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Haematology- Carol > 2.6 myeloma and other plasma cell disorders > Flashcards

2.6 myeloma and other plasma cell disorders Flashcards

1
Q

2 roles of b-cells

A

antibody production

antigen presenting cells

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2
Q

monomer immunoglobulins

A

IgD
IgE
IgG

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3
Q

dimer immunoglobulin

A

IgA

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4
Q

pentamer immunoglobulin

A

IgM

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5
Q

b-cell location in the lymph node

A

follicle geminal centre of the lymph node

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6
Q

what do b-cells do in the lymph node?

A

antigen fit is improved

may return to marrow as plasma cell or circulate as memory cell = site of transformation

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7
Q

gamma globulins most + or most - by electrophoresis?

A

gamma globulin sticks next to the negative electrode- (so presumably positively charged) and largest in size

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8
Q

what test do you do to classify the abnormal protein band?

A

seum immunofixation

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9
Q

how are paraproteins detected?

A

serum electrophoresis

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10
Q

how is bence jones protein detected?

A

urine electrophoresis detects these immunoglobulin light chains

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11
Q

single light chain product

A

kappa light chains

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12
Q

paired light chain product

A

lambda light chains

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13
Q

what is the effect of IL-6 on osteoblasts and osteoclasts?

A

inhibits osteoblasts

activates osteoclasts

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14
Q

renal disease in myeloma

A 
tubular cell damage by light gains 
light chain deposits 
cast nephropathy
sepsis
cypercalcaemia, dehydration 
drugs- nsaids bad 
amyloid 
hyperuricaemia
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15
Q

tamm-horsfal proteins

A

produce casts in myeloma in the thick ascending loop of henle

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16
Q

where does toxic injury occur in the nephron in myeloma?

A

proximal convoluted tubule

17
Q

treatment of cast nephropathy?

A

steroids/chemo

18
Q

myeloma treatment

A

steroids: dexamethasone, prednisolone
akylating agents- cyclophosphamide, melphalan
novels: thalidomide, bortezomib, lenalidomide

19
Q

monitoring of myeloma therapy

A

paraprotein measurement

20
Q

MGUS definition

A

paraprotein

21
Q

risk of progression of MGUS to myeloma

A

1% per year

22
Q

AL amyloidosis

A

light chain that ppts in tissues as insoluble beta pleated sheet

23
Q

diagnosis of AL amyloidosis

A

congo red stain on affected organ = apple green refringenece
-rectal or fat biopsy if high clinical suspicion because its less invasive

24
Q

IgM paraproteinaemia also known as

A

waldenstroms macroglobulinaemia

25
Q

treatment of waldenstroms macroglobulinaemia

A

chemotherapy

PLASMAPHERESIS_ removes paraprotein

Haematology- Carol (29 decks)

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