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Gen Med (Haem) > Plasma Cell Disorders > Flashcards

Plasma Cell Disorders Flashcards

1
Q

Multiple myeloma is a haematological malignancy characterised by proliferation of what?

A

Plasma cells

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2
Q

Which type of immunoglobulin is a dimer?

A

IgA

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3
Q

Which type of immunoglobulin is a pentamer?

A

IgM

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4
Q

What is the name for a monoclonal immunoglobulin, which can be used as a marker of underlying clonal B cell disorders?

A

Paraprotein

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5
Q

Excess free light chains leaking into the urine are known as what?

A

Bence-Jones proteins

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6
Q

What investigation is used to detect abnormal paraproteins in the serum or urine?

A

Electrophoresis

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7
Q

What is the median age at presentation of myeloma?

A

70 years

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8
Q

What electrolyte abnormality is most associated with myeloma?

A

Hypercalcaemia

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9
Q

Predominantly, why does renal impairment occur in myeloma?

A

Deposition of light chains in the renal tubules

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10
Q

Bone marrow crowding with plasma cells leads to what complications of myeloma?

A

Anaemia, thrombocytopenia, neutropenia

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11
Q

What bony features are often present in patients with myeloma?

A

Back pain, lytic bone lesions, pathological fractures

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12
Q

What type of anaemia occurs in individuals with myeloma?

A

Normocytic, normochromic

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13
Q

What will be seen on an FBC of someone with myeloma?

A

Anaemia, thrombocytopenia, possibly neutropenia

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14
Q

What will be seen on U&Es of someone with myeloma?

A

Raised urea and creatinine

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15
Q

What will a blood film show in myeloma?

A

Rouleaux formation

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16
Q

What are the most important screening investigations for myeloma?

A

Serum and urine electrophoresis

17
Q

In myeloma, raised concentrations of which monoclonal proteins will be present in the serum?

A

IgA and IgG

18
Q

What is the classic x-ray finding in individuals with myeloma?

A

Lytic ‘punched out’ lesions (pepper pot skull)

19
Q

How is myeloma definitively diagnosed?

A

Bone marrow biopsy showing > 10% plasma cells

20
Q

What investigation is used to survey the whole skeleton for bone lesions in patients with myeloma?

A

Whole body MRI

21
Q

The ability to undergo what treatment is used to decide on what induction therapy is used for patients with myeloma?

A

Autologous stem cell transplant

22
Q

What induction therapy is used for patients with myeloma who are suitable for an autologous stem cell transplant?

A

Bortezomib and dexamethasone

23
Q

What induction therapy is used for patients with myeloma who are not suitable for an autologous stem cell transplant?

A

An alkylating agents (e.g. cyclophosphamide), thalidomide and dexamethasone

24
Q

How are myeloma patients monitored after completion of induction treatment?

A

Blood tests and electrophoresis every 3 months

25
Q

What is the first line treatment for relapsed myeloma?

A

Bortezomib monotherapy

26
Q

What is used to monitor response to treatment in patients with myeloma?

A

Paraprotein levels

27
Q

What medication is given to all myeloma patients to manage osteoporosis and fragility fractures?

A

Zoledronic acid

28
Q

How is spinal cord compression as a result of myeloma treated?

A

Dexamethasone and radiotherapy

29
Q

What is the chance of a patient with MGUS developing myeloma at 10 years?

A

10%

30
Q

Around 10-30% of patients with MGUS have what developing complication?

A

Demyelinating neuropathy

31
Q

In MGUS, levels of paraproteinaemia will be less than what?

A

30g/L

32
Q

In MGUS, bone marrow plasma cell concentration will be less than what?

A

10%

33
Q

Who is Waldenstrom’s macroglobulinaemia typically seen in?

A

Older men

34
Q

Waldenstrom’s macroglobulinaemia is a lymphoplasmacytoid malignancy characterised by the secretion of what monoclonal paraprotein?

A

IgM

35
Q

Waldenstrom’s macroglobulinaemia typically causes hyperviscosity syndrome- what is the most common feature of this?

A

Visual disturbance

36
Q

What treatment can be used to manage hyperviscosity that occurs in Waldenstrom’s macroglobulinaemia?

A

Plasmapheresis

Gen Med (Haem) (12 decks)

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