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A 68-Year-Old Man Comes to the Office with a Deep

question 891

Multiple Choice

A 68-year-old man comes to the office with a deep headache throughout the day for the past 2 months. He works as a construction foreman and says his hard hat has felt unusually tight during that time, which he believes may be contributing to his symptoms. The patient has no associated muscle weakness, sensory changes, or eye symptoms. Laboratory studies show an elevated serum alkaline phosphatase level of 656 U/L. His other liver function tests are within normal limits, and serum calcium and phosphorus levels are normal. Erythrocyte sedimentation rate and serum prostate-specific antigen are also normal. CT scan of the head reveals no brain lesions, but the skull has thickened cortices with mixed lytic and osteoblastic lesions. Nuclear bone scan reveals increased uptake in the skull and tibia. In addition to optimization of vitamin D and calcium intake, which of the following is the most appropriate next step in management of this patient?

Definitions:

Anaerobic Exercise

High-intensity physical activity that does not rely on oxygen as the primary energy source and focuses on strengthening muscles.

Aerobic Exercise

Fitness activities that increase heart rate and lung capacity, leading to improved endurance and energy.

Oxygen Consumption

The rate at which oxygen is used by tissues or organs in the body, indicative of metabolic activity and energy expenditure.

Organic Fitness

A holistic approach to fitness that emphasizes natural methods of maintaining physical health, such as nutrition and active lifestyles, without depending heavily on artificial or mechanical means.