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23 Cards in this Set
- Front
- Back
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Multiple myeloma is malignancy of what?
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mature plasma cells
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In multiple myeloma, B cells proliferate where and produce what?
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-proliferate in the bone marrow and produce monoclonal IgM
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Multiple myeloma is more common in what race?
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African Americans
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What are some things that increase risk of multiple myeloma?
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-IONIZING RADIATION
-nickel, agricultural chemicals, petroleum products, benzene |
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What is the most common presenting symptoms of multiple myeloma?
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-bone pain and lesions
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What are some other bone clinical features of multiple myeloma?
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-incidental pathological fractures
-vertebral compression fx -osteolytic punched out lesions on x-ray -hypercalcemia related to lytic bone lesions |
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Multiple myeloma gives one an increased risk for what type of infections?
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-bacterial, especially pneumococcal
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Renal insufficiency in multiple myeloma is most commonly related to what?
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-tubular damage caused by reabsorption of large amounds of Bence Jones proteins
-amyloid deposition 2nd to myeloma also contributes to damage |
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Neurological symptoms of multiple myeloma:
1-what level of nervous system/ 2-get peripheral neuropathy from what? 3-nerve root symptoms from what? 4-confusion caused by what? |
1-all levels of nervous system can be affected
2-PN from amyloid infiltration 3-nerve root symptoms from compression fx 4-confusion caused by hypercalcemia, uremia, or hyperviscosity |
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What lab abnormalities are seen on multiple myeloma?
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-anemia
-renal insufficiency -hypercalcemia |
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What things should prompt workup for multiple myeloma?
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-unexplanied anemia
-unexplained renal failure -lytic bone lesions -pathologic fractures -recurrent infection -nephrotic syndrome -peripheral neuropathy |
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What is involved in the initial workup of MM?
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-serum protein electrophoresis
-urine protein electrophoresis -immunofixation -skeletal survey -assessment for end organ damage -bone marrow bx if Bence Jones proteins found in blood or urine |
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What are some complications to MM?
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-hypercalcemia
-skeletal lesions -renal insufficiency -anemia -hyperviscosity |
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Neoplasm of plasma cells in bone marrow which secretes a monoclonal Ig effects what things in the body? (think CRAB)
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-hyperCalcemia from bone resorptions
-renal failure caused by free light chain -anemia from marrow failure -bone lesions |
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In MM there are masses associated with lytic lesions of where?
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-the skull
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MM leads to increased susceptibility to what infections?
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PNA, pyelonephritis, strep, staph, Kebsiella, E.Coli
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Pts with MM might get edematous 2nd to what?
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-renal failure
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What might UA show in MM?
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Bence Jones (M-chain) proteins (M-spike)
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M component is increased on what in MM?
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-protein electrophoresis (IgG)
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What is often curative to solitary bone plasmacytomas?
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-radiotherapy
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What things are all indicated for the tx of hypercalcemia in MM?
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corticosteriods, hydrations, and natriuresis
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Uric acid nephropathy may occur when in MM and can cause what?
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-may occur during chemo and cause renal failure (tx with allopurinol)
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In MM, what vaccine does little to prevent infection?
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-pneumovax
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