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FINALS - HAEM > myeloma + plasma cells > Flashcards

myeloma + plasma cells Flashcards

1
Q

function of B cells

A

differentiate to plasma cells –> produce Ig

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2
Q

what are Ig made of

A

2 heavy chains and 2 light chains

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3
Q

what does polyclonal increase in Ig suggest

A

increased production from many different plasma cells (infection, malignancy, autoimmune)

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4
Q

what does monoclonal Ig increase mean

A

increased production from one plasma cell, increased antibodies (Ig) with no purpose // AKA paraprotein

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5
Q

causes paraproteinaemia

A

myeloma // amyloid // MGUS // lymphoma

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6
Q

most abundant Ig in blood

A

IgG (phagocytes bacteria + virus)

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7
Q

what Ig is in breast milk

A

IgA

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8
Q

what Ig is first secreted in response to infection

A

IgM

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9
Q

pentamer Ig

A

IgM

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10
Q

what is myeloma

A

haematological malignancy –> B cell proliferation —> plasma cells

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11
Q

age Myeloma

A

70

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12
Q

myeloma symptoms

A

CRABBI : hyperCa // Renal issues // Anaemia // Bleeding // Bones // Infection // (also amyloid, carpal tunnel, neuropathy, hypervicous blood)

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13
Q

symptoms from increased osteoclat activity myeloma

A

hyperCa - (bones, stones, groans, abdo moans) constipation, nausea, anorexia, confusion // bone pain + PATHOLOGICAL FRACTURES

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14
Q

renal symptoms myeloma

A

light chains within renal tubules // amyloidosis, nephcrocalcinosis, nephrolithiasis

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15
Q

symptoms from bone marrow suppression myeloma

A

anaemia (reduced erthyrpoeisis) // thrombocytopenia (bleeding)

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16
Q

how does infection occur myeloma

A

decreased production normal Ig

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17
Q

bloods myeloma

A

anaemia, U+Es off, raised Ca

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18
Q

blood film myeloma

A

rouleaux formation

19
Q

invx Ig in myeloma

A

PROTEIN ELECTROPHORESIS - raised IgG + IgA

20
Q

urine invx myeloma

A

Bence jones proteins

21
Q

bone marrow myeloma

A

raised plasma

22
Q

imaging myeloma

A

whole body MRI // X ray ‘rain drop’ (similar to hyperparathyroid)

23
Q

major diagnostic criteria myeloma (1 needed + signs/ symptoms

A

plasmacytoma (biopsy) // 30% plasma bone marrow // elevated M protein

24
Q

minor diagnostic criteria myeloma (3 needed + signs/ symptoms

A

10-30% plasma blood // minor M elevation // osteolytic lesion // low antibodies in blood

25
Q

mx myeloma

A

chemo (cyclophosphamide + dexamethasone) // analgesia // stem cel transplant

26
Q

what is MGUS

A

Monoclonal gammopathy of undetermined significance // similar to myeloma // causes paraproteinaemia (single affected Ig)

27
Q

symptoms MGUS

A

usually none (no bone pain or infection) // some demyelinating neuropathy

28
Q

features MGUS

A

normal Xray // normal renal function // stable levels of paraprotein // bone marrow plasma <10%

29
Q

what causes amyloidosis

A

cloning of plasma cells –> altered structure of Ig

30
Q

symptoms amyloid

A

protein accumulation in organs: heart, kidney, liver, neuropathy, GI tract

31
Q

invx amyloidosis

A

congo red staining: apple green birefringence // serum amyloid precurosor (SAP) scan // biopsy of skin, rectum, abdominal fat

32
Q

mx amycloid

A

steroids + chemo + stem cell transplant

33
Q

what is Waldenstrom’s macroglobulinaemia

A

lymphoplasmacytoid malignancy –> secretion of monoclonal IgM paraprotein (big pentamer)

34
Q

symtoms Waldenstrom’s macroglobulinaemia

A

old men // weight loss // HYPERVISCOUS - vision disturbance // hepatosplenomegaly // lymph // cryoglobulinaemia e.g. Raynaud’s

35
Q

invx Waldenstrom’s macroglobulinaemia

A

monoclonal IgM paraprotein // bone marrow biopsy lymphoplasmacytoid lymphoma cell

36
Q

mx

A

rituximab chemo

37
Q

what is Cryoglobulinaemia

A

Igs which precipitate (clump) at 4C, and dissolve at 37C

38
Q

type 1 Cryoglobulinaemia

A

monoclonal - myeloma, waldenstroms

39
Q

type 2 Cryoglobulinaemia

A

mixed - hepatitis, RA, sjorgens, lymphoma

40
Q

type 3 Cryoglobulinaemia

A

polyclonal - RA or sjorgens

41
Q

symptoms Cryoglobulinaemia

A

Reynauds (type 1) // vascular pupura, distal ulcer // arthralgia // renal involvment

42
Q

invx Cryoglobulinaemia

A

low complement (esp C4) // high ESR

43
Q

mx Cryoglobulinaemia

A

immunosuppresion + plasmapheresis

FINALS - HAEM (18 decks)

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