Download Diplomate of National Board (DNB) 2020 December MedIcal Oncology Paper III Question Paper
NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2020
MEDICAL ONCOLOGY
PAPER-III
Time: 3 hours
MED.ONCO./D/20/17/III
Max. Marks:100
Important Instructions:
You are provided with 5 answer sheet booklets. Each individual answer sheet booklet consists
of 10 pages excluding the covering jackets.
Answers to all the questions must be attempted within these 5 answer sheet booklets which
must be later tagged together at the end of the exam.
No additional supplementary answer sheet booklet will be provided.
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) A 50-year-old man, with no known comorbidities, has been diagnosed
6+4
with metastatic adenocarcinoma of pancreas. He also has deep vein
thrombosis of the right leg and severe back pain. Describe the
management of this patient.
b) Systemic therapy of advanced hepatocellular carcinoma.
2. a) Discuss the prognostic factors in pediatric Ewing's sarcoma.
4+6
b) A 14-year-old adolescent boy has been evaluated for a left thigh
swelling. Local MRI imaging and biopsy reveal Ewing's sarcoma of left
femur. As an algorithmic approach, describe the further evaluation and
multidisciplinary treatment of this patient, including relevant treatment
protocol(s) in brief.
3. a) A 54-year-old post-menopausal woman presents with a left breast lump
6+4
and palpable left axillary nodes. Biopsy from lump is suggestive of
infiltrating ductal carcinoma. Describe an algorithmic approach to the
multidisciplinary management of locally advanced breast cancer in this
patient.
b) Role of breast conservation in the treatment of breast cancers.
4. a) Role of molecular genetics in pediatric gliomas.
5+5
b) A 56-year-old woman, with no known comorbidities, has been
diagnosed with a glioblastoma multiform of the right parietal lobe of
brain. Describe an algorithmic approach to the multidisciplinary
management of this patient.
P.T.O.
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POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
FINAL EXAM
NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2020
MEDICAL ONCOLOGY
PAPER-III
5. A 38-year-old man with relapsed refractory diffuse large B-cell Lymphoma
6+4
after 3 lines of therapy has been advised Chimeric Antigen Receptor (CAR)
T-Cell therapy.
a) Describe the basic principles, manufacture and clinical pathway of CAR-
T Cell therapy.
b) Post CAR-T cell therapy, how will you grade and manage cytokine
release syndrome?
6. a) Concepts of treatment milestones in chronic myeloid leukemia and the
5+5
role of a treatment-free remission approach.
b) Role of bone marrow transplantation in post TKI era.
7. a) Supportive care and rehabilitation approach to a patient receiving
5+5
chemoradiation for head and neck cancer.
b) Indications and approach to neoadjuvant treatment of rectal cancer.
8. a) Management of patient(s) with locally recurrent cancer of uterine cervix. 5+5
b) Describe a treatment algorithm for the initial systemic therapy of
advanced/ metastatic renal cancer and discuss the role of molecularly
targeted agents as monotherapy or combination therapy in this
scenario.
9. A 62-year-old male with a 10-pack-year history of smoking and persistent 2+6+2
cough has been diagnosed with adenocarcinoma lung and staged
cT2N1M0 by PET-CT scan.
a) Discuss the indications and approaches for invasive mediastinal staging
in lung cancer.
b) Discuss the curative management of a pathologically confirmed N2
disease in this scenario of lung cancer.
c) The family states that the patient was planning to quit smoking. How will
you address smoking cessation in a patient?
10. a) Define Graft-versus-Host Disease (GVHD) and discuss the severity 4+3+3
grading of acute GVHD.
b) Discuss the various regimens used in acute GVHD prophylaxis of
allogeneic hematopoietic cell transplantation.
c) Discuss the side-effect profile of commonly used calcineurin inhibitors.
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POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
This post was last modified on 31 July 2021