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Haem AM > Myeloma > Flashcards

Myeloma Flashcards

1
Q

What is myeloma?

A

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

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2
Q

What are the types of myeloma?

A

IgG= 55%
IgA= 21%
Light chains only (kappa or lamda)= 22%

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3
Q

What is the peak age for myeloma?

A

60-70yo

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4
Q

What are the classic clinical features of myeloma?

A 
CRAB
Calcium high
Renal failure
Anaemia
Bone disease- lytic lesions, pathological fracture, cord compression..
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5
Q

What are the “other” features of myeloma?

A

Infection
Hyperviscocity
Hypogammaglobulinaemia
Amyloidosis- deposition of fibrillary proteins

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6
Q

What are the features of hyperviscocity in myeloma?

A 
Bleeding
Heart failur
Pulmonary congestion
Hypoperfusion
Renal failure
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7
Q

What are the features of amyloidosis in myeloma?

A

Nephrotic syndrome
Heart failure
Autonomic neuropathy
Cutaneous infiltration

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8
Q

What investigations are done for myeloma?

A

FBC, U&Es, CA- anaemia, thrombocytopenia, raised urea, creatinine and Ca
Bone marrow aspirate= >10% plasma cells
MRI
Serum/urine protein electrophoresis

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9
Q

What is a myeloma screen?

A

Igs
Serum protein electrophoresis
Bence Jones proteins in urine

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10
Q

What is the management of myeloma?

A

Chemotherapy +/- autologous stem cell transplant
Steroids
Bisphosphonate therapy- zolendronic acid
Surgery for bone disease

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11
Q

What are some complications of myeloma?

A

Spinal cord compression
Pathological fracture
Renal failure

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12
Q

What can cause renal failure in myeloma?

A

Cast nephropathy
Hypercalcaemia
Amyloidosis
Hyperviscocity

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13
Q

What is the prognosis of myeloma?

A

~50% 5 year

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14
Q

What is MGUS?

A

Monoclonal gammopathy f undetermined significance

Benign condition causing paraproteinaemia

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15
Q

What is the prognosis of MGUS?

A

At 5 years, 50% will have myeloma

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16
Q

What is the presentation of MGUS?

A

Usually asymptomatic

No increased risk of infection or bone pain

17
Q

What are the differentiating factors of MGUS vs myeloma?

A

Norma immune function
Lower paraprotein than myeloma
No clinical features of myeloma e.g. lytic lesions or renal disease

Haem AM (9 decks)

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