6.8 Plasma Cell Disorders

Question 1

Multiple Myeloma

Answer 1

Malignant proliferation of plasma cells in the bone marrow

Question 2

What is the most common primary malignancy of the bone?

Answer 2

Multiple Myeloma

Question 3

What immunological marker will often be elevated in multiple myeloma?

Answer 3

IL-6

Question 4

What is the effect of multiple myeloma on the bone?

Answer 4

The neoplastic plasma cells activate RANK leading to increased osteoclast activity which causes lytic lesion seen on x-ray in the vertebrae and skull

Question 5

What happens to the gamma globulin peak in a patient with multiple myeloma?

Answer 5

M Spike - indication of the monoclonal immunoglobulin formation that is IgG or IgA

Question 6

What is the most common cause of death in patients with multiple myeloma?

Answer 6

Infection

Question 7

What is seen on blood smear of a patient with multiple myeloma?

Answer 7

Rouleaux Formation

Question 8

Bence-Jones Proteins

Answer 8

Increased production of light chains leads to their excretion in the urine which is known as - Bence-Jones proteins

Question 9

Monoclonal Gammopathy of Undetermined Significance

Answer 9

Shows an M spike with no other features of multiple myeloma but patients can go on to develop the disease later

Question 10

Waldenstrom Macroglobulinemia

Answer 10

B cell lymphoma that produces monoclonal IgM

Question 11

What is the cause of the M spike in Waldenstrom’s macroglobulinemia?

Answer 11

IgM