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The patient is a 54 year old man who first noticed multiple "muscle cramps" in March 2003 and self-treated with aspirin, up to 15 tablets a day. His pain progressed in the lower back over the next two months and he began using crutches to walk. He went to a doctor for evaluation about two weeks ago, where an x-ray of the spine revealed lytic lesions.
Past medical history: CABG 11 years ago, Hypertension, Diabetes, GERD, BPH
1. What is your differential diagnosis?
2. What tests do you want?
Name |
Result/Unit |
|
Ref Interval |
White Blood Cell Count |
7.9 K/uL |
|
3.1-10.1 |
Red Blood Cell Count |
4.04 M/uL |
L |
4.32-5.84 |
Hemoglobin |
12.1 g/dL |
L |
13.5-17.5 |
Hematocrit |
35.6 % |
L |
41.2-52.4 |
Platelets |
223 K/uL |
|
140-440 |
Name |
Result/Unit |
|
Ref Interval |
Alkaline Phosphatase |
152 U/L |
H |
45-150 |
Potassium |
3.8 mmol/L |
|
3.3-5.0 |
Sodium |
137 mmol/L |
|
136-144 |
Glucose |
126 mg/dL |
|
64-128 |
Bilirubin, Total |
1.2 mg/dL |
|
0.2-1.3 |
Calcium |
9.7 mg/dL |
|
8.4-10.2 |
Albumin |
3.3 g/dL |
L |
3.5-4.6 |
Total Protein |
7.2 g/dL |
|
6.3-8.2 |
CREATININE, SERUM - mg/dL |
1.5 mg/dL |
H |
0.8-1.4 |
Chloride |
103 mmol/L |
|
98-107 |
AST/SGOT |
48 U/L |
|
15-59 |
Urea Nitrogen |
26 mg/dL |
H |
7-20 |
.jpg) |
Nuclear medicine Tc99 scan posterior 6-3-03 |
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Nuclear medicine Tc99 scan anterior |
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Nuclear medicine Tc99 scan chest views |
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CXR 6-7-03 AP |
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CXR lateral |
3. What is your assessment now?
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