Multiple Myeloma Flashcards
1
Q
Presentation of multiple myleoma?
A
- CRAB - hypercalcaemia, renal insufficiency, anaemia, bone lesions
- Osteolytic bone lesions
- Bone pain
- Pathological fractures
- Anaemia
- Dehydration
- Amyloidosis
- Dizziness, confusion, blurred vision, headaches - hyperviscosity
- Thirst, constipation, nausea - hypercalcaemia
2
Q
What is Multiple Myeloma?
A
Malignant proliferation of plasma cells. Diffuse bone marrow infiltration.
3
Q
Risk factors of multiple myeloma?
A
- Median age of presentation: 70
- Male
- More common in Afro-Caribbeans
4
Q
Investigations of of multiple myeloma?
A
bloods - raised calcium, uric acid, normocytic anaemia, leukopenia, thrombocytopenia
- Serum protein electrophoresis: type and presence of paraprotein
- Urine protein electrophoresis: presence of Bence-Jones protein
- Skeletal survey: xray for lesion monitoring, MRI, CT
- Bone marrow aspirate + FISH
5
Q
Management of of multiple myeloma?
A
- In over 70s: bortezomib, melphalan, prednisone, lenalidomide and low dose dexamethasone (chemotherapy)
- In less than 70s: high dose chemotherapy with autologous stem cells
Bisphosphonates
thrombopropyhlaxis
6
Q
Prognosis of of multiple myeloma?
A
Incurable, relapsing and remitting, chronic.
