Term
| What is the clinical use of total PSA? |
|
Definition
| prostate cancer monitoring; prognosis |
|
|
Term
| What is the clinical use of free PSA? |
|
Definition
| distinguish between prostate CA and benign disease |
|
|
Term
| What is the clinical use of CEA? |
|
Definition
| monitoring/pregnosis of breast, colorectal, lung and other cancers |
|
|
Term
| What is the clinical use of CA-125? |
|
Definition
|
|
Term
| What is the clinical use of alpha-fetoprotein as a tumor marker? |
|
Definition
| monitor certain germ cell and hepatocellular cancers |
|
|
Term
| What is the clinical use of beta-HCG? |
|
Definition
| monitor germ cell and trophoblastic cancer |
|
|
Term
| What is the clinical use of hormone receptors (ERP/PRP) as a tumor marker? |
|
Definition
| breast cancer therapy selection and prognosis |
|
|
Term
| What is the clinical use of BR 27.29? |
|
Definition
| monitoring/prognosis of breast cancer |
|
|
Term
| What is the clinical use of CA 15-3? |
|
Definition
| monitor/prognosis of breast cancer |
|
|
Term
| What is the clinical use of BTA level? |
|
Definition
| monitoring/prognosis of bladder cancer |
|
|
Term
| What is the clinical use of NMP22? |
|
Definition
| monitoring/prognosis of bladder cancer |
|
|
Term
| What is the clinical use of CA 19-9? |
|
Definition
| monitoring pancreatic cancer |
|
|
Term
| What is the definition of point of care testing? |
|
Definition
| tests performed on patient samples anywhere outside the main laboratory |
|
|
Term
| Is a "wet prep" of vaginal/cervical secretions considered point of care testing? |
|
Definition
|
|
Term
| What is another name for point of care testing? |
|
Definition
|
|
Term
| T/F Point of care testing must follow all of the basic principles of good laboratory control like quality control/assurance, proficiency testing, assement of competency, etc. that the main lab must follow. |
|
Definition
|
|
Term
| T/F Documentation of good laboratory practice is a must with POCT. |
|
Definition
|
|
Term
| What happens if there is a lack of compliance with regulation of POCT in a hosptial? |
|
Definition
| JCAHO accreditation may be withheld, medicare payments for testing performed may be without, fines and penalties may be imposed |
|
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Term
|
Definition
| when a known sample is assayed before patient speciemns. if the expected result for the known sample is produced, then the unkown patient specimens can be assayed |
|
|
Term
| T/F Quality control is done every day that the test is done. |
|
Definition
|
|
Term
| What is quality assurance? |
|
Definition
| interdisciplinary evaluation of a lab test; not just that the test was performed in a technically correct manner; involves issues of the appropriateness of the test being requested, the quality of collection, patient outcome based on how the test were used, etc. |
|
|
Term
| What is proficiency testing? |
|
Definition
| involves the assay of unknown specimens from an external source |
|
|
Term
| T/F Subscription to PT programs is mandated by law and by accreditation standards. |
|
Definition
|
|
Term
| Which labs are exempt from following CLIA? |
|
Definition
| labs that do only forensic testing, research labs that do not report patient specific results, NIDA approved labs, and state labs licensed under HCFA |
|
|
Term
| What is the clinical laboratory improvement act of 1988? |
|
Definition
| any laboratory soliciting or accepting human specimens for analysis must hold a certificate from the DHHS for EACH category of testing performed; lab registration; and qualification requirements for personel |
|
|
Term
| What are the three levels of complexity? |
|
Definition
| waived, moderate, and high |
|
|
Term
| T/F Laboratories performing waived complexity testing must meet requirements for proficiency testing, patient test management, quality control, quality assurance, and personnel. |
|
Definition
| false; only for moderate or high complexity |
|
|
Term
| What is the complexity of tests that have been approved by the FDA for home use? |
|
Definition
|
|
Term
| What is the complexity of a non automated sed rate? |
|
Definition
|
|
Term
| T/F Waived tests can test for strep A, H. pylori, and cholesterol levels. |
|
Definition
|
|
Term
| T/F Provider performed microscopy can be a waived test. |
|
Definition
|
|
Term
| What is the complexity of a spun microhematocrit? |
|
Definition
|
|
Term
| What tests are included as provider performed microscopy? |
|
Definition
