PAEDIATRIC LONG CASES- COMMON QUESTIONS

TYPE 1 DM
1.How do you diagnose type 1 DM
-It is based on symptoms suggestive of hyperglycaemia e.g polyuria, polydipsia, loss of weight and
confirmation by high glucose level (fasting of random) . Sr C-Peptide will be low and the
autoantibodies Anti Islet cell antibodies, Antibodies to insulin (IAA), glutamic acid decarboxylase
(GAA or GAD) etc
2. How does it differ from Type 2 DM

3.How do you diagnose Diabetic Ketoacidosis(DKA)?

4. Principal of managing DKA?

-ABC
-Slow Hydration
-slow correction of hyperglycaemia to prevent cerebral edema
-monitoring and correction of electrolytes
-treat associated infection
* correction of dehydration will correct acidosis. Avoid sodium bicarbonate to correct acidosis

5.Principal of management of Type 2 Diabetes

-Educate patient and caregivers
-Optimal sugar control with diet and insulin
-Learning of meal portions and carbohydrate counting .Adjustment of insulin according to meals
-Monitoring of complications and growth
-Address any school issues

6. What type of Insulin do you know?

-Short acting, Rapid acting, Intermediate acting , Basal bolus

NEPHROTIC SYNDROME
1.What is Nephrotic Syndrome?
2.Pathophysiology of edema in nephrotc syndrome?
3.Define steroid sensitive, steroid resistant, steroid dependent, Remission, relapse, frequent
relapser, steroid toxicity?
4. What are the complications long term steroids?
5. What are the others drugs used in nephrotic syndrome?
6.When do you use 2nd line medications?

THALASSAEMIA
1. What is thalassaemia
2.How to diagnose thalassaemia
3.What is the inheritance?
4.Why hepatosplenomegaly in thalassaemia?
5.Complications of iron toxicity? Usual cause of death?
6.What is hypersplenism?
7. How to prevent hypersplenism?
8.What is the risk the patient may face post splenectomy?
6. Can Thalassaemia be cured?
CEREBRAL PALSY (CP)
1.What is cerebral palsy?
A Motor disorder of posture and movement due to non progressive lesion/injury to developing
brain.
2.Common causes of CP?
-Intrauterine infection, congenital brain anomaly, hypoxic ischaemic encephalopathy, perinatal
asphyxia, Intraventricular haemorrhage, neonatal hypoglycaemia, meningitis, encephalitis, severe
hyperbilirubinaemia, intracerebral trauma etc
3.Types of CP?
4. Principal of management of CP
Multidisciplinary involving
-Paediatricians for overall health
-physiotherapist to prevent contractures and maintain adequate muscle power
-occupational therapist to improve function
-rehabilitation specialist to assist in mobilisation and special gadgets/aid
-Welfare services for financial assistance if needed
-orthopaedic if any tendon release procedures or spine support
-special schooling if no or no serious intellectually impairment
-treat associated conditions e.g epilepsy, constipations

EPILEPSY
1. Define epilepsy
2.Types of epilepsy
3.What is status epilepticus
4.Principal of managing Status epilepticus
-ABC
-abort the seizures by anticonvulsant e.g diazepam, phenytoin, phenobarbitone
-correct hypoglycaemia or precipitating factors
-prevent recurrence

5. Common maintenance anticonvulsant in epilepsy?

- sodium valproate, carbamazepine, levetiracetam, clonazepam etc

MUSCULAR DYSTROPHY
1. What is it
2. Inheritance of Duchenne Muscular dystrophy(DMD)
3.How to diagnose DMD
4.Principal of management

SPINA BIFIDA WITH NEUROGENIC BLADDER

1. What is spina bifida. Types?
2.Can neural tube defect be prevented?
3. Associated condition
4. Principal of management

BRONCHIAL ASTHMA
1. Define bronchial asthma
-Chronic reversible inflammatory airway disease due to hyper respnsiveness to external
trigger/antigen resulting in airway narrowing
2.What are atopic illnesses
-bronchial asthma, allergic rhinitis, atopic eczema & allergic conjunctivitis
3.How do you classify asthma control
4.How do you classify acute asthma
5.How do you manage acute severe asthma

HAEMOPHILIA
1. What is Haemophilia A? What other type of haemophilia do you know of?
2.Inheretance
3.Pathophysiology of bleeding
4.What is target joint
5.Principal of management of haemarthrosis

VON WILLEBRAND DISEASE

1. What is vWD? How many types do you know?
2.Inheritance
3.Pathophysiology of bleeding
4.Principal of managing bleeding

CHRONIC IMMUNE THROMBOCYTOPAENIC PURPURA (Chronic ITP)

1. Define acute ITP? When do you label as Chronic ITP
2.What are the causes of Acute ITP
3.Differential diagnosis of thrombocytopenia
4.Management of Acute ITP

RHEUMATIC HEART DISEASE (RHD)

1. What is the common cause of RHD
2. How do you diagnose Acute Rheumatic fever
3.Common valve affected
4.How to prevent recurrence of rheumatic fever
5.How long to use penicillin prophylaxis