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Monoclonal gammopathy — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Monoclonal gammopathyUSMLE Step 3

A 72-year-old man has an incidental IgG monoclonal spike of 0.8 g/dL. Hemoglobin, calcium, creatinine, and skeletal survey are normal. He has no bone pain. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: C — Premalignant plasma cell clone requiring surveillance

Low-level monoclonal protein without CRAB features is consistent with MGUS, which requires risk-stratified monitoring.

Reference: International Myeloma Working Group guidance