PLE-5532

PLE-5532

A 50-year-old postmenopausal female patient, presenting with a history of vertebral compression fractures and a hip fracture, was worked up due to repeated complaints of leg and extremity pains. She was noted to have had 4 episodes of flu over the past 2 months. Workups revealed mild anemia, slightly elevated serum calcium, and multiple lytic bone lesions were noted over the ribs. Some punched out defects were seen in the skull x-rays. Which of the following conditions does this patient most likely have?