A 45-year-old woman is examined two weeks after breaking her left radius in a fall from standing height. She had passed a renal stone two months prior. There is no history of osteoporosis or hypercalcemia in the family. The physical exam is unremarkable. The following are the serum laboratory results: 11ec160b 3abb 7e90 9249 2faf1d8276f1 MD0001 00 The use of dual-energy x-ray absorptiometry to measure bone density reveals osteoporosis. Which of the following is the major contributor to bone loss in this patient?

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Eductional Objective: Thyroid hormone stimulates osteoblasts directly, resulting in increased bone formation. RANK-L expression on osteoblasts increases bone resorption via a paracrine effect on nearby osteoclasts. Hyperparathyroidism increases RANK-L expression while decreasing osteoprotegerin expression, resulting in net bone loss.

A 45-Year-Old Woman Is Examined Two Weeks After Breaking Her