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52908 Medicine

A 74-year-old man presents to the clinic for assessment of symptoms of fatigue, shortness of breath on exertion, and back and rib pain that is made worse with movement. Investigations reveal he is anemic, the calcium, urea, and creatinine are elevated. X-rays reveal multiple lytic lesions in the long bones and ribs, and protein electrophoresis is positive for an immunoglobulin G (IgG) paraprotein. Which of the following is the most likely mechanism for the renal injury?

Aplasma cell infiltrates
Btubular damage by light chains
Cglomerular injury
Dvascular injury by light chains
Medicine
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