Plasma Cell Dysacrasias

Question 1

Waldenstrom’s macrogammaglobulinemia phenotype

Answer 1

• mature B cell

Question 2

symptoms of smoldering multiple myeloma

Answer 2

• asymptomatic

Question 3

light chains in amyloidosis

Answer 3

• lambda light chains

Question 4

result of malignant plasma cells interacting with bone marrow microenvironment

Answer 4

• activation of osteoclasts - suppression of osteoblasts - leads to lytic bone disease

Question 5

amyloidosis present with which stain?

Answer 5

• congo red staining of bone marrow biopsy

Question 6

immunoglobulins most often found in MM

Answer 6

• IgG - IgA - light chains only

Question 7

risk of developing myeloma from MGUS

Answer 7

• 1% per year

Question 8

case symptoms of Waldenstrom’s macrogammaglobulinemia

Answer 8

• headache - blurred vision - hyperviscosity

Question 9

Waldenstrom’s macrogammaglobulinemia most symptoms caused by

Answer 9

• elevated IgM

Question 10

gender most impacted by multiple myeloma

Answer 10

• males

Question 11

bence jones protein

Answer 11

• kappa light chains in urine protein electrophoresis

Question 12

Waldenstrom’s macrogammaglobulinemia associated with which immunoglobulin

Answer 12

• IgM

Question 13

risk factors for multiple myeloma

Answer 13

• age - gender - race - family history - radiation exposure - chronic antigenic stimulation

Question 14

which population is impacted by PCD

Answer 14

• adults

Question 15

diagnosis test for Waldenstrom’s macrogammaglobulinemia

Answer 15

• SPEP showing IgM monoclonal spike - serum viscosity

Question 16

race most impacted by multiple myeloma

Answer 16

• African Americans

Question 17

risk of developing myeloma from smoldering

Answer 17

• 10% per year

Question 18

Waldenstrom’s macrogammaglobulinemia is a disease of which population

Answer 18

• adults

Question 19

PCD are diseases associated with

Answer 19

• monoclonal proliferation of immunoglobulin producing plasma cells

Question 20

precursor protein in amyloidosis

Answer 20

• secreted in a soluble state - becomes insoluble at some tissue sites and compromises organ function

Question 21

Waldenstrom’s macrogammaglobulinemia related to cancer?

Answer 21

• low grade lymphoma - involving bone marrow and spleen

Question 22

smoldering myeloma labs

Answer 22

• > 3.0 g/dL serum monoclonal protein OR > 10-60% bone marrow plasma cells OR - urinary monoclonal protein AND - no myeloma defining events

Question 23

Amyloid light chain amyloidosis associated with

Answer 23

• multiple myeloma - abnormal light chains

Question 24

lab values for MGUS

Answer 24

• < 3.0 g/dL serum monoclonal protein AND - < 10% monoclonal plasma cells in bone marrow - no end organ damage

Question 25

findings associated with abnormal proliferation of plasma cells in the bone marrow

Answer 25

- impaired hematopoiesis - hypogammaglobulinemia - bone disease - nerve root compression

Question 26

age most impacted by multiple myeloma

Answer 26

- 65-70

Question 27

labs for amyloidosis

Answer 27

- \< 10% clonal plasma cells in bone marrow - \<3% g/dl monoclonal protein

Question 28

Waldenstrom's macrogammaglobulinemia cell morphology

Answer 28

- \>10% lymphoplasmacytic

Question 29

what does MGUS stand for

Answer 29

- monoclonal gammopathy of undetermined significance

Question 30

findings associated with abnormal immunoglobulins and other factors secreted by malignant plasma cells

Answer 30

- renal disease - rouleaux - amyloid - hyperviscosity - cryoglobulins - coagulation abnormalities CCRRAH

Question 31

clinical and pathology findings associated with multiple myeloma are a consequence of

Answer 31

- tumor mass effect of the malignant plasma cells - abnormal secretory products from the malignant plasma cells - monoclonal immunoglobulins and cytokines

Question 32

what are myeloma defining events

Answer 32

- hypercalcemia - renal disease - anemia - bone disease CRAB

Question 33

70% of patients with MM present with

Answer 33

- bone pain

Question 34

Waldenstrom's macrogammaglobulinemia more common in which gender

Answer 34

- men

Question 35

steps of multiple myeloma

Answer 35

- MGUS -\> smoldering -\> myeloma

Question 36

biomarkers for multiple myeloma

Answer 36

- extreme bone marrow clonal plasmacytosis - elevated free serum light chain level - more than one focal lesion on MRI

Question 37

bone disease associated with abnormal proliferation of plasma cells in the bone marrow

Answer 37

- lytic lesions/pathologic features - hypercalcemia

Question 38

is multiple myeloma curable?

Answer 38

- no

Question 39

diagnosis of multiple myeloma

Answer 39

- monoclonal plasma cells of \>10% AND - Myeloma Defining event

Question 40

multiple myeloma is a tumor of

Answer 40

- plasma cells

Question 41

multiple myeloma malignant plasma cells interact with

Answer 41

- bone marrow microenvironment

Question 42

clinical presentation of amyloidosis

Answer 42

- raccoon eyes - enlarged tongue - proteinuria