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-II
MEDONCO/J/18/17/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. Briefly describe staging used for Hodgkin's lymphoma.
Outline treatment for a 20-year-old unmarried female
diagnosed to have stage IVB Hodgkin's lymphoma.
How will you determine her prognosis?
How will you use PET-CT scan in her management?

2. A 25-year-old unmarried male has been diagnosed to have
retroperitoneal lymph node mass with fever. Biopsy is
suggestive of poorly differentiated tumour.
What is your differential diagnosis?
Plan further investigations to establish primary.
How immunohistochemistry will help you in arriving at a
diagnosis in this case?
Outline plan of treatment in this case assuming that no
definite primary could be made out on investigations.

3. List tumours (with indications) where anti-angiogenesis
treatment approach has shown positive results.
Molecular biology of ovarian cancer.
Mention clinical and laboratory markers of platinum
resistance.

4. Molecular classification of breast cancer.
Compare Oncotype Dx versus Mammaprint.
Role of hypofractionated radiation therapy as adjuvant
treatment for breast cancer.

5. List various childhood malignant tumours in order of
frequency.
Mention the International Classification of intra-ocular
retinoblastoma
Indications and key principles involved in Enucleation.
What are the indications of adjuvant chemotherapy post
enucleation?

6. Enumerate the differences between right vs left sided
metastatic colorectal cancer.
Role and technique of MSI (Microsatellite Instability) Testing
in colorectal cancer.
5+5
.
7. Classify bone tumours.
Role of MRI in the management of bone tumours.
What are the principles of diagnostic biopsy in a suspected
bone tumour?

8. Plan investigations (with rationale) for a 25-year old lady
suspected to have acute leukemia.
Explain value of cytochemistry and immunophenotypic
markers in such a case.
Discuss critically importance of estimating minimal residual
disease (with time points) in such a case.

9. Pathological classification of thyroid tumours.
List investigations including molecular tests.
Outline treatment of metastatic follicular carcinoma of thyroid.

10. List childhood tumours where genetics plays an important
role.
Write International staging for neuroblastoma.
Outline treatment for high risk stage 3 neuroblastoma.
Outline treatment of Wilm's tumour according to stage with
results.