MYELOMA Flashcards
0
Q
What are symptoms of myeloma?
A
Osteolytic bone lesions-> back ache, pathological fractures
Hypercalcemia
Anemia, neutropenia + thrombocytopenia from marrow infiltration -> anemia, infection + bleeding
Renal impairment -> deposition of light chains
1
Q
What is myeloma?
A
Abnormal proliferation of plasma cells.
2
Q
Ix for myeloma?
A
CBE - normocytic, normochromic
Raised ESR, Ca.
Screening test
- serum: paraproteins/M proteins
- urine: Benz jones proteins
3
Q
Diagnosis of myeloma?
A
High index of suspicion
- monoclonal protein band in serum or urine
- increased plasma cells on biopsy
- end organ damage (anemia, renal insufficiency, hypercalcemia)
- bone lesions following skeletal survey
4
Q
Rx?
A
Supportive
- analgesia (bone pain)
- bisphosphonates
- erythropoietin, transfusion
Chemo
- AGGRESSIVE: VAD (vincristine - risk of peripheral neuropathy, adriamycin and dexamethasone)
- prednisolone + melphalan (chemotherapy)
5
Q
Complications of myeloma?
A
Hypercalcemia
Spinal cord compression
Renal impairment
