A.W., a 50-year-old woman with a six-month history of frequent nosebleeds, was diagnosed with multiple myeloma. Before A.W. could meet with an oncologist, she presented to the emergency room with an uncontrollable nosebleed and spontaneous bleeding in her gums. Her menstrual period, which usually occurs over five or six days, lasted 10 with unusually heavy flow. A.W. also reported prolonged bleeding from cuts but had not noticed petechiae or unusual bruising. She was not taking anticoagulants, such as aspirin or other nonsteroidal anti-inflammatory medications. She felt fatigued and noticed that her blurry vision was getting worse. A.W.'s husband characterized her short-term ...

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