FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2017
MEDICAL ONCOLOGY
PAPER I

POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.
Time 3 hours MED.ONCO./D/17/17/I
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. Enumerate breakthrough hallmarks of cancer
b. List of tumours and indications where anti-angiogenic
approach has shown positive results
c. List three anti-angiogenic agents in clinical practice and
their side effects.

2. a. What is minimal residual disease with respect to
acute lymphoblastic leukemia?
b. Enumerate methods of MRD detection and their
advantages and disadvantages.
c. How is MRD detection different in ALL Vs T-ALL?

3. a. Enumerate the steps in performing Polymerase Chain
Reaction (PCR).
b. Name two methods of performing real time PCR.
c. Mention three applications of PCR in oncology.

4. a. Mechanism of action of cisplatin.
b. Mechanism and markers of platinum resistance in
various cancers.
c. Pharmacogenomics of cisplatin induced ototoxicity.

5. a. Principles of extra corporeal radiotherapy (ECRT)
b. Mention specific condition where ECRT may be used.
c. What are the problems associated with ECRT?

6. a. What are chimeric Antigen Receptor cells?
b. How are CAR-T cells different from Blinatumomab with
respect to use in acute lymphoblastic leukemia
c. Beside ALL, name two other conditions where CAR-T
cells are being used.

7. a. What is Hedgehog pathway?
b. Name the cancers where this pathway is relevant.
c. Utility of Hedgehog pathway inhibitors.

8. a. Mechanism of action and method of administration of
trabectedin.
b. Side effects of trabectedin
c. Therapeutic uses of trabectedin

9. a. What are end points for a Trial pertaining to newer
therapies in palliative care setting and why?
b. What is Basket Trial? Explain with example.
5+5
10. a. Explain next generation and whole genome
sequencing.
b. Explain with an example how the above may be useful
in oncologic therapeutics.
5+5