Saw this on NBME 11

[Silverish]

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I took NBME 11 and I saw a question with this image with only a gamma spike. This picture is from multiple myeloma with an "M spike" with a lot of IgG, hence the gamma spike.

I get that much.

But what are the alphas and beta here? I'm not sure if they are heme subunits or what?! Haha any insight would be appreciated.

 

[Silverish]

And heck, Waldenstrom's also has "M spike"... But with IgM. Where's the mu spike?!

 

[dfib slim]

Google SPEP

 

[Silverish]

Got it! Much appreciated!
I was obviously never taught this.

 

[allojay]

Hi there, can anyone who has taken the boards or in the process of prepping for it, give an idea of the difficulty of nbme 11 compared to the other ones and the real thing?