A 38-Year-Old Man Is Evaluated Due to a 2-Year History

question 69

Multiple Choice

A 38-year-old man is evaluated due to a 2-year history of gradually worsening low back pain, bilateral buttock pain, and stiffness.  Symptoms are worse in the morning and relieved with stretching and hot showers.  The patient also has fatigue but no fever, chills, night sweats, or weight loss.  Vital signs are normal.  The patient appears healthy but has a stooped walking posture.  Deep palpation over the lumbar spine at the midline and both sacroiliac joints elicits tenderness.  Erythrocyte sedimentation rate is 75 mm/hr.  Which of the following pathologic findings is most likely causing this patient's symptoms?

• A)Areas of bony erosions and new bone formation
• B)Areas of spindle cells and dysplastic bone
• C)Areas of trabecular and cortical bone thickening
• D)Disc protrusion and thickening of the ligamentum flava
• E)Plasma cell infiltrate in bone marrow

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Definitions:

Scores

Quantitative assessments that represent the outcomes or achievements of individuals based on performance or measurement criteria.

Variance

A measure of the dispersion of a set of data points around their mean value, demonstrating how spread out the data points are.

Standard Deviation

An indicator of the spread or variability among a set of numbers, showing the degree to which these numbers vary from their average.

Unbiased Estimates

Statistical estimates or predictions that are accurate on average over a number of samples.