Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

House Clinical Pathology > Tumour Markers > Flashcards

Tumour Markers Flashcards

1
Q

Cancer
—______ growth of cells that can develop into a ______ or _____ and spread to other areas of the body.

A

Uncontrolled

solid mass or tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tumorigenesis: ________ of ______

Metastasis-_____ of _______

A

Formation of tumors

Spreading of tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Oncofetal

Expressed during __________, then reexpressed in ________

A

the development of the fetus

tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Sensitivity

The likelihood that given the presence of disease, a test result ______________.

No ________

A

predicts the presence of the disease

false negatives.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Specificity

The likelihood that given the absence of disease, a test result ____________

No _________

A

excludes the presence of disease

false positives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A Tumour marker Is Produced by ______ or as an effect of __________

A

the tumor

the tumor on healthy tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A Tumour marker

Concentration ___eases with tumor progression

highest levels when ____________

Include diverse molecules such as serum ________,________ antigens, hormones, metabolites, receptors and enzymes

A

Incr

tumors metastasize

proteins; oncofetal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tumor Marker Detection:

Ideally, a tumor marker would be:

A substance that is released (directly or indirectly?) into the _______ detectable at _____ concentrations

Tumor specific ( [high or low?} specificity)

(Present or absent?) in healthy individuals

readily detectable in body fluids.

A

Directly ; bloodstream

small a

High

Absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mention 2 ideal tumour markers that tick all the boxes

A

Unfortunately, no tumour marker fits this ideal model.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Application of tumor markers

_______ populations at risk

______ : Use results from markers, imaging, risk factors, and symptoms

Prognosis: ________ of the marker determines prognosis

A

Screening

Diagnosis

Concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

all tumor markers are good screening tools

T/F

A

F

Not all

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Application of tumor markers

Detection of ________: Once tumor is removed, elevations of marker can indicate ______

Monitoring ________: ____eased levels of tumor marker indicate therapy is working
____eased levels of tumor marker may indicate need for a change to therapy

A

recurrence; regrowth

response to treatment

Decr
Incr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most commonly used method of tumors marker detection?

A

Immunoassay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Immunoassay
Challenges:

•Markers are often above_____

•Hook effect: excessive ____ marker concentrations result in ______

•Heterophile Antibodies
–Interfere with testing due to the presence of __________

•________,_______ and _______ cause interferences

A

linearity; high; false lows

circulating antibodies against animal immunoglobulin

Lipemia, hemolysis and antibody cross reactivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tumor markers: Enzymes

Increase due to ________ of cells
Indicate tumor ______

Examples
__________- Bone, liver, intestine

________- Prostate, lung, breast, colon, ovarian

__________-Liver, lymphomas, leukemias

___________-Prostate

A

metabolic demands; burden

Alkaline phosphatase

Creatine kinase

Lactate dehydrogenase

Prostatic acid phosphatase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Alkaline phosphatase(ALP):

Increased ALP activities are seen in primary or secondary ____ cancer. It’s level may be helpful in evaluating ___________ with _____ or ____ involvement.

A

liver

metastatic cancer with bone or liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Placental ALP, a ____________ elevates in a variety of malignancies including _____,______,______cancers and _____ disease

A

regan isoenzyme

ovarian, lung, GI

Hodgkin’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Prostatic acid phosphatase (PAP)

It is used for staging ____ cancer and for monitoring therapy. Increased PAP activity may be seen in _______,______, and ____ metastasis of other cancers and in some benign conditions such as ________ and _______.

A

prostate

osteogenic sarcoma, multiple myeloma and bone

osteoporosis and hyperparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Prostate Specific Antigen (PSA)
– The clinical use of ____ has been replaced by PSA. PSA is much (more or less?) specific for screening or for detection early cancer. It is found in mainly ______ tissue.

A

PAP

More

Prostatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

PSA exists in two major forms in blood circulation.
The majority of PSA is _______________.

A minor component of PSA is ____.

A

complexed with some proteins

free

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PSA testing itself is effective in detecting early prostate cancer.

A

F

PSA testing itself is not effective in detecting early prostate cancer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Other prostatic diseases, urinary bladder ________ and ______ examination may lead an increased ______ in serum.

A

cateterization

digital rectal

PSA level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The ratio between ____ and ____ PSA is an reliable marker for differentiation of ________ from _______

A

free and total

prostatic cancer from benign prostatic hyperplasia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

The use of PSA should be together with __________ and followed by ________ for an accurate diagnosis of cancer.

A

digital rectal examination

transrectal ultrasonography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

The greatest clinical use of PSA is in the __________ which includes ________,_______, and __________ therapy.

A

monitoring of treatment.

radical prostatectomy, radiation therapy and antiandrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

After treatment, The PSA level should fall below the detection limit.

