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: Medicine
In multiple myeloma following are seen except: 
Select and explain. 
A. Anion gap raised, B. Lytic bone lesion, C. Polyaicular pain, D. M spike present with polyaiculopathy
A: Anion gap raised
Answer: A: Anion gap raised 
Explanation: Answer is A (Anion Gap Raised) Multiple Myeloma is associaitd with decreased Anion Gap. Hypoalbuminemia Multiple Myeloma and other paraproteinemic states like Waldenstorm's macroglobulinemia Lithium intoxication / Bromide intoxication Decreased Anion Gap is rare / uncommon and occurs due to accumulation of positively charged unmeasured cations which lower the anion gap This is impoant as it may mask a significant anion gap acidosis.