<prompt> Increased alkaline phosphatase is seen in ?OsteoporosisMultiple myelomaPagets diseaseOsteolytic metastasis  <response>: Ans. is c i.e., Pagets disease Whenever the activity of osteoblasts increase, serum alkaline phosphatase is raised. Therefore, serum alkaline phosphatase acts as an index of osteoblastic activity. The conditions in which osteoblastic activity is increased and hence the alkaline phosphatase in increased are : - Ricketsosteomalacia Primary hyperparathyroidism Renal osteodystrophy secondary hyperparathyroidism Chronic renal failure and secondary hyperparathyroidism Pagets disease osteitis deformans Osteoblastic secondaries 