<prompt> A patient presents with decreased calcium, decreased phosphate and increased alkaline phosphatase. Diagnosis is -HyperparathyroidismVitamin D deficiencyOsteoporosisChronic renal failure  <response>: Ans. is b i.e., Vitamin D deficiency Changes in vitamin D deficiency Osteomalacia or Ricketso Serum Ca-Normal to decreaseo Serum P04-Decreasedo Alkaline phosphatase -Increasedo PTH -Nincrease Serum CaSerum phosohorusAlkaline PhosphatasePTHPrimary Hyperparathy roiriismIncreaseDecreaseIncreaseIncreaseSecondary hyper parathyroidismDecrease or NIncreaseIncreaseIncreaseOsteoporosisNNNPagets diseaseNNIncreaseNOsteomalacia Vitamin D deficiencyDecreaseIncrease decreaseIncreaseNIncrease 