Multiple Myeloma Flashcards
What is myeloma?
Neoplastic disorder
Plasma cells
What does the increased number of plasma cells lead to?
They’re all one specific plasma cell line so produce 1 specific protein called a paraprotein
This can be detected in the blood
Typical presentation?
” 60 y/o man presents with 3 month history of back pain. He has recently developed a cough that is exacerbating his bone pain and causing increasing fatigue. O/e he has clinical signs of pneumonia and an xray of his lumbar spine shows multiple lytic bone lesions. “
What acronym is used for MM symptoms?
CRAB
CRAB
Calcium - hypercalcaemia
Renal failure
Anaemia
Bone lesions (lytic)
What causes the renal failure?
Dense intratubular casts
What causes the anaemia?
Bone marrow failure
What can be caused by the osteolytic lesions?
Pathological fractures
Where is the most likely place for pathological fractures?
Spine
What other symptom is quite typical of MM in the spine?
Sciatica
Acute cord compression
Investigations? (think crab)
Calcium - U&Es
Renal failure - eGFR/Creatinine
Anaemia - FBC
Bone lesions - skeletal survey
+ Serum immunoglobulin tests
What immunoglobulin tests can be done?
Serum paraprotein -> gel electrophoresis
Urinary bence jones proteins
What are the 4 methods of treatment for MM?
Chemo
Bisphosphonates
Surgery
Antibiotics
When are antibiotics implicated in MM?
Fluctuating temperature
What antibiotics should be given?
Pipericillin +
Tazobactam
