Your Name: Hermione Race

Theme: Plasma Proteins

OPTION LIST

A	α-1 antitrypsin deficiency	I	Monoclonal gammopathy
B	Acute Renal Failure	J	Myeloma
C	Amyloidosis	K	Polycythaemia Rubra Vera
D	Asthma	L	Pnuemonia
E	Chronic Myeloid Leukaemia	M	Sarcoidosis
F	Emphysema	N	Tuberculosis
G	Hodgkin’s Lymphoma	O	Waldenstrom’s macroglobulinaemia
H	Hypoalbuminaemia	P	Wilsons Disease

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 70 year old female presents to A&E having fallen over and hit her head. She complains of vision deterioration. Her X-ray showed a ‘pepper pot’ skull and a bone marrow biopsy showed > 30% plasma cells.

2. A 60 year old male presents to his GP with symptoms of tiredness, dizziness and loss of vision. He has lymphadenopathy and splenomegaly. Serum electrophoresis shows an IgM spike.

3. A 50 year male with multiple myeloma comes to his GP complaining of ankle swelling. Urine dipstick shows proteinuria. On examination he is also noted to have macroglossia and waxy papules on his face.

4. A 19 year old student presents to A&E with shortness of breath, cough and pleuritic chest pain. Sputum is sent for culture and FBC shows a raised CRP.

5. A 35 year old smoker present to A&E with shortness of breath. He has unintentionally lost weight over the past year. Chest X-ray shows emphysematous changes and FBC shows raised LFTs.

ANSWERS

1. J

2. O

3. C

4. L

5. A