This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Blood, Subject name: Medicine
[{'content': 'False regarding Multiple myeloma is: \nSelect and explain. \nA. It is a calcified protein, B. Bence Jones protein in urine, C. Lytic bone lesions, D. Roulex formation of RBCs', 'role': 'user'}, {'content': "Answer: A \nExplanation: Ref: Harrison's Principles of Internal Medicine, 18th editionExplanation:Multiple myelomaMultiple myeloma is a malignant proliferation of plasma cells derived from a single clone.CharacteristicsLytic hone lesionsAnemia with high ESRRoulex formation of red cellsRenal failure InfectionsHypercalcemiaTriad of Multiple myelomaMa now plasmacytos is >10%Lytic bone lesionsSerum and /or urine M componentMonoclonal plasma cells (k, A light chain restricted) in B\\I or as a tumor (solitary plasmacytoma).End organ damage-Lytic bony lesions.Anemia.Hypercalcemia.Renal failure with paraprotenemia (mostly Ig G or Iga).S.electrophoresis for M band (b,g); Urine Bence Jones protein for light chainsNon secretory myeloma- no paraproteins, poor prognosisX-rays axial skeleton-skull, spine. long bones, ribs for lytic lesionsPET or MRI useful for early lesionsRadionuclide scan not usefulMust be differentiated from smoldering myeloma & MG USTreatment: Thalidomide/Ienolidamide + high dose dexamethasoneBortezomib. Autologous hematopoietic SCTLocalized RT for vertebral collapseBisphosphonates for malignant hypercalcemia (beware of their osteonecrosis jaw!)PrognosisStageb2 microglobulinAlbuminSurvivalStage 1<3.5mg/L> 3.5g/dL>5yrsStage 23.5-5.5mg/L Stage 3>5.5mg/L <2yrs", 'role': 'assistant'}]