AFP: American Family Physician Podcast Episode 250 | March 2026 | Part 2 American Family Physician
Mar 30, 2026
A rapid tour of a new menstrual A1C testing kit and its potential access benefits. Clear breakdowns of diagnosing, staging, and supportive care strategies for multiple myeloma. Evidence on whether SGLT2 drugs raise genital and urinary infection risk. Practical croup recognition and treatment tips for children. A concise review of sustained-release naltrexone data and a flu risk tool to guide testing decisions.
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Multiple Myeloma May Be Asymptomatic Initially
- Multiple myeloma is a plasma cell malignancy often producing monoclonal proteins with classic CRAB features but one-third of patients may be asymptomatic at diagnosis.
- Common presentations include bone pain (58%) and fatigue (32%), so maintain suspicion with abnormal labs or imaging.
Initial Diagnostic Workup For Suspected Myeloma
- When suspecting myeloma, order CBC with smear, CMP, TSH, urinalysis, and serum/urine protein electrophoresis with immunofixation, plus plain radiographs of symptomatic bones.
- If abnormal, refer to oncology for beta-2 microglobulin, LDH, free light chains, bone marrow biopsy, and advanced imaging.
Treatment Pathway And Supportive Care In Myeloma
- For transplant-eligible patients start a four-drug induction regimen for 3–6 months, proceed to autologous stem cell transplant, then long-term maintenance therapy.
- Always screen for HIV and viral hepatitis and give bone-targeting therapy (zoledronic acid or denosumab) for at least two years.