Multiple Myeloma Flashcards
MM can be defined as a haematological malignancy of plasma cells. It can be classified into 4 diseases. what are they?
MM makes up 10% of haematological malignancies and affects M>F. Explain the pathophyiology of MM
Osteolytic lesions typically affect the vertebrae. What symptoms may arise from this?
The oveproduction of IgG monoclonal antibodies in MM leads to increased viscosity of the blood leading to a similar presentation to Polycythemia called Hyper-viscosity Syndrome. How would this present?
MM can be limited to the BM but it is called multiple myeloma for a reason. What is it called when it forms outside the BM and what does it lead to?
Give the full pathophysiology of MM
From the pathophysiology of MM, you can work out the signs and symptoms of the disease. Go for it
What are the top 4 RF of MM?
What are your differentials for MM?
You perform SPEP/UPEP as part of your diagnostic investigations for MM. What do you expect to find? Describe it?
M protein band
It is a sharp, well-defined band with a single heavy chain + similar band with kappa or lambda light chains
What finding on BM aspirate/biopsy would confirm MM?
> 10% plasma cells in BM
What tool is used to obtain a BM biopsy?
Trephine
You perform U&E as part of your supportive investigations for MM, What do you expect to find which will support your diagnosis?
What about on an FBC?
What about a urine dipstick?
What about on Blood film?
Creatinine clearance/eGFR <40ml/min
FBC: Amaemia, leucopenia, thrombocytopenia (pancytopenia)
Urine dipstick: -ve for proteinuria => send for urinalysis to confirm bence jones proteinuria
Rouleux formation
What are the poor prognostic factors for MM?
B2 macroglobulin (higher is worse)
LDH (higher is worse)
Albumin (lower is worse)
Genetic testing, t:14 or 14:16 translocation
What are the diagnostic investigations for MM? State what you expect to find in each
Give the full list of investigations for MM
Management of MM involves managing the malignancy and preventing/managing complications.
What is your approach for managing the malignancy?
Go through the process of stem cell transplantation
What are the complications of MM?
How would you prevent and manage the complications of MM (including those of the treatment)?
