55 - Risk factors of Gall Bladder carcinoma

1. Gall stones ( 90% patients with carcinoma GB have gall stones. size of stone has a direct relationship with development of carcinoma , the risk is ten times more for larger stones (3 cm in diameter ) than for stones less than 1 cm in diameter. Risk is higher with symptomatic than asymptomatic stones ).
2. Adenomatous gall bladder polyps ( particularly polyps larger than 10mm )
3. Calcified ( procelain ) Gall bladder
4. Choledochal cyst
5. Estrogens
6. Anomalous pancreaticobiliary duct junction
7. Exposure to carcinogens like azotoulene and nitrosamine
8. Typhoid carriers
9. Sclerosing cholangitis
10. Cholecystoenteric fistula
11. Ulcerative colitis


*ASI surgery mentions two other risk factors which are chemicals used in rubber industry and use of adulterated mustard cooking oil in India .

54 - Drugs causing pancreatitis

Definite Causative agents of pancreatitis :

1. 5-Aminosalicylate
2. 6-Mercaptopurine
3. Azathioprine
4. Cytosine arabinoside
5. Dideoxyinosine
6. Diuretics
7. Estrogens
8. Furosemide
9. Metronidazole
10. Pentamidine
11. Tetracycline
12. Thiazide
13. Trimethoprim-sulfamethoxazole
14. Valproic acid

Probable Causative agents of pancreatitis  :

1. Acetaminophen
2. α-Methyl-DOPA
3. Isoniazid
4. l-Asparaginase
5. Phenformin
6. Procainamide
7. Sulindac

( DOPA, dihydroxyphenylalanine )

P.S : This question is very frequently asked in PGI chandigarh PUNJAB entrance examination .