Multiple Myeloma signs and symptoms Flashcards
(26 cards)
How is a urinalysis carried out on suspected MM patients?
For 24 hours. Using protein electrophoreisis to determine Bence Jones proteinuria and kappa/lambda light chains.
What may manifest in patients with renal involvement.
Fanconi syndrome.
What are signs of Fanconi syndrome?
Aminoaciduria, hyponatremia, hypoglycaemia associated with glucosuria, low anion gap <5mEq/L, hyperchloremic metabolic acidosis.
What does serum protein electrophoreisis identify?
M protein as a narrow ‘spike’ in γ, β or α2 regions of the densitometer tracing.
What do ALL secretory myeloma produce?
Excess free light chains.
What causes proteinuria?
High level of free light chains
What do light chains form on urine electrophoreises?
They form discrete bands.
What does immunofixtion determine about free light chains?
Whether the discrete bands are Kappa or Lambda
What disorder do patients with Bence Jones protein in their urine have?
Renal failure
What deteriorates with MM disease progression?
Renal function.
What is usually the presenting symptom of MM?
Renal tube damage and deterioration
What is immune paresis?
Suppression of normal immunoglobulin production by malignant plasma clone.
What myeloma chain is immune paresis associated with?
Light chain myeloma
What is the sign of presence of small serum-free light chains or IgD monoclone?
Low immunoglobulin levels.
Why would we carry out immunofixation on samples with not abnormal electrophoteric band shown?
Could be small serum free light chains or IgD monoclones.
Where do plasma cells often proliferate?
In bone
What causes bone damage in MM?
Breakdown of homeostasis of bone remodelling via osteoclasts and osteoblasts.
What forms in the damaged parts of bone?
Circular clones of plasma cells
What are osteoclasts and what do they do?
Dissolve bone and this is higher in myeloma patients as there is nothing to regulate this breakdown rate.
Define Plasmacytoma?
A single bone lesion
What types of bone lesions occur in MM?
Lytic lesions. Osteolytic lesions.
Where is MM often found?
In the skull
What may be responsible for activating the osteoclast and causing lytic lesions?
Plasma cell release of interlukin 6 IL-6
Define Osteoclast?
Large multinucleated cell formed from differentiated macrophage responsible for bone breakdown.
