Myeloma

Question 1

haemolytic/bile of strep pneumonia and pyogenes

Answer 1

pneumonia = alpha / soluble(not resistant)
pyogenes = beta/insoluble

Question 2

herpes family of virus

Answer 2

herpes simplex
varicella zoster virus
epstein-barr
cytomegalovirus

Question 3

2 classes of bisphosphonates

Answer 3

both cause osteoclast apoptosis

nitrogen containing: by disrupting signalling of regulatory proteins

non-nitrogen: metabolised in osteoclast disrupting osteoclast metabolism

Question 4

why osteolytic lesions with myeloma

Answer 4

high plasma cells which secrete IL1/6
increases expression of RANK-ligand on osteoblasts
—> stimulating osteoclasts

pressure from high myeloma cells–> causes pressure atrophy–> forces bone to remodel but osteoclasts>osteoblasts–> high bone resorption

Question 5

treatment for osteolytic lesion

Answer 5

denosumab(antibiotic)
mimics OPG (usually produced by osteoblasts)
binds to rank-ligand to prevent stimulating osteoclasts

bisphosphonates

• osteoclast apoptosis
• induce OPG from osteoblasts