(Goldman, 21/e, pp 751, 1039-1042.) Tumor markers should not be used to diagnose cancer, but may be helpful in following patients for whom a diagnosis has already been made. CEA is associated with colon and breast cancer. CA-125 is associated with ovarian cancer. Lactate dehydrogenase (LDH) is an important prognostic factor for Hodgkin's disease; p2-microglobulin is the most important prognostic factor for multiple myeloma. LDH, AFP, and hCG are associated with testicular cancer, and 5-HIAA is associated with carcinoid syndrome (facial flushing and diarrhea from a tumor usually located in the lung or ileum). AFP is also associated with hepatocellular carcinoma. PSA is associated with prostate cancer. The most commonly used marker for pancreatic cancer is CA 19-9.
317-318. The answers are 317-c, 318-b, d. (Fauci, 14/e, p 670.) The osmotic fragility test is used to identify patients with red blood cell membrane defects (hereditary spherocytosis), and the acid hemolysis test and the sugar-water test are screening tests for paroxysmal nocturnal hemo-globinuria (PNH). Leukocyte alkaline phosphatase is elevated in polycythemia vera, Hodgkin's lymphoma, hairy cell leukemia, aplastic anemia, myelofibrosis, and leukemoid reactions, but is decreased in CML.
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