QuestionSBA
QuestionChoice
This answer is incorrect. Patients with primary hyperparathyroidism will have a raised PTH, high calcium and low phosphate. ALP may be normal or slightly elevated.
10007359
d
Primary hyperparathyroidism
QuestionChoice
This is the correct answer. Her presentation and abnormally high ALP with otherwise normal biochemistry is characteristic of Paget's disease. None of the other options would present with an ALP so markedly raised.
10007356
a
Paget's disease
QuestionChoice
This answer is incorrect. Patients with chronic renal failure will have low calcium and vitamin D with elevated phosphate and PTH. ALP may be normal or slightly elevated.
10007360
e
Chronic renal failure
QuestionChoice
This answer is incorrect. Patients with osteoporosis typically have normal bone biochemistry.
10007357
b
Osteoporosis
QuestionChoice
This answer is incorrect. Whilst patients with osteomalcia may have a high ALP, they typically have low calcium, phosphate and vitamin D and an elevated PTH.
10007358
c
Osteomalacia
Concept
Chapter
2693
4589
Paget's disease of the bone
Topic
228
Musculoskeletal Physiology
14018
An 82-year-old woman presents to her GP with pain in her right hip and thigh. She describes the pain as deep and boring in nature. Her examination is normal.


Bloods:


||||
|--------------|:-------:|---------------|
|Calcium|2.34 mmol/L|2.2 - 2.6|
|Phosphate|3.2 mmol/L|0.8 - 1.5|
|Parathyroid Hormone|1.9 pmol/L|1.6 - 8.5|
|Vitamin D|53 nmol/L|>50|
|Alkaline Phosphatase (ALP)|985 IU/L|25 - 115|

Which of the following conditions is she most likely to have?
a