FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2016
POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
GASTROENTEROLOGY
PAPER I
GASTRO/J/16/10/I
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. Role of Toll Like Receptors in Innate Immunity.
Genetics of inflammatory bowel disease.
5+5
2. Pathogenesis of antibiotic induced/associated diarrhea and
Pseudomembranous colitis.
Pharmacological basis of the use of 5-HT3 antagonists in IBS
diarrheal type.
5+5
3. Draw a diagram showing the structure of the various layers of the
human colon. What changes are expected in a patient with long
standing ulcerative colitis.
Draw a diagram of the micro-anatomy of the liver with reference to
the acinar structure.

4. Anatomical basis of Zenker's Diverticulum.
Structure and function of the Lower Esophageal Sphincter.
5+5
5. Role of NOD-2/CARD-15, Autophagy and TH17 cells in the
pathogenesis of Crohn's disease.
10
6. Embryological basis of P.divisum
Life cycle of Strongyloides stercoralis infection in humans.
5+5
7. Principle of NBI (Narrow Band Imaging) and its utility in G I disease.
Pharmacological basis of drug interaction in a patient on Clopidogrel
who is recently started on Omeprazole (Proton Pump Inhibitor).
Which would be the safest PPI for this patient: give justification.

8. Define the term "Hepatic Granuloma".
Various causes of Hepatic Granulomas.
Draw a diagram of a hepatic granuloma as seen on liver biopsy in a
patient with disseminated tuberculosis.

9. Anatomical structure of the human anal canal.
Structure and function of "M" cells and Peyer's patches.
5+5
10. Pathophysiology diagnosis of Protein Losing Enteropathy. 5+5