Haematoncology

Question 1

Cancer stem cells accumulate leading to a

Answer 1

constant supply of malignant clone

Question 2

clonal disorder originates from

Answer 2

a single progenitor cell

Question 3

Point mutations include

Answer 3

missense
non-sense
frameshift

Question 4

Translocation mutations include

Answer 4

chimeric genes/proteins

overexpression of a normal cellular gene

Question 5

Genetic abnormalities include

Answer 5

poijnt mutations
duplications
translocations
gene and chromosomal deletions

Question 6

Mutated cells acquire characteristics of what cell

Answer 6

stem cells

Question 7

what do mutated cells lead to

Answer 7

population expansion and avoidance of cell death

Question 8

Myeloma is the clonal disorder of what cell

Answer 8

plasma cells

Question 9

what does MGUS mean

Answer 9

monoclonal gammopathy of undetermined experience

Question 10

what antigen experience in myeloma

Answer 10

igG or IgA
IgM
kappa/lamda light chain restrictions

Question 11

5 things in the anatomy of a plasma cell

Answer 11

perinuclear halo/Golgi zone 
Eccentric nucleus 
Clock face nucleus 
Oval cell shape 
Basophilic cytoplasm

Question 12

what are the drivers of clonal evolution

Answer 12

Clonal competition
Tumour microenvironment
Treatment Immune system

Question 13

Initiation in Post - GC Bcell what happens

Answer 13

hyperdiploidy

IgH translocations

Question 14

MGUS to -smm to MM progression inlcudes

Answer 14

KRAS mutation
MYC activation
Genomic instability
TP53 inactivation

Question 15

MM to EMD progression

Answer 15

secondary genetic events
pattern of mutations
Del (17p) TP53

Question 16

Clinical Presentations of Myeloma

Answer 16

Normocytic normochromic anaemia (75%)
Bone pain (60%)
Fatigue (30%)
Weight loss (25%)
Renal impairment (15%)
Hyperviscosity 
Recurrent infection s

Question 17

Myeloma is an

Answer 17

incurable lymphoid malignancy of post germinal centre of origin

Question 18

Typical findings on a blood film from a patient with myeloma

Answer 18

Rouleaux, background staining and in this case thrombocytopenia

Question 19

In blood findings of myeloma the results present and increase in

Answer 19

circulating immunoglobulin

Question 20

Bone marrow in myeloma will present

Answer 20

an accumulation of malignant plasma cells

Question 21

What components can be use to diagnose the condition of myeloma

Answer 21

secretion of immunoglobulin

Question 22

When do Bence jones appear in urine

Answer 22

Failure to filter free light chains

Question 23

The 4 things that make up CRAB criteria

Answer 23

Hypercalcaemia

Renal impairment = formation o frenal cast; Tamm Horsfall protein

Anaemia

Bone lesions - lytic lesions and pathological fractures

Question 24

What is a frequent finding of patients with myeloma

Answer 24

Punched out lesions and fractures

Question 25

Appearance of bone lesions

Answer 25

soft and gelatinous like fish flesh

Question 26

stromal cells have the affect of

Answer 26

greatly promoting the growth, survival, drug resistance and migration of myeloma.

Question 27

myeloma cells induce stromal cells to

Answer 27

to produce RANKL and interleukin -6 which induce proliferation of osteoblasts

Question 28

Myeloma cells also produce what inhibitory factors

Answer 28

DKK1, IL-3, soluble frizzle-related protein-2 and IL-7, which suppress osteoblast differentiation and new bone formation. DKK1, Dickkopf; IL, interleukin.

Question 29

myeloma produces what activating factors

Answer 29

Myeloma cells produce factors that directly or indirectly activate osteoclasts, such as macrophage inflammatory protein-1α and IL-3.