What is going on guys? Happy Monday today. We're going to be answering a question regarding hyper-albuminemia.

And we're going to get right into this question today. This is going to be a short lecture compared to the last video that I put out regarding back pain.

If you haven't checked out the last video on acute back pain, we go over

ediologies regarding back pain, serious pathology, we go over signs symptoms the work up including

imaging do we need to do any type of laboratory testing and how we follow up and

manage the patient with acute back pain but today we're going to be answering a

question regarding possible multiple my loma and hyper, I'll be minimia according to the question here. So let's get into it now. And this comes from a nurse practitioner and she says,

hi Andrew, I'm an MP from Pennsylvania and after four years of practice I still struggle

with lab interpretation in general. My question today is elevated serum protein. How do I work that up? When do I do

SPEP and immunofixation or just monitor in a young person versus an old person. Thank you. So these tests that she's discussing here, this immune fixation, the SPEP, even you PEP, these are all tests to diagnose multiple myeloma. Now very quickly, multiple myeloma.

Multiple myeloma is a disease in which your body produces an excess amount of immunoglobulins or antibodies, right?

So we have this overproliferation of antibodies which causes your immune system to be all out of

whack, right?

It causes immune dysfunction.

So patients are at increased risk for having infection.

The clinical picture, we can have bone pain,

pathological fractures, anemia, fatigue.

This is how the patient is going to present.

Now, the interesting thing, or the thing that a lot of students,

clinicians get confused is this protein aspect, right?

We have this overproliferation of plasma proteins.

This does not mean that the total serum protein is going to be elevated.

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