skip to main content

Multiple myeloma — ABIM Board MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHematology/OncologyMultiple myelomaABIM Board

A 69-year-old has fatigue, back pain, calcium 11.6 mg/dL, creatinine 2.0 mg/dL and hemoglobin 9.4 g/dL. Serum electrophoresis shows an IgG monoclonal protein and imaging shows multiple lytic lesions. Which diagnosis is most likely?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Multiple myeloma

The best answer is “Multiple myeloma”. The monoclonal plasma-cell disorder is accompanied by several myeloma-defining organ events: hypercalcemia, kidney injury, anemia and lytic bone disease. MGUS lacks myeloma-defining events, Waldenström disease usually produces IgM without lytic lesions, and prostate metastases are typically osteoblastic. The combination satisfies symptomatic myeloma rather than an asymptomatic precursor state and requires hematologic staging and therapy.

Reference: International Myeloma Working Group Diagnostic Criteria: https://pubmed.ncbi.nlm.nih.gov/25439696/