Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Haematology > 2: Myeloma > Flashcards

2: Myeloma Flashcards

1
Q

What is myeloma

A

Uncontrolled proliferation of plasma cells leading to Ig secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does classification of myeloma depend on

A

Ig secreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In which gender is myeloma more common

A

Males (3:2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What age is the peak incidence of myeloma

A

50-70 years-old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What ethnicity is myeloma more common

A

Afro-Carribean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is monoclonal gammopathy of unknown signficiance

A

Where there are plasma cells releasing abnormal antibody, however, levels are significantly less compared to myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What % of plasma cells are normal in MGUS

A

3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What % patients with MGUS will develop myeloma

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a common first presentation in myeloma

A

Back Pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes back pain in myeloma

A

Osteolytic lesions - causing pathological fractures and vertebral collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can osteolytic bone lesions cause

A

Fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a mnemonic to remember symptoms of myeloma

A

CRABBI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does CRABBI stand for

A 
Calcium High 
Renal Failure 
Anaemia 
Bone fractures 
Bleeding 
Infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the symptoms of hypercalcaemia

A

Stones, Bones, Groans and Psychic Overtones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the renal signs of myeloma

A

Renal: dehydration and first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How may anaemia present in myeloma

A

Breathlessness, Pallour, Fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What causes bleeding in myeloma

A

Thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does thrombocytopenia in myeloma manifest

A

Bleeding and bruising

19
Q

What are bone symptoms in multiple myeloma

A

Osteolytic lesions and fractures

20
Q

Why is infection more common in multiple myeloma

A

As monoclonal gammopathy leads to decrease functional Ig - predisposing to infection

21
Q

Explain initial pathophysiology of multiple myeloma

A
  • There is a shift from haematopoietic stem cells to produce plasma cells which produce Ig (light-chains only)
  • These light chains may enter kidney to cause renal failure
22
Q

Explain relationship between multiple myeloma and osteoblasts

A

Multiple myeloma secrete IL3 which inhibits production osteoblasts

23
Q

Explain relationship between multiple myeloma and osteoclasts

A

Multiple myeloma cells have RANKL that stimulate osteoclasts

24
Q

How does multiple myeloma cause anaemia

A
  • Increases haematopoietic stems cells used to produce lymphoid cells (B-cells) decrease those available to produce RBC
  • Causes renal failure, impeding EPO secretion
  • Over-production plasma cells in bone marrow reduces area and nutrients to produce other cells
25
Q

when is multiple myeloma suspected

A

Over 60 year-old with persistent bone pain or unexplained fracture

26
Q

what is basic blood tests should be ordered in multiple myeloma

A

FBC
ESR
Bone Profile
U+E

27
Q

what will be seen on FBC

A
  • Anaemia

- Thrombocytopenia

28
Q

what will be seen on Bone Profile

A
  • High calcium

- Normal ALP

29
Q

If an over-60 year-old with high calcium what tests should be ordered in 48 hours

A

Serum electrophoresis

Bence-Jones Proteins

30
Q

What will be seen on peripheral blood film in multiple myeloma

A

Rouleaux cells

31
Q

What are rouleaux cells

A

Aggregated RBC

32
Q

why are U+E ordered

A

Myeloma can cause renal failure

33
Q

If individual has bone pain what should be ordered

A

X-Ray bone

34
Q

What may be seen in myeloma

A

Raindrop skull = multiple osteolytic lesions of the skill

35
Q

What needs to be ordered to confirm myeloma

A

Trephine bone-marrow biopsy

36
Q

What will be seen on trephine biopsy in multiple myeloma

A

> 10% plasma cells

37
Q

What is the gold-standard to view extent of multiple myeloma disease

A

MRI

38
Q

When do individuals with myeloma require urgent referral to secondary care

A

Calcium >2.9

39
Q

If calcium below 2.9, when should individuals be referred

A

2W referral to haematologist

40
Q

in multiple myeloma how often are patients reviewed

A

3-months

41
Q

what supportive measures are given for myeloma

A
  • NSAIDs: pain
  • Bisphosphonates and Radiotherapy: Bony Lesions
  • Epo: for anaemia
  • Broad spectrum antibiotics
42
Q

What is used to treat multiple myeloma in young individuals

A

Autologous stem cell transplant

43
Q

What is autologous stem cell transplant

A
  • Stem cells taken from individual
  • Then, high dose chemotherapy used to irradiate bone marrow
  • Stem cells re-introduced
44
Q

If individual is not suitable for autologous stem cell transplant what is done

A

High-dose chemotherapy agents

Haematology (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions