<prompt> Which of the following is the least common feature of Multiple Myeloma:Bone painNormocytic Normochromic AnemiaSusceptibility to bacterial infectionHyperviscosity syndrome  <response>: Answer is D Hyperviscosity syndrome Hyperviscosity syndrome is an uncommon infrequent complicationpresentation of Multiple myeloma. Hyperviscosity syndrome is an infrequentuncommon complicationpresentation of multiple myeloma The Monoclonal M component in Multiple Myeloma usually consists of monoclonal IgG or monoclonal IgA. Hyperviscosity syndrome from monoclonal IgGIgA in multiple myeloma is an infrequentuncommon event, though when present it is potentially destructive. Hyperviscosity syndrome is commonly seen with monoclonal 1gM as in Waldenstroms Macroglobulinemia Although potentially destructive hyperviscosity is a relatively uncommon complication of multiple myeloma In Multiple Myeloma, Hyperviscosity has been described in 3-4 of IgG Myeloma and 5-10 of IgA Myeloma. Review Patients with multiple myeloma develop hvperviscosity infrequently - Oxford Desk Reference Bone pain skeletal destruction, Anemia and Susceptibility to bacterial infections are frequentcommon features of Multiple Myeloma Bone Pain Bone Painis the most common symptoms in myeloma affecting nearly 70 of patients - Harrison 18m938 Susceptibility to Bacterial Infection The most common clinical problem after skeletal destruction in patients with multiple myeloma is susceptibility to bacterial infections 75 of patients will have a serious infection at some time in their course and recurrent infections are the presenting feature in approximately 25 of patients. - Harrison 18th938 Anemia Wormocytic Normochromic anemia is present in approximately 80 of myeloma patients Clinical Feature of M. Myeloma Approximate frequency Bone painskeletal Destruction - 70 Most common presenting feature Recurrent bacterial Infection - 25 Presenting _feature in 25 Renal failure - 25 Renal Failure occurs in - 25 of MM patients Hypercalcemia - 25 About 25 of patients develop Hypercalcemia at some stage of disease. It is the most common cause of Renal failure in MM patient Anemia Normocytic Normochromic 80 Normocytic Normochromic anemia occurs in approx. 80 ofpatients. It is usually not a presenting feature. 