Paget's disease is related to which?

NHM UP Staff Nurse - 2017

Pathology & Genetics

Easy

Appeared in: NHM UP Staff Nurse - 2017

Explanation

Paget's disease, also known as osteitis deformans, is a chronic metabolic disorder that directly affects the bone.
The core pathophysiology involves an accelerated and disorganized process of bone remodeling, where bone resorption (breakdown) and formation are excessive and uncoordinated.
This leads to the development of new bone that is structurally weak, enlarged, highly vascular, and prone to deformities and fractures.
While complications can affect other systems, the primary disease process is localized to the skeletal system.

Option B: Paget's disease is not a primary disease of the brain. However, if the skull bones are affected, the enlargement can compress cranial nerves or brain tissue, leading to neurological symptoms like headaches or hearing loss.
Option C: The heart is not the primary organ affected. In rare cases of severe, widespread Paget's disease, the increased vascularity of the affected bones can create an arteriovenous shunt effect, leading to high-output heart failure. This is a secondary complication, not the primary disease.
Option D: Paget's disease does not directly involve the lungs. The disease process is confined to the skeletal system.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology of Paget's disease helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must prioritize patient safety by implementing fall precautions, as the weakened, deformed bones in Paget's disease significantly increase the risk of pathological fractures, especially in weight-bearing bones like the femur and tibia.
Pain management is a key nursing intervention. This includes administering bisphosphonates (e.g., zoledronic acid) as prescribed to slow bone resorption and providing analgesics for bone pain.
Patient education should focus on maintaining adequate calcium and vitamin D intake to support bone health, especially when bisphosphonate therapy is initiated, to prevent hypocalcemia.

How to Approach the Question

First, identify the key term in the question stem: 'Paget's disease'.
This is a factual recall question that asks you to identify the body system primarily affected by this condition.
Recall the definition of Paget's disease. Its alternative name, osteitis deformans, provides a strong clue ('osteo-' refers to bone).
Evaluate the given options: Bone, Brain, Heart, and Lungs.
Based on the name and pathophysiology (a disorder of bone remodeling), 'Bone' is the direct and correct answer.
Consider why the other options are incorrect. While complications of Paget's can affect the nervous system (from skull enlargement) or cardiovascular system (from increased blood flow), the disease itself is a primary disorder of the bone.

Concept Tested & Keywords

Q1BBeNy6pIVzThE38su0kd

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed pp. 1181-1183, 1182-1184

E6 Medicine Harrison 22e Part 2 p. 1217-1219