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Clinical Review Quiz

Multiple Myeloma

Darren S. Fentress, MD, Luisa A. Orrico, MD, Megan Kruspe, BS, Kristi S. Briscoe, BS, and Damian A. Laber, MD, FACP

Drs. Fentress and Orrico are resident physicians, Department of Medicine, University of Louisville; Ms. Kruspe and Ms. Briscoe are medical students, University of Louisville School of Medicine; and Dr. Laber is director of the Hematology and Medical Oncology Fellowship Program, University of Louisville, Louisville, KY.


The questions below are based on the article
“Multiple Myeloma”.


Choose the single best answer for each question.


1. What evaluations should be included in the initial work-up for suspected multiple myeloma (MM)?
  1. Serum protein electrophoresis, urine protein electrophoresis, and skeletal survey
  2. Complete blood count and complete metabolic profile
  3. Computed tomography scan of the chest, abdomen, and pelvis
  4. Technetium bone scan
  5. A and B
Click here to compare your answer.


2. On average, what percentage of patients with monoclonal gammopathy of unknown significance will progress to malignancy every year?

  1. 0%
  2. 1%
  3. 5%
  4. 10%
Click here to compare your answer.


3. What is the recommended management approach for a 57-year-old woman with newly diagnosed MM who has a beta-2 microglobulin level of 3.9 µg/mL, normal albumin, no end-organ damage, and no comorbidities?

  1. Start induction chemotherapy followed by high-dose chemotherapy with hematopoietic stem-cell rescue
  2. Active surveillance with treatment if progression occurs
  3. Melphalan and corticosteroid
  4. Thalidomide alone or with corticosteroid
Click here to compare your answer.


4. What is the best first-line treatment for a very active 68-year-old man with progressive, symptomatic MM and no comorbidities?
  1. Start induction chemotherapy followed by high-dose chemotherapy with hematopoietic stem-cell rescue
  2. Melphalan and corticosteroid
  3. Active surveillance with treatment only if progression occurs
  4. All are equal
Click here to compare your answer.


5. Management of MM in a patient with suspected cord compression must include

  1. Bone scan
  2. Dexamethasone and intravenous bisphosphonate therapy
  3. Urgent magnetic resonance imaging, dexamethasone, and neurosurgical consultation
  4. Careful observation
Click here to compare your answer.


6. Which statement is true regarding kidney disease in patients with MM?

  1. Renal disease is rare in patients with MM
  2. Myeloma kidney can present as acute renal failure
  3. Uric acid nephropathy is commonly associated with MM
  4. None of the above
Click here to compare your answer.



 

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