A 60yr old man presented with severe back pain after a long distance travel in a bus. On x-ray of the vertebral column the man was shown to have a fracture of the first lumbar vertebra with associated punched out lesions of the other vertebrae. The physician became suspicious and ordered other investigations.Investigations: Serum uric acid 11mg/dl (3--6mg/dl);Serum Calcium 7.2mEq/L(4.5--5.7mEq/L);Serum phosphate 3.5mEq/L (1.45-2.76mEq/L);Blood urea 30mg/dl(10-20mg/dl);Serum Creatinine 1.7mg/dl(0.7-1.5mg/dl); 24hr urine specimen showed presence of casts and Bence-Jones protein.Serum electrophoresis for immunoglobulins showed the presence of abnormal amounts of IgG immunoglobulin.The most likely diagnosis is : a) Osteoporosis b) Multiple myeloma c) Hyperparathyroidism d) Chronic renal failure e) metastatic bronchogenic carcinoma To get Correct answers please visit : usmlemcq/?p=922
Posted on: Wed, 14 Jan 2015 09:30:26 +0000
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