(MCQS 328-330):The average age of patients with Legg-Calve-Perthes disease is

Correct Answer: E
Legg-Calve-Perthes disease occurs three times more frequently in boys than in girls. The average age of patients with Legg-Calve-Perthes disease is 7 years. Children with irritable hips have an average duration of symptoms of 6 days, whereas those with Legg-Calve-Perthes disease have symptoms present for an average of 6 weeks

Correct Answer: D
Journals tend to accept articles which show something which would be of interest to their readership. They want to be the first journal to report something new. Publication bias is another concern that is particularly germane to the meta-analytic process. It occurs when study results are differentially reported, depending on the direction and strength of their findings. Publication bias is not an uncommon phenomenon, and it appears that the failure to publish the results of a particular study actually lies more with the investigator than with the editor. Investigators acknowledge that they are less likely to pursue publication when they have obtained uninteresting results. Moreover, authors can also impose publication bias if they selectively exclude data from a publication based on the nature of the findings. Methods have been devised to estimate the size of the problem in a given analysis

Correct Answer: J
A probable diagnosis is: j) agnogenic myeloid metaplasia Agnogenic Myeloid Metaplasia Agnogenic myeloid metaplasia (AMM, primary idiopathic myelofibrosis, myelosclerosis) is a clonal stem cell defect characterized by panmyelosis , progressive bone marrow fibrosis and splenomegaly. It usually appears in middle age to elderly individuals, and only rarely in younger people. There is an equal incidence of agnogenic myeloid metaplasia in males and females. Patients with agnogenic myeloid metaplasia can appear relatively healthy for years. In later stages of the disease, however, patients present with fever, weight loss, and sweating. Anemia associated with agnogenic myeloid metaplasia can also result in fatigue and weakness. Physical examination will show splenomegaly, and gout due to hyperuricemia. Fibrosis in agnogenic myeloid metaplasia makes bone marrow aspiration difficult. Bone marrow biopsy will show the following: Initially hypercellular Atypical megakaryocytic hyperplasia Megakaryocytic pleomorphism (micro to hyperlobated) Dilated sinusoids with intravascular hematopoiesis Fibrotic phase: collagen fibrosis and loss of hematopoiesis except for megakaryocytes Marked thickness of bone trabeculae (osteosclerosis) The fibrosis in agnogenic myeloid metaplasia is a result in a defect in regulation, production and degradation of reticulin. Patients with agnogenic myeloid metaplasia will usually show increased reticulin, even in early stages of the disease. Acute leukemia, usually myeloid type develops in 10-20% of patients with agnogenic myeloid metaplasia. The megakaryocytic component is not unusual, and there are no distinctive chromosomal abnormalities. Median survival for patients with agnogenic myeloid metaplasia is 4-5 years


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