Multiple Myeloma Exam With Verified Solutions
Multiple Myeloma is a malignancy of _________ cells
plasma
T or F: MM is the most common hematologic malignancy in the US.
False, 2nd most common after non-hodgkin's disease
Which ethnicity has a 2x incidence of MM?
African Americans
...
Bacterial Infections
-Depleted T lymphocytes and non-functional IgG
"Myeloma Kidney"
-50% patients have increased CrCl
-caused by hypercalcemia, hyper viscosity,hyperuricemia
List two complications of Myeloma
1. Bone disease
, -stimulated osteoclasts and bone breakdown
RANKL and inflammatory mediators upregulated
2. Angiogenisis: increase in blood vessel density can use PCLI is predict increased density
High plasma cell labeling index (PCLI)
Increased angiogenesis
-> increased blood thickness
List Diagnostic tests for MM
CBC with diff
CMP: Ca, SCr,BUN,LDH,albumin
Bone marrow biopsy
*B2-microglobulin (Ig heavy chain)*
MRI, bone scan
Serum Protein electrophoresis
*identify M spike-85% patients**
Which prognosis/risk cytogenetic mutation occurs in ~65% of MM patients?
chromosome 14 mutation which leads to Ig heavy chain translocation
List the disease progression of MM
Normal plasma cell
MGUS
(Monoclonal gammopathy of undetermined significance)
Smoldering/indolent myeloma
multiple myoloma
Which diagnostic criteria is used most commonly in active (symptomatic myeloma)?
Lytic bone lesions: parts of bone are punched out by cancer
CRAB criteria
What does CRAB stand for?
Calcium
Renal dysfunction
Anemia
Bone
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