myeloma Flashcards

1
Q

what

A

cancer of plasma cells

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2
Q

monoclonal gammopathy of undetermined significane (MGUS)

A

excess of single type of antibody w/o other features of myeloma

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3
Q

smouldering myeloma

A

progression of MGUS with higher levels antibodies

premalignant

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4
Q

Waldenstrom’s macroglobulinemia

A

type of smouldering myeloma where excessive IgM specifically

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5
Q

monoclonal paraprotein

A

single type of antibody produced by all identical cancerous plasma cells

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6
Q

Bence Jones protein

A

can be found in urine of many patient with myeloma

usually light chains

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7
Q

bone marrow infiltration

A

cancer plasma cells invade bone marrow

anaemia
neutropenia
thrombocytopenia

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8
Q

myeloma bone disease - result of

A

increased osteoclast activity
decreased osteoblast activity

caused by cytokines released from plasma cells and stromal cells

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9
Q

myeloma bone disease - results in

A

osteolytic lesions
pathological fractures
hypercalcaemia

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10
Q

myeloma renal disease - due to

A

high levels of Ig blocking flow through tubules
hypercalcaemia
dehydration
medications used to treat myeloma

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11
Q

hyperviscosity: why

A

more proteins in blood e.g. Ig which increase inflammation

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12
Q

hyperviscosity: issues

A
easy bruising 
easy bleeding
reduced/loss sight due to eye vascular disease
purple discolouration of extremeties
heart failure
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13
Q

CRAB

A

calcium - elevated
renal failure
anaemia
bone lesions + pain

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14
Q

risk factors

A
age 
male 
black african 
FHx
obesity
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15
Q

consider myeloma in anyone…

A

over 60 with persistant bone pain or unexplained fracture

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16
Q

FBC shows

A

low WCC

17
Q

calcium in myeloma

A

riased

18
Q

ESR in myeloma

A

raised

19
Q

plasma viscosity in myeloma

A

raised

20
Q

Ix

A

urine electrophoresis
serum light chain assay
serum Ig
serum protein electrophoreses

bone marrow biops

21
Q

xray signs

A

punched out lesions
lytic lesions
pepperpot skull

22
Q

1st line Rx - combination of chemotherapy with

A

bortezomid
thalidomide
dexamethasone

23
Q

Mx of myeloma bone disease

A

bisphosphonates
radiotherapy
orthopaedic surgery