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': "60 yrs old male with bony abnormality at upper tibia associated with sensorineural hearing loss. On laboratory examination serum alkaline phosphatase levels are (440mU/I) elevated and serum Ca ++ and PO4- are normal, Skeletal survey shows ivory vertebrae and cotton wool spots in x-ray skull.Diagnosis is - \nSelect and explain. \nA. Fibrous dysplasia, B. Paget's disease, C. Osteosclerotic metastasis, D. Osteoporosis", 'role': 'user'}, {'content': "Answer: B \nExplanation: Increased serum alkaline phosphatase\nNormal calcium and phosphate\nBony lesions in skull and vertebrae\nSensorineural hearing loss\n\n\nAmongst the given option, these feature can occur only in Paget's disease.", 'role': 'assistant'}]