ARDMS Abdomen board- Lab Values Questions and Complete Solutions Graded A+, Exams of Medicine

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ARDMS Abdomen board- Lab Values Questions and Complete Solutions Graded A+ Denning [Date] [Course title]

Alkaline phosphatase is a marker for - Answer: Bone CA lactate dehydrogenase is a marker for - Answer: GI CA & Germ Cell Tumor Carcinoembryonic antigen (CEA) is a marker for - Answer: Colorectal CA, Bile duct CA, breast CA, GI CA, esophageal CA, lung CA, thyroid CA, bladder CA, uterine CA S 100 is a marker for - Answer: melanoma Neurospecific enolase (NSE) is a marker for - Answer: Lung CA Chromogranin A is a marker for - Answer: neuroendocrine tumors CA19-9 is a marker for - Answer: Pancreatic CA, cholangiocarcinoma, GI tract CA, lung CA, colorectal CA CA 72-4 is a marker for - Answer: Gastric, ovarian & colorectal CA CA 15-3/CA 27-29 markers for - Answer: Breast CA Beta 2 microglobulin is a tumor marker for - Answer: Chronic lymphocytic leukemia, multiple myeloma & lymphoma Biliary obstruction causes - Answer: Elevated ALP, direct conjugated bilirubin & GGT Causes of elevated aminotransferases - Answer: Fatty liver, meds, excessive alcohol intake, heart failure, Hep A, B or C, autoimmune hepatitis & inherited disorders Alkaline Phosphatase (ALP) - Answer: Rises in disorders of liver & GB when excretion is impaired (ex obstruction)

Aspartate aminotransferase (AST) - Answer: Increase in presence of liver cell necrosis such as in viral hepatitis Increases with hepatocellular injury (and injury in other tissues, e.g. skeletal and cardiac muscle) What secretes amylase - Answer: Pancreas Kidneys Salivary glands AFP levels are always normal with - Answer: Seminomas Normal LFTs occur with - Answer: Simple cysts Hemorrhagic cysts Adenoma Hemangioma FNH glycogen storage disease Cirrhosis causes increased - Answer: Indirect bilirubin Increased serum aldosterone causes - Answer: Reduced urine output & increased blood volume in the body blood urea nitrogen (BUN) - Answer: Waste product from protein metabolism Unsuitable as single measure of renal function because it varies with urine flow rates & production of urea Serum Creatinine - Answer: Breakdown product of skeletal muscle Filtered out by kidneys Levels vary from 1.2-2.

Hypoalbuminemia - Answer: Low protein can be caused by liver failure, nephrotic syndrome or malnutrition Causes of elevated bilirubin - Answer: Biliary obstruction Elevated serum alpha feta protein is caused by pregnancy and - Answer: HCC germ cell tumor Occasionally pancreatic, stomach or biliary system cancers Can be modestly elevated in hepatitis & cirrhosis AST elevation can be caused by - Answer: Acute hepatic disease or recent myocardial infarction Hepatocellular dysfunction (ex hepatitis) Can cause elevated - Answer: Indirect bilirubin Labs to evaluate liver function - Answer: GGT ALT direct & indirect bilirubin Aspartate aminotransferase (AST) evals for - Answer: Acute hepatic disease prostate-specific antigen (PSA) - Answer: blood test used to screen for prostate cancer Upper limit of normal 4ng/ny Increased AST without ALT occurs with - Answer: Myocardial infarction, heart failure, muscle injury, CNS disease & nonhepatic disorders AST (SGOT) - Answer: Present in liver, heart, skeletal, muscle, kidney & brain so elevation is not specific but is elevated in almost all significant hepatocellular disease AFP (alpha-fetoprotein) elevated in - Answer: HCC, germ cell tumors, Mets & hepatoblastoma

High levels are very suggestive of HCC Thyroid venous blood is drained via - Answer: Superior & middle thyroid veins into internal jugular vein Inferior thyroid vein into innominate veins Glomerular Filtration Rate (GFR) - Answer: Calculated by determining creatinine clearance Requires measurement of serum creatinine, urine creatinine & 24hr urine volume (Urine creatinine x urine volume)/ serum creatinine Arteriovenous shunts - Answer: Connection btw artery & vein Presents as bruit or thrill, hypertension, cardiomegaly & heart failure