D:-Lymphatic involvement is less than 5%
Correct Answer:- Option-D
Question55:-Which of the following margin matches is not correct for radiotherapeutic planning for skin cancer ?
A:-Recurrent BCC : 0.5 - 1. cm
B:-Morpheaform BCC : 0.5 - 1. cm
C:-Tm > 3 cm SCC: 3.cm
D:-Ulcerative SCC : 2cm
Correct Answer:- Option-C
Question56:-What is the optimal total radiation dose required for immunosuppression and tumoral cell eradication in
fractionated TBI regimes ?

A:-2-4 Gy
‏6۔‎ Gy
-8 Gy

D:-8-12 Gy

Correct Answer:- Option-D
Question57:-A 7 year old boy was admitted to the emergency with severe headaches, nausea, and vomiting. His
examination revealed decreased upward gaze in addition to inability to focus on objects and double vision. There was
abnormal light response during accommodation. He had an MRI demonstrating hydrocephalus with a pineal region mass
obstructing the aqueduct of Sylvius. What syndrome is this ?

A:-Parinaud syndrome

B:-Ventral midbrain syndrome

C:-Benedict syndrome

D:-None of these

Correct Answer:- Option-A
Question58:-4 years old boy was brought to the attention of an ophthalmologist because of strabismus and right-sided
leukocoria. He was clinically diagnosed as having retinoblastoma and the intraocular mass workup revealed a 13-mm
diameter and 11 mm thick tumor with vitreous seeding, as well as sub-retinal seeding more than 4 mm from the tumor. The
tumor did not touch the lens and did not involve anterior segment structures such as the ciliary body. He had no
neo-vascular glaucoma or opaque media from hemorrhage. His tumor has only caused a minor loss of vision. Which is false
? A:-The international classification for intraocular retinobalstoma in this case is "C"

B:-Lumbar puncture for CSF evaluation, bone marrow biopsy and a bone scan if the tumor is not confined to the globe
are mandatory investigations

C:-This patient is out of brachytherapy limits with vitreous seeding and sub-retinal seeding

D:-Vincristine/Carboplatin/Etoposide (VCE) times 6 cycles and then external beam radiotherapy is the treatment

Correct Answer:- Option-A
Question59:-45-year-old woman with a long history of hyperthyroiditis presents with eyelid retraction, exophthalmos,
diplopia and periorbital edema. In her history of illness, she specifically notes that she has had deterioration in her vision
over the last 10 days accompanied by diplopia 1 day ago. She has not experienced any loss of color vision or demonstrated
corneal involvement, but she has minor visual field defects with blurred vision. She is diagnosed with Graves' disease and
thyroid ophthalmopathy. Which of the statement is false ?

A:-There is a threat of impending visual loss, although the color vision is protected. She does not seem to require
decompressive surgery, but orbital radiotherapy could be recommended in addition to systemic immunosuppression with
oral or IV steroids.

B:-With radiotherapy there is improvement in proptosis, eyelid retraction , or soft tissued chnages which has not been
clearly defined

C:-Radiotherapy has been recommended for its efficacy for compressive optic neuropathy, which has not yet been
clearly determined

D:-The current recomended external beam radiotherapy dose is 20 Gy (2 Gy/fraction/d)

Correct Answer:- Option-B
Question60:-38 years old male with complaints of non-specific headaches for almost 6 months has been evaluated by
neurology. His brain MRI has demonstrated a recent bleeding and a dark flow void surrounding the nidus of an arteriovenous
malformation in the thalamus, which was 1.5 cm in size. The angiography confirmed this diagnosis in addition to showing no
deep venous drainage. He currently has no neurological symptoms. What is the rough risk of bleeding in his lifetime ?

A:-62%

B:-52%

167%

D:-57%

Correct Answer:- Option-C
Question61:-45 years old male presents for a hip reconstruction operation after a blunt trauma to his femoral prosthesis. In
his workup, radiology demonstrated bone spurs from the proximal fernur in addition to a = 1 cm gap between the opposing
surfaces. The surgeon asks your opinion about prophylaxis of heterotropic ossification in order to choose between a medical
or radiotherapy approach. Which is incorrect statement ?