Medical Emergencies · patient case question
Which complication is likely?
Patient case: Patient with multiple myeloma
Scenario: A patient with MULTIPLE MYELOMA. What complication may be present or likely in this patient?
Show answer and explanation
Correct answer: B. Myocardial infarction
- A. Emphysema is a smoking-related obstructive lung disease unrelated to plasma cell dyscrasia.
- B. Correct per the source key. Multiple myeloma predisposes to cardiovascular events through several mechanisms: HYPERVISCOSITY from the monoclonal paraprotein, a markedly increased risk of arterial and venous THROMBOSIS (compounded by immunomodulatory therapy), amyloid deposition in the myocardium producing restrictive cardiomyopathy, and anemia increasing cardiac demand.
- C. Thyroid disease is not a feature of myeloma.
- D. Cirrhosis is not a myeloma complication, although amyloid can deposit in the liver.
Note: The CRAB criteria are the higher-yield myeloma facts: hyperCalcemia, Renal failure, Anemia, Bone lesions (punched-out radiolucencies, classically in the skull and jaws). DENTAL RELEVANCE: amyloid deposition causes MACROGLOSSIA, and these patients are frequently on BISPHOSPHONATES or denosumab for skeletal protection, creating substantial MRONJ risk.
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