National Board of Chiropractic Examiners (NBCE) Practice Test

Bence Jones proteinuria is most characteristic of which condition?

1. Waldenström's macroglobulinemia

2. Multiple myeloma

3. Chronic lymphocytic leukemia

4. Amyloidosis

The correct answer is: Multiple myeloma

Bence Jones proteinuria is a condition characterized by the presence of free light chains of immunoglobulins in the urine, which are associated with plasma cell disorders. This particular protein is most commonly associated with multiple myeloma — a type of cancer that arises from the abnormal proliferation of plasma cells in the bone marrow, leading to the overproduction of monoclonal immunoglobulin or its components (light chains). In multiple myeloma, these light chains can spill into the urine, where they are excreted, leading to Bence Jones proteinuria. The detection of these proteins is a significant diagnostic marker for the disease and is helpful in both the diagnosis and management of multiple myeloma. While the other conditions listed can involve immunoglobulin abnormalities, they do not typically present with Bence Jones proteinuria. For example, Waldenström's macroglobulinemia involves the production of large amounts of IgM, but it does not lead to the significant light chain proteinuria observed in multiple myeloma. Chronic lymphocytic leukemia (CLL) is characterized by a lymphoproliferative disorder with different immunological features and does not usually produce Bence Jones proteinuria. Similarly, amyloidosis involves a