BSC 2346 A&P Case Study Module 3 Complete Solution
Alyssa is a 74-year-old female patient who presents to her primary care provider for a rout... [Show More] ine physical. She states that she feels “quite healthy” and has no complaints other than mild back pain. She has a family history of various cancers, diabetes, and osteoporosis, so she knows that it is important to stay active and keep up with screenings and annual physical exams. Alyssa’s provider finds that she has lost 10 pounds since last year’s exam. She is almost a full inch shorter, as well.
Alyssa’s provider suspects that she may have osteoporosis. Which other two factors would support that other diagnosis?
Taking calcium supplements and intense daily exercise
Family history of cancer and obesity
Weight loss and history of surgery
A history of smoking and being post-menopausal
Explain, in your own words, how Alyssa’s loss of height could be related to her possible osteoporosis diagnosis.
When a person has osteoporosis, they typically do not have any signs or symptoms until a fracture happens. Over time, the bones in someone that has osteoporosis start to deteriorate due to losing bone density faster than it can be replaced. In result, individuals tend to become shorter over time and have more frequent bone fractures (Department of Health and Human Services, 2019).
Alyssa’s provider orders a DEXA scan. Which of the following T-score outcomes would indicate a diagnosis of osteoporosis?
Why might Alyssa’s provider ask her about her diet? Provide two reasons and explain how they are related to osteoporosis.
One reason Alyssa’s provider may ask her about her diet is because, a balanced diet is very much connected to bone growth as well as overall health. Making sure that you are getting enough Vitamin D and Calcium in your diet throughout the day is extremely important in maintaining your bone health which will keep the osteoporosis at bay (International Osteoporosis Foundation, 2017). Another reason is that if she is not eating correctly or getting enough of the needed vitamins and calcium, he can educate her on what she needs to do outside of the doctor’s office to keep the osteoporosis from progressing too rapidly.
Explain how the body controls calcium levels in the bones and blood. Be sure to describe the roles of parathyroid hormone (PTH) and calcitonin in detail.
Blood calcium levels are regulated by PTH, PTH is generated by the parathyroid glands (LibreTexts, 2019). PTh is released whenever blood calcium levels are low, it stimulates osteoclasts to break down the bone to allow the release of calcium into the blood. Once released PTH increases blood calcium levels by enhancing the amount of calcium being reabsorbed by the kidneys before being excreted in the urine (LibreTexts, 2019). PTH triggers calcitriol formation which in turn “increases absorption of dietary calcium through the intestines” (LibreTexts, 2019). On the other side of things, calcitonin does the opposite of PTH. Calcitonin is also produced by the thyroid but inhibits osteoclasts and activates osteoblasts and increases calcium in the urine through the kidneys (LibreTexts, 2019). Calcitonin is very important in children because it stimulates bone growth, in pregnancy it reduces maternal bone loss, and in prolonged starvation it lessens bone mass loss (LibreTexts, 2019).
Alyssa has been prescribed several medications over the past two decades for various reasons. Which of the following may have had an impact on developing osteoporosis?
Over-the-counter antacid medication
1. Alyssa’s doctor recommends that she increase her calcium intake. List at least five foods that have high calcium content.
Collard greens; 360mg of calcium, Sardines (canned with bones); 325mg of calcium, Broccoli rabe; 200mg of calcium, Salmon (canned with bones); 180mg of calcium, Kale; 180mg of calcium
1. Alyssa does some research on risk factors for osteoporosis and comes across the term “peak bone mass.” In your own words, explain what peak bone mass means and at which age it typically occurs.
2. Peak bone mass is the amount of bone a person will have during their life time. It typically occurs in early 20’s in females and late 20’s in males.
1. Which of the following choices has NOT been shown to cause a decrease in blood calcium levels?
1. If Alyssa does have osteoporosis, can she reverse its effects on her bone density? Explain why or why not. What is the best course of action she can take to keep her bones as healthy as possible?
Osteoporosis cannot be reversed because by time you are diagnosed with osteoporosis you have already lost too much bone density (National Institute on Aging, 2017). Although you cannot reverse osteoporosis you can take action to prevent further damage and build stronger bones. The best action for Alyssa to take is to watch the food that she consumes, eat more dark green leafy foods, less sodium intake, and less dairy. It is also wise of her to stay active and stay aware of her body and changes that may happen (National Institute on Aging, 2017
Kaysee is a 14-year-old athlete who was injured during a basketball game. Another player fell on the lateral aspect of her right leg as her foot was pinned in place. She was taken by ambulance to the hospital after having her lower leg splinted on the court. She is in extreme pain and every bump in the road makes the pain worse. When the ambulance arrived at the hospital, the ER physician ordered x-rays.
Based on the limited information you are given, which of the following bones is most likely injured?
The x-ray shows that both lower leg bones have been fractured. There is no break in the skin tissue. Which of the following terms describes the type of fracture that has occurred?
Kaysee has always been a fairly healthy child. She has no history of any major illness. However, her physician is surprised that she has sustained two fractured bones from a relatively mild trauma. List and describe three possible underlying conditions that would increase Kaysee’s risk of fracture. (Keep her age in mind.)
Three possible underlying conditions could be osteogenesis imperfecta, rickets, and juvenile rheumatoid arthritis. Osteogenesis imperfecta is usually detected at birth and is also known as brittle bone disease. When a person has this disease their bones are soft, fracture easily, and are not formed normally. Osteogenesis imperfecta has 8 different types of the disease that range from mild to more severe (St. Louis Children’s Hospital, 2019). Rickets is a bone disease where the bones become soft and deformed over time which causes the individuals legs to bow and ankles to swell. Rickets occurs due to lack of vitamin D in the persons diet or not getting enough sunlight (St. Louis Children’s Hospital, 2019). Juvenile arthritis is caused by the child’s immune system attacking its healthy tissue. Due to this research has shown that children with JRA have a higher risk of bone fractures and higher risk of bone fractures after the age of 45 (Jennifer Freeman, MD, 2018).
The time required for healing a fracture depends on all of the following except:
Type of fracture
During bone healing, osteoclasts are by far the most active bone cells.
Which of the following may diminish Kaysee’s body’s ability to heal her fracture?
An increase in calcium intake
Over-the-counter pain medications
Her history of athletic activity
Vitamin D supplements
In your own words, describe the term “neoangiogenesis” and explain how it relates to fracture healing.
Angiogenesis is responsible for creating blood vessels throughout the entire body, while Neogenesis creates new blood vessels that supply cancerous tumors to ensure they grow (Memorial Sloan-Kettering Cancer Center 2002). Angiogenesis is necessary during the bone healing process because it provides new blood vessels which provides oxygen to the new callus that is forming. It also provides a path for inflammatory cells, cartilage, and bone cells to get to the fracture cite (Memorial Sloan-Kettering Cancer Center 2002).
The first step in bone healing involves the formation of a:
Considering Kaysee’s age, could this injury impact bone growth at her epiphyseal plates? Why or why not?
Yes, it can because she is not done growing yet, the epiphyseal plates have not hardened into bone at her age. Because of this, it can cause the plates to harden early which can cause uneven limb growth or may end up slightly crocked in the future (Richard W. Kruse, DO and Susan M. Dubowy, PA-C, 2018).
Which of the following statements is true?
Vascularization never returns to an injured bone site.
Formation of a soft callus is the first step in bone repair.
The soft callus is composed of elastic tissue and collagen fibers.
A fibrocartilaginous callus is converted to bone tissue over time. [Show Less]