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A 75-Year-Old Man Comes to the Office for a Routine

question 1309

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A 75-year-old man comes to the office for a routine preventive examination.  He has no ongoing symptoms.  The patient's medical history is significant for osteoarthritis, hypertension, and hyperlipidemia.  Current medications include hydrochlorothiazide and atorvastatin.  He does not smoke and consumes 1 or 2 beers on weekends.  The patient walks 2 miles every morning and eats a balanced diet.  Vital signs are within normal limits.  His cardiopulmonary examination is normal, and his abdomen is soft and nontender.  Rectal examination shows a diffusely enlarged prostate without nodules.  The distal interphalangeal joints are enlarged, and his gait is normal.  Laboratory results are as follows: A 75-year-old man comes to the office for a routine preventive examination.  He has no ongoing symptoms.  The patient's medical history is significant for osteoarthritis, hypertension, and hyperlipidemia.  Current medications include hydrochlorothiazide and atorvastatin.  He does not smoke and consumes 1 or 2 beers on weekends.  The patient walks 2 miles every morning and eats a balanced diet.  Vital signs are within normal limits.  His cardiopulmonary examination is normal, and his abdomen is soft and nontender.  Rectal examination shows a diffusely enlarged prostate without nodules.  The distal interphalangeal joints are enlarged, and his gait is normal.  Laboratory results are as follows:   Which of the following is the most likely cause of the elevated alkaline phosphatase in this patient? A) Adverse effect of medication B) Alcohol use C) Metastatic bone disease D) Paget disease of bone E) Plasma cell neoplasia Which of the following is the most likely cause of the elevated alkaline phosphatase in this patient?


Definitions:

FTC

The Federal Trade Commission, a U.S. government agency focused on consumer protection and maintaining competition.

Estate Settlement

The process of managing and distributing a deceased person's assets according to their will or state laws if there is no will.

Real Estate Brokers

Licensed professionals who arrange real estate transactions, putting buyers and sellers together and acting as their representatives in negotiations.

Phonebook

A printed listing of individuals' and organizations' telephone numbers, addresses, and sometimes additional information, grouped geographically.

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