An 80-year-old male presents in a state of confusion. His carers say he has
been complaining of backache and he had been constipated for some time. He
has also been increasingly thirsty.
On examination he is confused and disoriented. He appears dehydrated.
Hb 8.0 g/dL
ESR 90 mm in 1st hour
Urea 12.7 mmol/L
Creatinine 130 mmol/L
Blood glucose 6.0 mmol/L
Chest X-ray shows multiple rib fractures
Spinal X-ray shows wedge fractures
In this patient which one of the following investigations is essential in
initial management of this patient?
Plasma protein electrophoreses
Bone marrow examination
Urine for Bence-Jones protein