This may require ________. If PSA still at high level after that, it must be assumed that _________________

A

2-3 weeks

residual tumor is present.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

______________ treatment may have direct effect on the PSA level that is independent of the antitumor effect. This subject must be considered always

A

Androgen deprivation therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Tumor markers: Endocrine/ hormones
Helpful in identification of:

_________
______ tumor
______ tumor

Examples
Beta-human chorionic gonadotropin
Calcitonin
Adrenocorticotropin hormone (ACTH)

A

Choriocarcinoma

Pituitary

Adrenal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Calcitonin
– Calcitonin is a hormone which ____eases blood calcium concentration.
– Its elevated level is usually associated with _________ cancer.

A

decr

medullary thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Calcitonin levels correlates with tumor volume and metastasis.

T/F

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Calcitonin is also useful for monitoring treatment and detecting the recurrence of cancer.

T/F

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

However calcitonin levels are also at a high levels in some patients with cancer of ____,______,_____, and _____ and in nonmalignant conditions such as ____ diseases, ____itis, _____ disease, hyperparathyroidism, myeloproliferative disordes and pregnancy.

A

lung, breast, kidney, liver

pulmonary; pancreat; Paget’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Human Chorionic Gonadotropin (hCG)

–Hormone normally secreted by the ______ to _______
– Molecule consists of two subunits: ____ and ____
– Elevated in ______ tumors, _______ and _______ tumors of the ovary and testis
– Most immunoassays detect either the subunits or the total molecule

A

placenta; maintain pregnancy

alpha & beta

trophoblastic; choriocarcinoma; germ cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Tumor markers: Oncofetal antigens

Become ______ in tumor formation

Examples
–______________
–____________

A

detectable

Carcino-embryonic antigen(CEA)

Alpha-fetoprotein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Oncofetal antigens are Considered normal in fetal development

T/F

A

T

36
Q

Frequently Ordered Tumor Markers

Carcinoembryonic Antigen (CEA)
Expressed during ________ then re-expressed in _______

Clinical use
Used to detect colorectal, lung, breast ovarian, and GI cancers
Monitor therapy

A

fetal development ; tumor growth

37
Q

Carcinoembryonic antigen (CEA)

– It is a ______ protein
– CEA is a marker for ___, gastrointestinal, lung and breast carcinoma.
– CEA levels are also elevated in ____ and some patients having benign conditions such as _____,_____,______ and _____ disease.

A

cell-surface

colorectal

smokers

cirrhosis, rectal polips, ulcerative colitis and benign breast

38
Q

Carcinoembryonic antigen (CEA) is a well defined tumor marker.

T/F

A

T

39
Q

CEA testing should be used for screening.

T/F
With reason

A

F

CEA testing should not be used for screening

Some tumors don’t produce CEA.

40
Q

CEA testing should be used for ______ and _____

A

staging and monitoring therapy.

41
Q

Frequently Ordered Tumor Markers

Alpha(α) Fetoprotein (AFP)

– Synthesized by the _____
– Re-expressed in certain types of tumors
– Normally functions as a ______ and helps to regulate ___________ in the ______
– Used to diagnose _______ carcinoma and ______ tumors (testes, ovaries)

A

fetal liver

transport protein

oncotic pressure in the fetus

hepatocellular; germ cell

42
Q

AFP is useful for screening

T/F

A

T

43
Q

AFP levels greater than _____ μg/L are indicative for cancer except pregnancy

A

1000

44
Q

AFP can be useful in determining prognosis and monitoring therapy of liver cancers

T/F

A

T

45
Q

AFP is also a prognostic indicator of survival.

T/F

A

T

46
Q

Serum AFP levels is less than ___ μg/L in healthy adults.

A

10

47
Q

Elevated AFP levels are associated with (shorter or longer?) survival time.

A

Shorter

48
Q

___________ combined are useful in classifying and staging germ cell tumors.One or both markers are increased in those tumors.

A

AFP and hCG

49
Q

Carbohydrate markers

These markers either are antigens on the ________ or are ________

A

tumor cell surface

secreted by tumor cells.

50
Q

Carbohydrate markers

They are (low or high?)-molecular weight _____ or ________.

____________ have been developed against these antigens.

A

High ; mucins

blood group antigens

Monoclonal antibodies

51
Q

Carbohydrate markers

Most reliable markers in this group are CA ____, CA ___ and CA _______

A

15- 3

125
19-9.

52
Q

CA 15-3

– CA 15-3 is a marker for ____ carcinoma.

Elevated CA 15-3 levels are also found in patients with pancreatic, lung, ovarian, colorectal and liver cancer and in some benign breast and liver diseases.

A

breast

53
Q

CA-15-3 is useful for diagnosis.

A

F

It is not useful for diagnosis.

54
Q

CA-15-3 is most useful for monitoring therapy.

