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12 Cards in this Set
- Front
- Back
Hallmark feature of plasma cell dyscrasia:
M-protein in serum or urine without identifiable disease: MGUS appearance on electrophoresis? |
isolated peak of M-protein (single IG) on serum electrophoresis
MGUS - monoclonal gammopathy of unknown significance "shoulder" on gamma peak |
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75% of MGUS secrete what IG?
Treatment for MGUS? What are some critera for solitary plasmacytoma of bone? |
IGG
supportive care only - NOT CANCER single area of bone destruction, negative bone survey, MRI, normal marrow, no/low level of M-protein |
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Clinical presentation of indolent myeloma?
When should you treat indolent myeloma? Why? |
asymptomatic, coincidental dx
don't treat until you see symptoms; pts still sensitive to chemo |
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Disseminated malignancy, proliferation of transformed plasma cells in bone marrow:
Median age of onset of multiple myeloma? Morbidity? Pathophysiology of multiple myeloma? |
multiple myeloma
median age 60; 75% morbidity neoplasm originates from single malignant plasma cell, progressive growth into the marrow |
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Clinical manifestation of muyltiple myeloma?
How is the hypercalcemia from multiple myeloma different from other cancers? |
inhibition of erythropoiesis, marrow structure altered, *LYTIC BONE LESIONS* from OAF-mediated resorption of bone
result of OAF activity/bone resorption, not PTH-related protein |
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Most common infections in MM?
Complications of M-protein? Most common cause of renal failure? Hallmark appearance of renal failure? |
pneumonias, pyelonephritis
hyperviscosity, coagulation problems, cryoglobulin --> Raynaud's, gangrene Calcium nephropathy "blocked pipe" - distal tubules blocked by eosinophilic casts |
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Classic triad for diagnosis of MM?
How do you evaluate for MM? |
marrow plasmacytosis, lytic bone lesions, serum/urine M-protein
CBC, renal function, serum Ca++/albumin, *skeletal XR survey*, SPEP, UPEP |
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Which plasma cell dyscrasias should you not treat?
Which one is treated with radiotherapy? What is the new standard of care for MM? What drug is a purified form of thalidomide? Complications of thalidomide? |
indolent myeloma, MGUS
solitary plasmacytoma thalidomide/dexamethasone lenalidomide somnolence, neuropathy, fluid retention, weight gain |
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Explain hypercalcemia and MM.
What should you consider in a MM patient with developing neuro symptoms in LE's + back pain? Which test should you order? How do you treat it? |
25% of patients get high Ca++, ionized Ca++ correlated better than total Ca++;
Modest increases can be treated with hydration; high levels (>16 mg/dl) - medical emergency extradural cord compression - EMERGENCY - order MRI Tx with high dose steroids + radiotherapy |
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Plasma cell malignancy in which affected cells screte IGM, lymphadenopathy and hepatosplenomegaly:
What is the major feature? What do you see in patient's eyes? |
Waldenstrom's Macroglobulinemia
hyperviscosity syndrome - segmental dilation of reitinal veins |
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Disease characterized by lymphadenopathy, fever, anemia, weakness, palatal edema involving Waldeyer's ring:
Most common heavy chain disease, related to Mediterranean lymphoma: |
Gamma Heavy Chain disease (Franklin's disease)
Alpha Heavy Chain disease (Seligmann's disease) |
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Systemic illness resulting from deposition of B-pleated sheets of IG fragments:
Clinical features? sign from shoulder muscle infiltration: sign from periorbital hemorrhage: |
amyloidosis
organ infiltration - GI, renal, cardiac "Shoulder pad sign" "raccoon sign" |