Which of the following is NOT a common diagnostic finding in Multiple Myeloma?

• A. Low calcium levels
• B. Bence-Jones proteins in urine
• C. Elevated serum protein levels
• D. Bone marrow biopsy

Answer: (A)

The key idea is that multiple myeloma commonly causes high calcium levels rather than low. Osteolytic bone destruction from malignant plasma cells releases calcium into the blood, leading to hypercalcemia, so a finding of low calcium is not typical for this disease. In contrast, the other features are classic: Bence-Jones proteins in urine reflect free light chains produced by the malignant plasma cells; elevated serum protein levels come from the monoclonal (M) protein spike; and bone marrow biopsy typically shows a clonal proliferation of plasma cells, which is diagnostic. So the not-typical finding is low calcium because hypercalcemia is part of the common presentation.