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Block 7 Week 1 Colt > Myeloma, Waldenstroms, and Spleen - Parks > Flashcards

Myeloma, Waldenstroms, and Spleen - Parks Flashcards

1
Q

What are Bence Jones proteins

A

monoclonal light chains in the urine

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2
Q

In multiple myeloma, the first bones to show osteolytic lesions is the (blank)

A

vertebral columns

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3
Q

Multiple myeloma is a clonal expansion of (blank) cells

A

plasma cells

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4
Q

After the vertebral column, what other bones are sights of lesions of multiple myeloma?

A

ribs, skull, and lymph nodes

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5
Q

Why do patients with multiple myeloma have hypercalcemia?

A

Myeloma plasma cells have osteoclastic activity via RANKL and DKK1 which results in hypercalcemia

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6
Q

T/F: myeloma osteoclasts break down the marrow

A

true

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7
Q

What is the calcium phosphate molecule broken down by MM plasma cells?

A

hydroxyappetite

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8
Q

What are four concerns of hypercalcemia?

A

Heart arrythmias, renal disease, depression, and kidney stones

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9
Q

T/F: multiple myeloma can lead to osteoporosis

A

not necessarily; osteoporosis is a system wide issue while myeloma lesions are local

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10
Q

T/F: compression factures and pathologic fractures of the humerus are common in MM

A

true

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11
Q

“Flaming” plasma cells are indicative of (MM/Waldenstroms)

A

MM

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12
Q

Malignant plasma cells make high levels of (functional/disfunctional) Ig

A

dysfunctional

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13
Q

T/F: Myelomas only secrete the light chain portion of Abs

A

false; they secrete the whole chain

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14
Q

Myelomas produce (all/one) type(s) of Igs

A

one type of Ig onnly

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15
Q

An M spike or protein spike would be indicative of (blank)

A

myelomas

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16
Q

Multiple myeloma shows an M spike in which two types of Ig?

A

IgA or IgG

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17
Q

Waldenstroms Macroglobulinemia presents as what type of Ig spike?

A

IgM

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18
Q

High levels of Ig can result in hyper(blank)

A

viscosity

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19
Q

Despite making lots of Ig, pts with myeloma or waldenstroms have hypo(blank)

A

hypogammaglobulinemia

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20
Q

You need (cell mediated/humoral) immunity to fight bacterial infections

A

humoral

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21
Q

Pts with myeloma or waldenstroms have a difficult time fighting (viral/bacterial) infections

A

bacterial

22
Q

T/F: myelomas actively suppress normal Ig production

A

true

23
Q

The (heavy/light) chain can be filtered by the kidneys and seen in the urine as a diagnostic test for myeloma

A

light

24
Q

Will myelomas present with both kappa and lambda chains in the urine?

A

NO, they are monoclonal so they will only present with one type or the other

25
Q

(blank) are toxic to tubular lining cells

A

ligh chains

26
Q

High levels of Bence Jones proteins can form (blanks) within kidney tubules

A

casts

27
Q

T/F: hypercalcemia is injurious to kidney function

A

ture

28
Q

In MM, renal failure occurs in (blank)%, and renal disease occurs in (blank)%

A

25% for renal failure

50% for renal disease

29
Q

T/F: MM pts can get calcium stones

A

true

30
Q

What the hell is Rouleaux? What the fuck does it mean?

A

Coin stacks of RBCs, may indicate myeloma

31
Q

What issue with Hgb do MM pts have?

A

anemia

32
Q

What type of anemia do MM pts get?

A

normochromic normocytic anemia

33
Q

Why do MM pts get anemia?

A

the sheets of plasma cells in the marrow pushes out all other precursors

34
Q

What type of protein precipitates in the cold and can cause ischemic necrosis?

A

cyroglobulins

35
Q

What are the cardinal symptoms of multiple myeloma?

A 
HIRF
Hypercalcemia
Infections
Renal failure
Fatigue/anemia
36
Q

t(11;14) or hyperdiploidy has a (standard/worse) prognosis of MM while t(4;14) and csome 1 abnormalities have a (standard/worse) prognosis

A

t(11;14)/hyperdiploidy: standard

t(4;14)/csome 1: worse prognosis

37
Q

Waldenstrom’s arises from which B cell maturation stage?

A

Plasma cytoid cell; after mature b cell but before plasma cell

38
Q

CLL and NHL comes from what B cell maturation stage?

A

mature B cell

39
Q

multiple myeloma comes from what B cell maturation stage?

A

plasma cell

40
Q

Sezary syndrome comes from what T cell maturation stage?

A

Peripheral T cell

41
Q

Waldenstroms pts present with what type of symptoms from hyperviscosity syndrome?

A

neurologic: can’t see, can’t think, psychosis

42
Q

The linked sausage effect is seen when you examine what body part and what does it indicate?

A

retinal vessels, hyperviscosity most likely from waldenstroms

43
Q

T/F: Waldenstroms can lead to both cold agglutinins and cryoglobulins

A

true

44
Q

If someone presents with anemia, fatigue, and a bone marrow biopsy showing high levels of plasma cytoid cells, you think they have (MM/Waldenstroms)

A

waldenstroms

45
Q

T/F: Waldenstroms will present with bone lesions, fractures, and bone pain

A

FALSE; NO BONE INVOLVEMENT

46
Q

Does MM or Waldenstroms present with HSM and lymphadenopathy?

A

Waldenstroms: you get the IgM deposits

47
Q

What brain issue can arise from hyperviscosity?

A

encephalopathy

48
Q

Does Raynaud’s present with MM or Waldenstroms?

A

Waldenstroms

49
Q

pts that have raynaud’s from Waldenstroms is caused by what mechanism? Is this primary or secondary raynaud’s?

A

from IgM irritating the endothelial cells; secondary

50
Q

Waldenstrmoss is caused by a (gain/loss) of function of MYD88,

A

gain of function

51
Q

gain of function of MYD88 in Waldenstrom’s will lead to over expression of what transcription factor?

A

NF-kB

Block 7 Week 1 Colt (9 decks)

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