Myeloma and Lymphoma

Question 1

damaged light chains in urine called what?

Answer 1

Bence Jones protein

Question 2

what is MGUS?

Answer 2

monocloncal gammopathy of Undetermined significance

“has the para protein but nothing else”

Question 3

who gets MGUS?

Answer 3

more likely elderly

Question 4

why is MGUS important?

Answer 4

more likely to transform to myeloma

Question 5

does everyone with myeloma have hx of MGUS?

Answer 5

Nope

Question 6

what do you see in marrow with multiple myeloma?

Answer 6

marrow full of plasma cells?

Question 7

diagnostic criteria for myeloma?

Answer 7

M-protein in serum/urine
plasmacytoma
end-organ damage: CRAB

Question 8

what is CRAB?

Answer 8

hypercalcaemia
renal insufficiency
anaemia
lytic bone lesions

Question 9

what is beta-2 microglobulin?

Answer 9

measures plasma cell burden

but renal impairment alone can raise it

Question 10

why is multiple myeloma called multiple?

Answer 10

affects multiple bones with lytic lesions ‘pathological fracture’, long bones, spinal

Question 11

if patient is ill and has high total protein and low albumin, what could it be?

Answer 11

hidden protein (paraprotein)

Question 12

what kind of lesions on x-ray for multiple myeloma?

Answer 12

lytic lesion

Question 13

what is the best single agent for treating multiple myeloma?

Answer 13

melphalan

Question 14

what is immune paresis?

Answer 14

in multiple myeloma, you have a high IgG kappa or lambda, but a very low lgA, IgM

Question 15

transplant in myeloma is what?

Answer 15

autologous bone marrow, to allow recovery from the strong chemo

Question 16

thalidomide use these days?

Answer 16

multiple myeloma

Question 17

someone with paraprotein means myeloma?

Answer 17

Nope, probably MGUS, but watch out for CRAB features

Question 18

lymphoma by definition is?

Answer 18

malignant

Question 19

where can lymphoma arise?

Answer 19

liver
spleen
MALT
lymph nodes

Question 20

2 most common hodgkin

Answer 20

NODULAE SCLEROSIS

MIXED CELLULARITY

Question 21

classic hodgkin histology?

Answer 21

reid-sternberg cells

mixed infiltrate

Question 22

B Cell Non hodgkin lymphoms high clinical aggressiveness is?

Answer 22

Burkitt Lymphoma

Question 23

B Cell Non hodgkin lymphoma intermediate aggressiveness?

Answer 23

diffuse large B cell lymphoma

Question 24

B Cell Non hodgkin lymphomas low aggressiveness?

Answer 24

follicular lymphoma

Question 25

grade or stage in Non-hodgkin?

Answer 25

grade ('nastiness'"

Question 26

what is stage?

Answer 26

WHERE it is.

Question 27

non hodgkin lymphoma is grade of stage?

Answer 27

grade

Question 28

Hodgkin lymphoma grade or stage more predictive?

Answer 28

stage

Question 29

B symptoms?

Answer 29

weight loss fever night sweats

Question 30

difference between non-hodgkins 1a and 1b stage?

Answer 30

1b has B-symptoms (do worse)

Question 31

important cut off in hodgkin lymphoma treatment?

Answer 31

``` up to 2a (get radiotherapy only) after 2b (radio and chemo) ```

Question 32

what important biochem marker is elevated in non-hodgkin lymphoma?

Answer 32

LDH | lactate dehydrogenase

Question 33

non hodgkin grade or stage?

Answer 33

grade

Question 34

Burkitt lymphoma is what kind of lymphoma?

Answer 34

non hodgkin

Question 35

what is CHOP?

Answer 35

Cyclophosphamide Hydroxydornorubicin (Adriamycin) Oncovin (vincristine) Prednisolone Rituximab

Question 36

Rituximab targets what?

Answer 36

CD20 on B-cells

Question 37

light chain restriction is what?

Answer 37

restricted to kappa or lambda light chains