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SuprIM > 107 Plasma Cell Disorders > Flashcards

107 Plasma Cell Disorders Flashcards

Focus on multiple myeloma

1
Q

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

A

KRAS, NRAS

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2
Q

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

A

40 years

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3
Q

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

A

African Americans, Pacific Islanders

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4
Q

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

A

Mediterranean area

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5
Q

Most common symptom in myeloma (H20 C107 P795)

A

Bone pain

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6
Q

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

A

Dickhoff-1 (DKK-1)

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7
Q

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

A

Pneumonias, pyelonephritis

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8
Q

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

A

Hypercalcemia

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9
Q

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

A

Adult Fanconi syndrome

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10
Q

Normal relative serum viscosity (H20 C107 P796)

A

1.8

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11
Q

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

A

> 4 centipoise

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12
Q

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

A

~40 g/L or 4 g/dL

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13
Q

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

A

50 g/L or 5 g/dL

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14
Q

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

A

70 g/L or 7 g/dL

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15
Q

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

A

Myelin-associated globulin (MAG)

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16
Q

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

A

Thalidomide, bortezomib

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17
Q

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

A

> 15 g/L or 1.5 g/dL

18
Q

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

A

> 30 g/L or >3 g/dL

19
Q

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

A

Local radiation

20
Q

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)

A

IgG3 subclass

21
Q

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

A

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

22
Q

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

A

5 mm

23
Q

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

A

MRI

24
Q

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

A

18F FDG PET/CT

25
Q

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

A

Serum beta2 microglobulin

26
Q

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

A

Chromosome 13q deletion

27
Q

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

A

Every 6 months

28
Q

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

A

Lenalidomide + bortezomib + dexamethasone (RVD)

29
Q

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

A

Herpes zoster

30
Q

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

A

Lenalidomide

31
Q

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

A

Within 6 months

32
Q

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

A

Continuous use of lenalidomide and dexamethasone (RD)

33
Q

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

A

Nonmyeloablative allogeneic transplantation

34
Q

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

A

Daratumumab

35
Q

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

A

Elotuzumab

36
Q

Drug class of panobinostat (H20 C107 P801)

A

Histone deacetylase inhibitor

37
Q

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

A

~3 weeks

38
Q

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

A

~6 h

39
Q

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

A

Plasmapheresis

40
Q

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

A

Plasmapheresis

SuprIM (31 decks)

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