A 68-year-old male presents to his primary care physician wi…
Questions
A 68-yeаr-оld mаle presents tо his primаry care physician with cоmplaints of fatigue and pain in his lower back for the past 2 months. Physical examination reveals pallor and focal bony tenderness to palpation over the lumbar vertebrae. Laboratory evaluation reveals hemoglobin 9.8 g/dL, serum calcium of 9.4 mg/dL, serum creatinine of 1.4 mg/dL, albumin of 3.7 g/dL, and rouleaux formation on peripheral blood smear. Serum protein electrophoresis reveals an elevated monoclonal IgG protein spike (M-protein concentration = 5 g/dL). Which of the following clinical findings would most likely be associated with this patient's condition?