Plasma cell disorders CIS

Question 1

Plasma cell disorders- are what?

Answer 1

• clonal prolif and immortalization of immunoglobulin-secreting plasma cells
• hallmark- isolated peak in the GAMMA region on serum protein electrophoresis representing a single immunoglobulin molecule (M-protein)

Question 2

Plasma cell disorders- in who? presenting complaints?

Answer 2

• middle-aged/older
• heavy chain dz- in any age group
• fatigue, weight loss, bone pain, infection
• bones are brittle!
• hyperviscosity in macroglobulinemia- rare with other disorders

Question 3

if A:G ratio < 1 (albumin:globulin)- diff dx?

Answer 3

-plasma cell disorder!!!

Question 4

MUGS- what spike?

Answer 4

Y (gamma) globulin spike

Question 5

solitary plasmacytoma- tx?

Answer 5

radiation

Question 6

MM- staging how? dx?

Answer 6

• skeletal xray survey!! (cant use a bone scan)

- dx- BM biopsy- marrow plasma cells > 10% and abnormal looking!!!

Question 7

MM- tx?

Answer 7

• bisphosphonates (for hypercalcemia and preventing bone resorption)
• floradimide, dexamethasone, protease inhibitors

Question 8

hyperviscosity- fundoscopy?

Answer 8

sause linking!!

Question 9

what can cause hyperviscosity?

Answer 9

• waldenstrom’s macroglobulinemia

- polycythemia vera

Question 10

waldenstrom’s macroglobulinemia- tx?

Answer 10

-plasmapheresis for hyperviscosity