7. Path of Bone & Joints-2

Question 1

A 62 year old man from York England goes to his doctor with complaints of pain and that his hats done fit any more. X-rays is done showing a large and deformed left tibia with noted hypervasculatiry. Labs are done notable with excessive ALK phosphatase. What would best categories the stage of the mans condition?

A. Ostolytic 
B.  Osteolytic-Osteoblastic 
C. Osteoblastic-Osteoscleoric 
D. Osteoscleoric 
E. Osteoid 

RFA

Answer 1

Ans. D. Osteoscleoric- The man has Paget’s disease( hat don’t fit, Pain, ALK phosphatase, isolated to one bone) 3rd stage bone formation dominated by hypervascularity.

A. Ostolytic-this is the first 1st stage of Paget’s ( noted for break down and bizarre bone shape)

B. Osteolytic-Osteoblastic- 2nd stage of Paget’s( equal amount of break down and growth)

C. Osteoblastic-Osteosclerotic- isn’t a stage of Paget’s

E. Osteoid- Osteoid isn’t a stage of Paget’s rather it is what builds up in patients with Ricket’s and Osteomalacia

Question 2

A 1 year old boy in South Sudan is brought to a red cross hospital. On physical examination he is notable for bowed legs and a “rosary appearance” along his ribs. When talking to his mother she tell you that their diet is mostly of white rice. What would you except the lab finding in the child to reflect?.

A. Low Ca, Low Vit. D, Low PTH, High P
B. High Ca, Low Vit. D, High PTH, Normal P
C. High Ca, Normal Vit. D, High PTH, Normal P
D. Low Ca, Low Vit. D, High PTH, Low P
E. Normal Ca, Normal Vit. D, Normal PTH, Normal P

RFA

Answer 2

Ans. D- The description of the child fits rickets which would have ( Low Ca, Low Vit. D, High PTH, Low P )

A. Makes no sense

B.Makes no sense

C. Would be Osteitis Fibrosa Cystica, Parathyroid adenoma

E. Would be labs of -Osteoporosis, Osteopetroris, Paget’s, Bone tumors