question: Q:A 71-year-old African American man with a history of prostatic adenocarcinoma presents to his oncologist with low back pain. He was diagnosed with non-resectable prostatic adenocarcinoma 4 years ago. He has undergone radiation therapy and chemotherapy. Over the past 3 months, he has developed constant mild non-radiating low back pain that occasionally wakes him up from sleep. He denies any recent falls or trauma. His past medical history is notable for hypertension, diabetes mellitus, coronary artery disease, and gout. He also has a history of thyroid cancer and underwent thyroidectomy 5 years ago. He takes lisinopril, metoprolol, aspirin, metformin, and allopurinol. He has a 40-pack-year smoking history and drinks alcohol socially. His temperature is 99.2°F (37.3°C), blood pressure is 150/85 mmHg, pulse is 84/min, and respirations are 18/min. On exam, he is well-appearing and in no acute distress. He is mildly tender to palpation along the lumbar vertebral spinous processes. A computerized tomography (CT) scan of the lumbar spine demonstrates a blastic and sclerotic lesion in the L5 vertebral body. Which of the following findings would most likely be seen on a serum study of this patient?? 
  {'A': 'Decreased calcium, decreased phosphate, increased alkaline phosphatase, and increased parathyroid hormone', 'B': 'Decreased calcium, increased phosphate, increased alkaline phosphatase, and increased parathyroid hormone', 'C': 'Increased calcium, decreased phosphate, increased alkaline phosphatase, and increased parathyroid hormone', 'D': 'Normal calcium, normal phosphate, increased alkaline phosphatase, and normal parathyroid hormone', 'E': 'Normal calcium, normal phosphate, normal alkaline phosphatase, and normal parathyroid hormone'},