This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Haematology, Subject name: Medicine
Which one of the following is not a feature of multiple myeloma - 
Select and explain. 
A. Hypercalcemia, B. Anemia, C. Hyperviscosity, D. Elevated alkaline phosphatase
D: Elevated alkaline phosphatase
Answer: D: Elevated alkaline phosphatase 
Explanation: In multiple myeloma , hypercalcaemia is due to destruction of bone. Anaemia is due to marrow replacement by tumor cells & inhibition of hematopoiesis. Hyperviscosity is due to hyperglobulinaemia & produce headache,fatigue,visual disturbance & hemorrhage.In the absence of fractures , plasma alkaline phosphatase & isotope bone scan will be normal despite lytic lesions.Reference : Harsh mohan textbook of pathology 6th edition pg no 383 & Davidson's principle & practice of medicine 22nd edition pg no1046.