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Pathology · single question

Multiple myeloma presents with all of the following EXCEPT:

  1. Anemia
  2. Lytic bone lesions ('punched-out' radiolucencies)
  3. Hypocalcemia
  4. Bence Jones proteinuria
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Correct answer: C. Hypocalcemia

  • A. Anemia is a classic feature of multiple myeloma (plasma cell infiltration of bone marrow displaces erythroid precursors).
  • B. Lytic ('punched-out') bone lesions throughout the skeleton are classic radiographic findings of multiple myeloma.
  • C. Correct. Multiple myeloma causes HYPERcalcemia (NOT hypocalcemia) because osteoclastic activity from myeloma destroys bone and releases calcium into the bloodstream. The mnemonic 'CRAB' stands for: hyperCalcemia, Renal failure, Anemia, Bone lesions. Hypocalcemia is NOT a feature.
  • D. Bence Jones proteins are immunoglobulin light chains (kappa or lambda) excreted in urine — a classic finding in multiple myeloma.

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