<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 76-year-old woman presents to the office with a generalized weakness for the past month. She has a past medical history significant for uncontrolled hypertension and type 2 diabetes mellitus. Her temperature is 37.0C 98.6F, blood pressure is 13582 mm Hg, pulse is 90min, respiratory rate is 17min, and oxygen saturation is 99 on room air. Physical exam shows no remarkable findings. Her last recorded glomerular filtration rate was 30 mLmin. A radiograph of the patients hand is given. Which of the following lab findings is most likely to be found in this patient?? A: Increased PTH, decreased calcium, increased phosphate, B: Increased PTH, decreased calcium, decreased phosphate, C: Increased PTH, increased calcium, decreased phosphate, D: Increased PTH, increased calcium, increased phosphate, E: Normal PTH, increased calcium, normal phosphate,  <response>: Based on the information provided in the question stem, this patient is an elderly woman with a history of uncontrolled hypertension, type 2 diabetes mellitus, and chronic kidney disease stage 3 GFR 30 mLmin. The radiograph shows subperiosteal bone resorption along the radial aspect of the middle phalanges bilaterally, consistent with renal osteodystrophy. In chronic kidney disease, decreased GFR leads to impaired phosphate excretion, resulting in hyperphosphatemia. This causes secondary hyperparathyroidism with increased PTH levels to compensate for the hypocalcemia caused by hyperphosphatemia. Therefore, the lab findings most likely in this patient are increased PTH, decreased calcium, and increased phosphate.A: Increased PTH, decreased calcium, increased phosphate 