skip to main content

Multiple myeloma — RACP Adult Medicine MCQ

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

ModerateHaematologyMultiple myelomaRACP Adult Medicine

A 69-year-old woman has back pain, normocytic anaemia, calcium 2.92 mmol/L and creatinine 168 micromol/L. X-ray shows lytic vertebral lesions. What is the most appropriate investigation?

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

Reveal the answer and explanation

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

CRAB features and lytic lesions suggest myeloma, requiring monoclonal protein assessment with SPEP, immunofixation and free light chains, followed by marrow and imaging work-up. Ferritin, coagulation assays and HLA-B27 address other conditions. Faecal occult blood testing does not evaluate plasma cell dyscrasia.

Reference: eviQ myeloma guidance; AMH