Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• Peak age 50-60
• Clinical problems of multiple myeloma stem from
1. Infiltration of organs, especially bone marrow, by malignant plasma cells.
2. Production of excess immunoglobulin (often referred to as an "M protein").
3. Suppression of normal immunity, and altered function of bone marrow derived cellular elements.
4. Calcium loss and bone wastage.
• Recurrent infections are common
• Strep
• Staph and
• E. coli
• Renal failure is very common.
• Large amount of protein cleared in the urine.
• Lambda light chains (Bence Jones protein) are toxic to renal epithelium.
• Amyloid deposits in the glomeruli.
• Hypercalcemia