myeloma Flashcards
what
cancer of plasma cells
monoclonal gammopathy of undetermined significane (MGUS)
excess of single type of antibody w/o other features of myeloma
smouldering myeloma
progression of MGUS with higher levels antibodies
premalignant
Waldenstrom’s macroglobulinemia
type of smouldering myeloma where excessive IgM specifically
monoclonal paraprotein
single type of antibody produced by all identical cancerous plasma cells
Bence Jones protein
can be found in urine of many patient with myeloma
usually light chains
bone marrow infiltration
cancer plasma cells invade bone marrow
anaemia
neutropenia
thrombocytopenia
myeloma bone disease - result of
increased osteoclast activity
decreased osteoblast activity
caused by cytokines released from plasma cells and stromal cells
myeloma bone disease - results in
osteolytic lesions
pathological fractures
hypercalcaemia
myeloma renal disease - due to
high levels of Ig blocking flow through tubules
hypercalcaemia
dehydration
medications used to treat myeloma
hyperviscosity: why
more proteins in blood e.g. Ig which increase inflammation
hyperviscosity: issues
easy bruising easy bleeding reduced/loss sight due to eye vascular disease purple discolouration of extremeties heart failure
CRAB
calcium - elevated
renal failure
anaemia
bone lesions + pain
risk factors
age male black african FHx obesity
consider myeloma in anyone…
over 60 with persistant bone pain or unexplained fracture