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58.有關佩吉特氏病（Paget's disease）的敘述，下列何者最正確？
(A)病理機轉主要是因為骨生成增高及骨吸收降低
(B)病理檢查可以發現粗大的骨小樑、不規則的編織骨（woven bone）與骨泥線（cement lines）
(C)與正常人相比，尿中 pyridinoline和deoxypyridinoline偏低
(D)可給予連續副甲狀腺素注射治療
答案：登入後查看
統計： A(41), B(330), C(17), D(16), E(0) #2363369
統計： A(41), B(330), C(17), D(16), E(0) #2363369
詳解 (共 2 筆)
pauline40742
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- Paget's Disease is an idiopathic condition of abnormal bone remodeling with normal bone being replaced through an active interplay between excessive bone resorption and abnormal new bone formation. The condition typically present in patients age > 40 with asymptomatic lesions discovered incidentally on radiographs.
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Blood tests: The most important blood test for diagnosing Paget’s disease measures alkaline phosphatase, an enzyme produced by bone. Elevated levels of this enzyme can indicate the disease. If the levels are high, further tests may be recommended2.
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Urine tests: These tests reveal signs of excess calcium and rapid bone turnover. Specifically, elevated levels of deoxypyridinoline and N-telopeptide in the urine provide clues about the disease activity and progression. Monitoring non-isomerized C-telopeptide fragments can also help assess treatment efficacy3.
- Treatment
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Medications: The most common treatment involves bisphosphonates, which slow bone breakdown. These can be given intravenously (e.g., zoledronic acid, pamidronate) or orally (e.g., alendronate, risedronate). If bisphosphonates aren’t suitable, calcitonin (administered via injection or nasal spray) may be an alternative12.
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Surgery: Rarely, surgery may be needed to realign deformed bones, help fractures heal, or replace damaged joints. However, surgery carries risks due to increased blood vessel formation in affected bones1.
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