Myeloproliferative disorders/ Multiple Myeloma Flashcards
Multiple myeloma is a malignancy of the bone marrow in specifically which cells?
1 - T cells
2 - plasma cells
3 - monocytes
4 - natural killer cells
2 - plasma cells
- develop from B cells become clones with a specific antibody
- they produce an abnormal immunoglobulin called a PARAPROTEIN
In a healthy patient, do plasma cells secrete antibodies or paraprotein?
- antibodies
- paraprotein = monoclonal immunoglobulin or light chain present in the blood or urine
What is the incidence of multiple myeloma?
1 - 5 / 1,000,000
2 - 5 / 100,000
3 - 5 / 10,000
4 - 5 / 1000
2 - 5 / 100,000
What age is most affected by multiple myeloma?
1 - 18 y/o
2 - 30 y/o
3 - 50 y/o
4 - 70 y/o
4 - 70 y/o
- increases with age
- africans have slightly higher risk that caucasians
Is multiple myeloma currently curable?
- no
Although the exact cause of multiple myeloma is unknown, there are risk factors. Which of the following is a risk factor for multiple myeloma?
1 - family history (1st degree relative)
2 - increasing age
3 - increased oncogenes
4 - exposure to toxins
5 - all of the above
5 - all of the above
Multiple myeloma is a malignancy of the bone marrow, specifically plasma cells. In addition to secreting an abnormal immunoglobulin, they can also secrete what else?
1 - abnormal light chains
2 - abnormal heavy chains
3 - abnormal disulphide bond
4 - abnormal constant region
1 - abnormal light chains
- light and heavy chain make up the Fab region that binds to antigens
- important for specific antigen binding
- can also have different subtypes including kappa and lamba light chains or different immunoglobulins (IgA, IgG etc..)
Multiple myeloma is a malignancy of the bone marrow, specifically plasma cells. They can be categorised into the type of immunoglobulin, kappa or lamba that is affected. Which of the following is the most common?
1 - IgA
2 - IgG
3 - IgM
4 - IgD
5 - IgE
2 - IgG
- IgG accounts for 2/3 of all cases
- IgA is next most common
Multiple myeloma is a malignancy of the bone marrow, specifically plasma cells. Which of the following tissues is NOT typically affected in multiple myeloma?
1 - blood
2 - spleen
3 - heart
4 - bone
3 - heart
Multiple myeloma is most common in older adults as it has a slow insidious onset, when typically end organ damage becomes symptomatic. This can be remember using the mnemonic CRAB. What does the C stand for?
1 - carpal tunnel syndrome
2 - cardiac failure
3 - calcium is elevated
4 - all of the above
3 - calcium is elevated
- causes hypercalcaemia
- increased reabsorption of bone, suggests more serious disease
- remember Bones, Groans, Stones and Psychotic Undertones
Multiple myeloma is most common in older adults as it has a slow insidious onset, when typically end organ damage becomes symptomatic. This can be remember using the mnemonic CRAB. What does the R stand for?
1 - renal insufficiency
2 - retinopathy
3 - reflex hypotonia
4 - all of the above
1 - renal insufficiency
- multi factorial
- hypercalcaemia
- infections (low WBC variability)
- dehydration (high Ca2+)
- medications due to bone pain
- type 3 hypersensitivtiy
Multiple myeloma is most common in older adults as it has a slow insidious onset, when typically end organ damage becomes symptomatic. This can be remember using the mnemonic CRAB. What does the A stand for?
1 - adrenal insufficiency
2 - anaemia
3 - adenoma
4 - all of the above
2 - anaemia
- RBC production is reduced due to overproduction of paraprotein
Multiple myeloma is most common in older adults as it has a slow insidious onset, when typically end organ damage becomes symptomatic. This can be remember using the mnemonic CRAB. What does the B stand for?
1 - breasts
2 - brain
3 - bones
4 - all of the above
3 - bones
- malignancy causes bone destruction
- lesions are common
- collapse vertebrae can cause life threatening cord compression
When we try to diagnose myeloma we can do a FBC. Which of the following would NOT be commonly observed?
1 - microcytic anaemia
2 - rouleux
3 - raised erythrocyte sedimentation rate
4 - normocytic, normochromic anaemia
1 - microcytic anaemia
- rouleux = lots of proteins in the blood causing RBCs to stick together which can be seen on histology
When we try to diagnose myeloma, which 2 of the following would be elevated?
1 - creatine
2 - bilirubin
3 - urea
4 - neutrophils
1 - creatine
3 - urea
- kidneys are heavily affected by multiple myeloma