B3-043 Plasma Cell Myelomas

Question 1

neoplasms of terminally differentiated, immunoglobin secreting plasma cells

Answer 1

plasma cell neoplasm

Question 2

M component

Answer 2

monoclonal immunoglobin

Question 3

multifocal destructive infiltration of plasma cells in bone marrow

Answer 3

multiple myeloma

plasma cell myeloma

Question 4

M component without features of myeloma

1% a year transform to multiple myeloma

Answer 4

monoclonal gammopathy of undetermined significance

Question 5

CRAB criteria

Answer 5

hyperCalcemia: bone pain, fractures
Renal disease
Anemia, thrombocytopenia
punched out Bone lesions

Question 6

primary cause of death for plasma cell myeloma

Answer 6

infection or renal disease

Question 7

monoclonal immunoglobin or light chain
serum free light chains
rouleaux formation

Answer 7

plasma cell myeloma

Question 8

protein found in urine in plasma cell myeloma

Answer 8

Bence Jones protein

monoclonal free light chain

Question 9

if the y band on electrophoresis has wide distribution

Answer 9

polyclonal

nonspecific marker

Question 10

if the y band on electrophoresis has narrow distribution

Answer 10

hypogammaglobinemia

consider further evaluation for paraprotein

Question 11

a monoclonal band on electrophoresis indicates

Answer 11

M protein

Question 12

y band on electrophoresis indicates

Answer 12

immunoglobins, CRP

Question 13

immunofixation electrophoresis can determine

Answer 13

Ig class
and
detect M protein

Question 14

measurement by nephelometry using antibody to a region of the light chain not normally accessible in intact immunoglobin molecules

Answer 14

free kappa and lamba chains

Question 15

can confirm monoclonality
determines light chain class

Answer 15

kappa:lambda ratio

Question 16

disease progression and monitoring

Answer 16

kappa and lambda levels

Question 17

urine protein electrophoresis has [higher/lower] sensitivity for MFLC/BJP

Answer 17

lower

Question 18

urine immunofixation has [higher/lower] sensitivity for MFLC/BJP

Answer 18

higher

Question 19

24-h urine studies

Answer 19

detect monoclonal free light chains (MFLC) and Bence Jones protein

Question 20

direct measurement from SPE
serum free light chains
urinary MFLC/BJP

Answer 20

m-protein

Question 21

flow cytometry
kappa/lambda immunohistochemistry

Answer 21

bone marrow clonal plasma cells

Question 22

Answer 22

rouleaux

Question 23

> 10% monoclonal plasma cells
nodules or diffuse sheets of plasma cells

Answer 23

plasma cell myeloma

Question 24

CD38+
CD138+

Answer 24

plasma cell myeloma

Question 25

Answer 25

kappa lambda staining of plasma cell myeloma

Question 26

Answer 26

plasma cell myeloma | note eccentric nuclei

Question 27

cast nephropathy

Answer 27

plasma cell myeloma | light chain aggregates form tubular casts

Question 28

plasma cell treatment

Answer 28

immunomodulators (thalidomide) proteosoma inhibitors (bortezomib) monoclonal antibodies (daratumumab) | theres a lot on the slide but these are what he focused on

Question 29

induction of plasma cell myeloma therapy should be followed by

Answer 29

hematopoietic stem cell transplant

Question 30

CD19 CD20 CD103

Answer 30

hairy cell leukemia

Question 31

myeloid markers

Answer 31

CD13 CD33 CD15 myeloperoxidase

Question 32

rearrangement of immunoglobin heavy chains is unique to

Answer 32

B lymphocytes

Question 33

VDJ recombination takes place in the

Answer 33

bone marrow

Question 34

initially, B lymphocytes produce

Answer 34

IgM

Question 35

the primary function of splenic red pulp is

Answer 35

filtration of defective/old RBCs

Question 36

t(8;14)

Answer 36

Burkitt

Question 37

diffuse infiltrate of small, non cleaved cells with high mitotic index, scattered histiocytes

Answer 37

Burkitt

Question 38

nodular architecture with small cell size

Answer 38

follicular

Question 39

diffuse architecture with small cell size

Answer 39

SLL

Question 40

sheets of plasma cells

Answer 40

plasma cell myeloma

Question 41

most neoplasms of small lymphocytes are

Answer 41

indolent

Question 42

aggressive small lymphocyte neoplasm

Answer 42

mantle cell

Question 43

are the cells in plasma cell myeloma monoclonal?

Answer 43

yes

Question 44

the presence of rouleux is due to

Answer 44

elevated serum protein | from elevated immunoglobin levels

Question 45

free monoclonal light chains in the urine are called

Answer 45

bence jones proteins

Question 46

bence jones proteins cause

Answer 46

renal damage

Question 47

patients with MGUS can transform into

Answer 47

plasma cell myeloma

Question 48

anemia and renal dysfunction

Answer 48

plasma cell myeloma

Question 49

most common type of monoclonal immunoglobin in myeloma is

Answer 49

IgG, followed by IgA

Question 50

B cell lymphomas that produce monoclonal immunoglobin usually produce

Answer 50

IgM | rarely IgG

Question 51

translocations involving cyclin D1 are favorable for

Answer 51

plasma cell myeloma

Question 52

translocations involving .... are favorable for plasma cell myeloma

Answer 52

cyclin D1

Question 53

what small molecule inhibitors are effective in plasma cell myeloma?

Answer 53

proteosome | increase apoptotic death due to accumulation of misfolded immunoglobins

Question 54

CD38

Answer 54

plasma cell myeloma

Question 55

what CD marker is characteristic of plasma cell myeloma?

Answer 55

CD38