An 82-year-old woman comes to the physician for a follow-up appointment. She had nephrolithiasis 10 years ago that self-resolved with increased oral intake and fluids. Vitals are normal. Laboratory studies show a calcium of 9.0 mg/dL and phosphate of 3.4 mEq/L. An illustration of the patient’s vertebral column is shown. Which of the following is most directly responsible for this patient’s condition?
Binding of peptide hormone to osteoblastic receptor
Binding of peptide hormone to osteoclastic receptor
Binding of steroid hormone to osteoblastic receptor
Binding of steroid hormone to osteoclastic receptor
IL-1
TNF-alpha
