Download DNB 2015 Dec GASTROENTEROLOGY II Question Paper

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FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2015

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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.

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• 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:

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1. a) What are the risk factors to predict bleeding from esophageal varices?
   b) Pharmacotherapy of acute variceal bleed.
   c) Primary prevention of variceal bleed.
   d) Secondary prevention of variceal bleed.
2. a) Medical therapy of pain due to chronic pancreatitis.
   

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   b) Role of endotherapy in complications of chronic pancreatitis.
   c) Role of surgery in complications of chronic pancreatitis.
3. Indeterminate biliary structures:
   a) Various modalities for diagnosis & their advantages & limitations.
   b) Treatment strategy.

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4. HBsAg quantification:
   a) Role of HBsAg quantification in HBeAg positive and HBeAg negative patients.
   b) Correlation of HBsAg with HBV DNA levels.
   c) Significance of HBsAg quantification and treatment response.
   d) The ‘Stop Rule’ for treatment using HBsAg quantification.

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5. Liver transplantation:
   a) Long term complications after liver transplant.
   b) Risk factors for post transplantation lympho proliferative disorder (PTLD).
   c) Clinical presentation of PTLD.
6. Acute on chronic liver failure (ACLF):
   

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   a) Compare definitions according to APASL, AASLD, EASL Consensus and WGO.
   b) Pathophysiology.
   c) Specific management options for ACLF.

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FINAL EXAM NATIONAL BOARD OF EXAMINATIONS

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7. An epidemiologist is conducting a survey to evaluate the presence of hepatitis B infection among the different age groups in a village with 5 lakh population. He also wants to identify the possible risk factors that may be associated with hepatitis B injection in this population.
   a) Briefly describe the kind of study that is being conducted.
   

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   b) Describe the different sampling methods that can be used.
   c) Define the common measures of association of risk factors that the epidemiologist can use.
   d) What kind of bias is the researcher likely to encounter in this study?
8. Regarding bile duct calculi:
   a) Define the ‘difficult’ bile duct calculus.
   

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   b) What are different techniques available for bile duct clearance in these patients?
   c) Discuss results with these techniques.
   d) Suggest an algorithmic approach to bile duct clearance in patients with ‘difficult’ calculi.
9. Histological features of following diseases:
   a) Alcoholic hepatitis.
   

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   b) Autoimmune pancreatitis.
   c) Primary biliary cirrhosis.
   d) Non cirrhotic portal fibrosis.
   e) Primary sclerosing cholangitis.
10. Hepatitis E virus infection:
    

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    a) Chronic Hepatitis E infection.
    b) Extrahepatic manifestations.
    c) Treatment of chronic HEV infection.
    d) HEV Vaccine.

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