multiple myeloma Flashcards
what is multiple myeloma ?
neoplasm of plasma cells which secrete antibodies
what is multiple myeloma preceded by in virtually all cases ?
MGUS
monoclonal gammopathy of undetermined significance
what is the clinical picture of multiple myeloma ?
CRAB HAI
hypercalcemia
renal impairment
anemia
Bone pathology
hyperviscosity
amyloid deposition
infection
what are the main causes of M protein ?
MGUS
multiple myeloma
AL amyloidosis
what is the defining criteria of MM ?
more than 10% of plasma cells in peripheral blood or a biopsy proven plasmacytoma
along with one of thee CRAB symptoms
what is the median survival of standard risk myeloma ?
6-7 years
what is the median survival of high risk myeloma ?
2-3 years
what investigations are to be performed for cases of multiple myeloma ?
serum protein electrophoresis
urine bence jones proteins
skeletal survey
bone marrow biopsy
what is the classic presentation of bone lesions in multiple myeloma ?
multiple
well circumscribed
lytic
punched out lesions
how does electrophoresis separate proteins ?
according to size and charge
requires serum not plasma
what is the thickest band when performing electrophoresis on a normal serum sample ?
albumin
when is haptoglobin increased and when iis it decreased ?
increased ass an acute phase reactant
decreased in intravascular haemolysis
what is high IgA characteristic off ?
liver disease
wheen is amyloidosis more common in multiple myeloma ?
when the paraprotein is a free light chain
what are bence jones proteins ?
immunoglobulin light chain found in the urine
in a patient with suspected multiple myeloma if i don’t find hypergammaglobulinemia what is the next best step ?
check urine for bence jones proteins
iff the CT scan for a SAh is equivocal what is the next best step ?
check CSF for xanthochromia
what is found in CSF in MS ?
oligoclonal bands
what test is performed in order to know what type of immunoglobulin is in the disease ?
immunofixation
what is seen in peripheral blood smear of multiple myeloma ?
plasma cells
rouleaux formation
what type of anemia is in multiple myeloma
normochromic normocytic
