Multiple Myeloma Flashcards

1
Q

Define Multiple Myeloma?

A

Haematological malignancy characterised by proliferation of plasma cells resulting in bone lesions and the production of a monoclonal immunoglobulin (paraprotein, usually IgG or IgA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the aetiology of Multiple Myeloma?

A

Possible viral trigger
Chromosomal aberrations frequent
Associated with ionising radiation, agricultural work or occupational chemical exposures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the epidemiology of Multiple Myeloma?

A

Annual Incidence: 4/100,000
Peak Incidence: 70 yrs
Afro-Caribbean > White People > Asians

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the presenting symptoms of Multiple Myeloma?

A
May be an INCIDENTAL finding on routine blood tests 
Bone Pain
Infections (often recurrent)
General Symptoms 
Hyperviscosity symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What bone pain might you see in Multiple Myeloma?

A

Usually in the back and ribs

Sudden and severe bone pain may be caused by a pathological fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What general symptoms might you see in Multiple Myeloma?

A
Tiredness 
Thirst 
Polyuria 
Nausea 
Constipation
Mental change (due to hypercalcaemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What Hyperviscosity symptoms might you see in Multiple Myeloma?

A

Bleeding
Headaches
Visual Disturbances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the signs of Multiple Myeloma on physical examination?

A
Pallor 
Tachycardia 
Flow Murmur 
Signs of heart failure 
Dehydration 
Purpura 
Hepatosplenomegaly 
Macroglossia 
Carpal Tunnel Syndrome 
Peripheral Neuropathies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What investigations would you do for Multiple Myeloma?

A
Bloods
Blood Film
Serum or Urine Electrophoresis 
Bone Marrow Aspirate and Trephine 
Chest, Pelvic or Vertebral X-Ray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What bloods would you do for Multiple Myeloma and what might you expect to see?

A

FBC - low Hb, normochromic normocytic
High ESR (and possible high CRP)
U&Es - high creatinine, high Ca2+
Normal ALP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What would you see on a Blood Film for Multiple Myeloma?

A

Rouleaux formation with bluish background (suggests high protein)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What would you see on a Serum or Urine Electrophoresis in Multiple Myeloma?

A

Serum Paraprotein

Bence-Jones Protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What’s Bence-Jones Protein?

A

Monoclonal immunoglobulin light chain that’s found in the urine and suggest multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would you see on a Bone Marrow Aspirate and Trephine in Multiple Myeloma?

A

High plasma cells (usually > 20%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What would you see on a Chest, Pelvic or Vertebral X-Ray in Multiple Myeloma?

A

Osteolytic Lesions without surrounding sclerosis

Pathological fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly