107 Plasma Cell Disorders

Question 1

Most frequently mutated genes in multiple myeloma [2] (H20 C107 P794)

Answer 1

KRAS, NRAS

Question 2

Multiple myeloma is uncommon in patients under the age of (H20 C107 P794)

Answer 2

40 years

Question 3

Myeloma is highest in these ethnic groups [2] (H20 C107 P795)

Answer 3

African Americans, Pacific Islanders

Question 4

Immunoproliferative small-intestinal disease (IPSID) with alpha heavy chain disease is most prevalent in this region (H20 C107 P795)

Answer 4

Mediterranean area

Question 5

Most common symptom in myeloma (H20 C107 P795)

Answer 5

Bone pain

Question 6

Protein produced by myeloma cells that supresses osteoblastic new bone formation (H20 C107 P795)

Answer 6

Dickhoff-1 (DKK-1)

Question 7

Most common infection syndromes in myeloma [2] (H20 C107 P795)

Answer 7

Pneumonias, pyelonephritis

Question 8

Most common cause of renal failure in myeloma (H20 C107 P796)

Answer 8

Hypercalcemia

Question 9

Earliest manifestation of tubular damage in myeloma (H20 C107 P796)

Answer 9

Adult Fanconi syndrome

Question 10

Normal relative serum viscosity (H20 C107 P796)

Answer 10

1.8

Question 11

Symtoms of hyperviscosity occur at this viscosity (H20 C107 P796)

Answer 11

> 4 centipoise

Question 12

Symptoms of hyperviscosity occur at this paraprotein concentration for IgM (H20 C107 P796)

Answer 12

~40 g/L or 4 g/dL

Question 13

Symptoms of hyperviscosity occur at this paraprotein concentration for IgG3 (H20 C107 P796)

Answer 13

50 g/L or 5 g/dL

Question 14

Symptoms of hyperviscosity occur at this paraprotein concentration for IgA (H20 C107 P796)

Answer 14

70 g/L or 7 g/dL

Question 15

In >50% of myeloma patients with neuropathy, the IgM monoclonal protein is directed against: (H20 C107 P797)

Answer 15

Myelin-associated globulin (MAG)

Question 16

Sensory neuropathy is a side effect of these therapies for multiple myeloma [2] (H20 C107 P797)

Answer 16

Thalidomide, bortezomib

Question 17

Serum M protein concentration associated with progression of MGUS to MM (H20 C107 P797)

Answer 17

> 15 g/L or 1.5 g/dL

Question 18

Serun M protein concentration associated with progression from SMM to MM (H20 C107 P797)

Answer 18

> 30 g/L or >3 g/dL

Question 19

Both solitary bone plasmacytomas and extramedullary plasmacytomas are highly responsive to this therapy (H20 C107 P797)

Answer 19

Local radiation

Question 20

Among the IgG myelomas, this subclass has the highest tendency to form both concentration- and temperature-dependent aggregates, leading to hyperviscosity and cold agglutination at lower serum concentrations (H20 C107 P798)

Answer 20

IgG3 subclass

Question 21

Definition of myeloma-defining renal insufficiency (H20 C107 P798)

Answer 21

CrCl <40 mL/min or SCrea >177 mmol/L (>2 mg/dL)

Question 22

Minimum size of MRI-detected focal lesion to be classified as myeloma defining event (H20 C107 P798)

Answer 22

5 mm

Question 23

Imaging test used to document extent of bone marrow infiltration and cord or root compression in multiple myeloma (H20 C107 P798)

Answer 23

MRI

Question 24

Recommended imaging test to distinguish between smoldering and active MM (H20 C107 P798)

Answer 24

18F FDG PET/CT

Question 25

Single most powerful predictor of survival in multiple myeloma (H20 C107 P798)

Answer 25

Serum beta2 microglobulin

Question 26

Cytogenetic abnormality that no longer predicts poor prognosis following the use of newer agents for multiple myeloma (H20 C107 P799)

Answer 26

Chromosome 13q deletion

Question 27

Frequency of follow-up for MGUS (H20 C107 P799)

Answer 27

Every 6 months

Question 28

One of the preferred induction therapy for transplant-eligible multiple myeloma patients, achieving close to a 100% response rate (H20 C107 P800)

Answer 28

Lenalidomide + bortezomib + dexamethasone (RVD)

Question 29

Prophylaxis against this viral infection is indicated if bortezomib will be used (H20 C107 P800)

Answer 29

Herpes zoster

Question 30

DVT prophylaxis is required when this immunomodulatory agent is used in the treatment of multiple myeloma (H20 C107 P800)

Answer 30

Lenalidomide

Question 31

In patients receiving lenalidomide, how soon should stem cells be collected? (H20 C107 P800)

Answer 31

Within 6 months

Question 32

Standard of care for maintenance therapy of older adults with myeloma (H20 C107 P801)

Answer 32

Continuous use of lenalidomide and dexamethasone (RD)

Question 33

Type of HSCT than can reduce toxicity in the treatment of myeloma that exploits an immune graft-versus-myeloma effect (H20 C107 P801)

Answer 33

Nonmyeloablative allogeneic transplantation

Question 34

Antibody against CD38 used in treatment of relapsed myeloma (H20 C107 P801)

Answer 34

Daratumumab

Question 35

Antibody against SLAMF7 used in the treatment of relapsed or refractory myeloma that cannot be used as a single agent

Answer 35

Elotuzumab

Question 36

Drug class of panobinostat (H20 C107 P801)

Answer 36

Histone deacetylase inhibitor

Question 37

Half-life of serum M component (H20 C107 P801)

Answer 37

~3 weeks

Question 38

Functional half-life of light chains (H20 C107 P801)

Answer 38

~6 h

Question 39

In the event of acute renal failure in myeloma, this therapy is ~10x more effective at clearing light chains (H20 C107 P801)

Answer 39

Plasmapheresis

Question 40

Treatment of choice for hyperviscosity syndromes in multiple myeloma (H20 C107 P801)

Answer 40

Plasmapheresis