A 60-Year-Old Man Comes to the Office for Follow-Up After

question 456

Multiple Choice

A 60-year-old man comes to the office for follow-up after a recent emergency department visit due to cough.  The patient was diagnosed with acute bronchitis and the symptoms resolved with symptomatic treatment.  A chest x-ray obtained during that visit revealed no lung abnormalities, but the bones appeared osteopenic.  The patient reports no bone pain and has had no fractures.  He has a history of prostate cancer treated with radiation therapy and is taking leuprolide.  The patient has no other medical problems and has no known drug allergies.  He drinks a glass of wine daily and does not use tobacco or illicit drugs.  He eats a balanced diet and exercises regularly.  Blood pressure is 120/80 mm Hg and pulse is 80/min.  Physical examination shows no abnormalities.  A dual-energy x-ray absorptiometry (DXA) scan shows low bone mineral density.  Which of the following is the most likely underlying mechanism of the observed finding in this patient?

• A)Decreased estrogen and testosterone levels
• B)Decreased intestinal calcium absorption
• C)Impaired 25-hydroxycholecalciferol activation
• D)Increased parathyroid hormone levels
• E)Paraneoplastic effects of the cancer cells

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Definitions:

Lecithin

A fatty substance found in plant and animal tissues, used as an emulsifier in food products and nutritional supplements.

Lecithin

A fatty substance found in plant and animal tissues, commonly used as an emulsifier in food products.

Societal-contractual System

A theoretical construct that signifies the system of implicit and explicit contracts that govern the conduct of members within a society.

Interpersonal Relationships

The connections and associations between two or more people, influenced by various factors including communication, social roles, and mutual interests.