multiple myeloma

Question 1

what is multiple myeloma?

Answer 1

a haematological malignancy characterised by plasma cell proliferation

Question 2

What age does multiple meyloma present?

Answer 2

70 years old

Question 3

Clinical features of Multiple myeloma?

Answer 3

1. Calcium - hypercalcaemia due to increased osteoclast activity
2. Renal - renal damage/nephrocalcinosis
3. Anaemia - bone marrow crowding suppresses erythropoeisis
4. Bleeding - thrombocytopenia
5. Bones - bone pain and lytic lesions
6. Infection - reduced production of normal immuniglobulin

Question 4

Symptom of multiple myeloma

Answer 4

1. hypercalcaemia - constipation, nausea and confusion
2. anaemia - fatigue and pallor
3. thrombocytopenia - excess bleeding
4. Back pain / bone pain - bone marrow infiltration

Question 5

Name 3 investigations which must be done?

Answer 5

1. FBC
2. serum/protein electrophoresis
3. bone marrow aspiration and biopsy

Question 6

What is seen on MRI?

Answer 6

lytic bone lesions

Question 7

What is a characteristic finding on x ray?

Answer 7

‘rain drop’ skull- numerous random dark spots seen on x ray due to bone lysis

Question 8

what is seen on urine protein electrophoresis?

Answer 8

Bence jones proteins

Question 9

what is seen on bone marrow aspiration>

Answer 9

high number of plasma cells

Question 10

what is the cell leniage of plasma cells?

Answer 10

1. Lymphocyte
2. B lymphovyte
3. Plasma cell

Question 11

multiple myeloma prognosis

Answer 11

1. chronic relapsing and remitting malignancy which is incurable

Question 12

management of multiple myeloma?

Answer 12

1. stem cell transplant

2. vigorous chemotherapy