Abnormal rapid bone turnover and resorption is seen in :

Appeared in: IGNOU PB Bsc Nsg.Entrance-2026

Explanation

Paget's disease is a chronic skeletal disorder defined by focal areas of excessive and disorganized bone remodeling.
The primary abnormality is a significant increase in osteoclastic bone resorption (breakdown), which is followed by a compensatory but chaotic increase in bone formation.
This process results in new bone that is structurally weak, enlarged, and prone to deformities and pathological fractures.

Option A: Spondylitis is characterized by inflammation of the vertebrae and sacroiliac joints, not by a primary defect in bone turnover.
Option B: Osteoarthritis is a degenerative disease involving the breakdown of articular cartilage in joints. Bone changes, like osteophytes, are secondary to cartilage loss.
Option C: Rheumatoid arthritis is a systemic autoimmune disease where the immune system attacks the synovial lining of joints, causing inflammation and joint destruction.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of bone remodeling disorders as background academic context rather than a clinical decision trigger.
Nurses must monitor patients with Paget's disease for signs of complications like pathological fractures, bone pain, hearing loss (if the skull is involved), and neurological deficits from nerve compression.
Patient education is a key nursing role, focusing on safety measures to prevent falls and the importance of adhering to treatment with bisphosphonates to slow disease progression and manage symptoms.
What if? If a patient with Paget's disease reports a sudden increase in pain and swelling over an affected bone, the nurse must consider the possibility of a pathological fracture or, rarely, a malignant transformation to osteosarcoma, and facilitate urgent medical evaluation.

How to Approach the Question

First, identify the key phrase in the question stem: 'abnormal rapid bone turnover and resorption'. This points to a disorder of the bone remodeling cycle itself.
Next, analyze the primary pathophysiology of each option.
Recall or deduce that Spondylitis and Rheumatoid Arthritis are primarily inflammatory diseases, and Osteoarthritis is a degenerative cartilage disease.
Recognize that Paget's disease is the classic example of a disorder characterized by accelerated and chaotic bone remodeling (both resorption and formation).
By matching the key phrase from the stem to the defining characteristic of the diseases, you can identify Paget's disease as the correct answer.

Concept Tested & Keywords

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E6 Medicine Davidson Principles Practice 24e pp. 1073-1075, 1008-1010

E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 2 — Subpart A (pp 1-239 of 478) p. 167-169

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