Myeloma

Question 1

What is Myeloma?

Answer 1

Is a cancer of plasma cells where b lymphocytes make antibodies

Question 2

What is multiple Myeloma?

Answer 2

Where myeloma affects multiple parts of the body

Question 3

What is Monoclonal Gammapathy of undetermined significance (MGUS) ?

Answer 3

This is where there is excess of a single type of antibody but there is no features of myeloma or cancer. Could later lead to cancer so is monitored.

Question 4

What is smouldering Myeloma?

Answer 4

this is where there is progression from MGUS and progress to myeloma.

Question 5

What are key features of Myeloma?

Answer 5

C: Calcium elevated
R: Renal failure
A: Anaemia
B: Bone lesions + pain

Question 6

Risk factors of myeloma?

Answer 6

Old age
Male
Black african ethnicity
Family History
Obesity

Question 7

Investigations if suspecting myeloma?

Answer 7

FBC ( Low white blood cell count in myeloma)

Calcium ( raised in myeloma)

ESR (raised in myeloma)

Plasma viscosity ( raised in myeloma)

Question 8

Testing myeloma?

Answer 8

B: Bernice jones protein test
L: Serum light chain assay
I: Serum imunoglobins
P Serum Protein Electrophoresis

Bone marrow biopsy is needed to confirm myeloma

Question 9

What to lookout for in X-ray when testing myeloma?

Answer 9

Punched out lesions
Raindrop skull
Lytic lesions

Question 10

Management of myeloma?

Answer 10

Chemotherapy with bortezomid, thalidomid and dexamethasone

Stem cell transplantation

Question 11

Complications of Myeloma?

Answer 11

Infection
Pain
Hypercalcaemia
Spinal cord compression
Renal failure
Anaemia
Peripheral neuropathy
Hyper viscosity.