FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2017

POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
MEDICAL ONCOLOGY
PAPER III
MEDONCO/J/17/17/III
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. A 38 year old male is receiving imatinib mesylate for chronic myeloid
leukemia (CML).
Briefly mention plan for monitoring response at various time points.
Compare evaluation with cytogenetics, FISH and PCR.
What is the principle of real time quantitive PCR (RQPCR) for
monitoring CML?
Concept of treatment free remission in CML.

2. Epidemiology, risk factors, pathology, genetic alterations and clinical
staging for pancreatic cancer.

3. AIDS related malignancies:
List the AIDS related cancers.
Investigations for a patient with AIDS associated lymphomas.
Treatment for stage II DLBC NHL in a 40- year-old male who is
on anti-retroviral treatment (ART).

4. Epidemiological link between obesity and cancers at various sites.
'Cancer Control Program' in India.
List methods for screening of cervical cancer.

5. Mention indications for germline predisposition testing in patients
with breast and ovary cancer.
Mention important hereditary syndromes in this context.
Mention various preventive strategies for patients with strong family
history for breast cancer.

6. Mention methods of assessing performance status in children and
adult (one each).
Merits and limitations of prescribing chemotherapy based on body
surface area versus fixed dose.
List prognostic factors for Hodgkin's lymphoma.

7. Define platinum refactory ovarian cancer.
Outline treatment for a 50-year-old lady with grade III neuropathy
having stage II C high grade serous ovarian cancer.
Compare toxicities of cisplatin and carboplatin.
List causes of high serum CA-125.

8. A 66-year-old male has ben diagnosed to have stage I prostate
cancer. His Gleason Score is
Outline treatment for this case.
Give TNM staging.
Treatment of hormone refractory, extensie bony metastasis.
How will you assess quality of life for such a case?

9. Epidemiology and risk factors for stomach cancer in India.
Outline treatment for locally advanced stomach cancer.
Mention important molecular abnormalities with possible strategies
for treatment.

10. Define cancer cachexia and its mechanisms with potential
strategies for treatment.
Briefly define ELISA methodology to estimate Galactomannan in a
patient suspected to have fungal infection.
Outline a clinical trial with end points to compare two antibiotic
regimens in treatment of high risk febrile neutropenia.