Plasma Cells

Question 1

what population gets plasma cell problems?

Answer 1

adults only

Question 2

MM rules for diagnosis

Answer 2

clonal bone marrow plasma cells over ten percent and myeloma defining event

Question 3

myeloma defining events

Answer 3

CRAB…hypercalcemia, renal disease, anemia, bone disease

Question 4

what scan to use to see lytic lesions in MM

Answer 4

have to use skeletal survery not a bone scan!!

Question 5

What globulins are in MM?

Answer 5

IgG and IgA…not M/E

Question 6

5 findings due to increase in immunoglobulins in MM?

Answer 6

nephron disease...can be kidney failure
clotting issues
hyperviscous blood
rouleaux
amyloid

Question 7

what do we use electrophoresis and immunofixation for in MM?

Answer 7

finding out what light chains and globulins are in the disease

Question 8

how to see renal disease in MM

Answer 8

creatinine will be elevated past 2

Question 9

how high will calcium be in MM?

Answer 9

over 11

Question 10

what is Hb for anemia in MM?

Answer 10

under 10

Question 11

3 biomarkers for the main symptoms of MM?

Answer 11

bone marrow clonal is 10% or more
elevated free light chains in serum
more than one focal lesion on MRI

Question 12

MGUS classifications

Answer 12

serum protein (less than 3) but clonal in marrow is less than 10%
NO end organ damage

Question 13

what is the risk of MGUS becoming MM?

Answer 13

very unlikely

Question 14

smoldering MM diagnosis rules

Answer 14

protein elevated above 3
OR
more than 10% clonal
OR 
urinary monoclonal protein present 
AND
NO defining events

Question 15

risk of getting MM from smoldering?

Answer 15

10%

Question 16

how does amyloidosis work?

Answer 16

protein becomes insoluble and compromises organ function

Question 17

AL amyloidosis rules for diagnosis

Answer 17

less than 10% clonal
less then 3 serum protein
LAMBDA chains

Question 18

what test to use for AL amyloidosis?

Answer 18

congo red stain…will appear peachy

Question 19

what organ is mainly affected by amyloidosis?

Answer 19

KIDNEY

Question 20

AL amyloidosis presentation

Answer 20

raccoon eyes and enlarged tongue with kidney problems

Question 21

waldenstroms macroglobulinemia

Answer 21

lymphoplasmacytic cells…B Cells clone line…making tons of IgM

Question 22

lymphoplasmacytic cells

Answer 22

in between being a B cell and a plasma cell

Question 23

waldenstroms presentation

Answer 23

headache, blurry vision

hyperviscous blood

Question 24

how to diagnose waldenstroms

Answer 24

look for IgM spike and serum viscosity changes

Question 25

what percent of cells do you need to be clone in waldenstroms?

Answer 25

10% considered a low grade lymphoma