Plasma Cell Disorders Flashcards

1
Q

what is myeloma?

A

a plasma cell malignancy

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2
Q

what effects can the tumour have in myeloma?

A
bone lesions 
hypercalcaemia 
bone pain 
marrow failure 
pancytopenia
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3
Q

what bone lesions are seen in myeloma?

A

lytic bone lesions

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4
Q

what causes the bone lesions in myeloma?

A

clonal plasma cells causing focal erosion of bone

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5
Q

what is a potential complication of the bone lesions in myeloma?

A

compression fractures and spinal cord compression

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6
Q

what effects can the paraproteins have in myeloma?

A

renal failure
immunosuppression
hyperviscosity
amyloid

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7
Q

what renal disease is seen in myeloma?

A

cast nephropathy due to light chain deposits

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8
Q

how is myeloma classified?

A

by the type of antibody produced

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9
Q

what is the median age of diagnosis of myeloma?

A

65

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10
Q

what is the mainstay of treatment for myeloma?

A

combination chemotherapy

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11
Q

what drugs can be involved in the chemotherapy in myeloma?

A

corticosteroids
alkylating agents
novel agents
monoclonal antibodies

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12
Q

name a corticosteroid that may be given in myeloma

A

dexamethasone

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13
Q

name alkylating agents that may be given in myeloma

A

clyclophosphamide

melphalan

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14
Q

name novel agents that may be given for myeloma

A

bortezomib

lenalidomide

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15
Q

name a monoclonal antibody that may be given for myeloma

A

daratumumab

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16
Q

what can be used to monitor response to treatment in myeloma?

A

paraprotein levels

17
Q

what analgesia should be avoided in myeloma?

A

NSAIDs

18
Q

what does MGUS stand for?

A

monoclonal gammopathy of undetermined significance

19
Q

how is MGUS defined?

A

paraprotein <30
bone marrow plasma cells <10%
no evidence of myeloma end organ damage

20
Q

what population group is most commonly affected by MGUS?

A

older males

21
Q

what is there a risk of in MGUS?

A

small risk of progression to myeloma

22
Q

what causes AL amyloidosis?

A

mutation in the light chain, resulting in an altered structure

23
Q

how is AL amyloidosis managed?

A

chemotherapy to switch off light chain supply

24
Q

what paraprotein is seen in waldenstrom’s macroglobulinaemia?

A

IgM paraprotein

25
Q

what is waldenstrom’s macroglobulinaemia?

A

a lymphoplasmacytoid neoplasm

26
Q

how can waldenstrom’s macroglobulinaemia present?

A

lymphadenopathy
splenomegaly
marrow failure

27
Q

how is waldenstrom’s macroglobulinaemia managed?

A

chemotherapy

plasmapheresis