A 58 years old woman, who had backache and recurrent chest infections for 6 months, develops sudden weakness of the legs and urinary retention. His investigations show a hemoglobin of 7.3 gm/dl, serum calcium 12.6 mg/dl, phosphate-2.5 mg/dl, alkaline phosphatase-100 u/1, serum albumin-3 gm/dl, globulin-7.1 gm/dl and urea-178 mg/d. What is the most likely diagnosis?
Lung cancer
Disseminated tuberculosis
Multiple myeloma
Osteoporosis
The above mentioned features are consistent with the diagnosis of mutiple myeloma. So multiple myeloma is the single best answer of choice. Ref: Harrison's Principles of Internal Medicine, 16th Edition Pages 657-60; Ferri's Clinical Advicer, 2009, Page 589.