A 69-year-old man comes to the physician for a two-week history of central back pain and fatigue. He also reports occasional nosebleeds over the past three months. Serum calcium is 10.4 mg/dL, creatinine 4.6 mg/dL, and blood urea nitrogen (BUN) 70 mg/dL. A peripheral smear is shown.
Which of the following is the next best step in diagnosis?
Bone marrow biopsy
Hemoglobin electrophoresis
Karyotype analysis
Serum protein electrophoresis
Thin and thick blood smears
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Cut-to-the-chase Answer (0:34):
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HY USMLE Answer (5:30):
