Bone Tumours · NEET PG Preparation Orthopaedics
A 65-year-old male presents with generalized bone pain and fatigue. Laboratory investigations reveal hypercalcemia, normocytic normochromic anemia, e…
Practice question from Bone Tumours (NEET PG Preparation Orthopaedics), with the correct answer and a step-by-step solution.
medium · MCQ · Q-5FDB15
A 65-year-old male presents with generalized bone pain and fatigue. Laboratory investigations reveal hypercalcemia, normocytic normochromic anemia, elevated erythrocyte sedimentation rate (ESR), and reversed albumin-globulin ratio. Serum protein electrophoresis shows an M-spike, and radiographs of the skull show multiple 'punched-out' lytic lesions. Which of the following cells is responsible for the bone destruction in this condition?
- A.Malignant plasma cells directly lysing bone
- B.Osteoclasts activated by myeloma cell-derived RANKLCorrect answer
- C.Reactive fibroblasts forming a fibrous capsule
- D.Chondrocytes undergoing premature hypertrophy
Solution
The clinical picture is characteristic of Multiple Myeloma. Myeloma cells secrete factors such as RANKL (Receptor Activator of Nuclear Factor Kappa-B Ligand) and inhibit osteoprotegerin (OPG), leading to local stimulation and activation of osteoclasts, which results in the classic punched-out osteolytic lesions.
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