multiple myeloma Flashcards
define mutliple myeloma
Malignant disease of plasma cells in bone marrow, characterised by proliferation and production of excessive paraproteins
what is myeloma
Myeloma is a type of cancer affecting
plasma cells in the bone marrow.
pathophysiology of multiple myeloma
- The plasma cells have a genetic
mutation - causes them to produce large quantities of a specific paraprotein, which is an abnormal antibody or part of an antibody (often the light chain).
which systems in the body are affected by the abnormal levels of plasma cells
- Bone destruction
- Neurological symptoms
- Bone marrow failure
- Renal impairment – due to light
chains in the renal tubule. - Recurrent infections
signs and symptoms of multuple myeloma
CRAB
*Calcium levels are high
* Renal impairment
* Anaemia
* Bone pain (commonly as
backaches
hyperviscosity sydnrome
why does multiple myeloma cause hyperviscosity syndrome
– due to
increased circulating Igs, presents a
triad of mucosal bleeding,
neurologic, and visual changes:
presentation of hyperviscosity syndrome
- Epistaxis, gum, or rectal bleeding
- Vertigo
- Paraesthesia’s
- Visual changes
- Hearing loss
- Headaches/seizures/somnolence
- Heart failure
- SOB/hypoxia
- Fatigue
how is multiple myeloma usually found
Presentation can be vague and is often “incidentally” found on routine blood tests.
3 main investigations for multiple myeloma
- Serum electrophoresis
- Immunofixation
- serum FLC
what does serum electrophoressis for multiple myeloma do
detect paraproteins (abnormal abs), which appear as monoclonal bands.
what does immunofixation for multiple myeloma do
determine the type of
paraprotein e.g. IgG, IgM etc
what does serum FLC for multiple myeloma do
(free light chain assay) –
detect abnormally abundant light chains.
supporting investigations for multiple myeloma
FBC, ESR, CRP, U&Es
other key investigations for multiple myeloms
- blood film
- urine electrophoresis
- bone marrow aspirate
- x rays
what does multiple myeloma blood film show
rouleax formation
