myeloma + plasma cells Flashcards
function of B cells
differentiate to plasma cells –> produce Ig
what are Ig made of
2 heavy chains and 2 light chains
what does polyclonal increase in Ig suggest
increased production from many different plasma cells (infection, malignancy, autoimmune)
what does monoclonal Ig increase mean
increased production from one plasma cell, increased antibodies (Ig) with no purpose // AKA paraprotein
causes paraproteinaemia
myeloma // amyloid // MGUS // lymphoma
most abundant Ig in blood
IgG (phagocytes bacteria + virus)
what Ig is in breast milk
IgA
what Ig is first secreted in response to infection
IgM
pentamer Ig
IgM
what is myeloma
haematological malignancy –> B cell proliferation —> plasma cells
age Myeloma
70
myeloma symptoms
CRABBI : hyperCa // Renal issues // Anaemia // Bleeding // Bones // Infection // (also amyloid, carpal tunnel, neuropathy, hypervicous blood)
symptoms from increased osteoclat activity myeloma
hyperCa - (bones, stones, groans, abdo moans) constipation, nausea, anorexia, confusion // bone pain + PATHOLOGICAL FRACTURES
renal symptoms myeloma
light chains within renal tubules // amyloidosis, nephcrocalcinosis, nephrolithiasis
symptoms from bone marrow suppression myeloma
anaemia (reduced erthyrpoeisis) // thrombocytopenia (bleeding)
how does infection occur myeloma
decreased production normal Ig
bloods myeloma
anaemia, U+Es off, raised Ca
blood film myeloma
rouleaux formation
invx Ig in myeloma
PROTEIN ELECTROPHORESIS - raised IgG + IgA
urine invx myeloma
Bence jones proteins
bone marrow myeloma
raised plasma
imaging myeloma
whole body MRI // X ray ‘rain drop’ (similar to hyperparathyroid)
major diagnostic criteria myeloma (1 needed + signs/ symptoms
plasmacytoma (biopsy) // 30% plasma bone marrow // elevated M protein
minor diagnostic criteria myeloma (3 needed + signs/ symptoms
10-30% plasma blood // minor M elevation // osteolytic lesion // low antibodies in blood
