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Myeloma (Investigations (Blood film: rouleax formation, Bone marrow…
Myeloma
Investigations
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X-ray shows pepper pot skull, vertebral collapse, fractures
Pathogenesis
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Disease is classified by the type of Ig produced: 66% IgA, 33% IgG, and it is rare to have IgD
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Signs
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Pathological fractures, hypercalcaemia, osteolytic lesions + spinal cord compression due to bone destruction from increased osteoclast activity
Treatment
Chemotherapy: melphalan + prednisolone for 1 year, after that give thalidomide if disease cannot be controlled
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