A 60-year-old woman presents to the physician for a one-year history of progressive fatigue. Laboratory studies show: MCV 110 fL; folate and cyanocobalamin are normal; calcium 10.4 mEq/L.
Which of the following is most likely to be seen in this patient?
20/200 transitory visual acuity
Hematuria
IgM M protein spike
Rouleaux formations
S3 heart sound
