What is the typical pattern of bone involvement in Paget's disease?
Uniform increase in bone density throughout the skeleton.
Focal areas of bone demineralization scattered throughout the skeleton.
Diffuse increase in bone density with areas of focal bone loss.
Patchy areas of increased bone density and disorganized bone formation.
The Correct Answer is D
The typical pattern of bone involvement in Paget's disease is characterized by patchy areas of increased bone density (osteosclerosis) and disorganized bone formation. These areas of abnormal bone remodeling result in structurally weak and misshapen bones.
a. Uniform increase in bone density throughout the skeleton: This pattern of bone density is not characteristic of Paget's disease. The condition involves localized areas of increased density rather than uniform changes.
b. Focal areas of bone demineralization scattered throughout the skeleton: This pattern of bone demineralization is more characteristic of osteoporosis, not Paget's disease.
c. Diffuse increase in bone density with areas of focal bone loss: This pattern is not typical of Paget's disease. The condition primarily involves areas of increased bone density and disordered bone remodeling.
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Correct Answer is B
Explanation
A. Encouraging high-impact exercises to strengthen bones:
High-impact exercises are contraindicated in patients with Paget's disease due to the risk of fractures and bone injury. Low-impact and weight-bearing exercises are safer to maintain bone health and improve mobility.
B. Monitoring serum calcium levels regularly: Paget's disease often requires treatment with bisphosphonates or calcitonin to regulate bone remodeling. These treatments can affect calcium levels, potentially leading to hypocalcemia. Regular monitoring is crucial to detect and manage these imbalances.
C. Assisting with range-of-motion exercises to maintain joint mobility: While maintaining joint mobility is important, this is not the priority intervention. ROM exercises can be part of the overall care plan but do not address the critical metabolic imbalances associated with Paget's disease.
D. Administering corticosteroids to reduce inflammation: Corticosteroids are not a standard treatment for Paget's disease. Instead, the focus is on medications like bisphosphonates or calcitonin to regulate bone turnover.
Correct Answer is B
Explanation
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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