Final answer:
An older adult with back pain and elevated total protein levels should be evaluated for multiple myeloma, a type of blood cancer characterized by the excessive division of plasma cells and abnormal protein production.
Step-by-step explanation:
If an older adult presents with back pain and an elevated total protein level, they should be evaluated for multiple myeloma. This condition is a type of blood cancer that arises from plasma cells in the bone marrow. Elevated protein levels, particularly when related to the abnormal Bence Jones proteins, suggest the excessive division of lymphocytes producing immunoglobulins, which is characteristic of multiple myeloma. Symptoms such as back pain can be related to bone damage or lesions caused by the disease, while elevated protein levels could indicate an increased production of monoclonal proteins or light chains (such as in Bence Jones proteinuria), common in multiple myeloma. Additionally, multiple myeloma can lead to kidney issues like cast nephropathy or hypercalcemia, which may tie in with the symptoms of back pain if there is kidney damage or dysfunction.