WBR0475

Author	[[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pathology
Sub Category	SubCategory::Musculoskeletal/Rheumatology
Prompt	[[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?]]
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 of the bone is associated with increased risk of high output heart failure due to arteriovenous shunts. Educational Objective: References: ]]
Approved	Approved::No
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
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::