Biochemistry of Neoplasia

Question 1

why would PSA marker levels be raised?

Answer 1

prostate cancer or benign prostate hyperplasia (BPH)

Question 2

raised CK & AST shows..

Answer 2

damage to muscle tissue

Question 3

raised ALT/AST/ Alk Phos/GGT shows…

Answer 3

damage in liver

Question 4

raised troponin, CK, AST, LDH shows…

Answer 4

cardiac damage or risk of CVD

Question 5

AST/LDH shows…

Answer 5

haematological damage

Question 6

amylase/lipase shows…

Answer 6

pancreatic damage (usually pancreatitis)

Question 7

alk phos may show liver damage or…

Answer 7

bone damage

Question 8

what combination of 2 markers indicated liver cancer?

Answer 8

GGT & Alk Phos

Question 9

what are 2 mechanisms of fluid accumulation?

Answer 9

Ascites & Pleural Effusion

Question 10

what is a biochemistry indicator of ascites due to portal HT?

Answer 10

a wide serum-ascites gradient

Question 11

what 2 things tend to cause an exudative pleural effusion (ie. high protein content)?

Answer 11

inflammation (inflammatory cells shed protein) or malignant cause

Question 12

systemic cause point to a ____ pleural effusion

Answer 12

transudative (less protein)

Question 13

what is the normal Ca range?

Answer 13

2.10-2.55

Question 14

what does Parathyroid hormone (PTH) do?

Answer 14

controls levels of Ca in blood by releasing Ca via bone reabsorption fundamentally inc Ca

Question 15

so if PTH is high and Ca is high what does this suggest?

Answer 15

this is not a normal reaction as Ca is high so would expect PTH to be low so PTH is faulty

Question 16

is Ca is high and PTH is low then..

Answer 16

this is an appropriate response so what is inc the levels of Ca in blood? usually PTHrP (antagonist of PTH)

Question 17

what does the presence of PTHrP suggest?

Answer 17

malignancy present

Question 18

what are tumour markers used for?

Answer 18

diagnosis, monitor success of Tx, prognosis/ recurrence

Question 19

what is AFP a tumour marker of?

Answer 19

germ cell carcinoma

Question 20

what is HCG a tumour marker for?

Answer 20

germ cell and chondriocarcinoma

Question 21

what is CA125 a tumour marker for?

Answer 21

ovarian cancer

Question 22

what is CEA a tumour marker for?

Answer 22

colorectal cancer

Question 23

what is unique about the calcitonin tumour marker?

Answer 23

it is 100% sensitive

Question 24

what does calcitonin mark for?

Answer 24

medullary carcinoma of thyroid

Question 25

what is a hormonal marker that indicated lung cancer?

Answer 25

ACTH

Question 26

name 2 paraneoplastic syndromes and what cancers they can precede?

Answer 26

Cushing’s: SSLC, bronchial, carcinoid

Lambert-Eaton: SSLC, lymphoma