Myeloma

Question 1

Things I must know about Multiple Myeloma?

Answer 1

MONOclonal plasma cell proliferation

MONOclonal gammopathy (same light chains on Igs)

Decreased normal immunoglobulins

Osteolytic lesions

Question 2

What is the most common Ig in MM?

Answer 2

IgG

Question 3

Which Ig is NEVER found in MM?

Answer 3

IgM

Question 4

What an M spike?

Answer 4

Detection of a huge number of identical Igs on electrophoresis

Question 5

What’s the light chain proteins in the urine of pts with MM?

Answer 5

Bence-Jones protein

Question 6

What do the normal Igs look like in MM?

Answer 6

way decreased

Question 7

Blood picture morphology of MM:

Answer 7

anemia

rouleaux

Question 8

What’s rouleaux?

Answer 8

RBCs stacked like coins

Question 9

Whats the marrow picture in MM?

Answer 9

plasma cells and amyloid (aggregated light chains)

Question 10

Pink clumps of Ig built up in cytoplasm?

Answer 10

Russel bodies

Question 11

Igs built up look like they are in the nucleus?

Answer 11

Duthcer bodies

Question 12

Cell with a lot of light blue circles in it?

Answer 12

Mott cell

Question 13

Lymphoplasmacytoid lymphoma

produces IgM

Hyperviscosity syndrome –> RETINAL distortion

Answer 13

Waldenstrom macroglobinemia

Question 14

Triad of presenting symptoms:

Answer 14

Anemia

BONE PAIN

RENAL failure

Question 15

What can be a result of increased bone destruction by osteoclasts?

Answer 15

Hypercalcemia

Question 16

Diagnostic criteria for MM?

Answer 16

> 20% plamablasts in BM

monoclonal protein in serum

monoclonal protein in urine

lytic lesion on XR

Question 17

Tx for management of MM (no cure)?

Answer 17

AUTOlogous BM transplant

Lenolidomide/Bortezomib

Dexamethasone

Question 18

Two supportive therapies for MM?

Answer 18

Biphosphonate –> inhibits bone resorption and helps hypercalcemia

EPO–> helps anemia and decreases need for transfusions