Haematology: multiple myeloma: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Haematology: multiple myeloma

Sample item

A patient has bone pain, anaemia, renal dysfunction and a narrow monoclonal spike on serum electrophoresis. Which urinary finding is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Free monoclonal light chains

Plasma-cell myeloma often produces excess free kappa or lambda light chains, historically called Bence-Jones proteins. They contribute to cast nephropathy and renal impairment.

Option by option

  • A. Bilirubin crystals

    Bilirubin crystals are not a feature of myeloma.

  • B. Free monoclonal light chains (correct)

    Correct. Filtered light chains are a characteristic myeloma finding.

  • C. Bence-Jones-negative albumin only

    Albumin alone does not explain the monoclonal plasma-cell disorder.

  • D. Haemoglobin from intravascular malaria

    Haemoglobinuria has different causes such as intravascular haemolysis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Free monoclonal light chains. Plasma-cell myeloma often produces excess free kappa or lambda light chains, historically called Bence-Jones proteins.

Why is "Bilirubin crystals" not the answer?

Bilirubin crystals are not a feature of myeloma.

Why is "Bence-Jones-negative albumin only" not the answer?

Albumin alone does not explain the monoclonal plasma-cell disorder.

Why is "Haemoglobin from intravascular malaria" not the answer?

Haemoglobinuria has different causes such as intravascular haemolysis.

What concept does this question test?

It tests Haematology: multiple myeloma in Pathology. They contribute to cast nephropathy and renal impairment.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology: multiple myeloma?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.