Myeloma and Other Plasma Cell Disorders

Immunoglobulins are antibodies produced by B cells/Plasma cells that are made up of [blank_start]2[blank_end] heavy chains and [blank_start]2[blank_end] light chains

Which of the immunoglobulins has a pentameric structure?

Which of the immunoglobulins has a dimeric structure?

Which of the immunoglobulins have monomeric structures?

[blank_start]Plasma[blank_end] cells have an eccentric 'clock face nucleus' on H&E Stain

Plasma cells are characterised by their [blank_start]open[blank_end] chromatin

Monoclonal immunoglobulins are all derived from clonal expansion of one single B cell. Monoclonal immunoglobulins are also known as [blank_start]paraproteins[blank_end]

Paraproteins = [blank_start]Monoclonal[blank_end] Immunoglobulins

Paraproteins are a marker of an underlying clonal B cell disorder

What is the best form of investigation for detecting Paraproteins

Paraproteins found on Serum Electrophoresis tend to present in the [blank_start]Gamma[blank_end] band

After serum electrophoresis has been conducted to detect paraproteins, serum [blank_start]immunofixation[blank_end] should then be conducted in order to classify the abnormal protein band

Bence Jones Protein is a monoclonal immunoglobulin light chain which is detected by [blank_start]urine[blank_end] electrophoresis

The presence of Bence Jones Protein in the urine is suggestive of which two of the following conditions?

Which of the following is most common condition causative of paraproteinaemia?

Monoclonal gammopathy of undetermined significance (MGUS) is a benign (premalignant) condition which can predispose to Multiple Myeloma

Myeloma causes [blank_start]renal[blank_end] failure and increased [blank_start]bone breakdown[blank_end]

Myeloma is classified based on which type of monoclonal antibody is produced. What is the most common type of Myeloma?

Due to bone breakdown occurring as part of Myeloma, it also typically causes raised [blank_start]Calcium[blank_end] levels in the blood

The paraproteins in Myeloma bring about renal failure by blocking the renal [blank_start]tublues[blank_end]

Paraproteins blocking the renal tubules as part of Myeloma forms small aggregations leading to what is known as [blank_start]cast[blank_end] nephropathy

Myeloma tends to affect those in their [blank_start]60s[blank_end]

Levels of [blank_start]paraprotein[blank_end] in the blood should be monitored in order to monitor the response of a Myeloma patient to Chemotherapy.

Which of the following should be avoided in Myeloma patients?

Which drug type should be given to myeloma patients in order to correct their hypercalcaemia and reduce their bone pain? [blank_start]Bisphosphonates[blank_end]

Monoclonal gammopathy of undetermined significance (MGUS) can be diagnosed when there is a paraprotein level of [blank_start]<30g/l[blank_end] and a bone marrow plasma cell level of [blank_start]<10%[blank_end]. There must also be no evidence of any end organ damage (e.g. renal failure, bone marrow failure, etc)

A plasma cell immunoglobulin disorder is suspected in a patient. When a sample from the patient was stained using Congo Red and placed under polarising light it showed an 'apple-green' birefringence. What condition is the patient suffering from? [blank_start]AL Amyloidosis[blank_end]

Waldenstrom’s macroglobulinaemia is a condition which characteristically involves [blank_start]IgM[blank_end] Paraproteins