Enumerate three changes in circulation that happen at birth.
Schematic representation highlighting the transition from fetal
circulation to adult circulation.

4. Effect of surgery in context of a surgical neonate:
Glucose metabolism
Fat metabolism
Protein and amino acids metabolism

5. Five phases of lung development.
2X5
6. Enumerate prognostic factors for a neonate with congenital
diaphragmatic hernia (CDH).
Paradigm shift in the management of CDH in the last 2 decade.
5+5
7. Nephron saving surgery in Wilms' tumor.
Indications of nephron saving surgery.
Contraindications of nephron saving surgery.

8. Impact factor of a medical journal.
Case controlled studies.
Five parameters to decide efficacy of any investigation.
Citation Index.

9. Liver transplantation under following heads:
Indications
Assessment of liver transplant urgency
Advances in surgical techniques
Post operative immunosuppression

10. What is standard 4-view FAST examination?
Grading of splenic injuries.
Three common complications seen in patients managed
conservatively for splenic trauma.
What does OPSI stand for?