Myeloma: MGUS, Multiple Myeloma Flashcards
1
Q
MGUS
- pathophysiology, types
- risk factors
- complications
- presentation
- diagnosis
- management
A
Asymptomatic premalignant plasma cell proliferative disorder in BM => production of M protein (has no AB function) => may progress to multiple myeloma, increased risk of fractures, VTE, infections
- Non IgM MGUS
- IgM MGUS
Genetic mutations - t(14:11), (14:6), TP53
More common in older males
Asymptomatic
Rash, paraesthsia, hypoesthesia
Labs - monoclonal proteins
BM biopsy - low plasma cells
Watch and wait
2
Q
Multiple myeloma
- pathophysiology
- presentation
- diagnosis
A
Neoplasm of plasma cells in BM => overproduction of M paraprotein (abnormal IgG, IgA or free light chains)
CRAB
- calcium elevated <= increased bone resorption
- renal disease <= AKI from accummulation of light chains, paraproteins in glomerulus
- anemia <= BM failure
- bone lysis (pathological fractures in axial skeleton, long bones) <= increased bone resorption
Skeletal survey - Xray, CT, MRI of spine Genetic - FISH Serum - monoclonal free chains, high Ca Urine - Bence Jones protein BM biopsy - high plasma cells
Chemo, immunomodulators, autologous/allogenic stem cells
Symptomatic - bisphosphonates, ABx, glucocorticoids
3
Q
Metastasis
A
Other bone marrow
