21 - Multiple Myeloma Flashcards
1
Q
Multiple Myeloma
A
- Plasma cell malignancy
- Arises in bone marrow, causing destruction of bone, kidneys, heart
2
Q
Key three classifications of multiple myeloma
A
- MGUS (Monoclonal Gammopathy of Uncertain Significance)
- Smouldering Multiple Myeloma
- Multiple Myeloma
3
Q
Plasma Cell Dyscrasias
A
MGUS > SMM > Multiple Myeloma
4
Q
RIsk factors
A
- Elderly
- Male
- Black
- Family history
- Radiation
- HIV
- MGUS
5
Q
Risk of MGUS progressing to MM
A
1% per year
6
Q
Pathogenesis
A
Increased number of abnormal plasma cells that infiltrate into bone marrow, express RANK ligand which activates osteoclasts, leading to bone destruction, anaemia, and hypercalcaemia leading to renal failure
7
Q
Cytokines involved in MM
A
Increased IL-6 and TNF alpha
8
Q
Mutations in MGUS
A
- (11;14q) translocation
- Ras mutation
- Myc overexpression
9
Q
Mutations in MM
A
- NF-kB mutations
- Myc translocation
- p53 loss
10
Q
Diagnosis of MM
A
- SLiM CRAB
- Blood tests (haemoglobin, calcium)
- Bone marrow biopsy
11
Q
CRAB
A
- Increased calcium level
- Renal dysfunction
- Anemia
- Destructive bone lesions
12
Q
SLiM
A
- S (Sixty % BM plasmacytosis)
- Li (Light chains >100)
- M (MRI)
13
Q
Abnormal monoclonal paraprotein diagnosis
A
- Blood: Serum protein electrophoresis
- Urine: Bence Jones protein
14
Q
Serum Protein Electrophoresis
A
- Measures different fractions of blood proteins (globulins) separated by an electric current
- Blood serum is applied to a buffered agarose gel matrix (pH ~8.6)
- Current applied and globulins are separated based on: charge (Determined by sum of charge of amino acids) and Size of globulin (endo-osmotic force)
15
Q
Albumin
A
Most negatively charged and moves the furthest to the anode
