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internal 4th > MM > Flashcards

MM Flashcards

1
Q

WHAT IS MM

A

cancer of b cellls (plasma cells)

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2
Q

what kind of antibodies are secreted

A

mostly IG G type

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3
Q

epidemiology

A

elderly just like cll

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4
Q

m protein

A

An antibody found in unusually large amounts in the blood or urine of people with multiple myeloma

stands for monocolal

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5
Q

what is the effect of having so many antibodies

A

they are uselss and makes the blood really viscous causing problems like visual, headaches clots

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6
Q

symptoms

pneumonic

A

bONE PAIN
PATHOLOGIC FRACRYRE and vertenra compression
RECURRENT INFECTION

CRAB HAI

-hypercalcemia
renal impariemtns
hyperviscsty
amylodioss

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7
Q

why is renal damage a thing

A

because hypercalcemia causes renal damage! and also the depostion of light chains

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8
Q

what type of AMYLOIDOSI

A

AL

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9
Q

DIAGNOSIS

A

x ray- look at osteolytic lesions common words is ‘punched out lesions’

bloods- anemia , u&E renal failure , hypercalcemiA
NB- ESR OVER 100

urine - bence jones proteins

electrophoresis of urine will show paraprotein spike

bM aspiration if 10 % of cells are plasma cellls

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10
Q

b2 microglobilin is used in which cancers

A

CLL, lymhomas , MM

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11
Q

THERE IS A CORRELATION WITH B 2 MICROGLOBLIN AND

A

kidney problems so the higher the level the higher the kindey issues

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12
Q

staging is

A

durie and salmon

INTERANTIONAL STAGING SYSTEM

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13
Q

what does the staging classifcation look at

A

HB levels
calcium levels
bone lesiosn
creatinin levels >2 or <2

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14
Q

durie and salmon

A
  1. low tumour mass

2.intermediate tumour mass

  1. high tumour mass
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15
Q

how to treat the hypercalcemia

A

calcitonin

bisphophonates

diueretics

CS- they increase urinary excretion and decrease gut absorption

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16
Q

what is the similarities of CLL and mM

A

NOT EVERY PATIENT REQUIRES TX

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17
Q

INTERNATIONAL STAGIG YSTSEM

A

looks at b2 microglobulin levels

albumin level

3 stages

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18
Q

rituximab marker

A

CD 20

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19
Q

what do we use ritubximan in

A

NON HODGKIN LYMPHOMA AND CLL

20
Q

THE NAME OF BIOLOIGCAL TX IN MM and marker

A

Daratumumab CD38

21
Q

whats the NB for diagnosi of mm

A

ESR IS VERY IMPORTANT >100 very typical

22
Q

tx

A

<65

autologous stem cell transplant or allogenic (selected cases)

and biological agents too

23
Q

tx

A

<65

autologous (more common) stem cell transplant or allogenic (selected cases)

24
Q

what can we give for the bones

A

bisphosphonates such as zoledronic acid

denosumab - monocloanal ab

25
Q

3 musketeers of drugs

A

bartesomib
thalidomide
lenalidomide

26
Q

whats importnat in the tx of mm

A

corticosteroids, monoclonal antibodies,

27
Q

supportive management

A

analgesisc
biphosphantes
EPO anemia

28
Q

what issues does hyperviscosity show

A

headaches,
visual impairemnt
clots

29
Q

why is the blood viscouse

A

extra prtoeins

30
Q

what is waldenstrom

A

cancer of b cells lik mm

31
Q

importnat thing to do with MM NB

A

FISH

32
Q

PROGNOSTIC FACTORS

A

B2
ALBUMIN

33
Q

What findings would you expect on bone marrow aspiration in myelofibrosis?

A

a dry tap

34
Q

What finding on bone marrow would you expect in multiple myeloma?

A

w biopsy will reveal >10% plasma cells in the bone marrow

35
Q

diagnosis criteria

A
  1. M protein
  2. bm biopsy
36
Q

rhyme associated with hypercalcemi a

A

bones, stones, groans and moans

37
Q

symptoms of hypercalcemia

A

cosntipated
vommiting !!!!!
peeing a lot (flush out)
bone pain
moods

38
Q

what can we specifcially see with the blood cells

A

reoleux formation

39
Q

whats the diff between waldenstrom and multiple myeloma

A

mM- PLASMA

W- B CELLS

40
Q

whats the diff between waldenstrom and multiple myeloma

A

mM- PLASMA

W- B CELLS

41
Q

DX

A

MGUS

42
Q

what radiological finding do we see with the skull

A

raindrop skull

43
Q

roleux is associatiated with

A

maliganacy and infection

44
Q

bone pain in mm

A

and unlike the pain of metastatic carcinoma, which often is worse at night, the pain of myeloma is precipitated by movement

45
Q

most common symptom

A

is bone pain

46
Q

steps for transplane

A
  1. induction
  2. conditioning with melephan
  3. transplant

internal 4th (19 decks)

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