Plasma cell disorders Quiz: Ace Your Exams
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A 72 year-old man comes to his outpatient provider’s office because of lower back pain and fatigue. The symptoms started two months ago and have progressively worsened. Past medical history is notable for hypertension, for which he is taking hydrochlorothiazide and carvedilol. Review of systems is significant for 5 kg (11 lb) unintentional weight loss. The patient’s temperature is 37.6°C (99.7°F), pulse is 75/min, and blood pressure is 136/85 mmHg. Cardiopulmonary and abdominal examination is noncontributory. There is tenderness to palpation of the lumbar spine at the L2 to L4 level. Laboratory results are as follows:
Which of the following is the most likely explanation for the patient’s symptoms?
| Laboratory value | Result |
| Hemoglobin | 8.7 g/dL |
| Mean corpuscular volume (MCV) | 85 fL |
| Leukocyte count | 3400/mm3 |
| Creatinine | 2.4 mg/dL |
| Calcium | 11.5 mg/dL |
| Total protein | 9.2 g/dL |
| Albumin | 3.9 g/dL |
Which of the following is the most likely explanation for the patient’s symptoms?
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