Myeloma & Lymphoma

Question 1

What is myeloma

Answer 1

cancer of differentiated b lymphocytes known as plasma cells

Question 2

feautures of acute leukaemia

Answer 2

high proliferative rate
chemosensitive

Question 3

features of multiple myeloma

Answer 3

• occurs in the over 40
• GMUS - too much immunoglobulin released by abnormal plasma cells
  -1% of cases develop into a myeloma

Question 4

what is multiple myeloma

Answer 4

where the myeloma affects multiple areas of the body

Question 5

Pathophysiology of myeloma

Answer 5

Plasma cells produce one type of antibody ,
80- Igg
20-1ga
GAMED

when measuring immunoglobulin in patients one will be significantly abundant - more than half the time it is IgG

Question 6

presentation of multiple myeloma

Answer 6

C- Calcium elevation( thirst)
R- Renal failure
A- Anaemia- fatigue-syncope
B-Bone lesions & pain

Question 7

risk factors for multiple myeloma

Answer 7

Older age
male
black african ethnicity
fx
obesity

Question 8

Diagnosis would inolve

Answer 8

FBC- anaemia
ESR- raised
Blood film - rouleaux formation
Urine- bence jones protein

Question 9

Management of Multiple myeloma

Answer 9

1st line- chemotherapy
stem cell transplant
analgesia
biophosphates
blood transfusions

Question 10

complications of myeloma

Answer 10

infection
pain
renal failure
anaemia
hypercalcaemia

Question 11

What is lymphoma

Answer 11

group of cancers that affect the lymphatic system

Question 12

features of hodgkin lymphoma

Answer 12

-proliferation of lymphocytes in the lymph nodes
- associated with EBV and immunosuppression
- peaks in early 20’s then 70’s

Question 13

presentation of hodgkin lymphoma

Answer 13

lymphadenopathy - painful upon drinking alcohol
B- symptoms- fever, night sweats, weight loss

Question 14

How would you make a diagnosis for Hodgkin lymphoma

Answer 14

ESR raised
Imagine CXR/CT for staging
lymph node biopsy - reed sternberg cells

Question 15

management of Hodgkin lymphoma

Answer 15

ABVD chemotherapy
radiotherapy
steroids
stem cell/bone marrow
transplant

Question 16

difference between Hodgkin and non Hodgkin lymphoma

Answer 16

Hodgkin is a specific disease whereas non encompasses all other lymphomas

Question 17

non Hodgkin lymphoma features

Answer 17

• associated with EBV and immunosuppression
• predominantly affects adults over the age of 40

Question 18

presentation of non hodgkin lymphoma

Answer 18

• painless lymphadenopathy
• B symptoms, weight loss, night sweats , fever
• hepatosplenomegaly

Question 19

diagnosis for NHL

Answer 19

Imaging for staging
lymph node biopsy - NO REED STERNBERG CELLS

Question 20

management of NHL

Answer 20

chemo
radiotherapy

Question 21

Describe the Ann arbor staging for lymphoma staging

Answer 21

Stage 1 -> the disease is in one area only
Stage 2 - the disease is in 2 or more areas on the same side of the diaphragm
Stage 3 -> the disease is in 2 or more areas on both sides of the diaphragm
Stage 4 - the disease has spread beyond the lymph nodes

Question 22

features of chronic leukaemia

Answer 22

chemo resistant

Question 23

differentiated myeloid cells would appear on blood film?

Answer 23

perinuclear halo
area of paleness

Question 24

What is systemic AL amyloidosis

Answer 24

is a protein conformation disorder associated with a subtle clonal plasma cell dyscrasia

Question 25

presentation of systemic al amyloidosis

Answer 25

oedema
heart failure

Question 26

how does stem cell transportation work

Answer 26

1- stem cell mobilisation
2- stem cell collection
3- high dose melphalan
4- stem cell transplant