Immunoglobulins are antibodies produced by B cells/Plasma cells that are made up of 2 1 3( 2, 1, 3 ) heavy chains and 2 1 3( 2, 1, 3 ) light chains
Which of the immunoglobulins has a pentameric structure?
IgM
IgG
IgA
Which of the immunoglobulins has a dimeric structure?
Which of the immunoglobulins have monomeric structures?
IgE
IgD
cells have an eccentric 'clock face nucleus' on H&E Stain
Plasma cells are characterised by their open closed( open, closed ) chromatin
Monoclonal immunoglobulins are all derived from clonal expansion of one single B cell. Monoclonal immunoglobulins are also known as
Paraproteins = Monoclonal Polyclonal( Monoclonal, Polyclonal ) Immunoglobulins
Paraproteins are a marker of an underlying clonal B cell disorder
What is the best form of investigation for detecting Paraproteins
Immunophenotyping by Flow Cytometry
Serum Electrophoresis
Fluorescence In-Situ Hybridisation
Cell Morphology
Paraproteins found on Serum Electrophoresis tend to present in the Gamma Beta Albumin Alpha-1 Alpha-2( Gamma, Beta, Albumin, Alpha-1, Alpha-2 ) band
After serum electrophoresis has been conducted to detect paraproteins, serum 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 urine serum bone marrow CSF( urine, serum, bone marrow, CSF ) electrophoresis
The presence of Bence Jones Protein in the urine is suggestive of which two of the following conditions?
Multiple Myeloma
Waldenström's Macroglobulinemia
Monoclonal Gammopathy of Undetermined Significance (MGUS)
Alpha heavy chain disease
Acute Lymphoblastic Leukaemia
Which of the following is most common condition causative of paraproteinaemia?
Monoclonal gammopathy of undetermined significance (MGUS)
Waldenstrom's Macroglobulinemia
Monoclonal gammopathy of undetermined significance (MGUS) is a benign (premalignant) condition which can predispose to Multiple Myeloma
Myeloma causes renal liver heart( renal, liver, heart ) failure and increased bone breakdown blood pressure erythrocytosis sodium levels( bone breakdown, blood pressure, erythrocytosis, sodium levels )
Myeloma is classified based on which type of monoclonal antibody is produced. What is the most common type of Myeloma?
IgG Myeloma
IgE Myeloma
IgA Myeloma
IgD Myeloma
IgM Myeloma
Due to bone breakdown occurring as part of Myeloma, it also typically causes raised Calcium Sodium Potassium Phosphate( Calcium, Sodium, Potassium, Phosphate ) levels in the blood
The paraproteins in Myeloma bring about renal failure by blocking the renal
Paraproteins blocking the renal tubules as part of Myeloma forms small aggregations leading to what is known as nephropathy
Myeloma tends to affect those in their 60s 40s 20s teens( 60s, 40s, 20s, teens )
Levels of 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?
NSAIDs
Amoxicillin
Antipsychotics
Antiemetics
Paracetamol
Which drug type should be given to myeloma patients in order to correct their hypercalcaemia and reduce their bone pain?
Monoclonal gammopathy of undetermined significance (MGUS) can be diagnosed when there is a paraprotein level of <30g/l <20g/l <50g/l <60g/l( <30g/l, <20g/l, <50g/l, <60g/l ) and a bone marrow plasma cell level of <10% <20% <30% <40% <50%( <10%, <20%, <30%, <40%, <50% ). 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?
Waldenstrom’s macroglobulinaemia is a condition which characteristically involves IgM IgG IgA IgE IgD( IgM, IgG, IgA, IgE, IgD ) Paraproteins
