#august2020mccqe1
A 72-year-old man with end-stage renal disease secondary to hypertension presents with several months of back pain. He denies fever, weight loss, difficulty walking, altered sensation in his legs, or incontinence. He was diagnosed with renal disease 20 years ago and was managed medically for many years. However, 2 years ago he began hemodialysis because of a progressive decline in renal function. There is no family history of renal disease or malignancy. Physical examination is unremarkable. X-ray of the chest shows ill-defined bands of increased bone density adjacent to the vertebral endplates. What laboratory abnormalities is most likely in this patient?
(A) Bence-Jones protein in urine
(B) Decreased parathyroid hormone
(C) Decreased phosphate
(D) Elevated bone-specific alkaline phosphatase
(E) Elevated parathyroid hormone
A 72-year-old man with end-stage renal disease secondary to hypertension presents with several months of back pain. He denies fever, weight loss, difficulty walking, altered sensation in his legs, or incontinence. He was diagnosed with renal disease 20 years ago and was managed medically for many years. However, 2 years ago he began hemodialysis because of a progressive decline in renal function. There is no family history of renal disease or malignancy. Physical examination is unremarkable. X-ray of the chest shows ill-defined bands of increased bone density adjacent to the vertebral endplates. What laboratory abnormalities is most likely in this patient?
(A) Bence-Jones protein in urine
(B) Decreased parathyroid hormone
(C) Decreased phosphate
(D) Elevated bone-specific alkaline phosphatase
(E) Elevated parathyroid hormone
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