Dental materials and radiology basics: multiple myeloma of the jaw: practice question

A Dentistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dentistry · Dental materials and radiology basics: multiple myeloma of the jaw

Sample item

A 65-year-old with bone pain, anaemia and hypercalcaemia has multiple punched-out radiolucencies in the mandible and skull. Which investigation finding is expected?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Bence Jones proteinuria

Multiple punched-out lytic lesions with anaemia, hypercalcaemia and bone pain suggest multiple myeloma. Neoplastic plasma cells secrete monoclonal immunoglobulin, and free light chains are excreted as Bence Jones protein, which is not detected by ordinary dipstick tests. Serum electrophoresis shows an M band.

Option by option

  • A. Raised urinary 5-HIAA

    5-HIAA is raised in carcinoid syndrome and has no link to this picture.

  • B. Raised serum alkaline phosphatase with normal calcium

    Raised alkaline phosphatase with normal calcium fits Paget disease, which is sclerotic rather than punched out.

  • C. Bence Jones proteinuria (correct)

    Correct. Free light chains in the urine (Bence Jones protein) are typical of myeloma.

  • D. Raised serum acid phosphatase

    Raised acid phosphatase is associated with metastatic prostate cancer.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dentistry question

What is the answer to this Dentistry question?

The best answer is C, Bence Jones proteinuria. Multiple punched-out lytic lesions with anaemia, hypercalcaemia and bone pain suggest multiple myeloma.

Why is "Raised urinary 5-HIAA" not the answer?

5-HIAA is raised in carcinoid syndrome and has no link to this picture.

Why is "Raised serum alkaline phosphatase with normal calcium" not the answer?

Raised alkaline phosphatase with normal calcium fits Paget disease, which is sclerotic rather than punched out.

Why is "Raised serum acid phosphatase" not the answer?

Raised acid phosphatase is associated with metastatic prostate cancer.

What concept does this question test?

It tests Dental materials and radiology basics: multiple myeloma of the jaw in Dentistry. Neoplastic plasma cells secrete monoclonal immunoglobulin, and free light chains are excreted as Bence Jones protein, which is not detected by ordinary dipstick tests. Serum electrophoresis shows an M band.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Dental materials and radiology basics: multiple myeloma of the jaw?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.