Myeloma Flashcards
describe the mechanism of myeloma
it is a dysproteinaemia, specifically it is caused by the overproduction of immunoglobin by clonal expansion of cells from B-cell lineage
what group of people does myeloma usually present in
around 60y/o, M > F
what cell is myeloma a cancer of
the plasma cell
describe how myeloma can cause anaemia
by impairment of the production of normal red blood cells
where can the abnormal plasma cells seen in myeloma accumulate
in the bone marrow and/or the soft tissue
what symptoms can be seen in myeloma
bone pain, weakness, fatigue, weight loss, recurrent infections
what signs can be seen in myeloma
anaemia, hypercalcaemia, renal failure, lytic bone lesions
what is the classic presentation of myeloma
back pain and renal failure
describe the lesions seen in imaging of myeloma
lytic lesions which appear as “punched-out” holes
what does light and heavy chain refer to in myeloma
refers to the light and heavy chains of the structure of immunoglobins(antibodies), which are affected by myeloma
describe the basic mechanism by which myeloma impacts the kidneys
the abnormal proteins are filtered by the kidneys and “clog up” and damage the renal system
what glomerular and tubular renal manifestations of myeloma are there
glomerular = AL amyloidosis, monoclonal Ig deposition tubular = light chain cast nephropathy
what investigations are involved in the diagnosis of myeloma, other than high suspicion
bloods(protein electrophoresis), urine(Bence Jones proteins), bone marrow biopsy, skeletal survey
what are the general and supportive measures in the management of myeloma
general = stop nephrotoxics, manage hypercalcaemia supportive = dialysis
what is involved in the disease specific management of myeloma
chemotherapy, stem cell transplant(refer to haematology)
