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Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 64-year-old woman presents for the scheduled annual physical examination for management of her hypertension. The patient is asymptomatic and her blood pressure is within normal limits throughout the year. She has a past medical history of polyarthrosis, and she is a carrier of hepatitis B antibodies. She does not smoke or drink alcohol. She is currently taking the following medications: enalapril, ranitidine, and lorazepam. The vital signs include: pulse rate 72/min, respiratory rate 14/min, blood pressure 138/76 mm Hg, and temperature 37.0°C (98.6°F). The physical examination shows no abnormalities. The laboratory test results are shown below:
Hemoglobin 11.6 g/dL
Hematocrit 34.8%
MCV 91.4 fL
MCH 31.4 pg
Platelets 388,000/mm3
Leukocytes 7,300/mm3
ESR 59 mm/h
On account of these laboratory test results, the patient was once again questioned for symptoms that would explain the abnormality detected in her laboratory test results. The patient insists that she is asymptomatic. Therefore, further laboratory studies were requested. The additional laboratory test results are shown below:
PCR 5.3 mg/dL
Serum protein electrophoresis
Total proteins 7.4 g/dL
Albumin 5.8 g/dL
Alpha-1 3.5 g/dL
Alpha-2 1 g/dL
Beta 0.9 g/dL
Gamma 1.7 g/dL
The gamma protein was later confirmed as an immunoglobulin G (IgG) kappa paraprotein (1,040 mg/dL). Due to these results a computed tomography (CT) scan was conducted, and it showed moderate osteopathy without any other lesions. A bone marrow biopsy was done that showed 5–10% plasma cells. Which of the following is most likely associated with the diagnosis of this patient?
assistant
Osteoporosis