Question

Which of the following are used as diagnostic signs of myeloma?

Select one:

a. Anaemia and recurrent infections

b. Anaemia and fractured bones

c. Recurrent infections and kidney failure

d. Bone pain and increases in prostate specific antigen levels

e. Presence of paraprotein and bone pain

Answer 1

Myeloma is the cancer of plasma cells in the bone marrow which produces antibodies. As the disease progresses it shows various symptoms and can lead to mis-disgnosis of the disease. The Symptoms include anemia, bone pain mainly in the ribs and spine which may lead to fractures, kidney failure, recurrent infection, nausea, weight loss etc. These symptoms are vague and similar to other conditions.

MGUS (monoclonal Gammopathy of Undetermined Significance) is a benign condition which is characterized by the presence of an abnormal protein produced by the plasma cells in the blood. The progression of this benign non cancerous condition into the active myeloma is due to the elevation in the production of the abnormal protein (paraprotein) which impedes the production of healthy blood cells and antibodies that fight infection. This characteristic is unique only to myeloma. Moreover, bone pain in the chest and ribs indicate the progression of myeloma.

Therefore, both these two characteristics can be used for the diagnosis of myeloma. So the correct option is (e) presence of paraprotein and bone pain.