MULTIPLE MYELOMA

Question 1

DEFINE

Answer 1

MALIGNANT NEOPLASM DERIVED FROM PLASMA CELLS

Question 2

PATHOLOGY

Answer 2

AFFECTS FLAT BONES ; PELVIS, VERTEBRAE, SKULL AND RIBS .
GROSS =
SOFT , GREY , FRIABLE
MICROSCOPICALLY =
ECCENTRIC NUCLEUS , CLUMPED CHROMATIN

Question 3

AGE

Answer 3

50 TO 70

Question 4

SEX

Answer 4

MALE

Question 5

SITE

Answer 5

FLAT BONES ; PELVIS , SKULL, VERTEBRAE , RIBS

Question 6

PRESENTING COMPLAINT

Answer 6

-SEVERE BONE PAIN IN LUMBAR AND THORACIC SPINE , PRECIPITATED BY MOVEMENT , WORST AT NIGHT
-NO SWELLING OR DEFORMITY UNLESS PATHOLOGICAL #
-IF TUMOUR PRESSES ON SPINAL CORD - NEUROLOGICAL SYMPTOMS
-PATHOLOGICAL # ESPECIALLY OF VERTEBRAE AND RIBS .

Question 7

INVESTIGATION

Answer 7

RADIOLOGICAL
OTHERS

Question 8

RADIOLOGICAL

Answer 8

MULTIPLE PUNCHED OUT LESION IN BONE INVOLVED
PATHOLOGICAL WEDGE COLLAPSE OF VERTEBRAE
NO PERIOSTEAL REACTION
DIFFUSE RAREFRACTION OF BONES ; VERTEBRAL PEDICLE INVOLVED = PEDICLE SIGN
BICONCAVE VERTEBRAE

Question 9

OTHERS

Answer 9

BLOOD = LOW HB , HIGH ESR ,UREA , NITROGEN CREATININE , URIC ACID
URINE = BENCE JONES PROTEIN
SERUM ELECTROPHORESIS = MYELOMA SPIKE
STERNAL PUNCTURE = MYELOMA CELLS
BONE BIOPSY
BONE SCAN
OPEN BIOPSY

Question 10

TREATMENT

Answer 10

CONSISTS CHEMOTHERAPY AND SPLINTAGE OF DISEASED PART BY POP, BRACE
-CHEMOTHERAPY = MELPHALAN WITH CYCLOPHOSPHAMIDE , VINCRISTINE , PREDNISOLONE IN REPEATED CYCLE
- RADIOTHERAPY = IN NEUROLOGICAL COMPRESSION , SOFT TISSUE LESION
- SURGERY = LAMINECTOMY IN COMPRESSION OF SPINAL NERVE