Multiple myeloma Quiz: Ace Your Exams
Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!
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A 70-year-old man presents with a two-month history of fatigue, a persistent dry cough, and leg swelling. Over the past week, he has also noticed decreased urine output. Past medical history is significant for hypertension and coronary artery disease. His temperature is 36.9°C (98.4°F), heart rate is 85/min, blood pressure is 125/80 mmHg, respiratory rate is 19/min, and oxygen saturation is 97% on room air. Physical examination reveals pallor, decreased breath sounds over the right upper lung field, and bilateral lower extremity edema. Chest radiography shows a well-circumscribed mass in the right upper lobe. Laboratory studies show hemoglobin of 9.1 g/dL, serum creatinine of 2.5 mg/dL, and a CT-guided biopsy of the lung mass confirms a plasmacytoma. Additional laboratory studies show an elevated serum beta-2 microglobulin and lactate dehydrogenase (LDH) and a serum protein electrophoresis (SPEP) with a monoclonal spike. Radiographic skeletal survey shows no lytic lesions or evidence of bone metastasis. Bone marrow biopsy confirms the presence of clonal plasma cells accounting for 20% of the marrow. Which of the following is the best next step in management?
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