Name: Matthew Maslen
Theme: Multiple Myeloma and
Other Lymphoproliferative Disorders.
OPTION LIST
|
A |
Acute Leukaemia |
I |
Sarcoidosis |
|
B |
Benign paraproteinaemia |
J |
Sézary syndrome |
|
C |
Bone Metastasis |
K |
|
|
D |
Fractured Vertebrae |
L |
|
|
E |
Hairy Cell Leukaemia |
M |
|
|
F |
Hodgkin’s disease |
N |
|
|
G |
Multiple Myeloma |
O |
|
|
H |
Non-Hodgkins
Lypmpoma |
P |
|
For each scenario below, choose the most appropriate
answer from the list above. Each option may be used once, more than once or not
at all.
1. A 49-year-old woman
presented with a 6-month history of vague aches and pains in her chest. On
examination, she was overweight but had no abnormal physical signs. Protein
electrophoresis showed a small paraprotein band in
the gamma region; this band was an IgG of lambda
type. A bone marrow biopsy showed only 12% plasma cells. There was no protein
in her urine.
2. A 71-year-old man
presented with sharp, constant, low back pain, dating from a fall from a ladder
6 weeks earlier. He admitted to vague malaise for over 8 months. He had a
raised serum calcium level (3.2mmol/l) but a normal alkaline phosphatase. X-rays of his back showed a small, punched-out
lesion in the second lumbar vertebra and a Bone marrow
biopsy showed an increased number of atypical
plasma cells; these constituted 45% of the nucleated cells found on
the film.
3. A 43 year old man presents to his GP with concerns
over a tender lump on the left side of his abdomen. Investigation showed a normal haemoglobin but a mildly raised white-cell count
(13.2 x 109/l). On the blood film these cells were mainly small
mononuclear cells resembling lymphocytes. These cells stained positively for tartrate-resistant acid phosphatase.
4. A 78 year old man is
admitted to hospital after experiencing problems urinating and defecating. He
also noticed numbness in some areas of his abdomen. Blood levels of calcium and
ALP were raised. A bone scan confirms the diagnosis.
5. A 69 year old man presents with a complaint of
right elbow pain. Radiography shows a lytic lesion in
the area of the right proximal radius. Biopsy of the lesion reveals a mono-clonal population of plasma cells consistent with a plasmacytoma. A radiographic skeletal bone survey shows
other similar lesions.
ANSWERS
|
1. B |
2. G |
3. E |
4. C |
5. G |