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Q. A 75 y/o man with history of Hypertension,

Pagets disease and peripheral vascular disease presents to you with complaints of chronic hearing impairment on right side. He is otherwise physically very active. Physical examination benign except for right sided sensorineural hearing deficit A skull x-ray was obtained to evaluate his paget’s disease.Lab studies reveal hemoglobin of 9.7, platelets 310, wbc 10k with normal differential, BUN 38, creatinine 1.4, calcium of 11.2. The patient is currently on alendronate for Pagets disease. Which of the lab measure or imaging would usually be expected to be abnormal in the condition that is responsible for his skull x-ray findings and hypercalcemia? image description

A. Alkaline phosphatase

B. Serum Immunoelectrophoresis

C. Bone Scan

D. Carcino Embryonic Antigen

E. CA-15-3

F. CA 19-9