[myeloma]

Answer 1

serum

urine

Answer 2

monoclonal band

aka paraprotein

Answer 3

immunoglobulins

or fragments of

Answer 4

plasma cell

lympoplasmacytic cell

Answer 5

IgG

Answer 6

IgA

Answer 7

reduction in the levels of other immunoglobulins

Answer 8

immunoparesis

Answer 9

Bence-Jones proteins

Answer 10

free light immunoglobulin chains

kappa/lambda

Answer 11

yes

Answer 12

pancytopenia (anaemia/neutro/thrombocytopenia)
Recurrent bacterial infections
renal impairment
osteolytic bone lesions

Answer 13

increased activity

Answer 14

increased osteoclastic activity resulting in bone reduction

Answer 15

Back pain

fractures of long bones

Answer 16

marrow infiltration by plasma cells

Answer 17

neutropenia

immunoparesis

Answer 18

light chain deposition

Answer 19

tamm-Horsfall protein (+bence jones)

Answer 20

Rouleaux formation of RBCs

Answer 21

pepper-pot lesions

Answer 22

back ache

most frequent localisation

Answer 23

plasma cell increased on biopsy
monoclonal band
evidence of end organ damage
bone lesions

Answer 24

anaemia
renal function impaired
hypercalcaemia

Question 25

[myeloma]: what are the 4 main complications related to myeloma

Answer 25

hyperviscosity hypercalcaemia AKI spinal cord compression

Question 26

[myeloma]: why is spinal cord compression a complication?

Answer 26

collapsing of vertebral bodies

Question 27

[myeloma]: Tx of spinal cord compression

Answer 27

DexamethasoneIV 4mg/6hrs

Question 28

[myeloma]: Tx of hyperviscosity

Answer 28

plasmapheresis

Question 29

[myeloma]: how does plasmapheresis reduce viscosity

Answer 29

removes light chains

Question 30

[myeloma]: Tx of hypercalcaemia (2)

Answer 30

``` IV saline (rehydrate) Bisphosphonate ```

Question 31

[myeloma]: Tx of anaemia?

Answer 31

transfusion

Question 32

[myeloma]: myeloma Tx: drugs used in intensive regimens?

Answer 32

Vincristine Adriamycin Dexamethasone

Question 33

[myeloma]: myeloma Tx: drugs used in non-intensive regimens? (elderly etc)

Answer 33

``` Melphalan Prednisolone +- bortezumab +- Thalidomide ```

Question 34

[myeloma]: what are the 2 causes of death in myeloma?

Answer 34

renal failure | infection

Question 35

[myeloma]: what is used/measured for myeloma prognosis

Answer 35

beta-2 microglobulin