Question of the Week # 184

Q184)  A 10 year old boy is evaluated in the emergency room after he tripped over and fell during a basketball game. There is no history of loss of consciousness. He denies any injury except  some pain in the occipital area of the skull.  He also reports chronic fatigue. A routine skull x-ray is obtained for evaluation and is shown below:

Which of the following is most likely to be associated with these incidental skull x-ray findings ?

A) Monoclonal gammopathy

B) Pituitary tumor

C) Hemolysis

D) Paget disease

E) Glioma

4 Responses

  1. D.

  2. C

    is not D…Paget disease is distinctly rare in persons younger than 25 years

  3. This is “hair on end appearance of skull” due to overactivity of the red marrow in response to anemia. seen in patients with thalassemia major, iron deficiency anemia, sickle cell disease, and spherocytosis.
    Ans: C) Hemolysis

  4. […] Question of the Week # 184 (usmlestep3blog.com) […]

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