Multiple myeloma: The Daily PANCE Blueprint
Which of the following best confirms the diagnosis of multiple myeloma?
A. MRI of the abdomen / pelvis
B. Peripheral blood smear
C. Urine protein electrophoresis
D. Serum protein electrophoresis
E. Bone marrow biopsy
Answer and topic summary
The answer is E. Bone marrow biopsy
Multiple myeloma is a condition defined by clonal proliferation of abnormal plasma cells. It often presents with “BREAK” symptoms: bone pain, renal failure, elevated calcium, anemia, and kidney failure. A serum and urine protein electrophoresis will reveal a monoclonal protein spike. Other diagnostic studies include a low dose CT or MRI (shows lytic bone lesions), peripheral blood smear (normocytic anaemia in rouleaux formation), urinalysis (Bence Jones proteins aka free light chains). Definitive diagnosis is a bone marrow biopsy. Treatment is high-dose chemotherapy with autologous hematopoietic cell transplantation.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Hematology ⇒ Neoplasms, premalignancies, and malignancies ⇒ Multiple myeloma
