Biomarkers for cardiovascular risk assessment and cancer

Medical Laboratory Observer, May, 2009

MLO and Northern Illinois University (NIU), Dekalb,IL, are co-sponsors in offering continuing education units (CEUs) for this issue's article on BIOMARKERS FOR CARDIOVASCULAR RISK ASSESSMENT and CANCER BIOMARKERS. CEUs or contact hours are granted by the College of Health and Human Sciences at NIU, which has been approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.(R) program (provider No. 0001) and by the American Medical Technologists Institute for Education (Provider No. 121019; Registry No. 0061). Approval as a provider of continuing education programs has been granted by the state of Florida (Provider No. JP0000496), and for licensed clinical laboratory scientists and personnel in the state of California Provider No. 351). Continuing education credits awarded for successful completion of this test are acceptable for the ASCP Board of Registry Continuing Competence Recognition Program. After reading the article on page 14, answer the following test questions and send your completed test form to NIU along with the nominal fee of $20. Readers who pass the test successfully (scoring 70% or higher) will receive a certificate for 1 contact hour of P.A.C.E[R] credit Participants should allow four to six weeks for receipt of certificates.

The fee for this continuing education test is $20.

The Cover Story, Clinical Issues, and Lab Management published in MLO are peer-reviewed.

Cover story objectives and the CE questions were prepared by Jeanne M. Isabel, MSEd, CLSpH(NCA), MT(ASCP), program director and associate professor, School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb, IL.

Note: This CE test includes questions from two articles featured in the cover story section: one on biomarkers for cardiovascular risk assessment and one on cancer biomarkers.

1. All of the following are lipid modifying medications except

a. statins.

b. omega-3 fish oil.

c. ezetimbe.

d. cetuximab.

2. Biomarkers used for cardiac risk assessment include all of the following except

a. hs-CRP.

b. [Lp-PLA.sub.2].

c. HDL cholesterol.

d. LD.

3. Which of the following is an acute inflammatory marker?

a. ESR

b. hs-CRP

c. RA

d. ANA

4. [Lp-PLA.sub.2] is produced primarily by

a. macrophages.

b. mesothelial cells.

c. neutrophils.

d. lymphocytes.

5. [Lp-PLA.sub.2] has been shown to be a predictor of

a. MI.

b. ischemic stroke.

c. unstable plaque.

d. All of the above.

6. [Lp-PLA.sub.2] has been found to be associated with risk of CHD.

a. TRUE

b. FALSE

7. [Lp-PLA.sub.2] can be measured by

a. absorbance.

b. RIA.

c. ELISA.

d. TLC.

8. The risk for patients with elevated [Lp-PLA.sub.2] and hs-CRP to have a heart attack is

a. twofold.

b. fourfold.

c. sixfold.

d. elevenfold.

9. Testing for [Lp-PLA.sub.2] uses

a. monoclonal antibodies.

b. polyclonal antibodies.

c. latex agglutination.

d. hemagglutination.

10. The current automated assay for [Lp-PLA.sub.2] can be run on which of the following analyzers?

a. Hitachi

b. Roche modular P

c. Olympus

d. All of the above.

11. Cardiologists are recommending which treatment for patients with [Lp-PLA.sub.2]?

a. lower LDL-C

b. lower HDL-C

c. lower TC

d. lower triglyceride

12. Elevated [Lp-PLA.sub.2] is related to atherosclerotic plaque and thrombotic events.

a. TRUE

b. FALSE

13. Cancer cells are not able to evolve to their environment.

a. TRUE

b. FALSE

14. The definition of biomarker is anything associated with a drug response that can be measured.

a. TRUE

b. FALSE

15. Use of which of the following can indicate whether a drug is having the expected effect?

a. skin

b. nails

c. hair follicles

d. teeth

16. Changes in normal cells may occur with

a. loss of oncogenes.

b. loss of DNA repair genes.

c. activation of tumor suppressors.

d. None of the above.

17. Which of the following genetic change transforms a normal cell to a tumor cell?

a. activation of oncogenes.

b. suppression of oncogenes.

c. increase of tumor suppressors.

d. None of the above.

18. Somatic gene changes include

a. mutations.

b. methylation changes.

c. gene rearrangements.

d. All of the above.

19. For a biomarker to be successful it must

a. be associated with a drug response.

b. show clinical utility.

c. be circulating.

d. Both a and b.

20. Detection of circulating nucleic acid shed from cancer cells may be the biomarker of the future.

a. TRUE

b. FALSE

MLO's Continuing Education Test is also online.

Both the CE test and a convenient payment feature are available through the auspices of Northern Illinois University.

Go to www.mlo-online.com/CE.aspx to send electronically with payment.

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