Download DNB 2016 Dec SURGICAL GASTROENTEROLOGY PAPER 1 Question Paper

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FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2016

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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.
4. Do not leave any blank pages between two answers.

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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.

Write short notes on:

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1. a) Enumerate causes of upper gastrointestinal haemorrhage. 2+5+3
   b) Provide an algorithm for the resuscitation and evaluation of a patient with massive upper gastrointestinal haemorrhage.
   c) List the indications for surgical intervention in a patient with massive upper gastrointestinal haemorrhage.
2. a) Couinaud’s segmental anatomy of the liver- Diagrammatic representation. 4+6
   b) Glissonian approach to liver resection.

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3. Compare the risks and benefits of trans-thoracic vs trans-hiatal esophageal resection in a middle third esophageal carcinoma. 5+5
4. a) Lymphatic drainage of the stomach. 6+4
   b) Draw a diagram to illustrate-the position of various lymph node stations in relation to D2 gastrectomy for carcinoma stomach.
5. a) Evaluation and management of an incidentally detected, (3+4)+3 asymptomatic gastrointestinal stromal tumour (GIST) in the fundus of the stomach.
   b) List the indications for adjuvant therapy in such tumors.

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6. a) List causes of faecal incontinence. 3+7
   b) Pathophysiology of faecal incontinence.
7. How would you assess and manage a duodenal stump ‘blow out’ after a BILLROTH II gastrectomy for a giant duodenal ulcer? 3+7
8. a) Indications and contraindications for neoadjuvant (4+3)+3 chemoradiotherapy in a patient with esophageal carcinoma.
   b) How will you assess such a patient after completion of therapy?

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9. Pathophysiological basis of pain in patients with chronic pancreatitis. 10
10. a) List motility disorders of the esophagus. 3+7
    b) How will you evaluate a patient with a suspected motility disorder of the esophagus?