41 - Lymphoma and Myeloma Flashcards

1
Q

may be worth looking at B cell development pathway

A

first slides on lecture

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2
Q

Ig - features

A

Glyoprotein molecules produced by plasma cells

Two light and two heavy held by covalent disulphide bonds

One variable and one constant region

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3
Q

How are Ig classified?

A

Based on aa sequence in constant region of heavy chains: determines IgG,M,A,D,E

Light chain determines kappa or lambda

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4
Q

Protein electrophoreis is…

A

Lab technique whereby serum is placed in gel and exposed to electric current

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5
Q

5 major fractions in protein electrophoresis

A
Serum albumin (biggest spike)
Alpha-1 globulins
Alpha-2 globulins
Beta globulins
Gamma globulins

From left to right

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6
Q

What happens to the protein electrophoresis in multiple myeloma?

A

“M-spike” in gamma section

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7
Q

Immunofixation takes place after protein electrophoresis why?

A

Anti-immunoglobulin antisera is added to each migration lane and if the immunoglobulin is present a complex precipitates

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8
Q

Dyscrasia meaning

A

an abnormal or disordered state of the body or of a bodily part.

Usually - blood components

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9
Q

What diagnostic criteria is used for myeloma?

A

IMWG

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10
Q

Primary lymphoid organs

A

(red) bone marrow and thymus gland

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11
Q

Secondary lymphoid organs

A

Lymph nodes and spleen

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12
Q

How do most people with myeloma present?

A

With kidney insufficiency

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13
Q

External factors affecting kidney sufficiency

A
Renal vein thrombus
Bisphosphonates
Hypercalcaemia
ACEi
Dehydration
NSAIDs
CT contrast
Hyperviscosity
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14
Q

AKI with myeloma is what

A

A MEDICAL EMERGENCY

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15
Q

AKI w/ myeloma treatment

A

TIME = NEPHRONS
Blood film + electrophoresis + immunofixation + bone marrow biopsy w/ flow cytometry

Treatment with steroids

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16
Q

IMWG diagnostic criteria for myeloma

A

Serum M-protein

17
Q

Amyloidosis found by

A

Renal stain on kidney biopsies where amyloid shows up apple green

Deposit and aggregate in kidneys

18
Q

What is amyloidosis? + pathogenesis

A

Amyloid light chain fragments misfold and self-aggregate forming beta-pleated fibrils causing damage into multiple organs

19
Q

Follicular lymphoma - definition

A

Neoplastic disorder of lymphoid tissue

Type of non-Hodgkin lymphoma characterised by slowly enlarging lymph nodes

20
Q

Follicular lymphoma - clinical presentation

A

Lumps in neck

21
Q

Follicular lymphoma - % of all non-Hodgkin lymphoma diagnoses

A

15%

22
Q

Follicular lymphoma - epidemiology

A

M=F

Incidence rises with age

23
Q

Hodgkin Lymphoma - defined by

A

Presence of Hodgkin Reen-Sternberg cells (HRS) in the presence of cellular infiltrate of non-malignant inflammatory cells

24
Q

Hodgkin Lymphoma - epidemiology

A

2.7 per 100,000

Peak in 10s and 20s and then again in 70s

25
Q

Hodgkin Lymphoma - prognosis

A

Related to severity of treatment but 86% 5 year survival rate

26
Q

Hodgkin Lymphoma - treatment

A

Chemo and radiotherapy

27
Q

Hodgkin Lymphoma - problems with treatment

A
Very damaging
Increased mortality >20years down the line
Pulm toxicity
CVD
2° malignancies