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Hematology > Ch22 Multiple Myeloma and Related Plasma Cell Disorders > Flashcards

Ch22 Multiple Myeloma and Related Plasma Cell Disorders Flashcards

0
Q

What type of cells are responsible for the production of antibodies called immunoglobulin?

A

Plasma cells

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1
Q

Where are plasma cells normally represented?

A

The final stages of the development of B lymphocytes

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2
Q

Subsequent rearrangement of the light chains enables the cell to:

A

Express surface immunoglobulin

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3
Q

B-cells differentiate into:

A

Plasmablasts

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4
Q

What holds together the heavy and light chains in immunoglobulin?

A

Varying numbers of disulfide bonds

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5
Q

What are the 5 types of heavy chains?

A

Gamma, alpha, Mu, delta, epsilon

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6
Q

What are the 2 types of light chains?

A

Kappa, lambda

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7
Q

What immunoglobulin is the initial transient antibody produced in response to infection?

A

IgM

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8
Q

What is the role of IgE?

A

Allergic/hypersensitive reactions

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9
Q

What is the function of IgA?

A

Provide protection of epithelial surfaces in the GI tract and the airways

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10
Q

What is the hallmark condition in plasma cell disorders?

A

Immunoglobulin overprotection

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11
Q

Protein in the serum consists mainly of:

A

Albumin, immunoglobulin, and a small amount of other proteins

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12
Q

How do you measure the immunoglobulin factor?

A

Total protein - albumin = ig factor

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13
Q

What method is usually used when investigating an abnormal M-spike on serum protein electrophoresis?

A

Immunofixation

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14
Q

Name a nephelometry method to measure the degree of turbidty by light scatter caused by antigen-antibody complexes

A

Quantitative immunoglobulin

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15
Q

What syndrome has the presence of excess Ig that can lead to viscous blood resulting in higher resistance to flow in the blood vessels.

A

Hyperviscosity syndrome

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16
Q

What is the result of hyperviscosity?

A

Decreased blood flow in the small vessels of various vital organs, thus increasing the workload on the heart

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17
Q

Low immunoglobulin levels lead to:

A

Increased susceptibility to infections

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18
Q

What are serum immunoglobulins that precipitate reversible on exposure to cold

A

Cryoglobulins

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19
Q

What is the most common plasma cell dyscrasia, altering terminal differentiated B cells?

A

Multiple myeloma

20
Q

What is presumed to be the origin of the malignant clone in multiple myeloma?

A

B-cell

21
Q

How is multiple myeloma characterized?

A

Abnormal proliferation of plasma cells in the BM
Overproduction of monoclonal Ig
Lytic/destructive bone disease

22
Q

Multiple myeloma accounts for____ of all hematological malignancies and ____ of all cancers

A

10%; 1%

23
Q

What is the median age for MM?

A

67 years

24
Q

What is plasma cell expansion in MM?

A

Expanding plasma cell tumors in the BM causing a destruction in the bone surface cortex

25
Q

Late in the disease course for MM, many patients report:

A

Loss of height because of vertebral collapse

26
Q

What is the major contributor to bone disease in MM?

A

Inhibition of osteoblasts

27
Q

Increased calcium in the urine can lead to:

A

Kidney stone and kidney failure

28
Q

What is a major manifestation in MM?

A

Anemia

29
Q

Diagnosis of MM is based on the symptoms:

A 
Anemia 
Renal insufficiency
Bone pain
Neuropathy
High protein levels
30
Q

What is an easy way to assess BM function?

A

CBC

31
Q

______ in MM you may see teardrop RBC and immature WBC

A

Late

32
Q

What is the nonspecific marker of tissue breakdown and elevated levels in MM?

A

Lactate dehydrogenase (LD)

33
Q

Calcium levels are often ________ in myeloma patients

A

Elevated

34
Q

Chromosomal abnormalities are found in ______ of patients with MM

A

30-40%

35
Q

What are the 2 pathways for plasma cell tumors that are defined in MM?

A

One is associated with hyperdiploidy

One is associated by the presence of chromosome translocation involving IgH locus

36
Q

Which immunoglobulin is produced in more than 50% of MM cases?

A

IgG

37
Q

What are some treatments of MM?

A

Chemotherapy
Allogenic stem cell transplant
Drug combinations

38
Q

Name of a malignant lymphoproliferative disorder involving small lymphocytes that exhibit plasma cell differentiation

A

Waldronstoms macroglobulinemia (WM)

39
Q

What chromosomal abnormality is most common in WM?

A

Deletion of 6q21, which is detected in 42% of patients

40
Q

What percentage of WM patients experience anemia?

A

80%

41
Q

What is the primary treatment for WM?

A

Chemotherapy

42
Q

What is a protein conformation disorder that renders the protein insoluble and results in its deposition in the extra cellular matrix of various organs?

A

Amyloid

43
Q

What is the most common precursor protein that leads to Amyloidosis?

A

AL amyloid

44
Q

How does amyloidosis occur?

A

When insoluble protein fibers are deposited in tissues and organs, impairing their functions

45
Q

What is the aim for treating amyloidosis?

A

Eliminating the source of the abnormal precursor proteins

46
Q

What lab tests provide the most important prognostic information in multiple myeloid?

A

Hemoglobin
Albumin
Beta2- microglobulin

47
Q

Which diagnostic criteria is for WM?

A

Lytic bone lesion and rouleax

48
Q

What does staging refer to?

A

Chemotherapy regimen

Hematology (10 decks)

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