A physician is working with a 30-year-old male client with Down ...

[j.rubin]

A physician is working with a 30-year-old male client with Down syndrome who has been admitted to hospital with a diagnosis of acute leukemia.
 
  Which of the following physical assessment findings would the physician be more likely to find in an examination of this client than in other clients without Down syndrome?
  A)
  Hepatomegaly
  B)
  Decreased visual acuity
  C)
  Congenital heart defects
  D)
  Diabetes mellitus

Question 2

A 60-year-old man has presented to a clinic and is requesting screening for tumor markers after reading about them in a magazine. What can the clinician most accurately tell the man about the clinical use of tumor markers?
 
  A)
  Tumor markers are a very useful screening tool, but they only exist for a very few types of cancer.
  B)
  Tests for the presence of tumor markers are limited by the fact that they are only accurate in the very early stages of cancer.
  C)
  Tumor markers are an excellent screening tool, but it's only practical to test for those cancers that you're at risk of.
  D)
  Tumor markers alone aren't enough to confirm whether you have cancer or not, so they're not a very useful screening tool.

[stallen]

Answer to Question 1

Ans:
C

Feedback:

Congenital heart defects are associated with Down syndrome. Hepatomegaly, visual disturbances, and diabetes are not associated with Down syndrome.

Answer to Question 2

Ans:
D

Feedback:

As diagnostic tools, tumor markers have limitations. Nearly all markers can be elevated in benign conditions, and most are not elevated in the early stages of malignancy. Hence, tumor markers have limited value as screening tests. Furthermore, they are not in themselves specific enough to permit a diagnosis of a malignancy.