A 75-year-old man has complained of lower back pain for years. As pa of a investigation for a persistently elevated lymphocytosis, he had a right posterior iliac crest biopsy performed. Hematopoiesis is normal, but the bone spicules are thickened with irregular cement lines forming a mosaic appearance with both increased osteoblastic and osteoclastic activity. Which of the following conditions is most likely to occur in conjunction with this disease process?

Correct Answer: Congestive Cardiac Failure
Description: This elderly person has Paget's disease of bone, and this is the classic phase of mixed osteolysis and osteogenesis. The increased blood flow into the involved areas of bone can lead to high output congestive hea failure in older persons with minimal cardiac reserve.
Category: Surgery
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