Tumor markers

Question 1

Which cancers are these tumour markers indicative of?

1. ca 19-9
2. CEA
3. PSA
4. Ca125
5. AFP
6. LDH

Answer 1

1. pancreatic cancer
2. colorectal cancer
3. prostate cancer
4. ovarian cancer
5. hepatocellular carcinoma
6. leukaemia (non specific)

Question 2

tongue carcinoma

Answer 2

associated with HPV, smoking, alcohol and betel nut ingestion

squamous cell carcinoma is the most common

metastasises to cervical and submandibular nodes

Question 3

hypercalcaemia in malignancy

clinical features

Answer 3

non-specific symptoms
secondary to cancer / boney mets / primary hyperthyrodisim / calcium supplemtation

> 2.65mmol/l
Mild- 2.65-3.00
Moderate 3.01-3.40
Severe >3.40

Question 4

hypercalcaemia treatment

Answer 4

IV fluid, IV bisphosphonate pamidronate

Bisphosphonate reduces serum calcium conc by inhibiting bone resorption by inhibiting osteoclast. this reduces the amount of ca2+ in circulatoin.

PTHrP

Question 5

PET scan

Answer 5

PET scan demonstrates any metastatic disease not found at CT/ uses radio labelled molecules to demonstrate high uptake areas of increased metabolism

Question 6

liposarcoma

Answer 6

Most common sarcoma of adulthood (4-60s)

Deep soft tissue of proximal extremities and retroperitoneum are known for developing into care tumours

Question 7

anti-emetic for chemo

Answer 7

ondansetron 5-HT3

Question 8

chemotherapy side effects

Answer 8

cytotoxic meds:

? capaectiabine mouth ulcers, hair loss, pancytopenia, loose stools

bleomycin: induced lung injury
cisplatin: tinnitus and a metallic taste in the mouth
imatinib: fluid retention
vincristine: peripheral neuropathy.