multiple myeloma Flashcards
Low back pain anemia osteopenia fracture elevated creatinine
MM
Lytic punched out bone lesions hypercalcemia renal failure pancytopenia hyperviscosity
MM
MM presents at what median age
~ 65
2x incidence in black males
5-8 yr survival
features of myeloma
CRAB Calcium elevation Renal disease Anemia Bone disease - frequent infection?!
Most common lesions in Multiple myeloma
- bone pain
Monoclonal antibody manifestation
M protein
IgA or Kappa
what is the bence jones test?
heat urine to 40 degrees, light chains can precipitate
How do you avoid missing light chance monoclonality in MM?
use the bence jones test
clonal plasma cell % in Bone marrow in MM
> 10% of the bone marrow
if you only have M-protein spike you can be diagnosed with
MGUS
what is the % risk of progression of mGUS into myeloma or lymphoma
1% per year
lymph nodes of patients < 30 are clinically benign in
80% of cases
40% benign in patients > 50
location of nodes most indicative of malignancy
Supraclavicular
paraumbilical
epitrochlear
DDx for a generalized lymphadenopathy
- Malignancy
- infection
- autoimmuna - sero+ RA SLE
- Drugs
what should you not prescribe in lymphadenopathy ?
corticosteroids
most common and aggressive but curable lymphoma
Diffuse large B cell lymphoma NHL
Indolent NHL
Follicular lymphoma
Classic cells in Hodgkin’s lymphoma
Reed-sternberg cells
inflammatory cells surround B and T cells
B symptoms includes
fever
night sweats
weight loss
Stage 1
Stage 2
Stage 3
Stage 4
lymph nodes in one site
adenopathy in 2 sites same side of diaphragm
both sides
extranodal sites
how do you treat Diffuse B cell lymphoma?
CD20 receptor antagonist
