Question 206 · LEK · Multiple myeloma

A male patient, 70 years of age, came to see his family doctor to discuss the results of laboratory tests he made to check whether he may have osteoporosis because he had had a radial bone fracture after a slight fall a few months before. Apart from that, he reports occasional lumbar pain and weakness which he thinks can be attributed to ageing. Laboratory tests showed blood calcium concentration 4 mmol/l (normal range: 2.1-2.6 mmol/l), creatinine 2.1 mg/dl (normal range: 0.6-1.3 mg/dl), and slight normocytic anaemia, with no other abnormalities. What is the most probable diagnosis?

1. AA. primary hyperparathyroidism.
2. BB. multiple myeloma.
3. CC. vitamin D deficiency.
4. DD. iron deficiency.
5. EE. primary osteoporosis.