Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

703 > Multiple Myeloma > Flashcards

Multiple Myeloma Flashcards

1
Q

What is the most common type of multiple myeloma?

A

IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What classifies MGUS?

A
  • M protein <3 g/dL
  • Bone marrow plasma cells <10%
  • No end organ damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What classifies smoldering MM?

A
  • M protein >3 g/dL
  • Bence-Jones protein >500 mg/24h
  • Bone marrow plasma cells 10-59%
  • No end organ damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What classifies multiple myeloma?

A
  • M protein >3 g/dL
  • Bone marrow plasma cells >10%
  • Biopsy
  • End organ damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What criteria DIAGNOSES multiple myeloma?

A

SLiMCRAB
- >Sixty% bone marrow plasma cells
- Light chains >100
- MRI >1 focal lesion >5mm
- Calcium >1 mg/dL above ULN or >11
- Renal clearance <40 mL/min
- Anemia hemoglobin >2 below LLN or <10
- Bone >1 osteolytic lesion on imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are consequences of bone disease?

A
  • Lytic lesions and fractures
  • Anemia
  • Hypercalcemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes renal impairment in multiple myeloma?

A
  • Hypercalcemia
  • Myeloma cast nephropathy (light chain precipitation)
  • Concomitant nephrotoxic agents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the preferred bone agent for hypercalcemia of malignancy?

A

Full-dose zoledronic acid (not renally adjusted)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which prophylactic agents should be started in all new MM patients?

A

Levofloxacin and acyclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the gold-standard treatment for MM?

A

Triplet therapy
- Revlimid (lenalidomide)
- Velcade (bortezomib)
- Dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

(Autologous/Allogenic) transplant is preferred consolidation after chemotherapy

A

Autologous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When is Daratumumab-RVd considerable (studied)?

A

Newly diagnosed transplant-eligible patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are side effects of daratumumab?

A
  • Infusion reactions
  • Herpes reactivation
  • HepB reactivation
  • Lab interference
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do we premedicate with before giving daratumumab?

A
  • APAP
  • Dexamethasone
  • Antihistamine
  • Montelukast
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What post-treatment do we give for daratumumab?

A

Methylprednisolone 20mg x2 days after each dose for the first cycle only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which formulation of bortezomib is preferred due to dose-limiting side effects?

A

SQ

17
Q

What are side effects of bortezomib?

A
  • Herpes reactivation
  • Thrombocytopenia
  • Peripheral neuropathy
18
Q

What are drugs in the same class as bortezomib?

A

Carfilzomib (IV, pulmo/cardiotoxic)
Ixazomib (oral, GI toxic)

19
Q

What are side effects lenalidomide?

A
  • Birth defects
  • Hematologic toxicity
  • Thrombotic events
  • Somnolence
  • Increased risk of secondary malignancy
  • Rash, skin toxicity
  • Diarrhea
  • Peripheral neuropathy
20
Q

What birth control is required to take lenalidomide?

A
  • Highly effective birth control (IUD, hormonal, etc…)
  • Additional effective birth control (male condom, cap)
21
Q

What do we start all patients taking IMiDs on for anticoagulation?

A

Enoxaparin 40 mg QD

Move to aspirin 81 mg QD after a partial response (M protein <50%) is achieved and no other risk factors

22
Q

What are side effects of dexamethasone?

A
  • Insomnia
  • Mood changes
  • Increased appetite
  • GI upset/reflux
  • Hyperglycemia
  • Edema
  • Weight gain
  • HTN
23
Q

What OTC considerations should be taken for patients on MM regimens?

A
  • Imodium for diarrhea
  • Avoid NSAIDs due to nephrotoxicity
24
Q

When can we use BiTEs?

A

After 4 failed lines of therapy

25
Q

What BiTE drugs do we have available?

A
  • Talquetamab
  • Teclistamab
  • Elranatamab
26
Q

What are side effects of talquetamab (GPRC5D)?

A
  • CRS
  • Neurotoxicity
  • Cytopenias
  • Rashes
  • Skin and nail toxicity
  • Taste change
  • Weight loss
27
Q

What are side effects of teclistamab/elranatamab (BCMAs)

A
  • CRS
  • ICANS
  • Cytopenias
28
Q

What is required for patients to take BiTEs therapy?

A
  • Step-up dosing, sometimes hospital administration
  • REMS program
  • BiTE card for reactions to look out for
29
Q

What do we do for CRS treatment?

A

Supportive care, treat like a transplant

30
Q

What do we do for immune effector cell-associated neurotoxicity (ICANS)?

A

Grade with ICE score (high is better)
- Supportive care
- Steroids
- Anti-seizure medications

703 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions