This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pathology
[{'content': 'A 50 year old male patient complains of pain in back and legs. On routine investigations, it is found that he is anemic and his ESR is also raised. Which of the following is the most probable diagnosis for this patient? \nSelect and explain. \nA. Sickle cell anemia, B. Polycythemia, C. Waldenstrom macroglobulinemia, D. Multiple myeloma', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Clinical findings stem mainly from:\n\nThe\xa0effects\xa0of\xa0plasma\xa0cells\xa0on\xa0the\xa0skeleton.\nThe\xa0production of excessive immunoglobulins, which often have abnormal physicochemical properties.\nThe suppression of humoral immunity.\n\nBone\xa0resorption\xa0often\xa0leads\xa0to\xa0pathologic\xa0fractures\xa0and chronic pain. The attendant hypercalcemia can give rise to neurologic\xa0manifestations,\xa0such\xa0as\xa0confusion,\xa0weakness,\xa0and lethargy,\xa0and contributes\xa0to\xa0renal\xa0dysfunction. Decreased production of\xa0normal\xa0immunoglobulins\xa0sets\xa0the\xa0stage\xa0for recurrent\xa0bacterial\xa0infections.\xa0Of great significance is renal\xa0insufficiency, which trails only infections as a cause of death.', 'role': 'assistant'}]