Multiple Myeloma

Question 1

Symptoms of MM

Answer 1

CRAB 
Ca inc (stones bones etc)
Renal F (amyloidosis + nephrotic syndro)
Anaemia (+pancytopenia)
Bones (osteoporosis, fractures)

= hyperviscosity syndro

Question 2

typical bone changes seen in MM

Answer 2

wedge lesions

pepper pot skull

Question 3

serum electrophoresis in MM

Answer 3

-> dense narrow band in gamma region

Question 4

classical blood film finding in MM

Answer 4

rouleaux

Question 5

urine finding in MM

Answer 5

bence jones protein

Question 6

Bone marrow changes in MM

Answer 6

BM = > 10 plasma cells

Question 7

how is MM staged

Answer 7

Durie salmon staging system

Question 8

treatment options for MM

Answer 8

Bortezomib +/- dexamethasone
cyclophosphamide
lenalidomide

Question 9

Ig, BM findings and symptoms in MM

Answer 9

IgA/IgG >30g/L
BM > 10% plasma
CRAB +ve

Question 10

Ig, BM findings and symptoms in smouldering MM

Answer 10

IgA/IgG >30g/L
BM > 10% plasma
CRAB -ve

Question 11

Ig, BM findings and symptoms in MGUS

Answer 11

IgA/IgG inc but < 30
BM <10% plasma
CRAB -ve

Question 12

low grade NHL in elderly men with weight loss + visual symptoms

Answer 12

waldenstroms macroglobinaemia

Question 13

symptoms in waldenstroms macroglobinaemia

Answer 13

weight loss, fatigue, hyper viscosity (-> visual problems, confusion, weakness etc)

Question 14

Tx for waldenstroms macroglobinaemia

Answer 14

plasmapheresis for hyper viscosity syndro

Question 15

symptoms of systemic amyloidosis

Answer 15

macroglossia, carpel tunnel syndro, periphery neuropathy, HF, Renal F

Question 16

Tx for systemic amyloidosis

Answer 16

Velcade (bortezomib) / chemo / allo SCT