Clinical Chemistry- 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. Human chorionic gonadotropin (hCG)
D. Nuclear matrix protein
A
A. BRCA-1
2
Q
- In general, in which of the following situations is
the analysis of a tumor marker most useful?
A. Testing for recurrence
B. Prognosis
C. Screening
D. Diagnosis
A
A. Testing for recurrence
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)
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
5
Q
- Which tumor marker is associated with cancer of
the urinary bladder?
A. CA-19-9
B. CA-72-4
C. Nuclear matrix protein
D. Cathepsin-D
A
C. Nuclear matrix protein
6
Q
- A person presents with a cushingoid appearance
and an elevated 24-hour urinary cortisol level. The
plasma adrenocotropic hormone (ACTH) is very
elevated, and the physician suspects the cause is
ectopic ACTH production. Which test would be
most useful in substantiating this diagnosis?
A. Plasma cortisol
B. CA-50
C. Alkaline phosphatase isoenzymes
D. AFP
A
C. Alkaline phosphatase isoenzymes
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
8
Q
- Which of the following statements regarding the
Philadelphia chromosome 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
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
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
11
Q
- A person is suspected of having testicular cancer.
Which type of hCG test would be 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 β-hCG subunits
D. Urine assay for hCG β core
A
B. Plasma immunoassay for intact hCG and
the β-hCG subunit
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
following 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 owing to 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
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
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
15
Q
- Which of the following assays is recommended as
a screening test for colorectal cancer in persons
over 50 years old?
A. CEA
B. AFP
C. Occult blood
D. Fecal trypsin
A
C. Occult blood
16
Q
- Which of the following assays is used to determine
the risk of developing cancer?
A. Epidermal growth factor receptor (EGF-R)
B. Squamous cell carcinoma antigen (SCC)
C. c-erb B-2 gene expression
D. p53 gene mutation
A
D. p53 gene mutation
17
Q
- A person has an elevated 24-hour urinary
homovanillic acid (HVA) and vanillymandelic
acid (VMA). Urinary metanephrines,
chromogranin A, and neuron-specific enolase
are also elevated but 5-hydroxyindoleacetic
acid 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 conditions is PSA least
likely to be increased?
A. Precancerous lesions of the prostate
B. Postprostate 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
B. Free PSA below 25% is associated with
malignant disease
C. A total PSA below 4 ng/mL rules out malignant
disease
D. A total PSA above 10 ng/mL is diagnostic of
malignant disease
A
B. Free PSA below 25% is associated with
malignant disease
20
Q
- A 55-year-old male with early stage prostate
cancer diagnosed by 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. 1–3 ng/mL
C. Less than 4 ng/mL
D. Less than 10 ng/mL
A
A. Undetectable