| wet mount, Fern tests, post-coital direct qualitative exams of vaginal or cervical mucous, qualitative semen analysis, KOH, pinworm, fecal leukocyte exam, urine sediment, nasal smears for granulocytes |
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|
Term
|
Definition
| a naturally occurring molecule present in serum/plasma, other body fluids/tissues, that can identify the presence of cancer, assess patient prognosis and/or to monitor a patients response to therapy |
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|
Term
| What are the characteristics of an "ideal" tumor marker? |
|
Definition
| specific for a particular type of tumor and not released by normal tissue, elevations occur with small tumors and early in disease, results can grade and stage the tumor and quantitatively reflects the therapeutic response |
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|
Term
| T/F No tumor markers, to date, are able to screen and diagnose malignancy in an asymnptomatic patient. |
|
Definition
|
|
Term
| Name the current clinical applications of tumor markers. |
|
Definition
| screening, detection, primary diagnosis, staging, prognosis, predicting therapeutic response, disease monitoring |
|
|
Term
| Name a tumor marker used to monitor testicular cancer? |
|
Definition
|
|
Term
| Name a tumor marker used to monitor gestational trophoblastic disase. |
|
Definition
|
|
Term
| Name a tumor marker used to monitor nonseminomatous germ cell tumors. |
|
Definition
|
|
Term
| What is the first step in management of a patient whose pregnancy has ended, but continues to have an enlarging uterus? |
|
Definition
|
|
Term
| From what tissues can a gestational trophoblastic neoplasm arise from? |
|
Definition
| ovarian, testicular tissues or from a pregnancy that has ended |
|
|
Term
| T/F Levels of beta-hCG can help diagnose and predict prognosis in patients with GTN arising from ovarian or testicular cancer. |
|
Definition
|
|
Term
| Where in the fetus is alpha-fetoprotein produced? |
|
Definition
| in the yolk sac and the liver |
|
|
Term
| What types of germ cell tumors are most commonly associated with alpha-fetoprotein (AFP)? |
|
Definition
| nonseminomatous germ cell tumors (embryonal cell carcinoma and yolk sac tumor) |
|
|
Term
| T/F Choriocarcinomas cause elevations in AFP. |
|
Definition
|
|
Term
| Which tumor markers should be measured to monitor nonseminomatous germ cell tumors? |
|
Definition
| monitoring AFP, beta-hCG, and LDH |
|
|
Term
| How do you determine a poor prognosis in nonseminomatous germ cell tumors? |
|
Definition
| when levels of AFP, beta-hCG, and LDH do not decline with treatment |
|
|
Term
| After therapy to treat nonseminomatous germ cell tumors, how often are tumor markers checked? |
|
Definition
| every one or two months for a year and less frequently thereafter |
|
|
Term
| What are the AFP and beta-hCG levels for seminoma? |
|
Definition
| no AFP elevation; occasional/minimal beta-hCG increase |
|
|
Term
| What are the AFP and beta-hCG levels in an embryonal cell carcinoma? |
|
Definition
|
|
Term
| What are the AFP and beta-hCG levels in a dysgerminoma? |
|
Definition
| no AFP elevation; occasional/minimal beta-HCG elevation |
|
|
Term
| What are the AFP and beta-hCG levels in a choriocarcinoma? |
|
Definition
| no AFP elevation; beta-hCG elevation |
|
|
Term
| What are the AFP and beta-hCG levels in a yolk sac tumor? |
|
Definition
| AFP is elevated; beta-hCG is not elevated |
|
|
Term
| What are the AFP and beta-hCG levels of a teratoma? |
|
Definition
|
|
Term
| What are the AFP and beta-hCG levels of a molar pregnancy? |
|
Definition
| only beta-hCG is elevated |
|
|
Term
| What AFP level can be used instead of biopsy to diagnose hepatocellular carcinoma in patients with a hepatic mass and risk factors for HCCA? |
|
Definition
|
|
Term
| What other liver problems besides hepatocellular carcinoma can cause elevated levels of AFP? |
|
Definition
| acute and chronic hepatitis, cirrhosis, and pregnancy (spinal cord abnromality) |
|
|
Term
|
Definition
| an oncofetal glycoprotein expressed in normal mucosal cells and overexpressed in adenocarcinoma, especially colorectal cancer |
|
|
Term
| What are non-neoplastic reasons for elevations in CEA? |
|
Definition
| cigarrette smoking, peptic ulcer disease, inflammatory bowel disease, pancreatitis, hypothyroidism, biliary obstruction, and cirrhosis |
|
|
Term
| What are neoplastic reasons for elevations in CEA? |
|
Definition
| breast, lung, gastric, pancreatic, bladder, medullary thyroid, head and neck, cervical, hepatic, lymphoma and melanoma |
|
|
Term
