05-12-2009, 03:29 PM
A 69-year-old woman is brought to the emergency room after falling off a step stool and fracturing her
hip. Her past medical history is significant for several bouts of pneumonia during the past
year. Laboratory results indicate a normal white blood cell count, but platelets are decreased,
and the erythrocyte sedimentation rate (ESR) is elevated. X-rays reveal multiple lytic bone
lesions. Serum electrophoresis demonstrates an M-protein spike. Which of the following is the
most likely diagnosis?
A. Chronic lymphocytic leukemia
B. Monoclonal gammopathy of uncertain significance
C. Multiple myeloma (plasma cell myeloma)
D. Plasmacytoma
E. Waldenström's macroglobulinemia
hip. Her past medical history is significant for several bouts of pneumonia during the past
year. Laboratory results indicate a normal white blood cell count, but platelets are decreased,
and the erythrocyte sedimentation rate (ESR) is elevated. X-rays reveal multiple lytic bone
lesions. Serum electrophoresis demonstrates an M-protein spike. Which of the following is the
most likely diagnosis?
A. Chronic lymphocytic leukemia
B. Monoclonal gammopathy of uncertain significance
C. Multiple myeloma (plasma cell myeloma)
D. Plasmacytoma
E. Waldenström's macroglobulinemia