A 64-Year-Old Man Is Evaluated for a 1-Month History of Worsening

question 153

Multiple Choice

A 64-year-old man is evaluated for a 1-month history of worsening fatigue and low back pain exacerbated by movement.  He has no prior medical history and takes no medications.  Vital signs are normal.  Physical examination shows mucosal pallor and bony tenderness.  Radiographs reveal lytic bone lesions.  Laboratory studies show that hemoglobin is 8.8 g/dL, serum creatinine is 3.0 g/dL, and serum calcium is 10.8 g/dL.  Urine dipstick is negative for protein, but quantitative measurement reveals elevated 24-hour urinary protein excretion.  Urine electrophoresis is most likely to detect which of the following?

• A)Gamma heavy chains
• B)Immunoglobulin A
• C)Immunoglobulin G
• D)Immunoglobulin M
• E)Lambda light chains

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Definitions:

Fixed Exchange Rate

Rate of exchange between currencies pegged within a narrow range and maintained by the central bank’s ongoing purchases and sales of currencies.

Central Banks

National financial institutions that provide financial and banking services for a country's government and commercial banking system, as well as implementing the government's monetary policy and issuing currency.

Trade Barriers

Measures imposed by governments to regulate international trade, often to protect domestic industries from foreign competition.

International Monetary Fund

An international organization dedicated to fostering global monetary cooperation, securing financial stability, and facilitating international trade.