I’m working on a health & medical discussion question and need the explanation and answer to help me learn.
A 65-year-old black male visits his physician with complaints including bone pain in his spine and hips, excessive thirst, numbness in his legs, and sporadic mental confusion. The patient also explained that previous blood tests had shown the presence of M protein in his blood. What type of cancer would the physician begin testing forgiven his history and physical?
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Introduction:
Based on the given information, the 65-year-old black male presenting with bone pain in his spine and hips, excessive thirst, numbness in his legs, and sporadic mental confusion, along with the presence of M protein in his blood, there are specific considerations for the type of cancer that the physician would begin testing for. This response will outline the likely cancer that the physician will investigate given the patient’s history and physical examination findings.
Answer:
Considering the symptoms presented by the 65-year-old male, along with the presence of M protein in his blood, the physician would begin testing for multiple myeloma (MM) as the most probable type of cancer. Multiple myeloma is a neoplastic plasma cell disorder characterized by the proliferation of malignant plasma cells, which produce excessive amounts of abnormal monoclonal protein (M protein) and infiltrate the bone marrow. Bone pain and pathological fractures frequently occur due to the infiltration of plasma cells in the bone marrow, leading to bone destruction. Therefore, the bone pain in the spine and hips reported by the patient is consistent with multiple myeloma.
Excessive thirst in this patient may be related to hypercalcemia, a common complication of multiple myeloma. High levels of calcium in the blood can lead to polydipsia and subsequently cause excessive thirst. Numbness in the legs may be attributed to peripheral neuropathy, a common neurological manifestation of multiple myeloma that results from the deposition of abnormal protein in nerves. Sporadic mental confusion can occur due to hypercalcemia, anemia, or other metabolic disturbances associated with multiple myeloma.
To confirm the diagnosis of multiple myeloma, the physician may initiate further investigations such as blood tests, imaging studies (e.g., X-rays, MRI, CT scan), bone marrow biopsy, and urine tests for Bence Jones proteins (light chains of immunoglobulins). These diagnostic tests will help determine the extent of bone involvement, assess levels of M protein, evaluate renal function, and identify any associated complications of multiple myeloma.
It is important to note that this response is based solely on the given information, and the final diagnosis should be made by a qualified healthcare professional after a thorough evaluation of the patient’s medical history, physical examination findings, and appropriate diagnostic investigations.
Reference:
Kumar, V., Abbas, A. K., Aster, J. C., Perkins, J. A., & Robbins, S. L. (2020). Robbins and Cotran pathologic basis of disease (10th ed.). Elsevier.
