Tag Archives: myeloma

Case 85 – summary

So, our patient has had quite a week! Thanks to your efforts, he is safely back on the ward, conscious and improving.  Recap: We have managed an emergency presentation of an unconscious patient with severe hypercalcaemia, hyperviscosity and an AKI. … Continue reading

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Case 85 – update 2

We rejoin our patient on HDU… He remains unconscious and lacks capacity to currrently make decisions regarding his further management.  Based on our team’s suspicion of an underlying plasma cell disorder, that may be driving our patient’s hypercalcaemia, AKI and … Continue reading

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Case 85 – update 1

Thank you for all your help so far on the medical admissions unit. Assessment Our patient was initially assessed using an ABCDE approach: A) Snoring, requiring an airway adjunct (nasopharangeal airway) B) RR16, chest clear to auscultation, sats 97% room … Continue reading

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Case 75 – summary

Case 75 – Summary! Thank you for all of the contributions with Case 75, where we encountered a 43 year old who presented with back pain and circulating plasma cells in his peripheral blood. In summary we established that this … Continue reading

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Case 75 – update 3

Bortezomib-based regimes are associated with better outcomes as it more rapidly reduces tumour load and reverses complications. What would you combine Bortezomib with in our patient? How would you consolidate this treatment if response achieved? Would the cytogenetics results influence … Continue reading

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Case 69 – part 3 – summary

During this short case we looked at serum protein electrophoresis. This showed a band in the gamma region and immunofixation confirmed a IgM kappa paraprotein. IgM paraproteins are commonly associated with MGUS, low grade lymphoma and rarely myeloma. Typically IgM … Continue reading

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Case 69 – part 3 – the beginning

Thanks for contributing! Please use #TeamHaem in your reply on Twitter!   A 69 year old gentleman presents to his GP with headache and visual blurring. Giant cell arteritis is suspected as the ESR is 120mm/hr. A serum protein electrophoresis … Continue reading

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Case 54 – case D

  Case D 45 year old gentleman complaining of back pain. Hb 120 g/l, calcium 2.33 mmol/L, creatinine 75 IgG 34g/L Serum involved:non-involved light chains – 115 BM – 35% plasma cells MRI – no lytic lesions How would you … Continue reading

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Case 50 part 3 – summary

It just goes to show that picking up on simple signs can lead to the start of a diagnostic journey. The patient with the film below (second from left) had a FBC as she had suffered from back pain and … Continue reading

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Case 50 part 3 – the beginning

You are reviewing the blood films from today. Can you make a diagnosis without a microscope?     Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the … Continue reading

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Case 48 – #UnofficialCSIM2 summary

Thank you for joining the case. We’ve already met Mr Jones, a 75 year old man admitted following a fall to an orthopaedic ward with a fractured neck of femur. We agreed that his behaviour was new and odd and … Continue reading

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Case 48 – #UnofficialCSIM2 update 1

Thanks for joining the case, where as a surgical FY1 doctor you were asked to review Mr  Jones, a 75 year old man who had been admitted after a fall leading to a femur fracture. The nurses were worried that … Continue reading

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Case 48 – UnofficialCSIM2 – oncology week

Hi to all those joining us from #unofficialCSIM2. To remind our usual teamhaem-ers again – the #unofficialCSIM2 project is aimed at 4th year medical students. Whilst everyone’s input is appreciated, it would be helpful if those of you with more … Continue reading

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Case 47 – summary

Thank you for all your help with this weeks case! We have had some very helpful renal input this week! This week we looked at the case of a normally fit 60year old gentleman who presented with peripheral oedema and … Continue reading

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Case 47 – update 2

So we have another update on our gentleman. He has been found to have nephrotic syndrome and a renal biopsy has been performed which has now come back and is consistent with AL Amyloid nephropathy. Further investigations revealed an IgG … Continue reading

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Case 47 – update 1

Here is our first update on our 60 year old gentleman, who only has childhood asthma in his pmh. He initially presented with ankle swelling and despite 20mg furosemide he felt it was getting slightly worse at his second visit. … Continue reading

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Case 27 – update 4

When evaluating the patient with a paraprotein it is important to rule out conditions that require treatment such as myeloma, amyloid and plasmacytoma. The patient did not have any end organ damage attributable to myeloma. However we were concerned that … Continue reading

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Case 27 – update 2

Thank you so far for your contributions via #TeamHaem on Twitter.  The start of case 27 can be found below… The patient states she gets dizzy when standing up and indeed she has postural hypotension. This is attributed to her … Continue reading

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Case 24 – summary

This case took us on a romp through the symptoms, signs and diagnosis of myeloma with a glance in the direction of some of the more serious complications. Let’s summarise: Symptoms and signs: Often non-specific, but back pain (due to … Continue reading

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Case 24 – update 2

Thanks for your input. We’ve established that Myeloma is a particular concern in this patient. The following investigations were suggested: Calcium Serum electrophoresis Urine electrophoresis Serum free light chains Bone marrow biopsy Skeletal survey. There are quite a few points … Continue reading

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