Kathmandu University
BIRAT MEDICAL COLLEGE
Budhiganga-02, Tankisinuwari, Morang

Level: III MBBS (Batch: 2023)
Semester: 5th
Time: 2 hrs. 30 mins.
Date: February 18, 2026

Examination: End-Semester
Subject: Paediatrics
Marks: 50

#INSTRUCTION TO THE CANDIDATE

• Answer each section in a separate answer book.

• Write brief, relevant and legible answers.

• Illustrate your answer with well labeled diagrams where required.

• All questions are compulsory.

#SECTION ‘B’

Short Answer Questions [5Q × 6 = 30 marks]

1. Write down the clinical features of severe malaria and its management.
   [3+3=6]

2. Write down the WHO classification of PEM (Protein Energy Malnutrition). Enumerate the steps of Management of Severe acute malnutrition in children.
   [2+4=6]

3. Define growth and development and discuss the factors affecting normal growth and development.
   [2+4=6]

4. How will you screen a child with an immunodeficiency disorder?
   [6]

5. Define failure to thrive. Write down common causes of Failure to thrive.
   [2+4=6]

#SECTION ‘C’

Problem Based Questions / Modified Essay Questions [2Q × 10 = 20 marks]

#Problem–I

A 12-year-old boy presents with high-grade fever for 8 days, headache, abdominal pain, and constipation.
On examination, temperature is 39.5°C with relative bradycardia and mild splenomegaly.

a. What is the most likely diagnosis? Name the pathogens causing such illness.
[2]

b. What are the appropriate investigations you do for such cases?
[3]

c. Enumerate the management of such illness.
[3]

d. List out the complications if untreated.
[2]

#Problem–II

A ten-year boy came in OPD of BMCTH with a sudden onset of high fever (40°C/104°F), severe headache, and intense joint and muscle pain. He also experiences pain behind his eyes, nausea, and a faint red rash on his arms and legs.

a. What is your diagnosis?
[2]

b. How do you investigate and what are the expected findings?
[2+3=5]

c. How will you manage this case?
[3]