Musculoskeletal Conditions

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Case Study

Mrs. L is a 63-year-old woman who reports constant back pain. Further inquiry into her medical history revealed that over the past 3 years, she has suffered fractures of her femur and wrist after minor falls. She experienced menopause at age 49. Mrs. L has a secretarial job, drives to work, and she “does not have time for exercise.” She reports that she consumes 8 to 10 cups of coffee a day and has been a smoker most of her adult life. She has not seen her physician recently nor had a recommended bone density test because of the time and cost involved.

Questions

. Relate Mrs. L’s history to the diagnosis of osteoporosis. What risk factors are present,

and how does each predispose to decreased bone density?

. Explain the cause of pathological fractures in this patient.

. How could osteoporosis have been prevented in Mrs. L?

. Discuss the treatments available to the patient.

Assignment #2: Cardiovascular system

Please kindly use (APA, 7th ed.) references separately under each question.

Case Study:

Mr. K. is a 57-year-old man who consulted his physician after noticing marked leg pains while playing golf. He had previously noticed increasing fatigue and discomfort in his legs associated with moderate exercise. When sitting for extended periods with legs dangling, his legs became red, and sometimes his feet felt numb. His history indicates he smokes cigarettes and is chronically overweight. His blood cholesterol and other lipid levels are abnormal, and his physician suspects peripheral atherosclerosis as the cause of his discomfort.

Questions

. Discuss the development of atherosclerosis, including the predisposing factors in this

case and the pathophysiological changes.

. Discuss the complications that might develop in this patient.

. Discuss the treatments for all aspects of the patient’s condition, including slowing the progress of the atherosclerosis, maintaining circulation in the leg, and treating complications.

Assignment #3: The Central Nervous system

Please kindly use (APA, 7th ed.) references separately under each question.

Case Study

Ms. J, a 19-year-old college student, has been living in a dormitory on campus. She began experiencing severe headaches, neck pain, and nuchal rigidity, along with irritability and nausea. She noticed that when lying with her hips flexed, she found it very hard to stretch out her legs. Within a day her condition deteriorated, she experienced a tonic-clonic seizure, and she was quickly admitted to the hospital. Tests revealed increased intracranial pressure, fever, and leukocytosis. Bacterial meningitis was suspected, and a lumbar puncture was scheduled.

Questions

. Describe the pathophysiologic changes associated with bacterial meningitis.

. Discuss the diagnostic tests available for identifying meningitis. What are the likely

characteristics of the CSF to be found in this case?

. Which signs indicating elevated intracranial pressure are likely to be present?

. Discuss the treatments available to help this patient and possible long-term

complications.

Assignment #4: Shock

Please kindly use (APA, 7th ed.) references separately under each question.

Case Study

Ms. L, a 19-year-old woman with no previous medical history, was involved in a serious automobile accident in which her best friend died. Examination by EMT personnel first on the scene revealed she had only minor scrapes and bruises and no sign of head trauma. While in route by ambulance to the hospital, Ms. L complained of thirst and appeared restless. Further examination indicated a rapid pulse and respirations, with her blood pressure now at 100/60 mm Hg. She appeared less responsive to the paramedics. She was slipping into circulatory shock as they checked her again for internal injuries.

Questions

. Discuss the contributing factors to shock in this case and the pathophysiologic

changes causing the changes in vital signs.

. Discuss the signs and symptoms of shock, including the rationale for each, as seen in

the early stage, and as compensation mechanisms respond.

. Discuss emergency and follow-up treatment for shock and for complications that may

arise if not treated quickly.

. Compare the types of shock, giving a specific cause, classification, and any significant

changes in onset or manifestations.

 

 

Sample Solution

Case Study: Osteoporosis in Mrs. L ### Relate Mrs. L’s history to the diagnosis of osteoporosis. What risk factors are present, and how does each predispose to decreased bone density?

