Your 66-year-old male patient complains of weakness, fatigue, ...

[sjones]

Your 66-year-old male patient complains of weakness, fatigue, chronic constipation for the last month, and dark stools. On CBC, his results show iron deficiency anemia. Colon cancer is diagnosed.
 
  Which of the following laboratory tests is used to follow progress of colon cancer?
  A. Alpha fetoprotein (AFP)
  B. Carcinogenic embryonic antigen (CEA)
  C. Carcinoma antigen 125 (CA-125)
  D. Beta-human chorionic gonadotropin (beta HCG)

Question 2

A 16-year-old female with anorexia and bulimia is admitted for hematemesis. She admits to inducing vomiting often. On physical examination, you note pallor, BMI less than 15, and hypotension. A likely reason for hematemesis is:
 
  A. Mallory-Weiss tear
  B. Cirrhosis
  C. Peptic ulcer disease
  D. Esophageal varies

[frre432]

Answer to Question 1

ANS: B
AFP can help diagnose and guide the treatment of liver cancer (hepatocellular carcinoma). CA-125 is the standard tumor marker used to follow women during or after treatment for epithelial ovarian cancer (the most common type of ovarian cancer) as well as fallopian tube cancer and primary peritoneal cancer. Serum beta HCG is a pregnancy marker. CEA is not used to diagnose or screen for colorectal cancer, but it's the preferred tumor marker to help predict outlook in patients with colorectal cancer. The higher the CEA level at the time colorectal cancer is detected, the more likely it is that the cancer is advanced.

Answer to Question 2

ANS: A
Upper GI hemorrhage may result from a tear at the gastroesophageal junction, known as a Mallory-Weiss tear. A patient may develop more than one tear. These tears are most common in alcoholic or bulimic patients following repeated episodes of vomiting or severe retching. If a laceration/tear of the mucosa causes GI bleeding, the patient may demonstrate alterations in hemodynamic status.