Download DNB 2019 June RADIOTHERAPY RADIOTHERAPY PAPER 4 Question Paper

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FINAL EXAM

JUNE 2019

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RADIOTHERAPY

PAPER-IV

Time: 3 hours RTH/J/19/41/\V Max. Marks:100

Important Instructions:

• Attempt all questions in order.

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• 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.

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• 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) Define metastasis of unknown origin(MUO). 2+3+5
   b) What are common manifestations of MUO?
   

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   c) Management of MUO at various body sites.
2. a) Hyperthermia in malignancy. 5+5
   b) Tumour-lysis syndrome.
3. a) Draw a diagram showing different phases of cell cycle. 4+6
   b) Describe briefly the importance of these phases in relation to radiotherapy and chemotherapy.

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4. Briefly describe their clinical relevance: 2.5x4
   a) Mitotic Index (MI)
   b) Labelling Index (LI)
   c) Growth fraction (GF)
   d) Potential doubling time (Tpot)

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5. a) Classify chemotherapeutic drugs in relation to different phases of cell cycle:-Add a note on drug resistance. 4+6
   b) Describe the radiobiological mechanisms of radiation sensitization by chemotherapy drugs and enumerate the rationale in sequencing RT + CT.
6. a) Describe the rationale in screening for cancer. What is the importance of screening in general population? 6+4
   b) Which tumours are considered suitable for a screening program in our country? What are the recommendation for screening of breast cancer?
7. a) Define plating efficiency. 2+4+4
   

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   b) Mechanism of cell killing by ionizing radiation.
   c) L-Q model.
8. a) Radiobiologic basis of fractionation. 2+2+6
   b) What will happen if total dose is given at a time?
   c) Acute, subacute and late toxicities of accidental whole body radiation exposure and its management.

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9. a) WHO ladder for pain management. 4+3+3
   b) Basics of morphine prescription.
   c) Buprenorphine and fentanyl patch.
10. a) Role of PET-CT scan in Oncology, its principles, its benefit; limitations and its impact on radiotherapy planning. 7+3
    b) RECIST versus PERCIST criteria.

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