Mrs. L’s medical history and risk factors are strongly suggestive of osteoporosis. Osteoporosis is a bone disease that weakens bones and makes them more likely to break. It is most common in postmenopausal women, but it can also affect men.

Risk factors for osteoporosis include:

  • Age: Bone density decreases with age.
  • Sex: Women are more likely to develop osteoporosis than men.
  • Race: White and Asian women are at highest risk.
  • Family history: Having a family member with osteoporosis increases your risk.
  • Early menopause: Women who experience menopause before age 45 are at higher risk.
  • Low body weight: People with low body weights tend to have lower bone density.
  • Smoking: Smoking can decrease bone density and increase the risk of fractures.
  • Excessive alcohol consumption: Excessive alcohol consumption can also decrease bone density.
  • Certain medical conditions: Certain medical conditions, such as rheumatoid arthritis and hyperthyroidism, can increase the risk of osteoporosis.
  • Certain medications: Certain medications, such as corticosteroids and some anticonvulsants, can also increase the risk of osteoporosis.

In Mrs. L’s case, the following risk factors for osteoporosis are present:

  • Age: She is 63 years old.
  • Sex: She is a woman.
  • Race: She is white.
  • Early menopause: She experienced menopause at age 49.
  • Low body weight: She is thin.
  • Smoking: She has been a smoker most of her adult life.
  • Excessive alcohol consumption: She consumes 8 to 10 cups of coffee a day.

Explain the cause of pathological fractures in this patient.

Pathological fractures are fractures that occur in bones that have been weakened by disease. In Mrs. L’s case, her bones have been weakened by osteoporosis. This makes them more likely to fracture even after minor falls.

How could osteoporosis have been prevented in Mrs. L?

There are a number of things that Mrs. L could have done to prevent osteoporosis, including:

  • Eating a healthy diet: A healthy diet includes plenty of calcium and vitamin D, which are essential for bone health.
  • Exercising regularly: Exercise helps to build and maintain bone density.
  • Quitting smoking: Smoking can decrease bone density and increase the risk of fractures.
  • Limiting alcohol consumption: Excessive alcohol consumption can also decrease bone density.
  • Getting regular bone density tests: Bone density tests can be used to diagnose osteoporosis early on, when it is most treatable.

Discuss the treatments available to the patient.

There are a number of treatments available for osteoporosis, including:

  • Lifestyle changes: The first step in treating osteoporosis is to make lifestyle changes, such as eating a healthy diet, exercising regularly, quitting smoking, and limiting alcohol consumption.
  • Medications: There are a number of medications available that can help to prevent and treat osteoporosis. These medications include bisphosphonates, denosumab, teriparatide, and raloxifene.
  • Surgery: In some cases, surgery may be necessary to repair a fracture or to prevent future fractures.

Recommendations for Mrs. L

Based on her medical history and risk factors, I recommend the following for Mrs. L:

  • See her physician for a bone density test to confirm the diagnosis of osteoporosis.
  • Discuss treatment options with her physician.
  • Make lifestyle changes, such as eating a healthy diet, exercising regularly, quitting smoking, and limiting alcohol consumption.
  • Take medication for osteoporosis, if prescribed by her physician.

Mrs. L should also be aware of the following:

  • Osteoporosis is a chronic disease, but it can be managed effectively with treatment.
  • It is important to take her osteoporosis medication as prescribed by her physician.
  • She should also follow her physician’s recommendations for lifestyle changes and follow-up care.

Preventing Osteoporosis in the Future

Osteoporosis is a preventable disease. People of all ages can take steps to prevent osteoporosis, including:

  • Eating a healthy diet: A healthy diet includes plenty of calcium and vitamin D, which are essential for bone health.
  • Exercising regularly: Exercise helps to build and maintain bone density.
  • Quitting smoking: Smoking can decrease bone density and increase the risk of fractures.
  • Limiting alcohol consumption: Excessive alcohol consumption can also decrease bone density

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