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Haematology > Myeloma > Flashcards

Myeloma Flashcards

1
Q

Which race is myeloma more common in?

A

Afro-Caribbean

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2
Q

What causes plasma cell dyscrasia?

A

Abnormal proliferation of a single clone of plasma or lymphoplasmacytic cells

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3
Q

How does myeloma cause problems?

A

Secretion of Ig or and Ig fragment causing dysfunction of many organs

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4
Q

What causes lesions?

A

Increased osteoclast activation from signalling by myeloma cells

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5
Q

What do osteolytic bone lesions cause?

A

Pepper pot skull, back pain

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6
Q

Why can you get recurrent bacterial infections?

A

Neutropenia

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7
Q

What does a positive serum/urine electrophoresis look like?

A

Ig comes up as a monoclonal band

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8
Q

What type of protein is in urine?

A

Bence Jones proteins

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9
Q

What are Bence Jones proteins?

A

Free Ig light chains of kappa or lambda type

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10
Q

What type of formation will RBCs have on a blood film?

A

Rouleaux - stacking

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11
Q

What imaging would you do?

A

CT, X-ray

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12
Q

What drug do you give to reduce fracture rates and bone pain?

A

Bisphosphonate

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13
Q

How would you correct their anaemia?

A

Transfusions

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14
Q

How would you manage infections?

A

Treat rapidly with broad-spectrum antibiotics until culture results known

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15
Q

How is myeloma classified?

A

By Ig product

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16
Q

How many patients have each myeloma type?

A

2/3 have IgG, 1/3 have IgA, very few have IgD or IgM

17
Q

What are signs/symptoms of myeloma?

A 
OLD CRAB
Old - over 75
Calcium over 2.75 mmol per L
Renal impairment
Anaemia
Bone lesions
18
Q

What can hypercalcaemia lead to?

A

AKI

19
Q

What would you see on an FBC?

A

Raised ESR, anaemia

20
Q

What would you see on X-rays?

A

Pepper pot skull, fractures

21
Q

What would you see on CT?

A

Bone lesions, cord compression

22
Q

Give an example of a bisphosphonate

A

Zoledronate

23
Q

What management would you start?

A

Bisphosphonates, analgesia, radiotherapy, transfusions, infection control, chemo

24
Q

What analgesia should you avoid?

A

NSAIDs

25
Q

What are the two options for chemotherapy?

A

CTD and VAD

Haematology (18 decks)

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