FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2018

POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.
EMERGENCY MEDICINE
PAPER-III
EM/J/18/52/III
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. A 22-year-old male presented with fever and jaundice of five
days duration. Clinical examination shows moderate jaundice
and splenic enlargement.
Enumerate differential diagnosis of fever with jaundice?
What are the various forms of complicated malaria?
How will you confirm diagnosis of malaria?
ED management of the present case if he was found to have
malaria.

2. Define hypoglycaemia.
Enumerate causes for hypoglycaemia.
Clinical features of hypoglycaemia.
How do you manage sulfonylurea induced hypoglycaemia?

3. Enumerate various diving-related emergencies.
Pathophysiology of decompression sickness.
Clinical features of decompression sickness.
Classification of decompression sickness.

4. Enumerate causes for acute respiratory distress syndrome
(ARDS)
Berlin diagnostic criteria for ARDS.
Ventilator management of ARDS.

5. Clinical features of tricyclic antidepressant overdose.
What are the ECG changes in a patient with tricyclic
antidepressant overdose?
How do you manage a patient with tricyclic antidepressant
overdose?

6. Clinical features of neuroleptic malignant syndrome (NMS).
Describe any one diagnostic criteria for NMS.
How do you differentiate between NMS and serotonin
syndrome?
Treatment of a case with NMS.


7. Enumerate various generalized skin disorders.
Clinical features of erythema multiforme.
Clinical features of toxic epidermal necrolysis.
Management of a patient with toxic epidermal necrolysis.

8. A 22-year-old medical student presented with an attempted
suicide. He had attempted suicide twice before but was
unsuccessful. He says he feel depressed.
How will you assess suicide risk in this patient?
How will you plan ED disposition?
5+5
9. Enumerate inherited and acquired clotting disorders
(thrombophilia).
Pathophysiology of hemophilia A
Clinical features of hemophilia A
Management of a patient with hemophilia presenting with
hemarthrosis.

10. Enumerate causes of rhabdomyolysis.
Clinical features of rhabdomyolysis.
Diagnosis of rhabdomyolysis
Treatment of rhabdomyolysis in ED.