UKMLA PLAB AMC USMLE Prometric MCQ

Question Number 0645

Question:
A 63yr old lady complains of generalized bony pains and muscle stiffness, worse in her legs. She complains of difficulty getting out of chairs and climbing stairs. She suffers from long-standing epilepsy for which she takes phenytoin. Calcium: 2.04 mmol/l; PO43-: 0.65 mmol/l; ALP: 420 iu/L. Serum 25(OH) D: 18 nmol/l. Normal values for Calcium: 2.12-2.65mmol/l; Phosphate: 0.8-1.45mmol/l; ALP [Alkaline phosphatase] 30-300iu/L; Serum 25(OH) D: 20-105nmol/l; Urea: 2.5-6.7mmol/l; Creatinine: 70-120µmol/l

a) Osteomalacia
b) Multiple myeloma
c) Paget's disease of bone
d) Sarcoidosis
e) Hyperthyroidism