Multiple Myeloma: Definition, Classification, Diagnosis, and Management

Question 1

Which type of myeloma is most prevalent?

Accepted Answer

IgG

Answer

IgA

Answer

IgM

Answer

IgD

Question 2

Myeloma is characterized by which specific chromosomal translocation?

Accepted Answer

t(11;14)

Answer

t(14;16)

Answer

t(16;18)

Answer

t(9;22)

Question 3

What is considered the definitive diagnostic test for myeloma?

Accepted Answer

Bone marrow biopsy

Answer

Serum protein electrophoresis (SPEP)

Answer

Urine protein electrophoresis (UPEP)

Answer

Flow cytometry

Question 4

Bisphosphonates are used in myeloma management primarily to:

Accepted Answer

Prevent bone fractures

Answer

Reduce bone pain

Answer

Inhibit myeloma cell growth

Answer

Improve immune function

Question 5

The current standard of care for newly diagnosed multiple myeloma includes which combination of medications?

Accepted Answer

Lenalidomide, bortezomib, and dexamethasone

Answer

Doxorubicin, cyclophosphamide, vincristine, and prednisone

Answer

Melphalan, prednisone, and thalidomide

Answer

Radiation therapy and autologous stem cell transplant

Question 6

Which type of multiple myeloma is most commonly diagnosed?

Accepted Answer

IgG kappa

Answer

IgA lambda

Answer

IgD kappa

Answer

IgE lambda

Question 7

Which of the following is a recognized risk factor for developing multiple myeloma?

Accepted Answer

Exposure to ionizing radiation

Accepted Answer

Family history of multiple myeloma

Answer

Obesity

Answer

Smoking

Question 8

Which condition is most often mistaken for multiple myeloma during diagnosis?

Accepted Answer

Monoclonal gammopathy of undetermined significance (MGUS)

Answer

Lytic lesions on bone scan

Answer

Waldenström macroglobulinemia

Answer

Amyloidosis

Question 9

Which immunoglobulin subtype is most commonly associated with multiple myeloma?

Accepted Answer

IgG

Answer

IgA

Answer

IgD

Answer

IgE

Question 10

Which of the following is NOT a typical clinical feature of multiple myeloma?

Accepted Answer

Hypertension

Answer

Bone pain

Answer

Fatigue

Answer

Anemia

Question 11

Which diagnostic test is considered the gold standard for confirming multiple myeloma?

Accepted Answer

Bone marrow biopsy

Answer

Serum M-protein electrophoresis

Answer

Urine M-protein electrophoresis

Answer

Flow cytometry

Question 12

What is the primary objective of therapy for patients with multiple myeloma?

Accepted Answer

Remission

Answer

Cure

Answer

Palliation

Answer

Prevention of complications

Question 13

Which of the following is NOT a molecular marker commonly used to guide treatment decisions in myeloma?

Accepted Answer

KRAS mutations

Answer

IGH translocations

Answer

MYC rearrangements

Answer

t(11;14) translocation

Question 14

Which type of multiple myeloma is the most prevalent?

Accepted Answer

IgG multiple myeloma

Answer

IgA multiple myeloma

Answer

IgD multiple myeloma

Answer

IgE multiple myeloma

Question 15

Define the central characteristic of multiple myeloma.

Accepted Answer

Bone marrow infiltration by malignant plasma cells

Answer

Enlarged lymph nodes

Answer

Elevated blood calcium levels

Answer

Bence Jones protein excretion in urine

Question 16

Which cytogenetic abnormality is strongly associated with an increased risk in multiple myeloma?

Accepted Answer

t(4;14)

Answer

t(11;14)

Answer

del(17p)

Answer

del(13q)

Question 17

Describe the primary mechanism by which multiple myeloma cells contribute to bone damage.

Accepted Answer

Releasing factors that activate bone-destroying cells (osteoclasts)

Answer

Suppressing the activity of bone-building cells (osteoblasts)

Answer

Directly invading bone tissue

Answer

Promoting the growth of cartilage cells (chondrocytes)

Question 18

Identify the definitive test for diagnosing multiple myeloma.

