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Block 7 Week 1 > Multiple Myeloma and Waldenstroms-Parks > Flashcards

Multiple Myeloma and Waldenstroms-Parks Flashcards

(61 cards)

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1
Q

What kind of neoplasm is multiple myeloma?

A

B cell neoplasma of older people

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2
Q

What is the median age of multiple myeloma?

A

70 years old

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3
Q

What is the manifestations of multiple myelom?

A

osteolytic bone lesions

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4
Q

In multiple myeloma, you commonly see (blank) in the serum

A

monocolonal protein with monoclonal light chains in the urine (bence jones protein)

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5
Q

In multiple myeloma, you will have increased osteoclast activity that results in (Blank)

A

hypercalcemia

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6
Q

Multiple myeloma will inhibit osteoblasts via (blank) and increase osteoclast activity via (blank)

A

DKK1

RANKL

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7
Q

Osteoprogenin (which stimulats osteoclast activity) is secreted by osteoblasts and bone marrow stem cells. It is degraded by (blank) receptors expressed on myeloma plasma B cells

A

CD138

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8
Q

you get lots of (blank) in multiple myeloma do to osteolytic lesions

A

fractures

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9
Q

In veterbral body you can get (blank) fractures-> the patients lose height, cause back pain, -> suspect myeloma

A

compression

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10
Q

How do you do immunoelectrophoresis?

A

you first electrophorese both serum then you but anti IgG into center well

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11
Q

What will the immunoelectrophoresis look like in multiple myeloma?

A

Normally you get an array of different clones but with myeloma you have mono clony so instead of getting an array of imungolobulins attaching, you will only have one antibody.

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12
Q

Most myelomas are (blank) and (blank)

A

IgG and IgA

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13
Q

Most myelomas are (blank) and (Blank)

A

IgG and IgA

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14
Q

IgD and IgE are found in some myelomas but typically these are associated with (blank)

A

Waldersontrons macroglobulenemia

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15
Q

Do you ever get IgM myeloma?

A

very rarely

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16
Q

In (blank) it involves a heavy chain and a light chain

A

multiple myeloma

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17
Q

Patients with myeloma frequently get (blank)

A

infections

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18
Q

What organisms cause infections associated with mutiple myeloma?

A

strep pneumonia, H influenze, N meningitidis

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19
Q

What do the malignant plasma cells associated with multiple myeloma suppress?

A

the normal good plasma cells so that normal cells cannot secrete immunoglobulin.
**since you dont have Ig you get bacterial infections

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20
Q

Can you test for myeloma in urine? Why?

A

yes
light chains can be filtered by kidneys, heavy chains cannot so you can find monoclonal light chains in urine (either kappa or lambda)

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21
Q

light chains are also called (blank) and they are toxic to the (blank)

A

bence jones proteins
tubular lining cells of the kidney
so people w/ multiple myeloma have kidney failure

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22
Q

Renal failure occurs in (blank) percent of myelomas

A

25

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23
Q

Renal disease occurs in over (blank) percent of myelomas

A

50

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24
Q

What does hypercalcemia do to your tubular lining cells?

