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 II
MEDONCO/J/17/17/II
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 70 year old male has been diagnosed to have
pancytopenia.
What is the differential diagnosis?
Mention briefly mechanism of hypomethylating agents.
Dose and toxicities of decitabine and Azacytidine.

2. Incidence, risk factors and causative factors for head and
neck cancer.
Briefly mention evidence for HPV in some sub-sites of
head and neck cancer.
Outline treatment for a 70 year old male with recurrent
tongue cancer.

3. Mention important causes of hyponatremia in a 75 year
old woman.
Outline diagnostic workup with rationale and possible
therapeutic strategies.
3+7
4. Indications, methods, efficacy and toxicity of total parental
nutrition in cancer patients.
How will you assess need for nutritional support in
children with leukemia?
7+3
5. A 61-year-old male has been diagnosed to have
suprascapular soft tissue mass with lytic lesions over D4 and
D5 spine.
Briefly mention differential diagnosis and outline
diagnostic work up.
Briefly mention pathology of soft tissue sarcomas and
immunohistochemistry markers used to arrive at the
diagnosis.
List molecular abnormalities for 3 soft tissue sarcomas.

P.T.O.
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 II
6. A 3 year old male child has been diagnosed to have
retinoblastoma of right eye:
Incidence, burden and genetics of retinoblastoma.
Plan complete evaluation and treatment for this child with
bone marrow metastasis.
5+5
7. A 25-year-old recently married lady has presented with
bleeding per vaginum and bilateral pulmonary metastasis.
Diagnostic work up and WHO score for gestational
trophoblastic disease (GTD).
How will you treat patient with high risk score? Mention
key toxicities of each drug in EMACO regimen.
5+5
8. A 50-year-old male has been diagnosed to have renal lump.
Various radiological investigations with reasoning for
evaluation.
Briefly compare similarities and differences between
sunitinib and pazopanib in treatment of metastatic renal
cell carcinoma.
5+5
9. Causes and mechanism of renal failure in multiple
myeloma.
Compare similarities and differences between
daratumomab and elotuzumab in the treatment of
relapsed/refractory myeloma.
Outline treatment for myeloma in a 70-year-old male with
renal failure.

10. Primary CNS lymphoma:
Incidence.
Key clinical features/presentation.
Investigations interpretation.
Management algorithm.
Prognostic factors.