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Haematology and Immunology AM > Myeloma > Flashcards

Myeloma Flashcards

1
Q

What are antibodies produced by?

A

B cells, mainly plasma cells

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2
Q

What is the primary role of antibodies?

A

Recognise and bind pathogens

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3
Q

What are the 5 types of heavy chain of antibodies?

A 
IgA
IgD
IgE
IgG
IgM
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4
Q

What is the most prevalent antibody?

A

IgG

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5
Q

What are the types of light chain?

A

Kappa

Lambda

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6
Q

What are paraproteins?

A

Monoclonal immunoglobulins present in blood or urine

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7
Q

What do paraproteins show?

A

Monoclonal proliferation of B lymphocyte/plasma cell in the body

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8
Q

What do IgM paraproteins suggest?

A

Lymphoma

Maturing lymphocytes make IgM at the start of the immune response

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9
Q

What so IgA or IgG paraproteins suggest?

A

Myeloma

Mature plasma cells generate IgG and IgA after isotope switching

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10
Q

What does serum protein electrophoresis do?

A

Separates protein based on size and charge

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11
Q

What is myeloma?

A

Neoplastic disorder of plasma cells, resulting in excess production of a single type of immunoglobulin

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12
Q

When is peak incidence of myeloma?

A

7th decade

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13
Q

What are the clinical features of myeloma?

A

CRAB
Calcium elevated
Renal complications
Anaemia
Bone disease- lytic lesions, pathological fractures, cord compression…
Other- infections, hyperviscocity, hypogammaglomulinaemia, amyloidosis

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14
Q

What causes renal failure in myeloma?

A

Immunoglobulin deposition and blockage of renal tubules

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15
Q

What causes hyperviscocity syndrome?

A

Increased viscosity- due to high protein
Impaired microcirculation
Hypoperfusion

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16
Q

What are the signs of hyperviscocity syndrome?

A 
Cardiac failure- LVH
Bleeding
Pulmomary congestion
Confusion
Renal failure
17
Q

What does hypogammaglobulinaemia cause?

A

Impaired production of normal immunoglobulin and therefore infection

18
Q

What is amyloidosis?

A

Deposition of fibrillary protein

19
Q

What does amyloidosis cause?

A 
Nephrotic syndrome
Cardiac failure
Carpal tunnel syndrome
Autonomic neuropathy
Cutaneous infiltration
20
Q

What types of Ig most often causes myeloma?

A

IgG- 55%

IgA= 21%

21
Q

What is staging of myeloma based on?

A

Albumin

Beta 2 microglobulin

22
Q

What is the treatment of myeloma?

A 
Chemo
Bisphosphonate therapy
Radiotherapy
Steroids
Surgery
Aytologous stem cell transplant
23
Q

What do IgM paraproteins cause?

A

Low grade lymphomas

24
Q

What are the clinical features of IgM lymphomas?

A

Bone marrow failure
Lymphadenopathy
Hepatosplenomegaly
B symptoms

25
Q

What investigations are done for myeloma?

A

FBC and blood film
Bone marrow aspirate
Serum and/or urine electrophoresis
XR

Haematology and Immunology AM (17 decks)

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