Q1. A 70-year-old woman with a history of multiple myeloma was admitted for treatment of hypercalcemia. Investigations: serum calcium 3.4 mmol/L (2.2- 2.6), serum creatinine 110 µmol/L , urinary protein : creatinine ratio 50 mg/mmol. He was initially treated with intravenous 0.9% saline and intravenous pamidronate. Because of recurrent hypercalcemia, she was given pamidronate every 4 to 6 weeks. After 12 months, the following results were obtained: serum calcium 2.69 mmol/L (2.2- 2.6), serum creatinine 256 µmol/L , 24 hour urine protein 8.9 grams. What would be the most likely finding on renal biopsy?
- (1) Acute interstitial nephritis
- (2) Cast nephropathy
- (3) Focal segmental glomerulosclerosis
- (4) LCDD
- (5) Question not attempted