Lectures Flashcards
What is the RES?
In anatomy the term “reticuloendothelial system”, often associated nowadays with the mononuclear phagocyte system, was originally launched by the beginning of the 20th century to denote a system of specialised cells that effectively clear colloidal vital stains from the blood circulation.
What are Lordoses and Kyphoses?
Lordosis = Anterior curvature of the spine (Cervical and Lumbar) Kyphosis = Posterior curvature of the spine (Thoracic and Sacral)
What are the differences between monoclonal and polyclonal antibodies?
Outline the pathophysiology of myeloma
Myeloma is a malignancy of plasma cells.
When someone has myeloma, a malignant clone, a rogue plasma cell, reproduces in an uncontrolled fashion, resulting in overproduction of the specific antibody the original cell was generated to produce.
When there is a malignant clone, there is usually overproduction of a single antibody, resulting in a “spike” on the normal distribution (sharp peak on the graph), which is called an M spike (or monoclonal spike).
People will sometimes develop a condition called MGUS (Monoclonal gammopathy of undetermined significance), where there is overproduction of one antibody but the condition is benign (non-cancerous).
An excess in the blood is known as paraproteinemia. Paraproteins form a narrow band, or ‘spike’ in protein electrophoresis as they are all exactly the same protein. Unlike normal immunoglobulin antibodies, paraproteins cannot fight infection.
Serum free light-chain measurement can detect free light chains in the blood. Monoclonal free light chains in the serum or urine are called Bence Jones proteins.
What is MGUS?
People will sometimes develop a condition called MGUS (Monoclonal gammopathy of undetermined significance), where there is overproduction of one antibody but the condition is benign (non-cancerous).
What are the main dangerous consequences of myeloma?
This proliferation of the myeloma protein has several deleterious effects on the body, including
- Impaired immune function
- Abnormally high blood viscosity (“thickness” of the blood)
- Kidney damage
- Bone Damage
Draw a diagram of how bone marrow stromal cells and myeloma combine to inhibit osteoblasts and lead to uncontrolled bone destruction?
How does hypercalcaemia cause kidney failure and polyuria?
Hypercalcemia causes
- Reduced glomerular filtration rate
- Increased sodium excretion
- Depletion of total body water, leading to increased bicarbonate reabsorption and metabolic alkalosis.
Up to 20% of patients with hypercalcemia develop polyuria. The postulated mechanism is downregulation of aquaporin-2 water channels, and calcium deposition in the medulla with secondary tubulointerstitial injury, leading to impaired generation of the interstitial osmotic gradient.
What is a lytic lesion?
An osteolytic lesion is a softened section of a patient’s bone formed as a symptom of specific diseases, including breast cancer and multiple myeloma. This softened area appears as a hole on X-ray scans due to decreased bone density,
What is metastasis?
Metastasis is a pathogenic agent’s spread from an initial or primary site to a different or secondary site within the host’s body;[1]
The term is typically used when referring to metastasis by a cancerous tumor.[2] The newly pathological sites, then, are metastases (mets).[3][4]
It is generally distinguished from cancer invasion, which is the direct extension and penetration by cancer cells into neighboring tissues.[5]
What is Glycosylation?
Glycosylation is the reaction in which a carbohydrate, i.e. a glycosyl donor, is attached to a hydroxyl or other functional group of another molecule in order to form a glycoconjugate. In biology, glycosylation usually refers to an enzyme-catalysed reaction, whereas glycation may refer to a non-enzymatic reaction.
What is allelic exclusion?
Allelic exclusion is a process by which only one allele of a gene is expressed while the other allele is silenced. This phenomenon is most notable for playing a role in the development of B lymphocytes, where allelic exclusion allows for each mature B lymphocyte to express only one type of immunoglobulin.
What are the possible substitutions/deletions/additions to genetic code and what results do they induce?
Silent mutation
A change of residue that - due the degenerative nature of the codon code - doesn’t cause a change in which amino acid is produced
Mis-sense mutation
A change of residue that causes a different amino acid to be produced
Nonsense mutation
A change of residue that causes a stop codon to be produced, often resulting in a failed protein
Deletions and Additions
Can be
- In-frame (multiple of three) - A single change in the line of amino acids produced
- Frameshift (not multiple of three) - A disruption and shift of the code, leading to an entirely different chain of amino acids
Why does myeloma cause rouleaux formation?
High levels of monoclonal immunoglobulins in patients with myeloma cause the red cells in peripheral blood smears to stick to one another in a linear fashion - a phenomenon labeled rouleaux formation. The high levels of M component also cause bluish staining of the background on Wright-Giemsa stain as seen in this image. Rouleaux formation is not specific for plasma cell disorders.
What are the main three types of Globulin?
Produced in the Liver
Alpha
Beta
Produced by B-cells/Plasma cells
Gamma (Ig/Antibodies)
What is the function of Alpha globulins?
What is the function of Beta globulins?
What is the function of Gamma globulins?
What is the SLiM CRAB criteria for MM?
What are the rough half-lives of each class of antibody?
