A65-year-old woman presents with severe mid-back pain of 2 weeks duration. she has no history of trauma. radiographic evaluation reveals compression fractures of t11 and t12. a complete blood count, erythrocyte sedimentation rate, serum protein, serum calcium, phosphate, and parathyroid hormone levels are all within normal ranges. in addition to ordering a dual-energy x-ray absorptiometry (dexa) scan, which of the following laboratory evaluations is most in evaluating this patient for secondary causes of this presentation? (a) bone biopsy(b) rheumatoid factor(c) serum magnesium(d) 25-hydroxyvitamin d(e) antinuclear antibodies test

25-hydroxyvitamin D

Explanation:

The patient has typical findings associated with the osteoporosis. Most of the patients who has osteoporosis are asymptomatic until fractures present.

Fractures occur spontaneously and are usually associated with back pain of varied degree.

The levels of parathyroid hormone, serum calcium and phosphate is normal. As vitamin D deficiency is common in osteoporosis,  25-hydroxyvitamin D  should be ordered.

i need the a b or c but mental disorders include repetitiveness,unable to listen, wanting to kill people, thinking that you are perfect, sexuality toward the wrong age types younger than you like a child bad reputations cutting yourself abuse! these are sad but these are true! the titles for some of these are ptsd and adhd. you need to go to jail or get an expert counselor if you face any of these problems or if you have indeed been involved!

b and c would be the answers