Download DNB 2017 Dec GASTRO GASTRO PAPER II Question Paper

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GASTROENTEROLOGY
PAPER — I

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Important instructions:

1. Attempt all questions in order.
2. Each question carries 10 marks.
3. Read the question carefully and answer to the point neatly and legibly.

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4. Do not leave any blank pages between two answers.
5. Indicate the question number correctly for the answer in the margin space.
6. Answer all the parts of a single question together.
7. Start the answer to a question on a fresh page or leave adequate space between two answers.
8. Draw table/diagrams/flowcharts wherever appropriate.

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Write short notes on:

1. A 30 year old primigravida presented to outpatient department with jaundice of 7 days.
   a. What are the causes of jaundice in her? (3)
   b. How shall you establish diagnosis? (4)
   c. How will you treat her? (3)

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2. A 50 year old male with advanced cirrhosis, underwent liver transplantation. On Day 6, post transplant, he developed jaundice and there was an increase in-ALT, AST and alkaline phosphatase.
   a. What are the possible causes? (3)
   b. How shall you confirm diagnosis? (4)
   c. How shall you treat? (3)
3. Discuss pancreas divisum under the following headings:
   

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   a. Embryological-basis (4)
   b. Anatomical variants (with diagram) (4)
   c. Which patients with pancreas divisum have the best response to endotherapy? (2)
4. a. Classify benign biliary stricture (with representative diagram) (4)
   b. Management based on site of stricture. (4)
   

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   c. Indications for surgery. (2)
5. a. Discuss replication cycle of Hepatitis B virus to highlight potential target for development of therapeutic strategies (6)
   b. What are the evolving drugs for Hepatitis B virus? (4)
6. a. Clinical presentation and management of papillary stenosis in HIV patient with CD4 count < 200/mm?. (5)
   b. Etiology and histology of vanishing bile duct syndrome. (5)

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7. a. Describe the spectrum of ductal plate malformation (5)
   b. How do you treat congenital hepatic fibrosis? (3)
   c. Enumerate associations of congenital hepatic fibrosis. (2)
8. a. Differences in the pathophysiology of hepatic encephalopathy due to acute live failure, acute and chronic liver failure and chronic liver disease. (7)
   b. Outline their management. (3)

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9. a. Micro-anatomy of Pancreatic Islets (with diagram) (4)
   b. Diagnostic approach for Pancreatic NET. (3)
   c. Treatment options for metastatic pancreatic NET. (3)
10. a. Anatomy of hepatic micro-circulation in advanced cirrhosis versus healthy liver. (4)
    b. What is the effect of Nitric Oxide (NO) on the hepatic micro-circulation? (3)
    

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    c. Role of hepatic stellate cells in health and disease. (3)

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