Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• It certainly explains the high total protein.
• It also explains the high serum calcium.
• This means there is a plasma cell proliferative process.
• The bleeding might be explained on the basis of a platelet dysfunction, secondary to the abnormal circulating protein.
• This might also explain the anemia because of bone replacement with plasma cells. (Or possibly a hemolytic process.)
• His fever and cough may be due to a chronic low grade infection because his immune system isn't working right.
• The elevated LDH could be the result of dying plasma cells.
• The alkaline phosphatase might be elevated because of reactive changes in the bone secondary to a marrow infiltrate.