A

affects them an can cause kidney stones

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25
(blank) is a major complaint in myeloma
fatigue
26
What causes rouleaux and where do you see it?
in myelomas, cuz you get lowering of the zeta potential and hence stacking of the RBCs
27
Myeloma causes you to get gangrene because of (blank)
cryoglobulins
28
What are the 7 major clinical findings of multiple myeloma?
``` Hypercalcemia/bone issues renal failure fatigue/anemia recurrent infections neuro symptoms nausea and vomiting bleeding/clotting disorders ```
29
What percent of multiple myeloma patients have hyperdiploid? What will this cause?
50% | trans cyclin D1 dysregulation
30
What percent of mutiple myeloma patients have non-hyperdiploid? what will this cause?
50% cis cycling ds dysregulation trans cyclin D2 disregulation
31
What chromosome problem is associated with poor prognosis for MM?
t4,14 and chromosome 1
32
High risk disease and poor prognosis are defined by the presentce of one of the following in each category,,,,,?
hypodiploidy, t (4,14), deletion 17p13; high levels of serum b2-microglobulin or lactate dehydrogenase
33
Standard risk disease is define by the presenct of (blank) or (blank)
hyperdiploidy or t(11;14)
34
What is lymphoplasmacytic lymphoma also known as?
Waldenstrom's macroglobulinemia
35
(blank) parallel pathways of normal differentiation
Lymphoid malignancies
36
Walden storm is only (blank) immunoglobulin and a light chain
IgM
37
Igm is a (Blank) thats why it gets stuck places.
pentamer
38
(blank) is what you get when you clot the blood (factors are all there)
serum
39
(bank) is anticoagulated, i.e unclotted bloo
plasma
40
You can get visual disturbances, dizziness, headaches altered state of consciousness in (blank)
waldenstroms
41
You can get a "linked sausage effect" in waldens called (blank)
hyperviscosity syndrome
42
Waldenstroms has cryglobulings that give you a (blank)
skin rash
43
(blank) can occur with atypical mycoplasm pneumonia, infectious mononucleosis, etc. (Blank) occur in multiple myeloma, hepatitis C
Cold agglutinins | Cryoglobulins
44
(blank) can given you a cold agglutin that can agglutinate the blood and cause anemia.
Waldenstroms
45
What are the symptoms of macroglobulinemia?
``` fatigue peripheral neuropathy Raynaud's phenomenon/cold sensitivity hepatosplenomegaly/lymphadenopathy Bleeding visual disturbances CHF dyspnea cutaneous lesions Bence Jones proteinuria ```
46
DO you have osteolytic lesions in waldens?
No, instead you get your bone marrow wiped out
47
Do you get hepatosplenomegaly in waldenstroms?
YES!!!!! (but remember in myeloma you do not!!!)
48
WHy can you get encephalopathy is waldenstroms?
cuz of hyperviscosity syndrome
49
(blank) phenomenon is characterized by triphasic color change
Raynauds
50
(blank) often heralds the onset of systemic scleroderma
vasospasm
51
``` What can these cause: collagen vascuar disease arterial occlusive disease pulmonary hypetensions neurologic disorders blood dyscrasias trauma drugs ```
Raynaud phenomenon
52
Raynauds phenomenon is seen in (waldenstroms/multiple myeloma)
Waldenstroms
53
Why do you have wayyyy to many B cells in waldenstroms?
because you have a MYD88 protein abnormality that results in a gain of fucntion that consistently turns NFK on which leads to increased B cell proliferation and decreased apoptosis.
54
What will be affected if you have B9 (folate) issues or a malignant disease and is typically secondarily involved?
Spleen
55
What are causes of massive splenomegaly?
``` thalassemia visceral leishmaniasis hyperactive malarial splenomegaly syndrome mycobacterium avium complex lymphomas myeloproliferative neoplasms gauchers disease ```
56
What does the spleen do?
formation, storage, destruction of RBCs and antibodies-> filters blood and removes abnormal or foreign material
57
(blank) occurs when the size of the spleen is increased by cells or tissue components or by vascular engorgement.
Hypersplenism
58
Hypersplenism will augments the spleens (blank) and even normal blood cells experience a delayed transit and temporary sequestration.
filtering functions
59
When you have hyperspelnism you cant function blood cels right so you get a lot of cells stuck in it and it causes (blank) and (Blank) but they are just fine sitting in teh spleen whereas (blanK) get destroyed and cause anemia
neutropenia and thrombocytopenia | RBCs
60
T or F | some patients with a splenic infarct have no pain
T
61
Beta 2 microglubin is a Very important prognostic serum marker for (balnk). Patients with a serum level of less than (blank) have a 43 month median survival. Patients with levels greater than (blank) have a 12 month median survival .
multiple myeloma 0. 004 gm/L 0. 004 gm/L

Block 7 Week 1 (10 decks)

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