Clinical Chem Test Bank (Final Exam)
1. In which of the following disorders would the maternal serum level of 1-
fetoprotein be elevated?
A. Neural tube defect.
B. Cardiac ischemia.
C. Down syndrome.
D. Small cell lung carcinoma - correct answer A. Neural tube defect
2. Which of the following is FALSE about PSA?
A. It is a single-chain glycoprotein
B. It is used as a tumor marker
C. It is not elevated in benign prostatic hyperplasia
D. It is quantified in serum by immunoassays - correct answer C. It is not
elevated in benign prostatic hyperplasia.
3. Which of the following biomarkers is elevated in nonmucinous epithelial
ovarian cancer?
A. CA 15-3
B. CA 19-9
C. CA 125
D. CEA - correct answer C. CA 125
4. Which of the following is a sialylated Lewis blood group antigen associated with
colorectal cancer?
A. CA 125
B. CA 15-3
C. PSA
D. CA 19-9 - correct answer D. CA 19-9
5. Which of the following biomarkers are elevated in advanced stages of breast
cancer?
,Clinical Chem Test Bank (Final Exam)
A. Total and free PSA
B. CEA and alpha-fetoprotein
C. CA 15-3 and CA 549
D. DUPAN-2 and Gastrin - correct answer C. CA 15-3 and CA 549
6. Which tumor marker is associated with cancer of the urinary bladder?
A. CA 125
B. CA19-9
C. CA 50
D. Nuclear matrix protein - correct answer D. Nuclear matrix protein
7. What is the primary clinical usefulness of measuring carcinoembryonic antigen?
A. Diagnosis of lung cancer
B. Diagnosis of colorectal cancer
C. Screening for breast cancer
D. Monitoring for recurrence of colon cancer - correct answer D. Monitoring for
recurrence of colon cancer
8. Which of the following is used to assess the usefulness of trastuzumab
(Herceptin®) therapy for breast cancer?
A. CA 15-3
B. HER-2/neu
C. CA 125
D. Prolactin - correct answer B. HER-2/neu
9. Which type of hCG test would be most useful to assess a person suspected of
having testicular cancer?
A. Plasma immunoassay for intact hCG and the β-hCG subunits
B. Plasma immunoassay fro the free alpha and β-hCG subunits
,Clinical Chem Test Bank (Final Exam)
C. Urine assay for hCG-β core
D. Plasma immunoassay for intact hCG only - correct answer A. Plasma
immunoassay for intact hCG and the β-hCG subunits
10. A markedly elevated serum AFP is associated with which of the following?
A. Ovarian cancer
B. Lung cancer
C. Hepatoma
D. Breast cancer - correct answer C. Hepatoma
11. Which of the following assays is recommended as a screening test for
colorectal cancer in persons over 50 years of age?
A. Fecal typsin
B. AFP
C. BTA
D. Occult blood t test - correct answer D. Occult blood test
12. Which of the following must be determined to calculate diagnostic specificity?
A. True-negatives and false-positives
B. True-positives and false-positives
C. True-positives and false-negatives
D. True-negatives and false-negatives - correct answer A. True-negatives and
false-positives
13. A new tumor marker assay for prostate specific antigen (PSA) is evaluated for
sensitivity by testing serum samples from patients who have been diagnosed as
having prostate cancer. The following results were obtained:
Number of prostate cancer patients who tested positive by the new assay = 42
out 46
, Clinical Chem Test Bank (Final Exam)
Number of patients who did not have cancer and tested negative by the new
assay = 31 out of 32
What is the sensitivity of the new assay for PSA?
A. 98.0%
B. 95.0%
C. 91.3%
D. 88.5% - correct answer C. 91.3%
14. Which statement below best describes the molecular difference between free
PSA (fPSA) and complex PSA (cPSA)?
A. Free PSA is bound by compounds such as ACT, PCI, API, or AMG
B. Free PSA is an active form that can complex with protease inhibitors
C. Free PSA is not bound by compounds such as ACT, PCI, API, or AMG
D. Free PSA cannot be detected in serum, whereas complex PSA can - correct
answer C. Free PSA is not bound by compounds such as ACT, PCI, API, or AMG
15. The production of alpha fetal protein (AFP) in a healthy individual is best
reflected by which of the following statements?
A. The production of AFP remains the same through life
B. The production of AFP declines rapidly at birth and healthy adults and children
have negligible or undetectable levels in serum
C. The production of AFP declines rapidly at birth and healthy adults and children
have higher than normal levels in serum
D. The production of AFP declines rapidly at birth and healthy adults and children
have negligible or undetectable levels in serum - correct answer D. The
production of AFP declines rapidly at birth and healthy adults and children have
negligible or undetectable levels in serum
16. The combination of squamous cell carcinoma antigen (SCCA) and CYFRA 21-1
test results can be used to provide reliable laboratory data for the differential
diagnosis of which disease?
