[Question #2]
A 4yr old boy is brought to a clinic by her foster parents beacause of a limp in her left leg and a serum Alk phosphatase 10 times the adult upper limit of normal for the test. the child is withdrawn and clinging to her foster mother. Physical examination is remarkable for a bluish green discoloration of the skin overlying a tender 3 cm mass on the ant portion of the left mid thigh. An x ray of the left thigh reveals a dense mass that extends into surrounding tissue. Which of the following best decribes the increased ALP in this case?
A. ALP is abnormal for her age and is unrelated to her bone lesion
B. ALP is abnormal for her age and the bone lesion represents an area of aseptic necrosis
C. ALP is abnormal for her age and the bone lesion represents an area of femoral fracture
D. ALP is normal for her age and the bone lesion represents an area of osteogeinc sarcoma
E. ALP is normal for her age an represnts an are of Ewings sarcoma
F. ALP is normal for her age and unrelated to her bone lesion |