FC Rad Onc(SA) Part

II

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Final Examination for the Fellowship of the
College of Radiation Oncologists of South Africa

19 March 2012

Paper 1 Tumour Pathology and General Oncology (3 hours)

All questions are to be answered. Each question to be answered in a separate book (or books if more than one is
required for the one answer)


1 a) Describe the different histological types of Hodgkins Lymphoma and how they
are different from one another. (7)
b) How does Hodgkins Lymphoma differ from Non Hodgkins Lymphoma clinically?
(3)
c) Discuss how you would manage a stage IIA favourable Hodgkins Lymphoma.
(15)
[25]

2 A patient presents with a 3x5cm cold nodule in the thyroid
a) Describe the procedures to make a histological diagnoses. (3)
b) What are the possible results you could expect from the different techniques and
how would the results influence your further management? (22)
[25]

3 Pancreas Cancer
a) Table stage grouping. (7)
b) Discuss management of stage III disease in detail. (18)
[25]

4 Oropharynx Cancer
a) Table TNM classification. (5)
b) Discuss management of cancer of the base of tongue in detail. (20)
[25]







FC Rad Onc(SA) Part II

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Final Examination for the Fellowship of the
College of Radiation Oncologists of South Africa

20 March 2012

Paper 2 Radiation and Medical Oncology (3 hours)

All questions are to be answered. Each question to be answered in a separate book (or books if more than one is
required for the one answer)

1 Discuss radiotherapy of the following benign conditions under the headings
a) Description of condition
b) Suggested treatment
c) General precautions
i) Arterial restenosis. (5)
ii) Keloid. (5)
iii) Pterygium. (5)
iv) Orbital pseudotumour. (5)
v) Desmoid tumour. (5)
[25]

2 a) Define
i) Triple Negative Breast Cancer (TNBC).
ii) Basal Like Breast Cancer (BLBC).
iii) Breast Cancer associated with BRCA 1 mutations (BRCA1). (5)
b) TNBC, BLBC and BRCA1 can be viewed as separate but overlapping entities.
Compare in view of
i) Typical clinical presentation.
ii) Histological and Immunohistochemical picture. (10)
c) Discuss therapeutic approach to TNBC
i) Current.
ii) Future direction. (10)
[25]

3 Use short notes to explain each of the following technologies which are used in the
practice of Radiation Oncology. In each category, name 2 clinical examples of when
such a technique could be appropriately used.
a) MRT(Intensity modulated radiotherapy). (5)
b) SRS(Stereotactic radiosurgery) (5)
c) PET (Positron emission tomography) (5)
d) IGRT(Image-guided radiotherapy) (5)
e) Interstitial brachytherapy. (5)
[25]

PTO/ Page 2 Question 4

-2-

4 A 30-year-old lady is referred to you by a gynaecologist for an opinion. She has primary
amenorrhoea and infertility. She also complains of severe constipation with frequent
rectal bleeding on defecation and has now developed intermittent claudication in both
legs with exercise.
On questioning, she was treated for a rhabdomyosarcoma of the bladder as a child
aged 5-years-old. She received chemotherapy, surgery and orthovoltage radiotherapy.
a) Suggest how this lady should be investigated further. (10)
b) Discuss how each of the above symptoms could be related to her history. (10)
c) The gynaecologist wishes to proceed with a laparoscopy in order to investigate
the infertility. What would you advise, and why? (5)
[25]







































FC Rad Onc(SA) Part II

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Final Examination for the Fellowship of the
College of Radiation Oncologists of South Africa

22 March 2012

Paper 3 Radiation and Medical Oncology (3 hours)

All questions are to be answered. Each question to be answered in a separate book (or books if more than one is
required for the one answer)

1 a) Discuss the investigation and assessment of a patient who presents at a
routine medical examination with an asymptomatic anterior mediastinal mass.
(10)
b) Investigation reveals a Thymoma, discuss further management. (15)
[25]


2 Discuss the management of a patient who presents with a localised anal mass.
Discuss treatment methods and techniques if malignant. [25]


3 Discuss the management of meningiomas. [25]


4 Discuss the potential adverse effects of radiating the following sites in a 3-year-old child
with photons
a) Cranio-spinal axis. (15)
b) eye and orbit. (10)
[25]