UKMLA PLAB AMC USMLE Prometric MCQ

Question Number 0644

Question:
An 81yr old man is admitted to A&E after falling in the garden of the residential care home. He has sustained a fractured neck of femur. He has also lost about 8Kg in weight. On examination he looks cachectic and his conjunctivae are pale. He complains of worsening pain over the back. Calcium: 3.14 mmol/l; PO43-: 1.3 mmol/l; ALP: 253 iu/L; Urea: 18.2 mmol/l; Creatinine: 294µmol/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