Clarify how additional tests (from both haematology and biochemistry) are essential to distinguish the cause and elicit the correct diagnosis for the patient, and how this would impact the treatment they would need to receive.

2. A 75-year-old man complained to his general practitioner (GP) about his recent weight loss and bone pain. Although a non-smoker, he has had several recent chest infections and has become increasingly short of breath on exertion. Routine biochemistry tests have been carried out and reveal that he has an increase in both his total protein and globulin protein fractions. This has prompted serum protein electrophoresis (SPE) of his sample which has revealed a monoclonal band in the mid-gamma region

Based on this limited information:

1. (a)  Carefully consider the differential diagnoses that need attention when a patient is found to have a monoclonal band in their blood plasma, and the pathological process by which they arise. (30 marks)
2. (b)  Clarify how additional tests (from both haematology and biochemistry) are essential to distinguish the cause and elicit the correct diagnosis for the patient, and how this would impact the treatment they would need to receive. (70 marks)

Instructions to authors

As a general rule for these case study assignments, it is important to remember that credit is gained not only for a correct final diagnosis, but for an answer that contains a careful analysis and logical explanations of the sequence of laboratory tests performed and expected results.There is a word limit which requires a very succinct analysis and response; the aim of this is to judge a student’s proficiency in selecting key information and presenting arguments and analysis concisely and clearly.To allow for concise responses to be made there is no need to frame answers within a ‘traditional’ essay style structure- specific questions are usually posed and can be addressed directly in order, e.g. using the specific questions set as sub-headings or sections.Information sources should be referenced in the usual way; unnecessary references will not gain you credit, and poor/inappropriate use of references may indicate poor judgement in referencing skills. References are not included as part of the word count BUT should be presented according to the PABS referencing guide.

The word limit is 1500 WORDS per case and MUST be stated at the end of your work.

Deadline for submission for is Wednesday 20^th January at 14:00pm