A 72-year-old woman has fatigue, back pain, recurrent infections, creatinine 2.1 mg/dL, calcium 11.5 mg/dL, and hemoglobin 8.8 g/dL. Serum protein

Question

A 72-year-old woman has fatigue, back pain, recurrent infections, creatinine 2.1 mg/dL, calcium 11.5 mg/dL, and hemoglobin 8.8 g/dL. Serum protein electrophoresis shows an M spike. Imaging shows lytic lesions in the vertebrae. Which of the following is the most appropriate at this time?

Accepted Answer

Refer for hematology evaluation and treatment initiation

Answer

Start antibiotics as definitive therapy

Answer

Treat with oral iron alone

Answer

Repeat labs in 10 years

Answer

Observe as low-risk MGUS

Multiple myeloma — USMLE Step 3 MCQ

A 72-year-old woman has fatigue, back pain, recurrent infections, creatinine 2.1 mg/dL, calcium 11.5 mg/dL, and hemoglobin 8.8 g/dL. Serum protein electrophoresis shows an M spike. Imaging shows lytic lesions in the vertebrae. Which of the following is the most appropriate at this time?