Ch22 Multiple Myeloma and Related Plasma Cell Disorders

Question 0

What type of cells are responsible for the production of antibodies called immunoglobulin?

Answer 0

Plasma cells

Question 1

Where are plasma cells normally represented?

Answer 1

The final stages of the development of B lymphocytes

Question 2

Subsequent rearrangement of the light chains enables the cell to:

Answer 2

Express surface immunoglobulin

Question 3

B-cells differentiate into:

Answer 3

Plasmablasts

Question 4

What holds together the heavy and light chains in immunoglobulin?

Answer 4

Varying numbers of disulfide bonds

Question 5

What are the 5 types of heavy chains?

Answer 5

Gamma, alpha, Mu, delta, epsilon

Question 6

What are the 2 types of light chains?

Answer 6

Kappa, lambda

Question 7

What immunoglobulin is the initial transient antibody produced in response to infection?

Answer 7

IgM

Question 8

What is the role of IgE?

Answer 8

Allergic/hypersensitive reactions

Question 9

What is the function of IgA?

Answer 9

Provide protection of epithelial surfaces in the GI tract and the airways

Question 10

What is the hallmark condition in plasma cell disorders?

Answer 10

Immunoglobulin overprotection

Question 11

Protein in the serum consists mainly of:

Answer 11

Albumin, immunoglobulin, and a small amount of other proteins

Question 12

How do you measure the immunoglobulin factor?

Answer 12

Total protein - albumin = ig factor

Question 13

What method is usually used when investigating an abnormal M-spike on serum protein electrophoresis?

Answer 13

Immunofixation

Question 14

Name a nephelometry method to measure the degree of turbidty by light scatter caused by antigen-antibody complexes

Answer 14

Quantitative immunoglobulin

Question 15

What syndrome has the presence of excess Ig that can lead to viscous blood resulting in higher resistance to flow in the blood vessels.

Answer 15

Hyperviscosity syndrome

Question 16

What is the result of hyperviscosity?

Answer 16

Decreased blood flow in the small vessels of various vital organs, thus increasing the workload on the heart

Question 17

Low immunoglobulin levels lead to:

Answer 17

Increased susceptibility to infections

Question 18

What are serum immunoglobulins that precipitate reversible on exposure to cold

Answer 18

Cryoglobulins

Question 19

What is the most common plasma cell dyscrasia, altering terminal differentiated B cells?

Answer 19

Multiple myeloma

Question 20

What is presumed to be the origin of the malignant clone in multiple myeloma?

Answer 20

B-cell

Question 21

How is multiple myeloma characterized?

Answer 21

Abnormal proliferation of plasma cells in the BM
Overproduction of monoclonal Ig
Lytic/destructive bone disease

Question 22

Multiple myeloma accounts for____ of all hematological malignancies and ____ of all cancers

Answer 22

10%; 1%

Question 23

What is the median age for MM?

Answer 23

67 years

Question 24

What is plasma cell expansion in MM?

Answer 24

Expanding plasma cell tumors in the BM causing a destruction in the bone surface cortex

Question 25

Late in the disease course for MM, many patients report:

Answer 25

Loss of height because of vertebral collapse

Question 26

What is the major contributor to bone disease in MM?

Answer 26

Inhibition of osteoblasts

Question 27

Increased calcium in the urine can lead to:

Answer 27

Kidney stone and kidney failure

Question 28

What is a major manifestation in MM?

Answer 28

Anemia

Question 29

Diagnosis of MM is based on the symptoms:

Answer 29

``` Anemia Renal insufficiency Bone pain Neuropathy High protein levels ```

Question 30

What is an easy way to assess BM function?

Answer 30

CBC

Question 31

______ in MM you may see teardrop RBC and immature WBC

Answer 31

Late

Question 32

What is the nonspecific marker of tissue breakdown and elevated levels in MM?

Answer 32

Lactate dehydrogenase (LD)

Question 33

Calcium levels are often ________ in myeloma patients

Answer 33

Elevated

Question 34

Chromosomal abnormalities are found in ______ of patients with MM

Answer 34

30-40%

Question 35

What are the 2 pathways for plasma cell tumors that are defined in MM?

Answer 35

One is associated with hyperdiploidy | One is associated by the presence of chromosome translocation involving IgH locus

Question 36

Which immunoglobulin is produced in more than 50% of MM cases?

Answer 36

IgG

Question 37

What are some treatments of MM?

Answer 37

Chemotherapy Allogenic stem cell transplant Drug combinations

Question 38

Name of a malignant lymphoproliferative disorder involving small lymphocytes that exhibit plasma cell differentiation

Answer 38

Waldronstoms macroglobulinemia (WM)

Question 39

What chromosomal abnormality is most common in WM?

Answer 39

Deletion of 6q21, which is detected in 42% of patients

Question 40

What percentage of WM patients experience anemia?

Answer 40

80%

Question 41

What is the primary treatment for WM?

Answer 41

Chemotherapy

Question 42

What is a protein conformation disorder that renders the protein insoluble and results in its deposition in the extra cellular matrix of various organs?

Answer 42

Amyloid

Question 43

What is the most common precursor protein that leads to Amyloidosis?

Answer 43

AL amyloid

Question 44

How does amyloidosis occur?

Answer 44

When insoluble protein fibers are deposited in tissues and organs, impairing their functions

Question 45

What is the aim for treating amyloidosis?

Answer 45

Eliminating the source of the abnormal precursor proteins

Question 46

What lab tests provide the most important prognostic information in multiple myeloid?

Answer 46

Hemoglobin Albumin Beta2- microglobulin

Question 47

Which diagnostic criteria is for WM?

Answer 47

Lytic bone lesion and rouleax

Question 48

What does staging refer to?

Answer 48

Chemotherapy regimen