Multiple myeloma - Myelodysplastic syndromes

Question 1

Myelodysplastic syndromes - mechanism

Answer 1

stem cell disorders involving ineffective hematopoiesis

–> defects in cell maturation of all nonlymphoid lineages

Question 2

Myelodysplastic syndromes is caused by

Answer 2

1. de novo mutations

2. environmental exposure (radiation, benzene, chemotherapy)

Question 3

Myelodysplastic syndromes - environmental exposure

Answer 3

1. radiation
2. benzene
3. chemotherapy

Question 4

Myelodysplastic syndromes - complications

Answer 4

may progress to AML

Question 5

Pseudo-Pelger-Huet anomaly

Answer 5

neutrophils with bilobed nuclei typically seen after chemotherapy

Question 6

Pseudo-Pelger-Huet anomaly - typically seen

Answer 6

after chemotherapy

Question 7

MGUS

Answer 7

Monoclonal gammopathy of undetermined significance

Question 8

Monoclonal gammopathy of undetermined significance - definition

Answer 8

monoclonal expansion of plasma cells

Question 9

Monoclonal gammopathy of undetermined significance - symptoms

Answer 9

asymptomatic

Question 10

Monoclonal gammopathy of undetermined significance - complications

Answer 10

may lead to multiple myeloma (1-2% per year)

Question 11

Multiple myeloma - age

Answer 11

more than 40-50

Question 12

Multiple myeloma is the most common primary tumor ….

Answer 12

arising with bone in people >40-50

Question 13

Multiple myeloma - cancer of

Answer 13

plasma cells (fried egg appearance)

Question 14

Multiple myeloma - arises in the

Answer 14

marrow

Question 15

Multiple myeloma - produces (proportions)

Answer 15

large ammount of:

• IgG (55%)
• IgA (25%)
• Ig light chains

Question 16

Multiple myeloma - histology

Answer 16

Numerous plasma cells with clock face chromatin and intracytoplasmic inclusions containing immunglobulin

Question 17

Multiple myeloma - increased susceptibility to

Answer 17

infection

Question 18

Multiple myeloma - symptoms/findings

Answer 18

1. hypercalcemia 2. anemia 3. renal involvement 4. bone lytic lesion/back pain 5. infections 6. Rouleaux formation
2. Bence Jones protein 8. Primary amyloidosis (AL) 9 . M spike on electrophoresis

Question 19

Multiple myeloma - x-ray

Answer 19

Punched out lytic bone lesions on x-ray

Question 20

Multiple myeloma - Rouleaux formation

Answer 20

RBCs stacked like poker chips in blood smear

Question 21

Multiple myeloma - Bence Jones protein

Answer 21

Ig light chains in urine

Question 22

Waldestrom macroblobulinemia - symptoms.mechanism

Answer 22

M spike = IgM –> hyperviscosity syndrome –> 1. blurred vision 2. Raynaud phenomenon

Question 23

multiple myeloma may cause … in kidney

Answer 23

Fanconi syndrome (generalized reabsorptive defect in PCT)

Question 24

causes of Fanconi syndrome

Answer 24

1. hereditary defects (Wislon, tyrosinemia, glycogen storage disease, cystinosis)
2. Ischemia
3. MM
4. nephrotoxins/drugs (ifosfmaide, cisplatin, tenofovir, expired tetracyclines)
5. LEAD POISONING

Question 25

Multiple Myeloma - cytokines

Answer 25

high serum of IL-6