6.9 Tumor Markers Flashcards

1
Q

Which of the following tumor markers is classified as a tumor suppressor gene?
A. BRCA-1
B. Carcinoembryonic antigen (CEA)
C. hCG
D. Nuclear matrix protein (NMP)

A

A. BRCA-1

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2
Q

In general, in which of the following situations is the analysis of a glycoprotein tumor marker, such as carbohydrate-associated antigen-125 (CA-125), most useful?
A. Testing for recurrence
B. Prognosis
C. Screening
D. Diagnosis

A

A. Testing for recurrence

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3
Q

Which of the following enzymes is increased in persons with prostate and small cell lung cancer?
A. Creatine kinase-1 (CK-1)
B. Gamma glutamyl transferase (GGT)
C. Amylase
D. Lactate dehydrogenase

A

A. Creatine kinase-1 (CK-1)

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4
Q

Which of the following is the best analyte to monitor for recurrence of ovarian cancer?
A. CA-15-3
B. CA-19-9
C. CA-125
D. CEA

A

C. CA-125

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5
Q

Which tumor marker is associated with cancer of the urinary bladder?
A. CA-19-9
B. CA-72-4
C. NMP
D. Cathepsin-D

A

C. NMP

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6
Q

A person presents with a cushingoid appearance and an elevated 24-hour urinary cortisol level. Plasma ACTH is very elevated, and the physician suspects that the cause is ectopic ACTH production. Which test would be most useful in substantiating this diagnosis?
A. Plasma cortisol
B. CA-50
C. ALP isoenzymes
D. AFP

A

C. ALP isoenzymes

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7
Q

Which of the following tumor markers is used to monitor persons with breast cancer for recurrence of disease?
A. Cathepsin-D
B. CA-15-3
C. Retinoblastoma gene
D. Estrogen receptor (ER)

A

B. CA-15-3

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8
Q

Which of the following statements regarding Ph1 is true?
A. It is seen exclusively in chronic myelogenous leukemia
B. It results from a translocation
C. It appears as a short-arm deletion of chromosome 21
D. It is associated with a poor prognosis

A

B. It results from a translocation

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9
Q

What is the primary clinical utility of measuring CEA?
A. Diagnosis of liver cancer
B. Diagnosis of colorectal cancer
C. Screening for cancers of endodermal origin
D. Monitoring for recurrence of cancer

A

D. Monitoring for recurrence of cancer

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10
Q

Which tumor marker is used to determine the usefulness of trastuzumab (Herceptin) therapy for breast cancer?
A. PR
B. CEA
C. HER-2/neu
D. Myc

A

C. HER-2/neu

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11
Q

A person is suspected of having testicular cancer. Which type of hCG test would be the most useful?
A. Plasma immunoassay for intact hCG only
B. Plasma immunoassay for intact hCG and the β-hCG subunit
C. Plasma immunoassay for the free alpha and beta-hCG subunits
D. Urine assay for hCG β-core

A

B. Plasma immunoassay for intact hCG and the β-hCG subunit

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12
Q

A patient treated for a germ cell tumor has a total and free β-hCG assay performed prior to surgery. The result is 40,000 mIU/mL. One week after surgery, the hCG is 5,000 mIU/mL. Chemotherapy is started, and the hCG is measured 1 week later and found to be 10,000 mIU/mL. What does this indicate?
A. Recurrence of the tumor
B. Falsely increased hCG as a result of drug interference with the assay
C. Analytical error with the test reported as 5,000 mIU/mL
D. Transient hCG increase caused by chemotherapy

A

D. Transient hCG increase caused by chemotherapy

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13
Q

Which set of results for ER and PR is associated with the highest likelihood of a favorable response to treatment with estrogen-suppression therapy (tamoxifen)?
A. ER positive, PR positive
B. ER positive, PR negative
C. ER negative, PR positive
D. ER negative, PR negative

A

A. ER positive, PR positive

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14
Q

Which type of cancer is associated with the highest level of AFP?
A. Hepatoma
B. Ovarian cancer
C. Testicular cancer
D. Breast cancer

A

A. Hepatoma

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15
Q

Which of the following assays is recommended as a screening test for colorectal cancer in persons over age 50 years?
A. CEA
B. AFP
C. Occult blood
D. Fecal trypsin

A

C. Occult blood

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16
Q

Which of the following assays is used to determine the risk of cancer?
A. Epidermal growth factor receptor (EGFR)
B. Squamous cell carcinoma (SCC) antigen
C. c-erb B-2 gene expression
D. p53 gene mutation

A

D. p53 gene mutation

17
Q

A person has elevated 24-hour urinary HVA and VMA levels. Urinary metanephrines, chromogranin A, and neuron-specific enolase levels are also elevated, but the 5- hydroxyindoleacetic acid (5-HIAA) level is within the reference range. What is the most likely diagnosis?
A. Carcinoid tumors of the intestine
B. Pheochromocytoma
C. Neuroblastoma
D. Pancreatic cancer

A

C. Neuroblastoma

18
Q

In which of the following situations is PSA least likely to be increased?
A. Precancerous lesions of the prostate
B. Post–prostate biopsy
C. Benign prostatic hypertrophy
D. Post–digital rectal examination

A

D. Post–digital rectal examination

19
Q

Which of the following statements regarding PSA is true?
A. Complexed PSA in plasma is normally less than free PSA (fPSA)
B. fPSA less than 25% is a risk factor for malignant disease
C. A total PSA less than 4 ng/mL rules out malignant disease
D. A total PSA greater than 10 ng/mL is diagnostic of malignant disease

A

B. fPSA less than 25% is a risk factor for malignant disease

20
Q

A 55-year-old male with early-stage prostate cancer diagnosed through biopsy had his prostate gland removed (simple prostatectomy). His PSA prior to surgery was 10.0 ng/mL. If the surgery was successful in completely removing the tumor cells, what would the PSA result be 1 month after surgery?
A. Undetectable
B. 1 to 3 ng/mL
C. Less than 4 ng/mL
D. Less than 10 ng/mL

A

A. Undetectable

21
Q

Which of the following combinations of targeted therapy and gene mutation is associated with colon cancer?
A. Pembudizmab for programmed death ligand 1 (PD-L1) mutation
B. Cetuximab for KRAS mutation
C. Gefitinib for EGFR mutation
D. Crizotinib for ALK mutation

A

B. Cetuximab for KRAS mutation

22
Q

The mutation of which of the following genes results in the blocking of destruction of tumor cells by lymphocytes?
A. ALK
B. PD-L1
C. BRAF
D. FTL3

A

B. PD-L1

23
Q

What process is used in next-generation sequencing (NGS) to analyze different samples simultaneously?
A. Fluorescent labels
B. Reference genes
C. Sample barcodes
D. Molecular barcodes

A

C. Sample barcodes

24
Q

Which is the most common modality used for cancer screening by NGS?
A. Whole-genome sequencing (WGS)
B. Whole-exome sequencing (WES)
C. Panel screening
D. Single mutation screening

A

C. Panel screening

25
Q

What type of NGS cancer panel is used to detect hereditary cancers?
A. Hotspot panels
B. Disease-focused panels
C. Comprehensive panels
D. Actionable panels

A

B. Disease-focused panels