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Classic presentation of multiple myeloma (CRAB) Hyper C alcemia Usually hypercalemia 2/2 lytic bone lesions R enal insufficiency Especially if calcium HIGH, concerning myeloma Since Ca is usually LOW in renal disease A nemia Lytic B one lesions Additional features: Amyloidosis (Big tongue macroglossia, restrictive cardiomyopathy) Hyperviscosity (e.g., WM) Gum bleeding, Epistaxis and Bruising without other explanation Polyneuropathies Pearl 2: What is our initial workup