75-year-old lady is brought to the emergency department by her next of kin after a three week history of having gone off her feet. A history of back pain radiating anteriorly around her chest and bilateral weakness of her legs is elicited. Physical examination shows a paraparesis. Blood investigations are notable for haemoglobin of 9.5 g/dL, serum calcium of 3.6 mmol/L and a creatinine of 250 µmol/L. Which of the following would be the most appropriate initial investigation? (Please select 1 option) A Intravenous hydration and bisphosphonate B Serum protein electrophoresis, quantitative immunoglobulins and serum free light chains C Transfusion of 2 units of red cell concentrate D Urgent magnetic resonance imaging of her spine and intravenous steroids E Urine for creatinine clearance and Bence Jones protein
Posted on: Mon, 18 Aug 2014 11:48:28 +0000
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