HY USMLE Q #976 – Endocrine

A 64-year-old woman is evaluated in hospital. Her serum alkaline phosphatase (ALP) and parathyroid hormone (PTH) are shown on the nomogram. Which of the following is the most likely explanation for these findings?

  Adenoma
  Increased bone turnover
  Increased RANK-L activity
  Increased unmineralized osteoid
  Renal insufficiency