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A 61-year-old man is admitted because of altered mental status. On physical examination, he is afebrile. Laboratory studies show sodium 136 mmol/L, potassium 4.4 mmol/L, chloride 108 mmol/L, CO2 30 mmol/L, glucose 78 mg/dL, urea nitrogen 49 mg/dL, calcium 13.8gm%, creatinine 5 mg/dL, hemoglobin 8.9gm%, total protein 8.3 g/dL, albumin 3.7 g/dL, alkaline phosphatase 116 U/L, AST 45 U/L, ALT 22 U/L, and total bilirubin 1.2 mg/dL. The patient is started on aggressive Intravenos hydration. Which of the following may be typically seen with this patient’s disease?
A) Hypercellular Bone marrow with many blasts
B) Serum protein electrophoresis with polyclonal hypergammaglobulinemia
C) An increase in all immunoglobulins ( IgA, IgG and IgM)
D) A negative anion gap
E) Increased Alkaline Phosphatase
F) A positive bonescan

B....................TP 8.3 and Alb 3.7, glob=4.6....Ca: elevated...is it Multiple Myeloma???

Sry...is it MGUS....

y mgus? Is not it MM?

I apologise...i missed that word.....""polyclonal""

is 'B' the right answer?? sry if it is too soon to reveal the answer......

Thanks

E

B.

E. MM, all other options are wrong.

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multiple myeloma...producing negative anion gap due to increase paraproteins....bone scan has no value detecting multile myeloma instead skeletal survey should be performed....