First-line laboratory finding in Paget's disease is an elevation of which enzyme?

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Prepare for the CMS II Rheumatology E1 Exam with our comprehensive quiz. Study using flashcards and multiple-choice questions, each with hints and explanations. Get ready for success!

Multiple Choice

First-line laboratory finding in Paget's disease is an elevation of which enzyme?

Explanation:
Paget's disease causes rapid, disorganized bone remodeling with markedly increased osteoblastic activity. Alkaline phosphatase is a marker of bone formation, so it rises when bone turnover is up. This makes elevated alkaline phosphatase the most consistent and early laboratory finding. Calcium and phosphate usually stay normal because systemic calcium balance is preserved, so you wouldn’t expect high calcium or low alkaline phosphatase in this setting. Low ALP would suggest reduced bone formation, which isn’t the process here.

Paget's disease causes rapid, disorganized bone remodeling with markedly increased osteoblastic activity. Alkaline phosphatase is a marker of bone formation, so it rises when bone turnover is up. This makes elevated alkaline phosphatase the most consistent and early laboratory finding. Calcium and phosphate usually stay normal because systemic calcium balance is preserved, so you wouldn’t expect high calcium or low alkaline phosphatase in this setting. Low ALP would suggest reduced bone formation, which isn’t the process here.

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