Accepted Answer

Bone marrow biopsy

Answer

Serum protein electrophoresis

Answer

Urine protein electrophoresis

Answer

Flow cytometry

Question 19

What is the intended benefit of bisphosphonate therapy in multiple myeloma management?

Accepted Answer

Preventing bone damage

Answer

Enhancing bone formation

Answer

Reducing pain

Answer

Improving mobility

Question 20

Define the primary characteristic of multiple myeloma.

Accepted Answer

Monoclonal proliferation of plasma cells

Answer

Excess production of immunoglobulins

Answer

Development of lytic bone lesions

Answer

Presence of elevated serum calcium levels

Question 21

Identify the most prevalent subtype of multiple myeloma, accounting for the majority of cases.

Accepted Answer

IgG

Answer

IgA

Answer

IgD

Answer

IgE

Question 22

What is the definitive diagnostic procedure for confirming a diagnosis of multiple myeloma?

Accepted Answer

Bone marrow biopsy and aspiration

Answer

Serum protein electrophoresis

Answer

Urine protein electrophoresis

Answer

Computed tomography (CT) scan

Question 23

Describe the typical prognosis of patients with multiple myeloma.

Accepted Answer

Variable, depending on individual patient characteristics and disease stage

Answer

Excellent, with a high cure rate

Answer

Good, with a significant number of patients achieving long-term remission

Answer

Poor, with a limited life expectancy

Question 24

What is the primary objective of stem cell transplant in the treatment of multiple myeloma?

Accepted Answer

To achieve a cure

Answer

To prolong survival

Answer

To improve quality of life

Answer

To prevent disease recurrence

Question 25

What is the primary role of bisphosphonates in the management of multiple myeloma?

Accepted Answer

To inhibit bone resorption and prevent fractures

Answer

To directly target and kill myeloma cells

Answer

To boost the immune system's response

Answer

To reduce pain and inflammation

Question 26

Which of the following is a definitive characteristic of multiple myeloma?

Accepted Answer

Presence of monoclonal immunoglobulins or immunoglobulin fragments in the blood or urine.

Answer

Absence of plasma cells in the bone marrow.

Answer

Normal levels of calcium in the blood.

Question 27

According to the Durie-Salmon staging system, anemia, bone lesions, and renal insufficiency are characteristic of which stage of multiple myeloma?

Accepted Answer

Stage III

Answer

Stage II

Answer

Stage IV

Answer

Stage I

Question 28

The gold standard for diagnosing multiple myeloma is:

Accepted Answer

Bone marrow biopsy demonstrating clonal plasma cells.

Answer

Serum protein electrophoresis revealing monoclonal spike.

Answer

Urine protein electrophoresis showing Bence Jones proteins.

Question 29

Which treatment option is commonly used as first-line therapy for multiple myeloma?

Accepted Answer

Lenalidomide and dexamethasone

Answer

Radiation therapy

Answer

Stem cell transplant

Answer

Cyclophosphamide and doxorubicin

Question 30

The prognosis for patients with multiple myeloma:

Accepted Answer

Varies depending on disease stage, genetics, and response to treatment.

Answer

Excellent with a high likelihood of cure

Answer

Poor with a median survival of less than 1 year

Question 31

When managing monoclonal gammopathy of undetermined significance (MGUS), which screening test is recommended?

Accepted Answer

Serial serum protein electrophoresis and urine protein electrophoresis

Answer

Computed tomography scan

Answer

Bone marrow biopsy

Question 32

In the treatment of multiple myeloma, what is the primary role of autologous stem cell transplant?

Accepted Answer

To administer high-dose chemotherapy and potentially improve long-term survival.

Answer

To eradicate residual myeloma cells after chemotherapy

Answer

To prevent relapse in patients with advanced disease

Question 33

Which criterion defines the MGUS stage of multiple myeloma?

Accepted Answer

Serum monoclonal protein <3 g/dL

Answer

Presence of related organ damage

Answer

Bone marrow plasma cells >10%

Question 34

What is the most frequent initial symptom of multiple myeloma?

Accepted Answer

Bone pain

Answer

Renal failure

Answer

Hyperviscosity syndrome

Answer

Neurological symptoms

Question 35

Which laboratory test is primarily used to monitor disease activity in multiple myeloma?

