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Médecine interne > Immunoglobuline monoclonale > Flashcards

Immunoglobuline monoclonale Flashcards

0
Q

circonstances cliniques révélatrices Ig monoclonale

A 
AEG
dl osseuses, fractures...
infections récidivantes
sd tumoral
sd hyperviscosité
maladies systémiques
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1
Q

épidémio Ig monoclo

A

fréquence augmente avec l’âge

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2
Q

manifestations systémiques au cours Ig mono

A

amylose
purpura vasc
Raynaud
neuropathie périph

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3
Q

manifestations biologiques au cours Ig mono

A 
VS
hyperCa
anémie
IR
hyperprotidémie
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4
Q

critères diag MGUS

A

1 an

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5
Q

situation permettant de se passer RX et myélo

A

asymptomatique

taux composant monoclonal<15g/L

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6
Q

définition Waldenstrom

A

gammapthie monoclonale IgM>5g/L et infiltration lymphoplasmocytaire avec fibrose réticulinique à iopsie

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7
Q

hémopathiemalignes avec Ig monoclonale

A 
myélome
leucémie
POEMS
amylose AL
plasmocytome
Waldenstrom
LLC
lymphome
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8
Q

3 virus donnant + Og mono

A

EBV
CMV
VIH
(VHC avec cryo)

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9
Q

gammapthie monoclonale assocée pathologie non lymphoIDE

A 
Infection
maladie hépatique chronique
maladie auto I
déficit immunitaire
néo
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10
Q

différents MGUS

A

IG A G M D
gammapathie biclonale
protéinurie Bence Jones

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11
Q

maladie AI donnant + fréquemment Ig mono

A

GS

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12
Q

facteurs influençant disparition Ig monoclonale au cours greffes

A

âge
intensité et durée IS
infections virales
importance stimulation Ag liées greffon

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13
Q

ex clinique dans enquete étiologie gammapathie mono clo

A

amylose? voix, langue, fragilité cut

hémopathie maligne

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14
Q

si Ig G et A

A

recherche myélome

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15
Q

si IgM

A

waldenstrom

16
Q

4 ECP bio à faire en 1ère intention pour MM Vs Waldestrom

A

hémograme
Ca
créat
protéinurie et immunofix

17
Q

si bilan 1ère intention N?

A

si taux composant15: poursuive investigations
myélogramme
bilan radio
béta2 microgb
étude cytogénétique
si IgM: TDM TA, immunophénotypage, BOM, cryo

18
Q

diag diff gammapathie monoclonale

A

pseudo gammapathie monoclonale

gammapathie polyclonale

19
Q

causes de pseudo gammapathie monoclo

A 
pré albu
hyperalpha 2: SN ou infl
hyperlip
complexe Hb-hapto
fibrinogène (erreur technique)
20
Q

étiologie des gammapathie polyclonales

A

infections: bactériens chro, parasitose, virose
hépatopathies
maladie systémiques: GS, LED, AHAI, cryo et sarcoidose
hémopathie: LMNH, MH, métaplasie myéloide, sd myélodys
Berger
Gaucher
malnutrition

Médecine interne (6 decks)

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