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Pathology 8

A 74-year-old woman presents to her family doctor with an aching upper back pain which has been progressively worsening for the past 2 weeks. She describes the pain as worse on movement and sometimes feels it in her ribs and chest. The patient has been urinating more but defecating less frequently and has noticed her belt is buckled one notch tighter than it used to be. Over the past few weeks, she admits to feeling tired and weaker, with less appetite than usual. She thinks that this is due to her husband being hospitalized with a heart condition. She has a history of hypertension for which she takes lisinopril 10mg once daily. She has a 20-pack-year smoking history. Vital signs reveal a slight tachycardia at 105 beats/minute but otherwise are within normal limits.

Laboratory results show the following:

  • Urinalysis is positive for Bence-Jones proteins
  • Hemoglobin: 9.9 g/dL
  • Erythrocyte count: 2.9x1012/L
  • Serum calcium: 11.5 mg/dL
  • Serum creatinine 1.4 mg/dL
  • Glomerular filtration rate: 49 mL/min

Considering the most likely diagnosis, which of the following complications would is unlikely to occur from the underlying disease processes?

  • A) AL amyloidosis
  • B) Cast nephropathy
  • C) Polycythemia
  • D) Radiculopathy
  • E) Recurrent infection

Authors

Octavi Casals Farre

Editor

Dr. Ted O'Connell

Last updated

Oct 12, 2022

Source

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