RT Book, Section A1 Hillman, Robert S. A1 Ault, Kenneth A. A1 Leporrier, Michel A1 Rinder, Henry M. SR Print(0) ID 1127767923 T1 PLASMA CELL DISORDERS T2 Hematology in Clinical Practice, 5e YR 2016 FD 2016 PB McGraw-Hill Medical PP New York, NY SN 9780071626996 LK accessbiomedicalscience.mhmedical.com/content.aspx?aid=1127767923 RD 2024/03/28 AB CASE HISTORY • Part 1A 65-year-old man presents with a 1-month history of lower back pain, which began after he strained his back stacking fire wood. Despite rest and aspirin therapy it has not improved. He has not had similar back pain in the past and has been in good health. There are no neurological signs or symptoms on examination and he has no other complaints except possibly increased fatigability, which he attributed to his age. The remainder of his examination is normal with the exception of some conjunctival pallor.CBC: Hematocrit/hemoglobin - 31%/10.1 gm/dLMCV - 90 fL MCH - 32 pg MCHC - 31 g/dLWBC - 8,500/μLDifferential - normalPlatelet count - 230,000/μLSMEAR MORPHOLOGYNormochromic, normocytic red blood cells with prominent rouleaux formation (stacking) and a vague bluish background on the slide.QuestionsWhat feature(s) of this case might distinguish it from a routine lower back pain evaluation?What further evaluation is indicated?