| Patients with poorly differentiated colorectal carcinoma are likely to have (higher/lower) levels of CEA. |
|
Definition
|
|
Term
| Elevated levels of CEA in patients with known colorectal carcinoma are most commonly seen with... |
|
Definition
| tumor extension into the lymph nodes or distal metastasis |
|
|
Term
| How long does it take CEA levels to return to normal after successful surgical resection of a colorectal carcinoma? |
|
Definition
|
|
Term
|
Definition
| glycoprotein produced by prostatic epithelium |
|
|
Term
| What tissue besides the prostate produces PSA? |
|
Definition
| none; PSA is specific for the prostate |
|
|
Term
| For what other reasons besides prostate cancer can PSA be elevated? |
|
Definition
| prostatitis, benign prostatic hypertrophy, prostatic trauma, after ejaculation |
|
|
Term
| A PSA below ___ means that cancer is unlikely. |
|
Definition
|
|
Term
| A PSA above ___ means cancer is likely. |
|
Definition
|
|
Term
| At what age should men start having an annual prostate evaluation? |
|
Definition
|
|
Term
| What does an annual prostate evaluation consist of? |
|
Definition
|
|
Term
| What is the next step if PSA result is higher than normal or DRE is suspicious? |
|
Definition
| prostate biopsy is required before a definitive diagnosis of cancer can be made |
|
|
Term
| What does an elevated free PSA mean? |
|
Definition
| less likely to be prostate cancer |
|
|
Term
| Which free PSA/total PSA ratio is seldom associated with prostate cancer? |
|
Definition
|
|
Term
| Free PSA/total PSA below __% has a much greater chance of prostate cancer. |
|
Definition
|
|
Term
| If a patient is successfully treated for prostate cancer with radical prostectomy and/or radiation therapy, what should PSA levels be? |
|
Definition
|
|
Term
| Where is cancer antigen 19-9 normally present? |
|
Definition
| intracellular adhesion molecule present in the epithelium of the fetal stomach, intestine, liver, and pancreas |
|
|
Term
| In patients with pancreatic cancer, elevated levels of ____ tends to be associated with advanced disease. |
|
Definition
|
|
Term
| When CA 19-9 levels are over ___ in patients with a pancreatic mass, the positive predictive value for pancreatic cancer is quite high (97%). |
|
Definition
|
|
Term
| Levels of CA 19-9 over 1,000 units/mL in patients with pancreatic cancer means... |
|
Definition
|
|
Term
| What are non-neoplastic conditions that may elevated CA 19-9 levels? |
|
Definition
| gallstones, pancreatitis, cirrhosis of the liver, cholecystitis |
|
|
Term
| Where/when is CA-125 normally expressed? |
|
Definition
| glycoprotein normally expressed in coelomic epithlium during fetal development; the epithelium lines body cavities and envelopes the ovaries |
|
|
Term
| What tumor marker is most often associated with epithelial ovarian cancer? |
|
Definition
|
|
Term
| Besides epithelial ovarian cancer, what other cancers have CA-125? |
|
Definition
| uterus, cervix, breast, lung, pancreas, liver, colon, digestive tract |
|
|
Term
| List the non-neoplastic conditions associated with elevated CA 125. |
|
Definition
| endometriosis, pelvic inflammatory disease, peritonitis, pancreatitis, liver disease, any condition which inflames the pleura, menstration, pregnancy |
|
|
Term
| At what CA 125 levels are benign disease unlikely? |
|
Definition
|
|
Term
| What percent of women with ovarian cancer have elevated levels of CA-125? |
|
Definition
|
|
Term
| What percent of women with stage I ovarian cancer have elevated levels of CA-125? |
|
Definition
|
|
Term
| Why isn't CA 125 used as a screening test for ovarian cancer? |
|
Definition
| insensitive marker in early disease; also, low disease prevalence |
|
|
Term
|
Definition
| guide therapy and for follow-up of disease (every three months for two years) |
|
|
Term
|
Definition
| epitope of the mucin-type glycoprotein, episialin |
|
|
Term
| What tissues express CA 15-3? |
|
Definition
| a variety of normal epithelial cells as well in primary and secondary carcinomas |
|
|
Term
| CA 15-3 is most commonly used to... |
|
Definition
| follow patients with breast cancer |
|
|
Term
| Besides breast cancer, CA 15-3 can also be elevated in... |
|
Definition
| various cancers such as ovarian, pancreatic, lung, and colorectal |
|
|
Term
| Name some benign diseases that cause an elevation of CA 15-3. |
|
Definition
|
|
Term
| Normal levels of CA 15-3 are ____. |
|
Definition
|
|
Term
| Wht percent of patients with early cancer have an elevated 15-3? metastatic cancer? |
|
Definition
|
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