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NATIONAL UNIVERSITY OF IRELAND, GALWAY
Ollscoil na hEireann, Gaillimh
4MB3 SUMMER EXAMINATIONS 2010 P A E D I A T R I C S MD
Professor Chris O Callaghan
Professor B.G. Loftus Dr. E. Moylett
Dr D. Gallagher Dr. R. Geoghegan
PAPER 1 This written examination is in two parts: Paper 1 (2 X MEQS) 1 hour Paper 2 (4 X Short Answer Questions) 2 hours
Number of pages: 9
INSTRUCTION TO CANDIDATES:
The following instructions apply to paper 1 only:
TIME ALLOWED: 1 Hour
ANSWER BOTH MODIFIED ESSAY QUESTIONS (MEQ).
ANSWER IN THE SPACES PROVIDED ON THE QUESTION PAPER.
ENSURE TO ADD YOUR NAME AND ID NUMBER AT THE START OF BOTH QUESTIONS:
RETURN THE QUESTION PAPER TO INVIGILATOR ON COMPLETION.
Remember: The MEQ is structured in such a way that marks are awarded for specific points in each section All answers should refer to the particular case history If answering in a list where X answers are requested only the first X answers will be accepted. All subsequent answers will not be considered even if correct. Thus marks will be lost if the answer is badly organized or particularly if irrelevant or incorrect material is used. You will receive NO marks for an incorrect answer or a question which is not answered
PAPER 1
CANDIDATE NAME: …………………………………………………………..
CANDIDATE I.D………….……………………………………………………..
Question 1 You are a paediatrician in a general out-patient clinic. An 18 month old boy, Sean, is brought to see you. His mother is worried that he is not walking. She reports that he is very interested in toys, can say Da-Da, Ma-Ma, and points on request to head, eyes, ears etc, and she thinks he can hear and understand what she says to him. He sat independently at 11 months old and is now crawling but is quite content to sit and play with his toys.
Are his development milestones normal? (2marks)
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What are the specific concerns? (2marks)
List 3 possible causes of late walking (3 marks)
What additional information is relevant? (1 mark)
Given the clinical findings, what abnormality would you expect from your work up? (5 marks)
Who else should see Sean and meet the family? (3 marks)
List 3 additional complications that may be present or develop? (3 marks)
Proceed to Question 2 on page 5.
QUESTION 2
CANDIDATE NAME: …………………………………………………………..
CANDIDATE I.D………….……………………………………………………..
Question 1 An 18 year old primagravida presents for the first time with spontaneous rupture of the membranes in the second trimester. Ultrasound examination indicates a 23 week gestation pregnancy.
Name 3 complications of rupture of the membrane at this stage in the pregnancy? (3 marks) ____________________________________________________________________
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She is managed with bed rest, given antibiotics and also a course of steroids. She goes into spontaneous labour at 26 weeks gestation and delivers a male infant that weighs 730 grams. He is active at birth.
Apart from airway, breathing and circulation, list two priorities in immediate management? (4 marks)
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The infant is admitted to the Neonatal Unit. He develops significant respiratory distress associated with prematurity and requires mechanical ventilation.
What 3 possible respiratory complications may occur over the next two to three days? (3 marks)
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The remainder of the baby’s hospital course is mostly uneventful. He has Bronchopulmonary Dysplasia but it is clinically mild and his oxygen therapy is discontinued at ten weeks old. Vaccinations are initiated and the baby is ready for discharge home three months after birth, on his due date of October 1st.
What additional protective treatment should be initiated at this point? (4 marks)
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What is the mode of action of this treatment? (4 marks)
Proceed to Paper 2 on page 8.
NATIONAL UNIVERSITY OF IRELAND, GALWAY
Ollscoil na hEireann, Gaillimh 4MB3 SUMMER EXAMINATIONS 2010
P A E D I A T R I C S MD
Professor Chris O Callaghan
Professor B.G. Loftus Dr. E. Moylett
Dr D. Gallagher Dr R Geoghegan
PAPER 2
INSTRUCTIONS TO CANDIDATES (PAPER 2 ONLY).
TIME ALLOWED: 2 Hours PLEASE ANSWER ALL QUESTIONS IN ANSWER BOOKS PROVIDED. ANSWER ALL SECTION ON SEPARATE ANSWER BOOKS
SECTION A
Q.1. Write short notes on:
a) Acute limp in a 2-year old child b) Constipation in an 8-year old child c) Wilm’s Tumor d) Vesicoureteric reflux
Q.2. Outline your acute management of:
a) Febrile seizure in a 12-month old infant presenting to the ER with ongoing convulsive activity. b) A 2-week old infant with a 24-hour history of lethargy, fever to 39˚C, and reduced oral intake. c) An 18-month old with fever, acute onset respiratory distress and audible stridor. d) An unwell appearing 4-year old child with abdominal pain, increased urine output, recent weight loss and a sweet smell from their breath.
Proceed to page 9
