@ All of the following is true about developmental milestones is true except a) unable to sit in 9 months b) 2 words with meaning

by 1 and 1/2 years c) pincer grasp by 9 months

Ans A Most babies can sit well without support by the time they're nine months old
Expressive Language Milestones 11mo:1wordwithspecificMamaandDada 12 mo: 2 words 13 mo: 3 words 15mo:immaturejargoning 16 mo: 4-6 words 17mo:maturejargoning 18 mo: 7-10 words Expressive Language Milestones 19 mo: 20 words 21 mo: two word phrases 26 mo: Pronouns 30 mo: 250 words, repeats 2 digits 36 mo: 3 word sentences, repeat 3 digits, @ most common comliplication seen in baby birth wt< 1000gm a)glaucoma b)Retinopathy of prematurity c) Ans b

More than 80% of premature babies who weigh less than 1000 grams (2.2 lbs) will develop ROP.

@ Premature baby wth seizure on 2nd day.. next investigation a) Transcranial Usg b) Ct c) Mri d) Xray

Ans A Hypoxic-ischemic encephalopathy (HIE): HIE secondary to perinatal asphyxia is the commonest cause of seizure in neonates, constituting 50-65% of all seizures. Most seizures (5065%) due to HIE start within 12 hrs, remaining have an onset within 24-48 hours. Additional problems like hypoglycemia,

hypocalcemia and intracranial hemorrhage may co-exist in neonates with perinatal asphyxia and these should always be excluded. Subtle seizures are the most common type of seizures following HIE. Intracranial hemorrhage: Seizures due to sub-arachnoid, intraparenchymal or subdural hemorrhage occur more often in term neonates, while seizures secondary to intraventricular hemorrhage (IVH) occur in preterm infants. Most seizures due to intracranial hemorrhage occur between 2-7 days. Seizures occurring in a term well baby on day 2-3 of life is often due to sub-arachnoid hemorrhage Seizures occurring on day 0-3 may be related to perinatal asphyxia, intracranial hemorrhage, metabolic and developmental defects. Seizures occurring on day 4-7 may be due to sepsis, meningitis, metabolic causes and developmental defects. Neurosonography is an excellent tool for detection of intraventricular and parenchymal hemorrhage but is unable to detect SAH and sub-dural hemorrhage. It should be done in all infants with seizures. A CT scan should be done in all infants where an etiology is not available after the first line of investigations. It can be diagnostic in sub-arachnoid hemorrhage and developmental malformations. A MRI scan is indicated only if investigations do not reveal any etiology and seizures are resistant to usual anti-epileptic therapy. It can be diagnostic in cerebral dysgenesis, lissencephaly and other neuronal migration disorders.

@ 2 year old child with solid mass in kidney with right hand and leg longer..diagnosis is a) nephroblastoma b) neuroblastoma c) wilms tumor d) angiomyolipoma Ans c BeckwithWiedemann syndrome

Five common features used to define BWS are: macroglossia, macrosomia (birth weight and length greater than the 90th percentile), midline abdominal wall defects (omphalocele/exomphalos, umbilical hernia, diastasis recti), ear creases or ear pits, and neonatal hypoglycemia (low blood sugar after birth). Most children with BWS do not have all of these five features. In addition, some children with BWS have other findings including: nevus flammeus, prominent occiput, midface hypoplasia, hemihypertrophy, genitourinary anomalies (enlarged kidneys), cardiac anomalies, musculoskeletal abnormalities, and hearing loss. Also, some premature newborns with BWS do not have macroglossia until closer to their anticipated delivery date. @ All are common cause of neonatal sepsis in India except a)Klebsiella b)E coli c) Group B streptococcus d)Staphylococcus Neonatal sepsis was one of the common causes of neonatal mortality contributing to 23% of all neonatal deaths3. Klebsiella pneumoniae was the most frequently isolated pathogen (31.2%), followed by Staphylococcus aureus (17.5%) among the intramural live births. Among extramural babies admitted for neonatal problems, Klebsiella pneumoniae was the commonest organism (36.4%), followed by Staphylococcus aureus (14.3%) and Pseudomonas (13.2%).

