Monday, November 11, 2019

Multiple Myeloma notes and mnemonics

Hi!

Multiple myeloma - everything P


- malignant Proliferation of Plasma cells derived from a single clone.
- Immunoglobulin produced is a "ParaProtein" (M- protein)
- POEMS syndrome

BONE MARROW INVOLVEMENT
- Pancytopenia

PERIPHERAL BLOOD
- plasma cell leukemia ( greater than 2,000 per mm3 )

BONE INVOLVEMENT
- punched-out lesions in radiographs of flat bones
- bone pain
- pathological fractures

RENAL INVOLVEMENT
- Bence -Jones proteinuria
- production of excess Amyloid protein
- hyPer- calci -emia and -uria

These three result in renal damage and renal failure.

IMMUNE SYSTEM INVOLVEMENT
- prone to infections, particularly in respiratory and urinary tract.

HYPERVISCOSITY SYNDROME
( mnemonic - HPRVSCST )
- Headache
- Postural hypotension
- Retinal venous congestion
- Vertigo
- Strain (blurred vision)
- Congestive cardiac failure
- subtype IgA
- nysTagmus

CLOTTING PROBLEMS
- purpura
- profuse bleeding ( epistaxis, gastrointestinal )

NEUROLOGICAL MANIFESTATIONS
- peripheral neuropathy
- compressive myopathy
- carpal tunnel syndrome ( nerve entrapment)
- Amyloidosis.

SERUM STUDIES
- total serum protein raised
- low albumin
- high globulin ( decreased A:G ratio )
- high beta-2 microglobulin ( greater than 5.5 mg/dL means poor prognosis; stage III)

Plasmacytomas in Paraskeletal soft tissues - poor prognosis; treated by palliative radiotherapy.


That's all
Anything more to add, you're most welcome :)
- Jaskunwar Singh

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