T/F

A

T

55
Q

CA 125

– Although CA 125 is a marker for _____ and ______ carcinomas

-CA 125 can be elevated in pancreatic, lung, breast, colorectal and GI cancers, and in benign conditions such as cirrhosis, hepatitis, endometriosis, pericarditis and early pregnancy.

A

ovarian and endometrial

56
Q

CA 125 is specific.

T/F

A

F

it is not specific.

57
Q

CA 125 is useful in detecting ______________________

A

residual disease in cancer patients following initial therapy.

58
Q

CA 125 is also useful in differentiating benign from malignant disease in patients with ___________

A

ovarian masses.

59
Q

In the detection of recurrence, use of CA 125 level as an indicator is about ___ % accurate.

A

75

60
Q

CA 19-9
– CA 19-9 is a marker for both ———- and ———- carcinoma.However elevated levels were seen in patients with hepatobiliary, gastric,hepatocellular and breast cancer and in benign conditions such as pancreatitis and benign gastrointestinal diseases.

A

colorectal and pancreatic

61
Q

CA 19-9 levels correlate with pancreatic cancer staging

T/F.

A

T

62
Q

CA 19-9 levels is useful in monitoring pancreatic and colorectal cancer.

T/F

A

T

63
Q

Elevated levels of CA 19-9 can be indicative of _____ before detected by radiography or clinical findings in ______ and _________ cancer.

A

recurrence

pancreatic and colorectal

64
Q

CA 15-3 =
CA 125=
CA 19.9=

A

Breast
Ovarian, endometrial
Colorectal, pancreatic

65
Q

PROTEIN MARKERS

Most reliable markers in this group are _______ ,______,______,______

A

β2- microglobulin, ferritin, thyroglobulin and immunoglobulin.

66
Q

β2-microglobulin

β2-microglobulin is a marker for ______,________ . It also increases in ___ inflammation and viral ______.

A

multiple myeloma, Hodgkin lymphoma

chronic; hepatitis

67
Q

Ferritin
– Ferritin is a marker for ____, _____ , liver, lung and breast cancer.

A

Hodgkin lymphoma

leukemia

68
Q

Thyroglobulin

– It is a useful marker for detection of _____ cancer.

A

Differentiated thyroid

69
Q

Immunoglobulin:
– Monoclonal immunoglobulin has been used as marker for ________ for more than 100 years.

A

multiple myeloma

70
Q

Monoclonal paraproteins appear as _______ in the globulin area of the serum protein electrophoresis.

A

sharp bands

71
Q

Bence-Jones protein is a ________________________ in the _____ and it is a reliable marker for multiple myeloma.

A

free monoclonal immunoglobulin light chain

urine

72
Q

RECEPTOR MARKERS

Estrogen and progesterone receptors are used in _____ cancer as indicators for __________

A

breast

hormonal therapy.

73
Q

Patients with ______ estrogen and progesterone receptors tend to respond to hormonal treatment.
Those with _______ receptors can be treated by other treatment modalities.

A

positive

negative

74
Q

Hormone receptors also serve as a prognostic factors in breast cancer.

T/F

A

T

75
Q

Hormone receptors also serve as a prognostic factors in breast cancer.

Patients with ______ receptor levels tend to survive longer.

A

positive

76
Q

Cytoplasmic estrogen receptors are now routinely measured in samples of breast tissue after surgial removal of a tumor.

T/F

A

T

77
Q

Of patients with breast cancer, ___ % have tumors with estrogen receptor.

A

60

78
Q

Approximately _____ of patients with estrogen receptor (+) tumors respond to the hormonal therapy.

___% of patients with estrogen receptor (-) tumors respond to the hormonal therapy.

A

two thirds

5

79
Q

________ receptor testing is a useful adjunt to the estrogen receptor testing. Because ______ receptor synthesis appears to be (independent or dependent?) on estrogen action.

A

Progesterone

progesterone

80
Q

Measurement of progesterone receptors provides a confirmation that _____________. Indeed breast cancer patients with both progesterone and estrogen receptor (+) tumors have a (higher or lower?) response rate to hormonal therapy

A

all the steps of estrogen action are intact

higher

81
Q

Tumor markers can be used to confirm diagnosis

T/F

A

F

Tumor markers can never be used to confirm diagnosis

82
Q

Tumor markers can be used to _______ diagnosis

A

Support

83
Q

Reference value for prostatic specific antigen ?

A

0-4ng/mL

84
Q

Levels of PSA greater than ___ng/ml strongly suggest cancer

A

10

85
Q

(Majority or minority?) of PSA is bound to plasma proteins

(Majority or minority?) is free

A

Majority

Minority

86
Q

CA _____ is a carcinoembryonic antigen

A

19-9

House Clinical Pathology (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions