Clinical Recalls 2010 | Breast Cancer | Chemotherapy

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Overall, the exam seemed fair. Not as picky and outlandish (urethra x5!!) as the inservice tends to be, though definitely some questions were ³out there´. On lot of the questions it was pretty obvious what the answer is, but some they gave percent ranges for recurrence or survival that only varied by 10% (eg
Transcript
  Overall, the exam seemed fair. Not as picky and outlandish (urethra x5!!) as the inservicetends to be, though definitely some questions were ³out there´. On lot of the questions itwas pretty obvious what the answer is, but some they gave percent ranges for recurrenceor survival that only varied by 10% (eg <10%, 10-20%, 20-30%, 30-40%). Images werein 4-5 questions (radiology or plans), though no path ones. There was actually fairly littleon straight path. I finished first pass (answering all questions but marking the ones Iwanted to recheck) with about 1.5 hours left. I took full time, 1) to go over the markedones and 2) then go over most of the questions a second time.This recall is a bit crappy, since after finishing the test on Friday around lunch, I had tolook through all the millions of boxes our movers brought down and deposited in thegarage, to pack for a month-long stay in Europe. Since I was leaving the following day, Ididn¶t really have a chance to do the recalls immediately. I am sitting in Frankfurt at theairport during a 5 hour layover, after not having slept overnight on the plane becauseOliver decided he didn¶t really want to sleep but wanted to play instead ± and how canyou refuse an 8 month old? My brain is not fully functional « but this is the best it¶sgonna be.I used the 2008 recalls as a baseline for my recall, and in retrospect there were even morequestions repeated (verbatim or with minor variations) than I picked up on during theexam. I would consider it very high yield to review prior recalls.Image of reconstructed 3D pelvic organs, asking what¶s purple one (sigmoid)Image of liver DVH, asking which is correctV30 <10%V30 <10 ccD30 <10%D30 <10 ccImage of LDR dose plan, asking what do isodose lines representMghrscGy/hr Gycouple other reasonably-sounding unitsBOT referred pain via which nerve?ArnoldJacobsonOthersOcular presenting symptoms, location of meningiomaCavernous sinus, othersWhich nerve most likely to be impacted after H&N RT  VVIIIXXXII Nasopharynx WHO I, who gets itWhiteBlack AsianEskimoSurvival in chemo-RT arm for Al-Sarraf trialPercentage choicesUnresectable desmoid, RT dose40-4950-5960-6970-79What genetic syndrome are desmoids associated withFAPMENOthersAbdominal desmoids, s/p surgery, how to manageRTChemoChemo-RTObservationFor oropharynx, what¶s T-stage is lateral pterygoidT2T3T4aT4bA question about nasopharynx and retropharyngeal LNsFor T4 nasopharynx, where is top of the fieldSkull baseCSI for low risk medullo, what is the first hormone to be affectedGH  TSHADHLH/FSHDose for CSI for completely resected medullo with M023.4303654Something elseWhat was true about ESPAC-1RT QCCentral path reviewHigh protocol complianceSplit-course RTWhat does not make pancreas unresectableSMASMVCeliax axisIVCWhich lung cancer not good candidate for SBRTHilar locationDLCO <50%FEV <1.0Parenchymal locationSBRT dose question, can¶t remember exactly, but I think answer was >= 10 Gy/fractionMortality with induction chemo-RT followed by pneumonectomy for right sided lungcancer RTOG xx (I think Albain trial), what was true for addition of surgeryBetter LCBetter DFSBetter OS No differenceEvidecence-based management for NSCLC T2N1ChemoRTChemo-RTObservation  Lot of lymphoma questionsAt least 3 on NLPHDHow treat stage I HD of the groin, CD20+ChemoChemo-RTRT aloneRituxan aloneHow treat follicular lymphoma Stage IObservationCHOPRituxanRT aloneLocal control rate for HD 2x2What is the principle of beneficence in clinical trial designsProtect prisonersDeidentificationDesign trials to do minimal harmSomething elseWhat does double blind trial meanBoth physicians and patients are blinded to arm of studySeveral sarcoma questionsEwings dose question, I think unresectableWhen is brachytherapy appropriate after sarcomaLow grade smallPositive marginHigh grade smallHigh grade largeSomething elseWhen to load brachy catheters after surgeryA number of prognostic questions, so worth reviewing RPA, mets, spinal cordcompression, IPI, etcUrachal primary has what histology?AdenoSquamous
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