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The Curbsiders Internal Medicine Podcast

#247 SPEP It Up: MGUS, Myeloma, and Immunology, Oh My!

The Curbsiders Internal Medicine Podcast

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.83.1K Ratings

🗓️ 21 December 2020

⏱️ 65 minutes

🧾️ Download transcript

Summary

On this episode, Dr. Jorge Castillo (Harvard, Dana Farber) walks us through some immunology basics, teaches us the limitations of the SPEP, plus some additional tests that complement it (think Immunofixation), shares his clinical gestalt about when to suspect MGUS, Myeloma, Waldenstrom’s, and Amyloidosis--and finally, how to talk to patients about them. If you, like Stuart, have ever wondered what on earth to do with that pesky free light chain ratio or the SPEP that so often gets inboxed to you without explanation, then fear not, Dr Castillo has your back!

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Credits

  • Written and Produced by Nora Taranto MD
  • Infographics by Nora Taranto MD
  • Cover Art by Kate Grant MBChB, MRCGP
  • Hosts: Matthew Watto MD, FACP; Stuart Brigham MD, FACP, Nora Taranto MD
  • Editor: Matthew Watto MD, FACP ; Clair Morgan of nodderly.com
  • Reviewer: Jooho Chung MD, PhD
  • Guest: Jorge Castillo MD



Sponsor: Panacea Financial

This episode is supported by Panacea Financial, digital banking built for doctors, by doctors. At Panacea Financial you can have your own free personal banker and a support team that works around the clock- just like you do. Open your free checking account today at panaceafinancial.com

Panacea Financial, a Division of Sonabank, Member FDIC



Sponsor: VCU Health CE

We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org and create your account!

Transcript

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0:00.0

We're supported by Panacea Financial, Digital Banking, Build for Doctors, Buy Doctors.

0:05.0

At Panacea Financial, you can have your own free, personal banker and a support team that works around the clock just like you do.

0:12.0

Open your free checking account today at panaceafinancial.com. Panacea Financial is a division of Sonobank, member FDIC.

0:21.0

The Curb Siders podcast is for entertainment, education and information purposes only. And the topics discussed should not be used solely to die in a streak, or prevent any diseases or conditions.

0:32.0

For the more that you've been used to express on this podcast are solely those of those, and should not be interpreted to reflect official policy or position of any entity that's side-run possible, cash-like-more-hospital and affiliate outreach programs.

0:38.0

If indeed there are any, in fact there are none.

0:40.0

Pretty much we aren't responsible if you serve up, you should always do your own homework and let us know when we're on.

0:53.0

Welcome back to the Curb Siders, where Paul is not here, but Stewart is just thinking of Paul and his Kermit the Frog voice as he describes it himself.

1:04.0

And tonight's episode we are talking about MGUS with the great Dr. Jorge Castillo, and as a reminder to the audience this episode will be available for free CME credit through our partnership with VCU Health.

1:16.0

You can get that at curbsiders.vcuhealth.org.

1:20.0

Stewart since Paul's not here, can you please tell the audience what is it that we do on this show?

1:25.0

Sure Matt, so we frequently have existential crises where we try to bring you information from the land of internal medicine.

1:33.0

We use expert interviews to bring you clinical pearls and practice change of knowledge, hopefully you glean something of use from these episodes.

1:40.0

I think it's almost impossible for them not to glean something useful from tonight's episode unless they don't work in healthcare in which case maybe not, but still it will be very interesting for them.

1:52.0

Nora can you please tell them about our wonderful guest?

1:55.0

Actually, I don't know that we introduced you yet. The great Dr. Nora Plought Toronto Nora a fantastic middle name, you're a fantastic medical resident. Please tell the audience about our guests.

2:08.0

I think that was such a flattering introduction. Got a shout out to my German roots with that Plought.

2:16.0

But we have a really wonderful conversation with our guest, Dr. Jorge Castillo tonight. Jorge Castillo was born in Peru, received his medical degree in Mexico City, and then completed his internal medicine and hematology and oncology training at the University of Massachusetts and Brown University respectively.

2:35.0

He is now an associate professor at Harvard Medical School and serves as the clinical director of the Bing Center for Waldensstrom Macro-Globionlinemia at the Dana-Harbour Cancer Institute.

2:47.0

Today, he actually teaches us about Waldensstroms and more. He specifically teaches us how to follow up on that SPAC that's always still pending at discharge and ends up in your inbox somehow, when to think about how to order one in the first place.

3:03.0

And how to think through the difference among the paraproutinemias from M. Gus to myeloma to Waldensstroms. Without further ado, let's get to it.

3:13.0

Jorge, thank you for joining us. We're very excited to have you on the show. And the audience is dying to hear your one liner and something about yourself, something you do outside of medicine.

...

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