Answers (if you’re doing the UKMLA this year there’s a little something at the end of the caption for you) Pathophysiology of myeloma Malignant clonal proliferation of plasma cells in the bone marrow Production of monoclonal immunoglobulin (paraprotein/M-protein) and/or free light chains, causing immune paresis and increased infection risk End-organ damage via multiple mechanisms: Bone destruction: Plasma cells secrete cytokines (IL-6, MIP-1α) → increased osteoclast activity and decreased osteob