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AY Haematology > Plasma cell disorders > Flashcards

Plasma cell disorders Flashcards

1
Q

Where are B cells produced and initially developed?

A

Bone marrow

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2
Q

What happens to B cells after they leave the bone marrow?

A

Travel to the follicle germinal centre of the lymph node
Identify antigen and improve the fitby somatic mutation by somatic mutation orbe deleted
May return to the marrow asplasma cell or cicrculate asmemory cell

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3
Q

What are plasma cells?

A

Factory cell

Pumps out antibody

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4
Q

What does a plasma cell nucleus look like?

A

Clock face

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5
Q

What are the 2 different types of increase in immunoglobulins?

A

Polycloncal

Monoclonal

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6
Q

What is a paraprotein?

A

monoclonal immunoglobulin - marker of underlying B-cell disorder

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7
Q

How are immunoglobulins detected?

A

Serum electrophoresis

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8
Q

How is Bence-Jones protein detected?

A

Urine electrophoresis

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9
Q

What are the firect tumour cell effects ofmyeloma?

A 
Bone lesions 
Increased calcium 
Bone pain 
Replace normal bone marrow 
Marrow failure
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10
Q

What are the paraprotein mediated effects of myeloma?

A

Renal failure
Immune suppression
Hyperviscosity
Amyloid

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11
Q

How does lytic bone disease present on head x-ray?

A

Pepper pot skull (holes where bone has been eaten away by plasma cells in cell wall)

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12
Q

Which cells become overactive in myeloma lytic bone disease?

A

Osteoclasts

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13
Q

How can myeloma cause hypercalcaemia?

A

Calcium from bones is leaked into blood

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14
Q

How does myeloma affect the kidney?

A

Tubular cell damage by light chains
Light chain deposition - cast nephropathy
Hyppercalcaemia and Hyperuricaemia
NSAIDs

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15
Q

Which proteins to light chains bind with to form casts?

A

Tamm-Horsfall

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16
Q

How is myeloma treated?

A

Steroids
Alkylating agents
‘Novel agents’
High dose chemo & transplant in fit patients

17
Q

How is response to treatment measured in myeloma?

A

Paraprotein level

18
Q

What should not be given for bone pain in myeloma?

A

NSAIDs

19
Q

What is MGUS?

A

Paraprotein <30g/l
Bone marrow plasma cells<10%
No evidence of myeloma end organ damage

20
Q

What is AL Amyloidosis?

A

Rare disorder
Small plasma cell clone
Mutation in the light chain which precipitates i tissues asaninsoluble beta pleated sheet

21
Q

How is amyloidosis diagnosed?

A

Congo red stain (apple-green birefringence)
Rectal or fat biopsy
Evidence in other organs (SAP scan, echo, proteinuria)

22
Q

What is Waldenstrom’s macroglobulinaemia?

A

Rare cancer ofcell halfway between lymphocyteandplasma cell- produce Igm

23
Q

How might Waldenstrom’s macroglobulinaemia present?

A

Lymphadenopathy
Splenomegaly
Hyperviscosity (visual disturbance, confusion,coma, bleeding)
Neuropathy

24
Q

Treat ment ofWM?

A

Chemo

Plasmapheresis

AY Haematology (12 decks)

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