multiple myeloma Flashcards
what is a myeloma
neoplastic disease of plasma cells
which race is it moore common in ?
afro-carribeans
what is the clinical picture of multiple myeloma ?
hypercalcaemia renal failure anemia bone pain and pathological fractures raised plasma viscosity
in common myelomas what are the intact immunoglobulins ?
IgG and IgA
what is the most common cause of M protein ?
MGUS
multiple myeloma
AL amyloidosis
what is the current definition of active MM ?
more than 10% biopsy proven plasmocytoma plus a myeloma defining event (CRAB)
what can be some other paraproteinemia that can lead to MM ?
smouldering myeloma
MGUS
what investigations would be taken in suspected multiple myeloma ?
full CBC creatinine, urea and calcium levels skeleton survey bone marrow biopsy total plasma protein serum and urine electrophoresis
what is the classic radiological appearance in multiple myeloma?
multiple small, well circumscribed lytic, round punched out lesions but without any reactive bone formation
why is there no reactive bone formation in multiple myeloma ?
tumor factors that simultaneously activate osteoclasts and inhibit osteoblasts
what other more subtle regions can be found in skeletal survey of multiple myeloma ?
endosteal scalloping , along with diffusely demineralized bones
what is the most sensitive tool for detection of bone destructive effect in MM ?
CT bone assessment
what is the disadvantage with CT ?
higher radiation dose even with low dose protocol
lower sensitivity than MRI for plasma cell infiltration
what is the management for multiple myeloma ?
induction chemotherapy
high dose chemotherapy
and then management of myeloma related organs
and supportive therapy
what are the features of hyper viscosity syndrome ?
blurry vision
reduced concentration
