This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Orthopaedics
[{'content': "A patient Shweta with raised serum alkaline phosphatase and raised parathormone level along with low calcium and low phosphate level is likely to have - \nSelect and explain. \nA. Primary hyperparathyroidism, B. Paget's disease, C. Osteoporosis, D. Vitamin D deficiency", 'role': 'user'}, {'content': "Answer: D \nExplanation: Vitamin D deficiency will have : -\n\nLow calcium\nLow phosphate\nHigh alkaline phosphatase\nHigh parathormone level (secondary hyperparathyroidism)\n\nAbout other options\n\nIn primary hyperparathyroidism : -\n\n\nHigh calcium\nLow phosphate\nHigh alkaline phosphatase\nHigh parathormone level\n\n\nIn osteoporosis all these parameters are normal.\nIn Paget's disease, calcium and phosphate levels are normal. Serum alkaline phosphatase is raised.", 'role': 'assistant'}]