American Board of Internal Medicine (ABIM) Certification Practice Exam

For patients with multiple myeloma, what does CRAB stand for?

1. Calcium, Renal, Anemia, Bone disease

2. Calcium, Red blood cells, Anemia, Bone density

3. Calcium, Renal, Albumin, Bevacizumab

4. Creatinine, Red blood cells, Albumin, Bone disease

The correct answer is: Calcium, Renal, Anemia, Bone disease

The acronym CRAB is a widely recognized mnemonic used in the context of multiple myeloma to describe the major clinical features that indicate the presence of the disease. CRAB stands for: - Calcium: Hypercalcemia is frequently observed in multiple myeloma due to the release of calcium from the bones affected by lytic lesions. - Renal: Renal impairment is common, often due to the high levels of monoclonal proteins that can cause damage to renal tubules. - Anemia: Anemia is prevalent in multiple myeloma as a result of inadequate red blood cell production due to the infiltration of the bone marrow by malignant plasma cells. - Bone disease: Osteolytic lesions are characteristic in multiple myeloma, leading to bone pain and fractures. Understanding these components helps healthcare professionals identify and manage the complications associated with multiple myeloma. Each element of CRAB directly correlates to the pathophysiology of the disease and its systemic effects on the patient. This mnemonic effectively summarizes the critical diagnostic criteria that oncologists and internists use to evaluate and classify the severity of multiple myeloma.