Q:

Which of the following options reflects the correct descending order for the type of immuno globulin that is responsible for the M -spike in MM?

0

A 79-year-old Caucasian man presents with a chief complaint of back pain. Hemoglo bin is 9.7 g/dl. leukocyte count 7.600/Jll. and platelet count 21 LJ,OOO/fll. BUN is 26 mg/dl. creatinine 2.1 mg/dl. total protein 9.0 g/dl. albumin 3.1 g/dl. and calcium 10.9 mg/dl. The images below show the bone marrow aspirate and a skull film from the skeletal survey. 

Which of the following options reflects the correct descending order for the type of immuno globulin that is responsible for the M -spike in MM? 


  1. IgG, IgD, IgA
  2. IgG, IgA, IgD
  3. IgD, IgG, IgA
  4. They occur with equal frequency

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B. The serum M-protein is IgG in 53%, IgA in 25%, and IgD in 1% of patients. 

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