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Multiple myeloma — RACP Written MCQ

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ModerateHaematologyMultiple myelomaRACP Written

A 64-year-old man has back pain, fatigue and recurrent infections. Hb is 86 g/L, calcium is 2.92 mmol/L and creatinine is 188 micromol/L. Serum electrophoresis shows an IgG kappa paraprotein and urine contains Bence Jones protein. What is the most appropriate investigation?

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Correct answer: B — Bone marrow biopsy with myeloma staging work-up

CRAB features with paraprotein and light chains suggest multiple myeloma. Bone marrow assessment and staging investigations are needed.

Reference: Australian blood and haematology guideline principles; Therapeutic Guidelines