musculoskeletal abnormalities - abrahem

[ArchivalUser]

Which of the following statements concerning the musculoskeletal abnormalities in patients with sickle cell disease is correct?

A) Hand-foot syndrome characterized by diffuse swelling, tenderness, and warmth of the hands and feet in children under the age of 5 leads to chronic disability in about 10% of patients.


B) Acute arthritis seen in patients with sickle cell crisis is often associated with high white cell counts in joint effusions.


C) The bone pain in sickle cell crisis is due to bone and bone marrow infarction.


D) Acute gouty arthritis is common in patients with sickle cell disease.


E) Total hip replacement is contraindicated in patients with sickle cell anemia who sustain avascular necrosis of the femoral head.

[ArchivalUser]

my guess is c

[ArchivalUser]

AAA...DACTYLITIS IS MORE COMMON
bbb...i think osteomyelitis is common than arthritis
ccc...bone pain is due to ischemic infarction,not marrow infarction
dd...yes possible
eee...i dont think it si contraindicated
i will go with ddd

[ArchivalUser]

C.

[ArchivalUser]

DDD

[ArchivalUser]

cc

[ArchivalUser]

and this one?

[ArchivalUser]

CC

[ArchivalUser]

c,

[ArchivalUser]

c is correct


Several musculoskeletal abnormalities are associated with sickle cell disease. Children may develop diffuse swelling, tenderness, and warmth of the hands and feet, termed sickle cell dactylitis or hand-foot syndrome, which is self-limited and not associated with long-term damage. Blood cell formation in the distal extremities decreases with age; this syndrome is rarely seen after age 5. Although sickle cell crisis is often associated with arthritis of the knees and elbows, joint effusions tend to be noninflammatory with low white cell counts and a predominance of mononuclear cells. Osteomyelitis is common, particularly with salmonella, and occasionally septic arthritis can occur. The major problems during sickle cell crisis is sickled red cell-mediated bone infarction, which is quite painful. Radiographic manifestations of such infarction include periosteal elevation and irregular thickening of the bone cortex. In its most extreme form this bony infarction can produce avascular necrosis of the head of the femur, which occurs in about 5% of patients. If this process is severe, total hip replacement may be quite beneficial. Although patients with sickle cell disease are often hyperuricemic, gouty arthritis is uncommon. Bone marrow hyperplasia with associated widening of the medullary cavities and thinning of the cortex can result in cupping of the vertebral bodies (fish-bone deformity on radiographs) and vertebral compression