FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2018

POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.
MEDICAL ONCOLOGY
PAPER-I
MEDONCO/J/18/17/I
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. List TTF-1 positive tumours.
List first, second and third generation tyrosine kinase
inhibitors in non-small cell lung cancer.
Briefly compare their pharmacology and adverse reactions.

2. Enumerate the steps involved in conducting a meta-analysis.
What is a Forest plot? Mention the key features in its
interpretation.
Compare weekly versus three weekly cisplatin based
chemotherapy in the treatment of locally advanced head and
neck cancer.

3. A 25-year-old male diagnosed as osteosarcoma was started on
neoadjuvant chemotherapy. He developed seizures on
chemotherapy.
Enumerate the differential diagnosis for the seizures.
How will you manage Ifosfamide encephalopathy?
Mechanism of MESNA in preventing Ifosfamide toxicity.

4. Briefly describe various techniques used for HLA typing.
List various regimens used for myeloablative and
nonmyeloablative allogeneic stem cell transplantation.
What long term toxicities can be encountered in a 40-yearold
male who has received allogeneic-stem cell transplant
from his elder sister?

5. List metabolic emergencies encountered in children with
leukemia/lymphoma.
Mention criteria for diagnosis of tumour lysis syndrome.
Compare allopurinol versus Rasburicase as regards to
mechanism of action, efficacy and side effects.

6. What are the indications of stereotactic radiosurgery in
brain metastasis?
Write the complications associated with SRS.
Describe a prognostic tool which can be used in the
assessment of patients with brain metastasis.


7. Schematically represent the events that occur in a cell cycle.
List the approved CDK inhibitors in breast cancer and their
side effects.
What is the therapeutic benefit of adding CDK inhibitors with
hormone therapy in metastatic breast cancer with evidence?

8. Mention the steps involved in cancer immunoediting.
List the adverse effects of CTLA-4 inhibitors and their
management.
Role of CTLA-4 inhibitors in the management of malignant
melanoma.

9. List 5 common oncoviruses and their associated malignancy.
Describe the molecular pathogenesis of HPV (Human
Papilloma Virus) infection resulting in cervical cancer.
Enumerate the Guidelines for using HPV Vaccine.

10. Physiology of nausea/vomiting.
How do you grade it?
List cytotoxic drugs associated with moderate to severe
nausea/vomiting.
Outline treatment of cisplatin associated nausea/vomiting.