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[ArchivalUser]

A 27-year-old man develops bilateral parotid gland swelling and orchitis, and is generally ill with fever of 102° F.
Which of the following substances is most likely to be significantly elevated in the patient's serum?


A. Alanine aminotransferase (ALT)

B. Amylase

C. Aspartate aminotransferase (AST)

D. Ceruloplasmin

E. Creatine phosphokinase, MB isoenzyme (CPK-MB)

[ArchivalUser]

B.

[ArchivalUser]

bb

[ArchivalUser]

Explanation:

The correct answer is B. The disease is mumps, caused by a paramyxovirus. In children, mumps causes a
transient inflammation of the parotid glands, and less commonly, the testes, pancreas, or central nervous
system. Mumps tends to be a more severe disease in adults than in children. Mumps in adults involves the
testes (causing orchitis) and pancreas with some frequency. Pancreatic involvement can cause elevation of
serum amylase.

ALT (choice A) and AST (choice C) are markers for hepatocellular damage.

Ceruloplasmin (choice D) is a copper-carrying protein that is decreased in Wilson's disease.

CPK-MB (choice E) is the isoenzyme of CPK that is relatively specific for the myocardium. This enzyme is
increased in the early stages of a myocardial infarction.