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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor={{YD}} (Reviewed by {{YD}})
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Pathology
|MainCategory=Pathology
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|MainCategory=Pathology
|MainCategory=Pathology
|SubCategory=Musculoskeletal/Rheumatology
|SubCategory=Musculoskeletal/Rheumatology
|Prompt=A 74 year old female patient presents to the physician's clinic for bone pain and hearing loss. After appropriate work-up, the diagnosis of Paget's disease of the bone is made. Which of the following is most likely to be additionally present in this patient's work-up?
|Prompt=A 74-year-old woman presents to the physician's office for bone pain and hearing loss. Following appropriate work-up, the physician explains that the patient's condition is caused by bone remodeling due to a simultaneous increase in osteoclastic and osteoblastic activities. Which of the following is most likely associated with the patient's condition?
|Explanation=Paget's disease of the bone (osteitis deformans) is characterized by abnormal bone architecture due to increased bone cellular activity.  Paget's disease is associated with increased risk of arteriovenous shunts that cause high-output heart failure.  Paget's disease is also associated with osteogenic sarcoma (osteosarcoma), a bone tumor of the young of poor prognosis that usually affects the metaphysis of long bones.
|Explanation=Paget's disease of the bone (osteitis deformans) is characterized by abnormal bone architecture due to increased bone cellular activity.  Paget's disease is associated with increased risk of arteriovenous shunts that cause high-output heart failure.  Paget's disease is also associated with osteogenic sarcoma (osteosarcoma), a bone tumor of the young of poor prognosis that usually affects the metaphysis of long bones.
|AnswerA=Heart failure
|AnswerA=Heart failure
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|AnswerE=Osteopetrosis
|AnswerE=Osteopetrosis
|AnswerEExp=Osteopetrosis is not classically associated with Paget's disease of the bone.
|AnswerEExp=Osteopetrosis is not classically associated with Paget's disease of the bone.
|EducationalObjectives=Paget's disease of the bone is associated with increased risk of high output heart failure due to arteriovenous shunts.
|EducationalObjectives=Paget's disease is caused by a simultaneous increase in osteoclastic and osteoblastic activities that result in bone remodeling and a mosaic bone pattern. Paget's disease of the bone is associated with increased risk of high output heart failure due to arteriovenous shunts.
|References=First Aid 2014 page 420
|References=First Aid 2014 page 420
|RightAnswer=A
|RightAnswer=A

Revision as of 16:02, 29 October 2014

 
Author [[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D.)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Pathology
Sub Category SubCategory::Musculoskeletal/Rheumatology
Prompt [[Prompt::A 74-year-old woman presents to the physician's office for bone pain and hearing loss. Following appropriate work-up, the physician explains that the patient's condition is caused by bone remodeling due to a simultaneous increase in osteoclastic and osteoblastic activities. Which of the following is most likely associated with the patient's condition?]]
Answer A AnswerA::Heart failure
Answer A Explanation AnswerAExp::High-output heart failure is associated with Paget's disease of the bone due to increased rate of arteriovenous shunts.
Answer B AnswerB::Hepatic failure
Answer B Explanation AnswerBExp::Hepatic failure is not classically associated with Paget's disease of the bone.
Answer C AnswerC::Renal failure
Answer C Explanation AnswerCExp::Renal failure is not classically associated with Paget's disease of the bone.
Answer D AnswerD::Rheumatoid arthritis
Answer D Explanation AnswerDExp::Rheumatoid arthritis (RA) is not classically associated with Paget's disease of the bone.
Answer E AnswerE::Osteopetrosis
Answer E Explanation AnswerEExp::Osteopetrosis is not classically associated with Paget's disease of the bone.
Right Answer RightAnswer::A
Explanation [[Explanation::Paget's disease of the bone (osteitis deformans) is characterized by abnormal bone architecture due to increased bone cellular activity. Paget's disease is associated with increased risk of arteriovenous shunts that cause high-output heart failure. Paget's disease is also associated with osteogenic sarcoma (osteosarcoma), a bone tumor of the young of poor prognosis that usually affects the metaphysis of long bones.

Educational Objective: Paget's disease is caused by a simultaneous increase in osteoclastic and osteoblastic activities that result in bone remodeling and a mosaic bone pattern. Paget's disease of the bone is associated with increased risk of high output heart failure due to arteriovenous shunts.
References: First Aid 2014 page 420]]

Approved Approved::Yes
Keyword WBRKeyword::Paget's, WBRKeyword::disease, WBRKeyword::Paget, WBRKeyword::bone, WBRKeyword::Paget disease of the bone, WBRKeyword::osteitis, WBRKeyword::deformans, WBRKeyword::osteitis deformans, WBRKeyword::high, WBRKeyword::output, WBRKeyword::heart, WBRKeyword::failure, WBRKeyword::high output, WBRKeyword::heart failure, WBRKeyword::high output heart failure, WBRKeyword::arteriovenous, WBRKeyword::shunt, WBRKeyword::arteriovenous shunt, WBRKeyword::osteogenic sarcoma, WBRKeyword::osteosarcoma
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