Myeloma

Question 1

Defin

Answer 1

Plasma cell dyscrasia.
Abn prolif of single clone of plasma cells causing sec of Ig or Ig frags causing organ dysfunc esp kidney.
High in afro carrib. Eld.

Question 2

Px

Answer 2

Osteolytic bone lesions- backache, fracs, verteb collapse. Hyper Ca.
Anaemia, neutropenia, thrmbocytopenia due to marrow infilt. Causes anaemia, infec, bleeding.
Recurr bact infec.
Renal impair due to light chain deposit- tamm horsefall prot in distal loop henle.

Question 3

Investig

Answer 3

Anaemia
Blood film
High ESR of PV
High urea and creatinine
High Ca
Serum and urine electrophoresis. Beta 2 microglobulin.
XR- pepper pot skull, OP, frac, verteb collapse. CT, MRI.

Question 4

Mx

Answer 4

Bisphosphonate
Transfus and EPO
Hydration and dialysis if req. 
rap tx of infec broad spectrum AB
Radiotherapy for focal
Chemo

Question 5

Complics

Answer 5

HyperCa
Spinal cord compress
Hyperviscosity
Acute renal inj.

Question 6

Dx criteria

Answer 6

Monoclonal prot in serum or urine electrophoresis
Plasma cells high in BM biop
End organ dam eg hyperCa, renal insuff, anaemia
Bone lesions