Clinical findings of MM Flashcards
(35 cards)
What causes a decreased production of normal blood cells in MM?
Infiltration of the bone marrow
What is a clinical finding of MM related to bone lesions?
Bone pain. Fractures, Vertebral collapse. Hypercalcaemia. Oseoporosis.
What are bone pain and fractures associated with in MM?
Bone lesions.
What are clinical findings related to the decrease production of normal blood cells in MM?
Anaemia fatigue, lethargy, dyspnoea. Thrombocytopenia-increased bleeding. Leukopenia-increased infection rate.
Where do symptoms of myeloma show for patients?
Often related to the organ system most affected e.g. renal/anaemia/bone pain.
What is the result of malignant plasma cells replacing Bm cells?
Decrease in production of normal cells.
What percentage of bone marrow cells can be replaced by malignant plasma cells?
More than 30%
Why do MM patients have recurrent infections?
Immunosuppressive effect of malignancy and proliferation of one cell (monoclonal or M protein).
What causes spinal cord compression in 20% of patients?
Vertebral collapse or tumour growth adjacent to spinal cord.
How does loss of bone lead to renal failure/drowsiness?
Bone loss results in high plasma calcium levels (hypercalcaemia)
What is the normal blood calcium range?
8.5 to 10.5 mg/dl
What causes serum hyperviscosity?
High concentrations of Ig in the serum
What is serum hyperviscosity?
Increased thickness due to increased protein conc.
Why does plasma volume increase in response to serum hyperviscosity?
In an aim to reduce this.
Which cells are negatively impacted by an increase in plasma volume?
RBC’s, Leucocytes, Platelets.
What does the reduction in RBC, Leucocytes and Platelets cause?
Worsening of anaemia, leukopenia, thrombocytopenia due to BM damage.
What can increased serum viscosity lead to?
Platelet abnormalities. Poor perfusion (passage of blood through vessels).
What are reasons for MM patients and impaired immunity?
Reduced WBC count. Large amount of a monoclonal antibody due to large plasma cells which reduced normal polyclonal Ig concentraation.
What can high protein plasma concentration and high calcium in kidneys cause?
Kidney damage resulting in RENAL FAILURE.
When might bence-jones be detected in the blood?
Renal failure that leads to a reduction in bence-jones products excreted in blood.
What might be expected to happen to patients with significant glomerular damage?
Leakage of ALL serum proteins into urine INCLUDING paraprotein.
What is normocytic anaemia?
Anaemia where erythrocytes are normal in size.
What is macrocytic anaemia?
Enlarged RBC’s. (Folic acid deficiency is 1 cause)
What 6 types of lab investigations are used for MM?
.Complete blood count
.Peripheral blood film
.Bone Marrow biopsy
.Serum protein electrophoresis
.Immunofixation Electrophoresis
.Cytogenetics