1. In which of the following disorders would the maternal serum level of 1-
fetoprotein be elevated?
A. Neural tube defect.
B. Cardiac ischemia.
C. Down syndrome.
D. Small cell lung carcinoma - correct answer A. Neural tube defect
2. Which of the following is FALSE about PSA?
A. It is a single-chain glycoprotein
B. It is used as a tumor marker
C. It is not elevated in benign prostatic hyperplasia
D. It is quantified in serum by immunoassays - correct answer C. It is not
elevated in benign prostatic hyperplasia.
3. Which of the following biomarkers is elevated in nonmucinous epithelial
ovarian cancer?
A. CA 15-3
B. CA 19-9
C. CA 125
D. CEA - correct answer C. CA 125
4. Which of the following is a sialylated Lewis blood group antigen associated with
colorectal cancer?
A. CA 125
B. CA 15-3
C. PSA
D. CA 19-9 - correct answer D. CA 19-9
5. Which of the following biomarkers are elevated in advanced stages of breast
cancer?
,Clinical Chem Test Bank (Final Exam)
A. Total and free PSA
B. CEA and alpha-fetoprotein
C. CA 15-3 and CA 549
D. DUPAN-2 and Gastrin - correct answer C. CA 15-3 and CA 549
6. Which tumor marker is associated with cancer of the urinary bladder?
A. CA 125
B. CA19-9
C. CA 50
D. Nuclear matrix protein - correct answer D. Nuclear matrix protein
7. What is the primary clinical usefulness of measuring carcinoembryonic antigen?
A. Diagnosis of lung cancer
B. Diagnosis of colorectal cancer
C. Screening for breast cancer
D. Monitoring for recurrence of colon cancer - correct answer D. Monitoring for
recurrence of colon cancer
8. Which of the following is used to assess the usefulness of trastuzumab
(Herceptin®) therapy for breast cancer?
A. CA 15-3
B. HER-2/neu
C. CA 125
D. Prolactin - correct answer B. HER-2/neu
9. Which type of hCG test would be most useful to assess a person suspected of
having testicular cancer?
A. Plasma immunoassay for intact hCG and the β-hCG subunits
B. Plasma immunoassay fro the free alpha and β-hCG subunits
,Clinical Chem Test Bank (Final Exam)
C. Urine assay for hCG-β core
D. Plasma immunoassay for intact hCG only - correct answer A. Plasma
immunoassay for intact hCG and the β-hCG subunits
10. A markedly elevated serum AFP is associated with which of the following?
A. Ovarian cancer
B. Lung cancer
C. Hepatoma
D. Breast cancer - correct answer C. Hepatoma
11. Which of the following assays is recommended as a screening test for
colorectal cancer in persons over 50 years of age?
A. Fecal typsin
B. AFP
C. BTA
D. Occult blood t test - correct answer D. Occult blood test
12. Which of the following must be determined to calculate diagnostic specificity?
A. True-negatives and false-positives
B. True-positives and false-positives
C. True-positives and false-negatives
D. True-negatives and false-negatives - correct answer A. True-negatives and
false-positives
13. A new tumor marker assay for prostate specific antigen (PSA) is evaluated for
sensitivity by testing serum samples from patients who have been diagnosed as
having prostate cancer. The following results were obtained:
Number of prostate cancer patients who tested positive by the new assay = 42
out 46
, Clinical Chem Test Bank (Final Exam)
Number of patients who did not have cancer and tested negative by the new
assay = 31 out of 32
What is the sensitivity of the new assay for PSA?
A. 98.0%
B. 95.0%
C. 91.3%
D. 88.5% - correct answer C. 91.3%
14. Which statement below best describes the molecular difference between free
PSA (fPSA) and complex PSA (cPSA)?
A. Free PSA is bound by compounds such as ACT, PCI, API, or AMG
B. Free PSA is an active form that can complex with protease inhibitors
C. Free PSA is not bound by compounds such as ACT, PCI, API, or AMG
D. Free PSA cannot be detected in serum, whereas complex PSA can - correct
answer C. Free PSA is not bound by compounds such as ACT, PCI, API, or AMG
15. The production of alpha fetal protein (AFP) in a healthy individual is best
reflected by which of the following statements?
A. The production of AFP remains the same through life
B. The production of AFP declines rapidly at birth and healthy adults and children
have negligible or undetectable levels in serum
C. The production of AFP declines rapidly at birth and healthy adults and children
have higher than normal levels in serum
D. The production of AFP declines rapidly at birth and healthy adults and children
have negligible or undetectable levels in serum - correct answer D. The
production of AFP declines rapidly at birth and healthy adults and children have
negligible or undetectable levels in serum
16. The combination of squamous cell carcinoma antigen (SCCA) and CYFRA 21-1
test results can be used to provide reliable laboratory data for the differential
diagnosis of which disease?
