65 yo male comes to ed due to generalized weakness , fatigue .he has been smoking for about 20 years ,one pack a day.He also complains of severe back pain ,he just remmember having left rib pain in the past.Physical exam:pallor and hepatomegaly.labs:hypercalcemia.Bun 80 and creatinine:2
what is the best next step in mgt???
A-bone marrow biopsy
B- xray
C-serum inmunoelectrophoresis
D-bone biopsy
E-ANA
i think is C..hypercalcemia and renal insuf.....think MM in older guy
any guy who has back pain and has rib pain (specially when coughing and he feels a "pop"), think myeloma. Best next step is X-ray, most accurate tests is bone marrow biopsy.
i disagree. if someone has pain in bone you don't just jump and do electrophoresis, you do an X-ray first!
I agree that you don't jump to do electrophoresis with just pain, but in this case, there are so many symptoms suggesting myeloma, so C is my choice too
According to mtb2 serum eletrophoresis is the most common wrong answer. The initial test is x ray and diagnostic test is bone marrow biopsy. Page 229, 231
hi guys! correct answer BBBB....the first test done is usually an Xray of the affected bone that will show lytic lesions...MTB step 2 ck