A 58-year-old man comes to the physician because of headaches and back pain for 5 months. He also noted that his favorite hat no longer fits him. He has hypertension, hypothyroidism, and benign prostate hyperplasia. His father had prostate cancer and osteoporosis. Current medications include calcium supplementation, metoprolol, and L-thyroxine. He does not smoke or drink alcohol. Vital signs are within normal limits. On examination, there is enlargement of the anterior head. An x-ray of the skull shows a thickened calvaria and osteoblastic and osteolytic lesions. Which of the following patterns of serum laboratory values is most likely in this patient?

Question

A 58-year-old man comes to the physician because of headaches and back pain for 5 months. He also noted that his favorite hat no longer fits him. He has hypertension, hypothyroidism, and benign prostate hyperplasia. His father had prostate cancer and osteoporosis. Current medications include calcium supplementation, metoprolol, and L-thyroxine. He does not smoke or drink alcohol. Vital signs are within normal limits. On examination, there is enlargement of the anterior head. An x-ray of the skull shows a thickened calvaria and osteoblastic and osteolytic lesions.   Which of the following patterns of serum laboratory values is most likely in this patient?

Quizplus · Accepted Answer

Eductional Objective: Paget disease of bone is characterized by disordered bone formation.  Involvement of long bones can lead to bone pain, bowing, fracture, or arthritis of adjacent joints.  Serum alkaline phosphatase is elevated due to increased production of new bone, but calcium and phosphorus levels remain normal.

A 58-Year-Old Man Comes to the Physician Because of Headaches