Chemistry 14 (Tumor markers)

Question 1

Hook effect

Answer 1

very high concentrations give falsely low result

Question 2

free PSA and CA

Answer 2

decreased free and increased bound correlated with CA

Question 3

percent free PSA markedly affected by

Answer 3

protatic and urethral instrumentation

Question 4

pro-PSA

Answer 4

increased in CA

Question 5

non-neoplastic conditions with increased CEA

Answer 5

smoking, PUD, IBD, pancreatitis, hypothyroidism, biliary obstruction, cirrhosis

Question 6

T1/2 of thyroglobulin

Answer 6

65hr

Question 7

anti-thyroglobulin abs

Answer 7

10% of normal, >20% with thyroid CA

Question 8

Tumor-associated trypsin inhibitor (TATI) is seen in

Answer 8

mucinous ovarian CA
ureothelial CA
RCC
Gastric CA
Panc CA
pancreatitis

Question 9

CA-125 shows greatest sensitivity for

Answer 9

non-mucinous ovarian epithelial tumors

Question 10

____ is especially elevated in signet ring gastic CA

Answer 10

TATI

Question 11

non-neoplastic conditions with increased CA125

Answer 11

pregnancy, fibrouds, benign ovarian cysts

PID, ascites, endometriosis

Question 12

palpable adnexal mass + _____ = ______ for ovarian malig

Answer 12

+ CA125>65

= >95% PPV for ovarian malignancy

Question 13

CA125 and prognosis

Answer 13

preop >65 is unfavorable

Question 14

CA27.29 and CA15-3

Answer 14

different epitopes of Brease CA assd MUC1 gene

Question 15

better sens/spec between CA27.29 and CA15-3

Answer 15

CA 27.29

Question 16

best marker for pancreato-biliary CA

Answer 16

CA19-9

Question 17

CA19-9 also increased in

Answer 17

esophageal CA, pancretitis
cholestasis
cholangitis
cirrhosis

Question 18

CA19-9 is not produced by people

Answer 18

who are Lewis Negative

Question 19

AFP synthesized by

Answer 19

fetal yolk sac, live, GI tract

Question 20

variant of gastric CA with increased AFP

Answer 20

hepatoid

Question 21

_____ use has been assd with low level increased HCG

Answer 21

marijuana

Question 22

beta2-microglobulin is independent pronositc factor in

Answer 22

myeloma

Question 23

forgut carcinoids produce

Answer 23

5-HT, catecholamines, 5-hydroxytryptophane

Question 24

midgut carcinoids produce

Answer 24

only serotonin

Question 25

hindgut carcinooids produce

Answer 25

usually are non-secretory | somes produce HCG

Question 26

what is metabolite of serotonin

Answer 26

5-HIAA

Question 27

____ may be most accurate marker for detection of carcinoid tumors

Answer 27

platelet serotonin

Question 28

increased chomogranini seen in

Answer 28

pheochromocytoma carcinoid islet cell tumors small cell CA

Question 29

calcitonin increased in

Answer 29

``` medullary thyroid hashimoto small cell breast CA chronic renal failure zollinger-ellison syndrome ```

Question 30

marker also increased in medullary ca

Answer 30

CEA

Question 31

pheochromocytomas usually produce

Answer 31

epinephrine and norepinephrine

Question 32

extra-adrenal paragangiomas usually produce

Answer 32

only norepinephrine

Question 33

metabolite or normetanephrine

Answer 33

VMA

Question 34

metabolism of epinephrine

Answer 34

made into metanephrine, then sulfated or conjugated and excreted in urine or metabolised into VMA

Question 35

most accurate test for initial screening of paraganglioma/pheo

Answer 35

free plasma metanephrine

Question 36

____ elevated in neuroblastoma

Answer 36

urine VMA and HVA

Question 37

HVA is final metabolic product of

Answer 37

DOPA and dopamine

Question 38

VMA is final metabolic product of

Answer 38

epinephrine and norepinephrine

Question 39

poorly diff neuroblastomas make more ___ than ___

Answer 39

HVA than VMA | decreased VMA/HVA is bad

Question 40

increased levels of NMP22 have been seen in

Answer 40

urothelial CA

Question 41

FISH for aneuploidy of ____ in urothelial CA

Answer 41

3,7,9,17

Question 42

PCA3 is expressed in

Answer 42

prostativ glandular epithelium | encodes protein DD3

Question 43

DD3 overexpressed in

Answer 43

95% of prostate CA

Question 44

urine obtained after prostatic massage is tested for

Answer 44

DD3 RNA transcripts