Haematology and oncology: monoclonal gammopathy of undetermined significance: practice question

A General Medicine 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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General Medicine · Haematology and oncology: monoclonal gammopathy of undetermined significance

Sample item

A 68-year-old man has an incidental serum M-protein of 1.8 g/dL. Bone marrow shows 5% clonal plasma cells. Haemoglobin, calcium and creatinine are normal and a skeletal survey shows no lytic lesions. What is the diagnosis?

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

The answer and the reasoning

A. Monoclonal gammopathy of undetermined significance

A small M-protein, less than 10% marrow plasma cells and no end-organ damage defines this premalignant state, which carries about a 1% yearly risk of progression. It needs follow-up rather than treatment.

Option by option

  • A. Monoclonal gammopathy of undetermined significance (correct)

    Correct. Low M-protein, under 10% plasma cells and no organ damage fit this diagnosis.

  • B. Waldenstrom macroglobulinaemia with IgM paraprotein

    Waldenstrom involves an IgM paraprotein and lymphoplasmacytic infiltration.

  • C. Systemic AL amyloidosis with organ involvement

    AL amyloidosis requires amyloid deposition causing organ dysfunction.

  • D. Symptomatic multiple myeloma with end-organ damage

    Myeloma requires 10% or more plasma cells or end-organ damage, which is absent.

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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Monoclonal gammopathy of undetermined significance. A small M-protein, less than 10% marrow plasma cells and no end-organ damage defines this premalignant state, which carries about a 1% yearly risk of progression.

Why is "Waldenstrom macroglobulinaemia with IgM paraprotein" not the answer?

Waldenstrom involves an IgM paraprotein and lymphoplasmacytic infiltration.

Why is "Systemic AL amyloidosis with organ involvement" not the answer?

AL amyloidosis requires amyloid deposition causing organ dysfunction.

Why is "Symptomatic multiple myeloma with end-organ damage" not the answer?

Myeloma requires 10% or more plasma cells or end-organ damage, which is absent.

What concept does this question test?

It tests Haematology and oncology: monoclonal gammopathy of undetermined significance in General Medicine. It needs follow-up rather than treatment.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Haematology and oncology: monoclonal gammopathy of undetermined significance?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.