Accepted Answer

Serum M-protein level

Answer

Bone marrow biopsy

Answer

Complete blood count

Question 36

Which of the following is a first-line treatment option for patients with newly diagnosed multiple myeloma?

Accepted Answer

Proteasome inhibitor-based combination therapy

Answer

Immunomodulatory drugs

Answer

Radiation therapy

Answer

Autologous stem cell transplant

Question 37

Which of the following prognostic factors indicates a poor prognosis in multiple myeloma?

Accepted Answer

ISS stage III

Answer

Age <50 years

Answer

Female gender

Answer

Solitary bone lesion

Question 38

Which condition is a common differential diagnosis for multiple myeloma?

Accepted Answer

Waldenström macroglobulinemia

Answer

Amyotrophic lateral sclerosis

Answer

Lymphoma

Answer

Leukemia

Question 39

Which of the following adverse effects is commonly associated with proteasome inhibitor therapy in multiple myeloma?

Accepted Answer

Peripheral neuropathy

Answer

Hyperglycemia

Answer

Nephrotoxicity

Answer

Cardiotoxicity

Question 40

Which aspect of patient education is particularly important in multiple myeloma?

Accepted Answer

Recognizing signs and symptoms of infection

Answer

Avoiding contact with pets

Answer

Dietary restrictions

Answer

Using only herbal remedies

Question 41

What is the characteristic chromosomal translocation frequently found in multiple myeloma?

Accepted Answer

t(11;14)

Answer

t(9;22)

Answer

t(14;18)

Answer

t(8;21)

Question 42

Which of the following is NOT a typical clinical presentation of multiple myeloma?

Accepted Answer

Skin rash

Answer

Anemia

Answer

Renal insufficiency

Answer

Bone pain

Question 43

Which of these factors is generally considered a negative prognostic indicator in multiple myeloma?

Accepted Answer

Elevated lactate dehydrogenase (LDH)

Answer

Young age at diagnosis

Answer

Low serum creatinine

Answer

Female gender

Question 44

What is the primary goal of maintenance therapy in multiple myeloma?

Accepted Answer

To prevent disease relapse

Answer

To improve quality of life

Answer

To reduce the need for future transplants

Answer

To achieve a complete cure

Question 45

What is the term used to describe a localized tumor composed of myeloma cells within the bone?

Accepted Answer

Plasmacytoma

Answer

Myeloid sarcoma

Answer

Solitary myeloma

Answer

Myeloma nodule

Question 46

Which of the following imaging modalities is considered the most effective for evaluating bone involvement in multiple myeloma?

Accepted Answer

Skeletal survey

Answer

CT scan

Answer

MRI

Answer

PET scan

Question 47

A 65-year-old male presents with fatigue, bone pain, and recurrent infections. Laboratory findings reveal hypercalcemia, renal insufficiency, and anemia. Which of the following is the most likely diagnosis?

Accepted Answer

Multiple myeloma

Answer

Monoclonal gammopathy of undetermined significance (MGUS)

Answer

Lymphoplasmacytic lymphoma

Answer

Waldenström macroglobulinemia

Question 48

Which of the following is the hallmark protein found in the urine of patients with multiple myeloma?

Accepted Answer

Bence Jones protein

Answer

C-reactive protein

Answer

Alpha-fetoprotein

Question 49

Which of the following cytogenetic abnormalities is associated with a poor prognosis in multiple myeloma?

Accepted Answer

Deletion 17p

Answer

t(11;14)

Answer

t(4;14)

Answer

Hyperdiploidy

Question 50

What is the primary mechanism by which myeloma cells cause bone destruction?

Accepted Answer

Activation of osteoclasts and suppression of osteoblasts

Answer

Increased production of parathyroid hormone

Answer

Direct invasion and lysis of bone matrix

Question 51

A patient with newly diagnosed myeloma is found to have a high risk of renal impairment. Which of the following interventions is most important to prevent further kidney damage?

Accepted Answer

Aggressive hydration

Answer

Plasmapheresis

Answer

Radiation therapy

Answer

Bisphosphonate therapy

Question 52

Which of the following imaging modalities is most sensitive for detecting lytic bone lesions in multiple myeloma?

Accepted Answer

MRI

Answer

CT scan

Answer

X-ray

Answer

PET scan