FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2017

POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
GASTROENTEROLOGY
PAPER II
GASTRO/J/17/10/II
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. Types of acute kidney injury in liver cirrhosis and
current diagnostic criteria for hepatorenal syndrome (HRS).
Current therapy for HRS and its results.
5+5
2. List the currently licensed directly acting antiviral agents
(DAAs) for HCV infection in India.
What are current recommendations for treatment of HCV
Genotype-3 infection among standard categories of patients
in India (treatment naive and treatment experienced, with and
without cirrhosis).
2+8
3. Current indications for treatment of chronic HBV infection.
What is the significance of commonly reported mutations in
chronic HBV infection?
Methods for preventing development of drug resistant
mutations.

4. Define hepatic encephalopathy
Vienna classification as well as pros and cons of the 'covert'
and HE terminology.
Role of various factors contributing to pathogenesis of HE.

5. Concept of acute on chronic liver failure (ACLF).
Merits of the different definitions of ACLF proposed by the
CLIF Consortium, APASL ACLF Consortium (AARC) and
World Gastroenterology Organization (WGO).
What is the PIRO concept of ACLF? (PIRO: Predisposition-
Insult-Response-Organ dysfunction).

6. Classify cystic neoplasms of the pancreas.
Algorithm for investigating these lesions and role of
diagnostic EUS in these patients.
4+6
7. Classify and outline management of choledochal cysts.
What is anomalous pancreatobiliary ductal union
What is its significance?
7+3
8. Definition and evaluation of recurrent acute pancreatitis
(RAP).
What are the genetic abnormalities reported in RAP and
chronic pancreatitis with special emphasis on Indian
patients?
5+5
9. Epidemiology of gall bladder cancer in India and its
etiopathogenetic factors.
Various methods for staging and assessing resectability in
gall bladder cancer.
Non-surgical palliation of biliary obstruction in GBC.

10. Current indications and timing for liver transplantation in liver
cirrhosis.
Post transplant immunosuppression.
5+5