Professional and Linguistic Assessments Board (PLAB) Practice Exam

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Which condition is associated with high levels of alkaline phosphatase and normal serum calcium and phosphate?

Osteoporosis
Paget's disease
Osteomalacia
Rickets

The correct answer is: Paget's disease

The condition associated with high levels of alkaline phosphatase along with normal serum calcium and phosphate is Paget's disease. This disease is characterized by abnormal bone remodeling, leading to the overproduction of bone tissue. This process increases the activity of osteoblasts, which are the cells responsible for bone formation. As a result, elevated levels of alkaline phosphatase, an enzyme associated with bone turnover, are commonly observed in patients with Paget's disease. In contrast, conditions such as osteomalacia and rickets involve low mineralization of bone due to deficiencies in calcium or phosphate, which would typically be reflected in altered serum calcium and phosphates, leading to an increased alkaline phosphatase level. Osteoporosis does not generally cause a significant increase in alkaline phosphatase levels, as it is primarily a decrease in bone density rather than a disorder characterized by abnormal bone formation. Therefore, Paget's disease is the key condition where you would see this specific combination of high alkaline phosphatase with normal calcium and phosphate levels.