Myeloma

Question 1

myeloma what cells are going crazy

where do the antibodies get secreted

Answer 1

plasma cells
secrete monoclonal antibodies into the serum and urine

Question 2

what are the clinical features of myeloma

CRAB HAI

Answer 2

hypercalcaimia - osteoclast medicated bone resorption ( also frothy urine)

renal impairment AKI - raisd CRP and UandE

anaemia - FBC

osteolytic lesion - bone pathology leading to fractures

hyperviscosity of blood

amyloidosis - caridac falure

infections

lower bakc pain and lethargy

Question 3

what can you detect in the urine

Answer 3

bence jones proteins

Question 4

what invetigations should be done

Answer 4

FBC AND UANDE
x-ray for osteolytic lesion s

electrophoreiss fro iGG antibodies

aspirate bone marrow and biopsy

hgiher lvels of CRP and LDH worse prognosis

Question 5

what is the treatment

Answer 5

thalidomide - non chemo
chemo - vincristine

prednisolone

supportive iwth analgesia, bisphosphonates, phsyiom
EPO for anaemia

Question 6

causes of peripehral sensory neruopathy

Answer 6

alcohol toxicity,
vitamin B12 deficiency
chronic renal failure
paraneoplastic
diabetes mellitus
vasculitis.

Causes of motor-predominant peripheral neuropathy
Guillain Barre syndrome
Hereditary motor neuropathies
Acute intermittent porphyria
Lead poisoning
Paraneoplastic syndromes

Question 7

what is the sepsis 6

Answer 7

Take bloods (FBC, U&E, LFT, CRP, lactate)
Take blood cultures
Administer oxygen if required
Administer IV antibiotics
Administer IV fluid resuscitation
Monitor urine output