Quesmed videos (myeloma) Flashcards
What are the associated features and complications of myeloma (CRAB HAI)?
MNEMONIC: CRAB HAI
HyperCalcaemia
Renal impairment
Anaemia
Bone disease
Hyperviscosity
Amyloidosis (AL)
Infections (recurrent)
What cells proliferate in myeloma?
Proliferation of the post-germinal centre B cells.
What is the typical age range affected in myeloma?
People > 60 years old
What are the features of a peripheral blood smear for myeloma?
Rouleaux formation (clumping of blood cells)
Circulating plasma cells
Basophilic (blue) background staining
What are typical bone marrow biopsy and urine/serum electrophoresis findings in myeloma?
Look for production of a single monoclonal antibody (paraprotein): “M” band in the gamma globulin region on either serum or urine electrophoresis.
> 20% monoclonal plasma cells on bone marrow biopsy.
When are conservative management options used for myeloma?
For minimal symptoms and no end organ damage
Supportive management for myeloma?
- Analgesia
- Biphosphonates (bone disease)
- Physio
- Transfusion/erythropoietin
- Vaccinations
- Good hydration
When is haematopoietic stem cell transplant done for myeloma?
In young, fit patients
What is the standard treatment regime for myeloma?
chemotherapy and steroids
What is amyloidosis?
The deposition of extracellular insoluble fibrins in organs and blood vessels.
Associated with multiple myeloma
Primary (idiopathic) and secondary (caused by underlying disorders)
What can amyloidosis present with?
Renal failure
Macroglossia (enlarged tongue)
Hepatosplenomegaly
Neuropathies
Joint pain
What is the main investigation option for amyloidosis and what characteristic will it show?
Diagnosed by tissue biopsy
Characteristic by apple-green birefringence when stained with Congo red and viewed under polarised light.
