<prompt> A 58 years old woman, who had backache and recurrent chest infections for 6 months, develops sudden weakness of the legs and urinary retention. His investigations show a hemoglobin of 7.3 gmdl, serum calcium 12.6 mgdl, phosphate-2.5 mgdl, alkaline phosphatase-100 u1, serum albumin-3 gmdl, globulin-7.1 gmdl and urea-178 mgd. What is the most likely diagnosis?Lung cancerDisseminated tuberculosisMultiple myelomaOsteoporosis  <response>: The above mentioned features are consistent with the diagnosis of mutiple myeloma. So multiple myeloma is the single best answer of choice. Ref: Harrisons Principles of Internal Medicine, 16th Edition Pages 657-60; Ferris Clinical Advicer, 2009, Page 589. 