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IHO Week 4 (MJ) > Multiple Myeloma > Flashcards

Multiple Myeloma Flashcards

1
Q

Bone marrow for multiple myeloma?

A

At high power - weird looking cells. Plasma cells are bigger and eccentric in shape. Nucleus off to side.

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2
Q

Definitions/things to know about MM

A

Monoclonal plasma cell proliferation
Monoclonal gammopathy
Decreased normal immunoglobins
Osteolytic lesions

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3
Q

Does MM go to blood?

A

No, tends to stay in marrow

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4
Q

What is an M-spike?

A

an increase in monoclonal immunoglobin

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5
Q

Most common Ig in M spike?

A

IgG, followed by IgA
Rarely IgD or IgE
Never IgM

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6
Q

What is Bence Jones protein?

A

light chain Ig in urine

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7
Q

Morphology of blood in Multiple Myeloma?

A

Anemia, rouleaux

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8
Q

Morphology of marrow in MM?

A

plasma cells, amyloid

hypercellular, monotonous, not a lot of fat

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9
Q

What is a Russell Body?

A

cell making Ig but the Ig cannot get out

Lots of Russell bodies - Mott Cell

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10
Q

Dutcher body?

A

invagination of cytoplasm in the plasma cell

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11
Q

What association with Rouleaux?

A

Multiple myeloma (duh)

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12
Q

What is amyloid?

A

Light chains that collect and make a conformation that is stuck together

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13
Q

Waldenstrom macroglobulinemia?

A

IgM, Lymphoplasmacytoid lymphoma

Hyperviscosity (IgM so big, makes blood sludgy)

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14
Q

Symptoms of Waldenstrom macroglobulinemia?

A

Retinal changes

Neurological changes

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15
Q

MGUS (Monclonal gammopathy of Undetermined Significance)

A

Small m spike with no myeloma symptoms

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16
Q

Does MGUS mean Myeloma?

A

occasionally MGUS will turn into Myeloma

17
Q

Relation of angiogenesis and myeloma?

A

Increased production of growth factors which stimulate angiogenesis and plasma cell development
Upregulation

18
Q

80% of people with MM present with what?

A 
Bone pain (low back, pelvis and ribs)
Associated with multiple lytic bone lesions (increased osteoclast activity)
19
Q

What is the cause of bruising/bleeding in MM?

A

decreased platelets

20
Q

What is the cause of infections in MM?

A

decrease levels of normal Ig

21
Q

What is the cause of hypercalcemia in MM?

A

Bone destruction

22
Q

50% of patients with MM present with?

A

Renal failure

23
Q

What is hyperviscosity syndrome?

A

large amounts of circulating Ig cause purpura, confusion and decreased vision

24
Q

Major causes of death in MM?

A

Infection and Renal failure

25
Q

Classic Triad of MM?

A

Anemia, Bone Pain, Renal Failure

26
Q

Is MM curable?

A

No, but it is treatable

27
Q

Classic agents for MM

A

Dexamethasone (steroid)
Melphalan - alkylating agent
Cyclophosphamide - alkylating agent

28
Q

Problem with PBSC

A

Contamination of the autologous graft by the myeloma cells

29
Q

Newer agents of MM

A

Thalidomide
Lenalidomide
Bortezomib

IHO Week 4 (MJ) (10 decks)

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