doc_clotaire
Forum Guru
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A 60 yo woman comes to the physician because of 3 month history of worsening fatigue and back pain . She has had diabetes melillus for the past 3 year and hypertension for the past 10 years .
Laboratory shows :
Hb : 9 mg/dl
Serum Ca : 11mg/dl
Serum Phosphurus : 3.5 mg/dl
BUN : 30 mg/dl
Serum Creatinine : 2.0 mg/dl
Which of the following is the most likely cause of her renal failure ?
a ) Hypertension
b ) Diabetes Mellitus
c ) Paraprotein
d ) Primary hyperparathyroidism
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| keepgoing
Forum Guru
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im confused with HTN but BUN:Cr ration is 15,acc. to goljan ,and as nothing much given to support hyperpaarthyriodism and paraproteins so i go with ==>DM
Edited by keepgoing on 12/11/07 - 12:02 AM
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| new_n_lost
Politically InCorrect
Topics: 650
Posts: 6,058
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Paraprotein >> Multiple Myeloma the only reason which i think could explain her backaches and fits teh lab values.
Normal Phosphorus count rules out PHTP.
DM was along 3yrs so it wasnt that long enuf.
HTN was the only thing holding me back but backache and fatigue she is 60 so osteoporosis came to mind but fatigue was bugging me ( and still is )
This one really scratched my head.
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| keepgoing
Forum Guru
Topics: 62
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U mean hypercalcemia of malignancy n renal failure due to MM??well now seems RT also,paraprotein,as doc_clotaire wud not have poste dif it was that simple  i better wait n watch.if its MM than critical thinking!!!
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| doc_clotaire
Forum Guru
Topics: 159
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the answer is C
Multiple Myeloma is a malignant plasma cell disorder that is usually accompanied by a serum or urine paraprotein that can accumulate in the kidney and lead to renal failure . Presenting manifestation may include hypercalcemia , anemia , lytic bone lesion with bone pain and acute renal failure due to accumulation of paraprotein
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