A client presents with bone pain, joint stiffness, and an enlarged skull. Which diagnostic test is most likely to confirm the diagnosis of Paget's disease?
Complete blood count (CBC)
Bone scan
Liver function tests (LFTs)
Magnetic resonance imaging (MRI)
The Correct Answer is B
A bone scan is the most appropriate diagnostic test for confirming the diagnosis of Paget's disease. It can reveal increased bone turnover and abnormal bone remodeling patterns characteristic of the condition. The bone scan can show "hot spots" of increased uptake in affected bones.
a. Complete blood count (CBC): While a CBC can be useful in ruling out other conditions, it does not directly diagnose Paget's disease. Specific bone imaging is required for confirmation.
c. Liver function tests (LFTs): Liver function tests are not used to diagnose Paget's disease. The condition primarily affects bone structures, and liver involvement is not a primary concern.
d. Magnetic resonance imaging (MRI): While an MRI can provide detailed images of bones and soft tissues, it may not be the initial choice for diagnosing Paget's disease. A bone scan is more specific to evaluate bone turnover and remodeling.
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Related Questions
Correct Answer is C
Explanation
Bisphosphonates are commonly used as the first-line treatment for Paget's disease. They work by slowing down bone resorption and promoting more balanced bone remodeling, helping to control the excessive bone turnover characteristic of the condition.
a. Calcium supplements: While calcium supplements are essential for overall bone health, they are not the first-line treatment for Paget's disease. Bisphosphonates specifically target the abnormal bone remodeling associated with the condition.
b. Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs may help manage pain and inflammation associated with Paget's disease, but they do not directly address the underlying bone remodeling abnormalities. Bisphosphonates are more effective in treating the condition.
d. Vitamin D supplements: Vitamin D is necessary for calcium absorption and bone health, but it is not the primary treatment for Paget's disease. Bisphosphonates are the mainstay of therapy.
Correct Answer is B
Explanation
The underlying pathophysiology of Paget's disease involves increased bone turnover and disordered bone remodeling. Osteoclasts, the bone-resorbing cells, become overactive, leading to excessive bone resorption. Osteoblasts, the bone-forming cells, attempt to repair the resorbed bone, but their activity is disordered, resulting in the formation of structurally abnormal bone.
a. Decreased bone density due to calcium deficiency: This is the pathophysiology of osteoporosis, not Paget's disease. In Paget's disease, bone density can be normal or increased due to the disordered bone remodeling.
c. Excessive collagen production leading to bone deformities: Excessive collagen production is not a characteristic feature of Paget's disease. The condition primarily involves abnormal bone remodeling by osteoclasts and osteoblasts.
d. Autoimmune attack on osteoblasts causing bone destruction: Paget's disease is not an autoimmune disorder. The disease is characterized by increased bone resorption and disordered bone formation, not an immune-mediated attack on osteoblasts.
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