robin082006
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A patient presents to a physician with alternating diarrhea and constipation. The patient looks cachectic to the physician, and questioning reveals a 40-lb. weight loss during the preceding 3 months. Colonoscopy fails to reveal a cause for the symptoms or weight loss. CT of the abdomen demonstrates multiple masses up to 3 cm diameter on the serosal aspect of the small intestine. Which of the following is the most likely to be found?
A. CA-125
B. PSA
C. CEA
D. S-100
E. alpha FP
give your diagnosis and explanation
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| msyamp
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yes it is carcino embyonic antigen. and yes it is carcinoma of the left descending colon with invasive type probably.
Ca 125 is seen in ca ovary
S-100 is seen in scwannoma
alfafetoprotein in liver, chorioca nonseminomatous testis
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| Natasa
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CEA definitely.
Another one that you do for colon CA is CA-19-9 and usually they order both.CEA is elevated from the begining of the disease,while CA-19-9 with advanced disease forms.(from Boards and wards,prep fpr USMLE steps2&3)
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| robin082006
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try again, not CEA
hint: serosal aspect of small intestines. this site of metastasis is most from....?
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| robin082006
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this hint very high yield, I saw three times during doing Qs
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| goljan_fan
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A?
mets from ovary
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| vallia
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I think it is A
the epithelial ovarian cancer usually spreads via local shedding into the peritoneal cavity followed by implantation on the peritoneum. The CA 125 is a surface Antigen specific for epithelial ovarian cancer which corelates with the dimension of metastasis and time of survival after chemotherapy.
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| msyamp
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Ya it is A . the only other possibiity. why robin are you making me go wrong all the time?
haha just kidding. nice questions. send more. and thank you
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| robin082006
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try again
another hint: a kind of skin cancer
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| reet
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S- 100 is the right answer ... MELANOMA ???
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| Geroo
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S-100.metastatic melanoma?but I don't see a hint for it
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| robin082006
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yes, this is melanoma
serosal aspect of small intestine is a special site for melanoma metastasis
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| msyamp
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wow thank you
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| Geroo
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good question robin thanks
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| vallia
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i didn't know that , where do you find this information in the step 1 books?
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