Parathyroid disorders and calcium imbalance Quiz: Ace Your Exams

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A 48-year-old female comes to her primary care physician for evaluation of fatigue and “diffuse pain in the bones.” Her symptoms started three months ago and have progressively worsened. Past medical history is notable for asthma and two kidney stones over the past three years, both of which passed spontaneously. She is uses an albuterol inhaler. Family history is notable for rheumatoid arthritis in her mother. The patient's vitals are within normal limits. Physical exam reveals intact strength and sensation in all extremities. Laboratory testing is ordered, and the results are as follows:
 
 Laboratory value  Result 
 Serum sodium  140 mEq/L 
 Serum potassium  4.5 mEq/L 
 Serum calcium  11.8 mg/dL 
 Serum phosphorus  2.5 mg/dL 

 Which of the following changes in bone structure would most likely be observed in this patient?  

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