Question

A 54-year-old woman presents with a 6-week history of fatigue, weight loss (4kg), and generalized aches. Blood tests reveal: Hb 98 g/L (115-165), MCV 85 fL (80-100), Platelets 550 x10^9/L (150-400), ESR 110 mm/hr (<20). What is the most appropriate next investigation?

Accepted Answer

Myeloma screen (serum protein electrophoresis and urine Bence-Jones protein)

Answer

Anti-CCP antibodies

Answer

CT chest, abdomen, and pelvis

Answer

Temporal artery biopsy

Answer

Trial of oral iron supplementation

Practice question

A 54-year-old woman presents with a 6-week history of fatigue, weight loss (4kg), and generalized aches. Blood tests reveal: Hb 98 g/L (115-165), MCV 85 fL (80-100), Platelets 550 x10^9/L (150-400), ESR 110 mm/hr (<20). What is the most appropriate next investigation?