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Plasma Cell Disorders > Plasma Cell Disorders > Flashcards

Plasma Cell Disorders Flashcards

1
Q

Plasma Cells

A

Fully differentiated B cells that make Immunoglobulin.

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2
Q

Structure of Immunoglobulins.

A

2 heavy chains and 2 light chains.

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3
Q

Types of light chains.

A

Kappa and lambda.

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4
Q

Types of heavy chains.

A

G, A, M, E, D.

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5
Q

Rules of making an Ig.

A

An Ig can only be made of one type of heavy chain and one type of light chain.

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6
Q

Classification of Plasma Cell Disorders (WHO Classification).

A

(1) Monocloncal Gammopathy of Undetermined Significance (MGUS).
(2) Plasma Cell myeloma.
(3) Plasmacytoma.

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7
Q

Connects the two heavy chains to one another and the two light chains to one another.

A

Disulfide bonds.

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8
Q

IgM

A

Detected first in the body after a primary antigenic stimulus.
It’s a macroglobulin, so it’s too big to cross the placenta.

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9
Q

IgD

A

Very little in the serum.

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10
Q

IgA

A

Found in external secretions (bowel).

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11
Q

IgE

A

The one that you get when you have allergic reactions - has immediate hypersensitivity.

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12
Q

IgG

A

The main Ig in the blood. Detected after a second exposure to an antigen.
It crosses the placenta.

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13
Q

How to identify plasma cells in a histo section?

A

Clock-faced chromatin.

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14
Q

“M” Protein

A

A “monoclonal” serum protein made by neoplastic plasma cells or B lymphocytes.

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15
Q

Definition of clonal.

A

Derived from one cell of origin.

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16
Q

Monoclonal gammopathy

A

A neoplastic plasma cell produces plasma cells that are all neoplastic and have the exact same type of light and heavy chains.

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17
Q

What do monoclonal gammopathies produce and secrete into the blood?

A

M protein.

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18
Q

How do monoclonal plasma cells stain?

A

All the cells would stain one color. If there’s a mixture of colors, then it’s a polyclonal population.

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19
Q

SPEP

A

Serum Protein Electrophoresis

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20
Q

Test for a monoclonal serum protein.

A

Serum protein electrophoresis.

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21
Q

The 5 regions of a normal serum protein electrophoresis.

A

Albumin (highest), alpha1, alpha2, beta, and gamma.

22
Q

What an abnormal SPEP looks like.

A

Goal Posts spike.

23
Q

Major protein in the blood.

A

Albumin.

24
Q

Done whenever you’re trying to figure out if there’s an abnormal protein in the blood.

A

SPEP.

25
Q

Identifies monoclonal proteins in the serum or urine.

A

Immunofixation Electrophoresis.

26
Q

Proteins are separated in the urine or serum and them incubated with specific antisera against Ig’s of interest.

A

Immunofixation Electrophoresis

27
Q

Is Monoclonal Gammopathy of Undetermined Significance considered neoplastic?

A

No

28
Q

Risk of progression of MGUS.

A

1.6%/year

29
Q

Age population of MGUS

A

Elderly.

30
Q

Plasmacytoma

A

A discrete, solitary mass of neoplastic monoclonal plasma cells in either bone or soft tissue.

31
Q

Myeloma

A

An osteolytic cancerous tumor in the bone marrow.

32
Q

Plasmacytomas have a normal….

A

bone marrow biopsy.

33
Q

Symptoms of plasmocytomas.

A

Swelling/bone pain.

34
Q

Myeloma presents as…

A

osteolytic bone lesions and abnormal marrow.

35
Q

Plasma cell myeloma is AKA

A

Multiple myeloma.

36
Q

Cells with eccentric nuclei are?

A

Plasma cells.

37
Q

CRAB

A

Signs of organ or tissue impairment with multiple myeloma: Hypercalcemia, Renal failure, Anemia, Bone lesions.

38
Q

Asymptomatic plasma cell myeloma.

A

Has no signs of CRAB.

39
Q

What is kidney damage caused by in plasma cell myeloma?

A

Excessive Ig.

40
Q

Where is plasma cell myeloma often found?

A

Vertebra, skull, scapula, ribs.

41
Q

What does a gross specimen of multiple myeloma look like?

A

Punched out osteolytic lesions, and juicy, red color.

42
Q

What don’t you see in normal plasma cells?

A

Nucleoli

43
Q

Seen in normal plasma cells and myeloma cells.

A

Russell bodies, which are Ig inclusions.

44
Q

Red blood cells and multiple myeloma.

A

The RBC’s in multiple myeloma are stacked, and this is called Rouleaux.

45
Q

What is Rouleaux caused by?

A

Increased serum protein.

46
Q

When a smear has Rouleaux, what disease could it be?

A

Plasma cell myeloma.

47
Q

Bence Jones proteins

A

Monoclonal light chains in the urine.

48
Q

Cause damage to the kidney as a result of multiple myeloma.

A

1) Monoclonal light chains form tubular casts.
2) Plasma cell infiltration.
3) Hypercalcemia makes calcium deposits.
4) Amyloid deposition.

49
Q

Il-6

A

Promotes myeloma proliferation.

50
Q

Role of bisphosphonates

A

Inhibit bone resorption/lysis by getting rid of osteoclasts.

Plasma Cell Disorders (1 decks)

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