FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2018

POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.
GASTROENTEROLOGY
PAPER-II
GASTRO/J/18/10/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 question 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. Define various diagnostic criteria for acute on chronic liver
failure.
Management of a patient with acute on chronic liver failure
4+6
2. Classify and enumerate various cystic lesions of the
pancreas.
Investigational and management approach to a patient with
Intraductal papillary mucinous neoplasm (IPMN)
4+6
3. Definition, causes and approach to a case of indeterminate
biliary stricture
Dominant stricture in primary sclerosing cholangitis
5+5
4. What are causes of dyspnoea in patients with cirrhosis of
the liver?
Pathophysiology and management of Hepatopulmonary
syndrome.
2+8
5. Pathophysiology of pain in chronic pancreatitis
Discuss the various modalities of treatment for patients with
chronic pancreatitis for pain relief
5+5
6. Enterohepatic circulation of bile acids
Brown pigment gallstones: Pathophysiology and
management
5+5
7. Management of chronic hepatitis C virus in a patient with
chronic renal failure who is a prospective kidney transplant
candidate.
Write a short note (with a diagram) on the site of action of
different classes of direct acting antiviral drugs against
hepatitis C virus.
5+5
8. Non-invasive assessment for liver fibrosis and how does it
help in clinical management of patients.
Newer drugs with their mechanism of action for treating nonalcoholic
fatty liver disease
5+5
P.T.O.
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2018

POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.
9. Immunosuppression protocol in liver transplantation.
Fibrosing cholestatic hepatitis
5+5
10. How would you manage a patient with acute necrotizing
pancreatitis who is in the 3rd week of illness and running
fever for 5 days?
When would you suspect and how would you diagnose
microlithiasis in a patient with acute idiopathic
pancreatitis?
7+3