MNLP – Module 4 – Final assessment

1. Question

Which of the following is the used to stage myeloma patients at diagnosis using the Revised International Staging System?

A. Presence of renal failure
B. C-reactive protein concentration
C. Serum β2M concentration
D. Bone marrow plasma cell count
E. Bence Jones protein concentration

2. Question

There are a number of prognostic factors in myeloma. Match the words below with their description.

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Sort elements

Cytogenetic factors
Plasma cell morphology
C-reactive protein
Plasma cell labelling index
Beta 2 microglobulin

Chromosomal abnormalities
Structural features of plasma cells indicate their degree of maturity
A protein produced by the liver during inflammatory or malignant processes
The relative percentage of plasma cells actively growing
A cell surface protein, the levels of which reflect the extent of the disease

3. Question

The estimated 5-year overall survival rate for newly diagnosed myeloma patients that are Stage II according to the Revised International Staging system is:

A. 80%
B. 40%
C. 60%
D. 20%

4. Question

Staging in myeloma is necessary because it

A. Determines the extent of the disease
B. Allows an assessment of the likely prognosis
C. Helps make decisions about treatment
D. All of the above
E. None of the above

5. Question

Which of the following is a staging system used in myeloma?

A. Revised International Staging System
B. The TNM classification
C. FIGO staging system
D. Dukes staging system
E. Gleason scoring system

6. Question

Which of the following is associated with a poorer prognosis

A. Serum β2M concentration of 3.0mg/L
B. Serum albumin concentration of 2.5g/dL
C. Hypocalcaemia
D. Chromosomal abnormality involving translocation t[11;14]
E. Chromosomal abnormality involving gain of chromosome 3

7. Question

The Durie-Salmon staging system for myeloma includes which of the following factors?

A. Serum paraprotein and haemoglobin concentrations
B. Serum paraprotein and serum albumin concentrations
C. Serum albumin and number of lytic lesions
D. Serum beta 2 microglobulin and number of lytic lesions
E. Serum beta 2 microglobulin concentration

8. Question

Which of the following is associated with improved prognosis?

A. Chromosomal abnormality involving deletion of chromosome 13
B. Serum albumin concentration of 30g/L
C. Normal lactate dehydrogenase levels
D. Predominance of plasmablasts on bone marrow examination
E. Beta 2 microglobulin concentration of 7.0mg/L

9. Question

The Revised International staging system for myeloma uses which of the following factors

A. Serum paraprotein concentration
B. Serum free light chain concentration
C. Haemoglobin concentration
D. Level of lactate dehydrogenase
E. Presence of high risk chromosomal abnormalities

10. Question

Which of the following tests is the best single indicator of tumour burden in myeloma?

A. Serum beta 2 microglobulin
B. C-reactive protein
C. Blood urea nitrogen
D. Serum lactate dehydrogenase
E. Serum creatinine

11. Question

Patients with the following chromosomal abnormalities are defined as “high-risk” except

A. Chromosomal abnormality involving translocation t[4;14]
B. Chromosomal abnormality involving translocation t[11;14]
C. Chromosomal abnormality involving translocation t[14;16]
D. Chromosomal abnormality involving deletion of chromosome 17

12. Question

Which of the following imaging techniques provides the most useful prognostic information?

A. Radiological skeletal survey
B. Computed tomography (CT)
C. Magnetic resonance imaging (MRI)
D. Positron emission tomography (PET)
E. Combined positron emission tomography/ computed tomography (PET/CT)

13. Question

Assertion: It is important that patients are accurately staged when entering clinical trials

BECAUSE

Reason: Response to treatment is one of the most important factors that predicts long-term outcome

A. True True Reason correctly explains assertion
B. True True Both statements are true but the reason does not explain assertion
C. True False
D. False True
E. False False

14. Question

Assertion: Measurement of minimal residual disease (MRD) is considered to have powerful prognostic significance

BECAUSE

Reason: Patients who are MRD positive are likely to relapse more quickly

A. True True Reason correctly explains assertion
B. True True Both statements are true but the reason does not explain assertion
C. True False
D. False True
E. False False

15. Question

Match the terms with the definition.

Sort elements

High risk
Low risk
Intermediate risk

Patients who carry the cytogenetic mutations 1q+ and del(17p), have elevated LDH and fit into ISS stage II/III
Patients who have no high-risk cytogenetics, normal LDH, B2M < 3.5 mg/L and serum albumin ≥ 3.5 g/dL
Patients who are ISS stage II and carry the t(4;14) mutation only with normal levels of LDH

16. Question

The staging system in myeloma reflects the extent of the disease rather than where it is

A. True
B. False

17. Question

Which of the following statements is not true

A. Prognostic factors include a number of clinical and laboratory findings
B. Prognostic factors include age, comorbidities and performance status
C. Prognostic factors can accurately determine patient outcomes
D. Staging of myeloma helps to determine disease activity and burden
E. Staging of myeloma can help assess patient prognosis

18. Question

Fill in the words two, three and four to complete the following

According to the R-ISS, there are stages of myeloma based on the presence of main clinical features that reflect the amount and activity of the myeloma. There are four stages in the R2-ISS that include cytogenetic alterations from the R-ISS.

19. Question

Age alone can be used to guide treatment decisions and predict outcomes.

A. True
B. False