Myeloma Flashcards
Briefly describe the pathophysiology of multiple myeloma
Clonal proliferation of plasma cells, wherein clones may also produce free light chain
Plasma cells= B cells that produced antibodies
List three features of multiple myeloma
Anaemia- BM infiltration Myeloma bone disease Recurrent bacterial infections Myeloma renal disease Hypercalcaemia Hyperviscocity
Mneumonic to remember features of multiple myeloma?
CRAB calcium- elevated renal failure anaemia bone lesions and bone pain
Name two symptoms associated with myeloma bone disease
Backachae and bone pain
Pathological fractures
Vertebral collapse
Two risk factors for myeloma?
older age male black african ethnicity family history obesity
What are the indications for investigating myeloma?
over 60 with persistent bone pain, back pain, unexplained fractures
Name two complications of hyperviscocity as seen in myeloma
easy bruising easy bleeding heart failure purple discolouration of extremities impaired vision
List three investigations for myeloma
FBC Blood film Calcium ESR/CRP Plasma viscosity Serum protein electrophoresis Urine bence jones protein test BM trephine biopsy Whole body MRI or whole body CT or XR- skeletal survey
Name two specific tests for myeloma
BLIP Bence-jones protein (request urine electrophoresis) Light chain assay (serum) Immunoglobulins (serum) Protein electrophoresis (serum)
Name one feature of myeloma you might see on XR
pepperpot skull
List three aspects of myeloma management
Analgesia Chemotherapy Thalidomide Dexamethasone EPO + transfusions (anaemia) VTE prophylaxis Biphosphonates
Name three complications of myeloma and its treatment
infection pain renal failure anaemia hypercalcaemia peripheral neuropathy spinal cord compression hyperviscocity
