3. Multiple Myeloma

Question 1

Malignant proliferation of plasma cells that infiltrate bone marrow

Answer 1

Multiple Myeloma

Question 2

Kahler’s disease aka

Answer 2

Multiple Myeloma

Question 3

mc primary malignant bone tumor

Answer 3

Multiple Myeloma

Question 4

• Anemia due to diseased hematopoietic tissue by
  proliferating plasma cells
• Osteopenia in bones with red bone marrow
• Abnormal serum and urinary proteins
• Renal disease

Answer 4

Multiple Myeloma

Question 5

cardinal symptom of Multiple Myeloma

Answer 5

Pain (aggravated by activity)

Question 6

in multiple myeloma, slight strain may produce

Answer 6

pathologic
compression fractures that may result in
paraplegia

Question 7

• Weight loss
• Cachexia
• Anemia
• Unexplained Osteoporosis

Answer 7

Multiple Myeloma

Question 8

m/c affected bones in Multiple Myeloma

Answer 8

Spine and other red marrow containing bones such as flat bones

Question 9

• “M spike” in 90% of patients
• IgG myeloma 50%
• Bence Jones proteinuria

Answer 9

Multiple Myeloma

Question 10

For multiple myeloma we aspirate and biopsy bone marrow

of

Answer 10

sternum and ilium

Question 11

reflects microscopic

appearance of nuclei in multiple myeloma

Answer 11

Round cell disorder

Question 12

Multiple, permeative lesions, that are filled by gelatinous,

red, soft masses of neoplastic plasma cells, that are surrounded by areas of increased

Answer 12

osteoclastic activity

Question 13

Multiple myeloma patients usually die of

Answer 13

pneumonia and
respiratory failure
(possibly renal failure)

Question 14

May erode into adjacent bony structures and is m/c seen in nasopharynx

Answer 14

Extraosseous Plasmacytoma

Question 15

are bones scans helpful for multiple myeloma?

Answer 15

NO

Question 16

Bone scans will only show increased uptake in multiple myeloma if
__________ is present

Answer 16

pathological fracture

Question 17

bone scan are negative in MM because they depend upon

Answer 17

osteoblastic

activity

Question 18

Plasma cells release __________ , therefore osteoblasts are deficient in myeloma patients

Answer 18

osteoclastic activating

factor

Question 19

Radiologic Hallmark of multiple myeloma

Answer 19

Punched Out Lesions

Question 20

• Multiple round lytic lesions
• Raindrop skull
• Uniform lesions

Answer 20

Punched Out Lesions

Question 21

may be earliest radiographic sign in Multiple Myeloma

Answer 21

Osteoporosis

wrinkled vertebrae

Question 22

Pedicle sign is due to deficiency of

Answer 22

red marrow

(not a reliable sign for MM)

Question 23

Osteoblastic lesions are very rare prior to

Answer 23

treatment with radiotherapy or drugs

Question 24

over what % of patients with MM die within 3 years?

Answer 24

90

Question 25

Agricultural workers, farmers, sheet metal workers and persons employed in the nuclear industry or
who are exposed to ________ are at increased risk
of developing ________.

Answer 25

wood dust, multiple myeloma

Question 26

Patients with multiple myeloma commonly

present with

Answer 26

osteopenia and back pain

Question 27

30% of MM patients present with a

Answer 27

pathologic fracture

Question 28

Localized form of plasma cell proliferation

Answer 28

Solitary Plasmacytoma

Question 29

Geographic radiolucent lesion, often highly

expansile, with a soap bubble appearance

Answer 29

Solitary Plasmacytoma

Question 30

__ % of patients with a Solitary Plasmacytoma develop diffuse MM and die within 5 years

Answer 30

70

Question 31

essential after DX of Solitary Plasmacytoma

Answer 31

Long term follow-up

Question 32

Raindrop Skull

Answer 32

multiple myeloma