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
Multiple punched out lesion in skull is characteristically seen in 
Select and explain. 
A. Thalassemia, B. Multiple Myeloma, C. Rickets, D. Osteoporosis
B: Multiple Myeloma
Answer: B: Multiple Myeloma 
Explanation: (Multiple myeloma): (1041 -Davidson 21st edition)MULTIPLE MYELOMA - presents as multifocal destructive bone tumours composed of plasma cells throughout the skeletal system* The bone lesions appears radiographically as punched out defects usually 1-4 cm in diameter and grossly consists of gelatinous soft red tumour masses* Hyperparathyroidism - "pepper pot skull", The mandible a common site for 'brown ' tumours* Moth - eaten appearance - syphilis* Rugor Jersy spine - Osteopetrosis* Beheaded scortish terrior sign - Spondylolisthesis