This 26-year-old gravida 1, para 0 female has been having

32.3 A 70-year-old woman presents with a 4-week history of low back pain, generalized weakness, and a 15-lb weight loss over the last 2 months. Her medical history is unremarkable, and her examination is normal except that she has generalized weakness with strength rated as 4/5 in all extremities. Initial laboratory tests reveal an erythrocyte sedimentation rate (ESR) of 80 mm/h (normal < 35), hemoglobin of 10 g/dL, creatinine level 1.8 mg/dL (nl 0.5-1.3), and calcium level 11.2 mg/dL (normal 8.5-10.5). Which of the following is the most likely diagnosis? OA Osteoporosis with compression fractures OB Renal failure with osteodystrophy OC Multiple myeloma OD Lumbar strain OE Osteomyelitis

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