Yasuo Yamagata, a 63-year-old, experienced severe back pain for several weeks before visiting his family physician. He also complained of fatigue and looked pale. Blood analysis revealed a red blood cell count of 3.2 × 106/μl (normal 4.2–5.0 × 106/μl), a white blood cell count of 2800/μl (normal 5000/μl), a sedimentation rate of 30 mm/h (normal <20 mm/h) and a serum IgG of 4500 mg/dl (normal 600–1500 mg/dl). IgA and IgM levels were well below normal. Skeletal survey showed lytic lesions in vertebrae, ribs and skull. A bone marrow sample revealed 75% infiltration with plasma cells. Elevated protein in urine was confirmed to be Bence-Jones protein (immunoglobulin light chains). The patient was diagnosed with IgG λ multiple myeloma and began an immediate chemotherapy regime. Which of the following would be consistent with this type of malignant tumor of plasma cells? a. Serum IgG is polyclonal. b. Anemia and neutropenia are present as the result of plasma-cell infiltration in the bone marrow and consequent limitation of space. c. Susceptibility to pyogenic infections is unaffected. d. Serum IgG consists of IgG1, IgG2, IgG3, and IgG4 in approximately equal proportions. e. κ and λ light chains are found in excessive quantities in the urine.

Human Physiology: From Cells to Systems (MindTap Course List)

9th Edition

ISBN:9781285866932

Author:Lauralee Sherwood

Publisher:Lauralee Sherwood

Chapter11: The Blood

Section: Chapter Questions

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Yasuo Yamagata, a 63-year-old, experienced severe back pain for several weeks before visiting his family physician. He also complained of fatigue and looked pale. Blood analysis revealed a red blood cell count of 3.2 × 106/μl (normal 4.2–5.0 × 106/μl), a white blood cell count of 2800/μl (normal 5000/μl), a sedimentation rate of 30 mm/h (normal <20 mm/h) and a serum IgG of 4500 mg/dl (normal 600–1500 mg/dl). IgA and IgM levels were well below normal. Skeletal survey showed lytic lesions in vertebrae, ribs and skull. A bone marrow sample revealed 75% infiltration with plasma cells. Elevated protein in urine was confirmed to be Bence-Jones protein (immunoglobulin light chains). The patient was diagnosed with IgG λ multiple myeloma and began an immediate chemotherapy regime. Which of the following would be consistent with this type of malignant tumor of plasma cells?

a. Serum IgG is polyclonal.

b. Anemia and neutropenia are present as the result of plasma-cell infiltration in the bone marrow and consequent limitation of space.

c. Susceptibility to pyogenic infections is unaffected.

d. Serum IgG consists of IgG1, IgG2, IgG3, and IgG4 in approximately equal proportions.

e. κ and λ light chains are found in excessive quantities in the urine.

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