Chem Path - Cancer Markers Flashcards
Select the most likely site for a tumour that produces an increase of both α-fetoprotein (AFP) and human chorionic gonadotropin (hCG):
Question 1Select one:
a.
Liver
b.
Lung
c.
Kidney
d.
Testicle
e.
Thyroid
f.
Placenta
Testicle
An elevated serum level of C-reactive protein (CRP) is now used as a clinical marker for determining an increased risk for developing which one of the listed disorders?
Question 2Select one:
a.
Osteoporosis in patients with the nephrotic syndrome
b.
Pulmonary emboli in patients with peripheral vascular disease
c.
Encephalopathy in patients with liver failure
d.
Myocardial infarction in patients with coronary artery disease
e.
Thrombocytopaenia in patients receiving heparin therapy
Myocardial infarction in patients with coronary artery disease
A 75-year-old man with point tenderness in the lower vertebral column has an increased serum alkaline phosphatase. He does not smoke cigarettes. His faecal occult blood test is negative. Which of the following tests or procedures would be the most cost effective step in the initial evaluation of this patient?
Question 3Select one:
a.
Prostate-specific antigen
b.
Serum gamma glutamyltransferase
c.
Radionuclide bone scan
d.
Colonoscopy
e.
Digital rectal examination
DRE
A 57 year old man present with signs of fatigue that are the result of anaemia. Workup reveals that his anaemia is the result of bleeding from a colon cancer located in the sigmoid colon. The lesion is resected and at the time of surgery no metastatic disease is found. Which of the following markers would be most useful for future follow-up of this patient for the evaluation of possible metastatic disease from his colon cancer?
Question 4Select one:
a.
Chloroacetate esterase (CAE)
b.
Human chorionic gonadotropin(hCG)
c.
α fetoprotein (AFP)
d.
Prostate-specific antigen
e.
Carcinoembryonic antigen (CEA)
CEA
A 23 year old woman has a progressive increase in her serum β human chorionic gonadotropin (βhCG) concentrations during an eight week period. A hydatidiform mole is removed, but the βhCG concentration continues to increase. Which of the following is the most likely diagnosis?
Question 5Select one:
a.
Adrenal adenoma
b.
Choriocarcinoma
c.
Pituitary insufficiency
d.
Ectopic pregnancy
e.
A second noninvasive mole
Choriocarcinoma
A 62-year-old man, who lives alone, has pitting oedema of his lower legs. The serum total protein concentration is decreased. He subsists primarily on bread and diet cola. A urinalysis is negative for protein. Which of the following best explains the pathogenesis of the hypoproteinaemia?
Question 6Select one:
a.
Acquired hypogammaglobulinaemia
b.
Nephrotic syndrome
c.
Malignant plasma cell disorder
d.
Decreased intake of protein
Malignant plasma cell disorder
A 42-year-old woman complains of diarrhoea and episodic flushing of the skin. She does not smoke cigarettes. Physical examination demonstrates a nodular liver. A pelvic examination is normal. A barium study reveals a constricting mass in the terminal ileum. Which of the following laboratory findings is most likely present?
Question 7Select one:
a.
Increased serum CA-19-9
b.
Increased serum α-fetoprotein
c.
Increased urinary 5-hydroxyindoleacetic acid
d.
Increased serum CA 125
e.
Increased serum antistreptolysin O
Increased urinary 5-hydroxyindoleacetic acid
An elderly woman presents with back pain: serum total protein concentration is 90 g/L; albumin, 35 g/L. Her serum creatinine concentration is 150 mmol/L and her haemoglobin is 96 g/L.
Which of the following is the best choice for subsequent investigations?
Question 8Select one:
a.
Urea, sodium and potassium
b.
Serum angiotensin converting enzyme and calcium levels
c.
Urinary Bence Jones protein, serum immunoglobulins, free light chains and protein electrophoresis
d.
Serum vitamin D, calcium and phosphate levels
e.
Chest x-ray, stool faecal occult blood and mammogram
Urinary Bence Jones protein, serum immunoglobulins, free light chains and protein electrophoresis
A 58-year-old man has pain in the lower lumbar spine and pelvis. Initial laboratory studies show a normocytic anaemia and marked rouleaux of red blood cells. Serum creatinine is 280 g/L. A bone marrow aspirate is performed and reveals sheets of malignant plasma cells. Which of the following additional laboratory findings is most likely to be reported?
Question 9Select one:
a.
Monoclonal protein spike on serum protein electrophoresis
b.
Decreased erythrocyte sedimentation rate
c.
Decreased serum calcium level
d.
Normal bleeding time
e.
Increased prothrombin time
Monoclonal protein spike on serum protein electrophoresis
