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

question 1309

Multiple Choice

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

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Definitions:

Classical Conditioning

A learning process that involves creating associations between a naturally occurring stimulus and a previously neutral stimulus.

Latency Stage

A phase in Freudian psychosexual development occurring from around age 6 to puberty, characterized by a decreased focus on sexual drives and increased focus on external interests and activities.

Psychoanalysts

Professionals who practice psychoanalysis, a therapeutic approach developed by Freud, focusing on exploring unconscious motives and conflicts.

Toilet Training

is the process of teaching a young child to use the toilet for urination and defecation independently.