<prompt> Which among the following doesnt cause an elevated serum alkaline phosphatase?Pagets diseaseMultiple myelomaOstiomalaciaHypehyroidsm  <response>: Serum ALP is normal in multiple myeloma. Its an impoant point. The most common cause of hypercalcemia in patients with hypercalcemia, decreased GFR, and anemia is multiple myeloma. Alkaline phosphatase is generally normal because there is only a limited osteoblastic response to myelomatous infiltrate in the marrow Calcium is elevated. Phosphate is elevated Alkaline phosphatase is normal PTH is suppressed PTHrP is normal or low Serum protein immunoelectrophoresis is abnormal 