Early onset sepsis: Early onset sepsis usually presents within the first 72 hours of life. he main organism is group B streptococci (GBS) Late onset sepsis: Late onset sepsis usually presents after 72 hours of age

@Retts disorder is associated with all except a) macrocephaly b) severe mental retardation c) seizures Ans A Rett syndrome, originally termed as cerebroatrophic hyperammonemia,[is a neurodevelopmental disorder of the grey matter of the brain[2] that almost exclusively affects females but has also been found in male patients. The clinical features include small hands and feet and a deceleration of the rate of head growth (including microcephaly in some). Repetitive

stereotyped hand movements, such as wringing and/or repeatedly putting hands into the mouth, are also noted.[3] People with Rett syndrome are prone to gastrointestinal disorders and up to 80% have seizures.[4] They typically have no verbal skills, and about 50% of individuals affected do not walk. Scoliosis, growth failure, and constipation are very common and can be problematic # ENT @ Father of neuro otology? a) DR. WILLIAM F. HOUSE

William F. House, DDS, MDThe Father of Neurotology

William F. House became forever known to many of us, as "Dr. Bill." n 1946, as a Navy dentist, he realized that sitting alongside a patient was fine while working on their lower teeth, but while working on the upper teeth, it made a lot of sense to have the patient recline. His captain cautioned that although having the patient lying down might be okay for males, the female patients might be concerned Dr. Bill would rape them! (Yes, the captain actually told Dr Bill that!). Of course, every dental patient across the world now has their teeth operated on while reclining. Another improvement he made with regard to dentistry was a diagnostic X-ray holder, which has been modified and remains in use today. Dr. Bill pioneered the "facial recess" approach @ Patient presented with persistant ear pain and discharge, retro orbital pain, mastoidectomy done, still continued diagnosisa) Acute petrositis Ans A Symptoms oof petrositis are usually subtle. Typically, a patient who has had prior mastoid surgery will complain of persistent infection and deep facial pain. In a series of eight patients, four patients had deep facial pain; only two had abducens paralysis, and two had meningitis @ old guy with 3m h/o hearing loss with intact tympanum with fluid behind TM further management a) investigate for nasopharyngeal CA

SOM is not uncommon in the diagnosis of nasopharyngeal carcinoma, and adult-onset SOM is otherwise distinctly uncommon, this provides a good opportunity for early recognition and, perhaps, better control of nasopharyngeal carcinoma.
@ complete cartilagea) thyroid b) cricoid c) cuneiform d) epiglottis

Ans B The cricoid cartilage is the only complete ring of cartilage around the trachea.

@ Facial recess boundaries include all except a) incus b) chorda tympani c) Facial nerve Ans d Facial recess Introduction: Is defined as an aerated extension posterior superior portion of the middle ear cavity medial to the tympanic annulus and lateral to the fallopian canal . Boundaries: o Medial Facial nerve o Lateral Tympanic annulus , chorda tympani o Superior Incus buttress (near the short process of incus) Running through the wall between these two structures with varying degrees of obliquity is the chorda tympani nerve. Chorda tympani nerve always run medial to the tympanic membrane. Drilling in this area between the facial nerve and annulus in the angle formed by the chorda tympani nerve leads into the middle ear cavity. This surgical approach to the middle ear cavity is known as facial recess approach @75yr diabetic with granulation tissue at external auditory canal with facial nerve palsy a) malignant otitis externa Ans A @ Left sided ear discharge with normal Tympanic membrane with posterior canal wall dehiscence ..diagnosis is a) Keratosis obturans b) Carcinoma of external auditory canal c) Chronic otitis media d) Otitis externa Ans a

@ Thumb sign on x ray is seen in a) Croup b) Epiglottitis Ans B @ Child with croup, well hydrated, feeding well, consolable. T/t is A) dexamethasone Ans A Steroids Corticosteroids, such as dexamethasone and budesonide, have been shown to improve outcomes in children with all severities of croup.[7] Significant relief is obtained as early as six hours after administration.[7] While effective when given orally, parenterally, or by inhalation, the oral route is preferred.[4] A single dose is usually all that is required, and is generally considered to be quite safe.[4] Dexamethasone at doses of 0.15, 0.3 and 0.6 mg/kg appear to be all equally effective

@. . patient presents with 4x5 cm lymph node ,mobile firm , not fixed in left lateral neck. Clinical examination and scans reveal no other nodes. no other symptoms.Examination of nose ,oral cavity and pharynx is normal What is the stage? a. T0N2Mx b. T1 N2aM0 c. T0N2aMx Ans b

TX Primary tumor cannot be assessed . T0 There is no evidence of primary tumor. Tis Carcinoma is in situ.

N2a Metastasis is in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension.

Distant Metastasis (M)

MX Distant metastasis cannot be assessed.
. M0 There is no distant metastasis. . M1 There is distant metastasis. @ Ideal PAtient for BAHA ? a) boy with bilateral microtia and auditory canal atresia

Ans A The BAHA is a unique implantable device that helps people with conductive or mixed hearing loss Baha Implantation (Bone Anchored Hearing Appliance)
# Forensic @ A girl coming with kerosene like odour on breath, lacrimation, pin point pupil, rhinorrhea, weakness. Which statement is false: a. atropine is the antidote b. plasma AChesterase levels has no prognostic value c. atropine reverses neuromuscular weakness d. Activated charcoal has no proven benefits ANS C