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Multiple myeloma — RCPSC IM MCQ

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ModerateHematologyMultiple myelomaRCPSC IM

A 69-year-old man has back pain, fatigue and recurrent chest infections. Hemoglobin is 91 g/L, creatinine is 188 umol/L, calcium is 2.86 mmol/L, total protein is elevated, and spine radiographs show lytic vertebral lesions. What is the most appropriate investigation?

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Correct answer: C — Serum protein electrophoresis, immunofixation and serum free light chains

Anemia, renal impairment, hypercalcemia, lytic bone lesions and high total protein suggest multiple myeloma. Initial testing includes serum and urine monoclonal protein assessment and free light chains.

Reference: Canadian myeloma practice; International Myeloma Working Group criteria