input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 55-year-old male presents with renal failure. He gives a history of mild bone pains for the last 7 years. X-ray pelvis shows osteolytic lesions. Serum electrophoresis reveals a M spike. Peripheral blood evaluation showed rouleaux formation of RBCs with 35% plasma cells. Bone marrow examination showed a increase in plasma cells with aberrant antigen expression. The most likely diagnosis is:   (A) Multiple myeloma   (B) Monoclonal gammopathy with unknown significance   (C) Smouldering myeloma   (D) Plasma cell leukemia
output: ['(A) Multiple myeloma <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Multiple myeloma  (B) Monoclonal gammopathy with unknown significance  (C) Smouldering myeloma  (D) Plasma cell leukemia <> possible answers', '  A 55-year-old male presents with renal failure. He gives a history of mild bone pains for the last 7 years. X-ray pelvis shows osteolytic lesions. Serum electrophoresis reveals a M spike. Peripheral blood evaluation showed rouleaux formation of RBCs with 35% plasma cells. Bone marrow examination showed a increase in plasma cells with aberrant antigen expression. The most likely diagnosis is: <> context']