WBR0475
| 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. |
| 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 |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |