Musculoskeletal Function

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G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn’t improved a bit this summer though,” she states. Discomfort in the left knee is greater than in the right knee. She has also suffered from low back pain for many years, but recently it has become worse. She is having difficulty using the stairs in her home. The patient had recently visited a rheumatologist who tried a variety of NSAIDs to help her with pain control. The medications gave her mild relief but also caused significant and intolerable stomach discomfort. Her pain was alleviated with oxycodone. However, when she showed increasing tolerance and began insisting on higher doses of the medication, the physician told her that she may need surgery and that he could not prescribe more oxycodone for her. She is now seeking medical care at the Family Practice Clinic. Her knees started to get significantly more painful after she gained 20 pounds during the past nine months. Her joints are most stiff when she has been sitting or lying for some time and they tend to “loosen up” with activity. The patient has always been worried about osteoporosis because several family members have been diagnosed with the disease. However, nonclinical manifestations of osteoporosis have developed.
Case Study Questions

Define osteoarthritis and explain the differences with osteoarthrosis. List and analyze the risk factors that are presented on the case that contribute to the diagnosis of osteoarthritis.
Specify the main differences between osteoarthritis and rheumatoid arthritis, make sure to include clinical manifestations, major characteristics, joints usually affected and diagnostic methods.
Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why.
How would you handle the patient concern about osteoporosis? Describe your interventions and education you would provide to her regarding osteoporosis.
Neurological Function:
H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week.
Her daughter start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store.
Case Study Questions

Name the most common risks factors for Alzheimer’s disease
Name and describe the similarities and the differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia.
Define and describe explicit and implicit memory.
Describe the diagnosis criteria developed for the Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association
What would be the best therapeutic approach on C.J.

Sample Solution

countries. ‘Free trade area covers all manufactured and agricultural products, although the timetables for reducing tariffs and removing quantitative restrictions and other non-tariff barriers differ, (Association of South Asian Nations, 2009 update on free trade). Due to entry of various industries in the market, infrastructures are improved in collaboration of state’s government and the industries for their market accessibility. Improvement of infrastructures such as roads, railways, communication, electricity, and social amenities by these industries serves as a gateway to developments in these countries. Increased developments results to increase in investments and thus a country realize its development goals of. Although a country does not benefit directly through revenues from tariffs and taxes, the industries help it to meet its development goals. , its development vision is addressed. Improvements of infrastructure such as transport, electricity and social amenities results to improvement of investment capacities of regions and countries, which in turn contribute to economic growth (Jovanovic??, 2013 p. 971). Policies that lift barriers on export and imports by lowering or elimination tariffs and duties encourage export and import of both goods and services to across the region. Developing countries are able to gain revenues from exports while imports supply them with necessary services and goods that are important in steering economic development. For example the European Economic Community elimination of import and export tariffs for its member states encouraged free movement of goods and services across the region in a common market (Bento, 2009 p. 73). Therefore, free trade has contributed greatly to development of small nations through improved trade that encourages export of goods and services without barriers.

Trade liberalization has increased countries integrations and as a result aid to trade inflow to developing countries in terms of technologies and capital has been increased. This has led to strong economic growth, which has been reflected by the increasing gross domestic product and exports for developing countries in East Asia, Africa and Latin America. For example, most of Latin America middle income level countries have integrated with developed countries such as china resulting to improvements of their financial system and consecutive developments (Chen, & Emile, 2013 p. 118). Consequently, technology transfer has led to shift to manufacturing industries, which has attracted investors to the countries. Technology has resulted to increase of improved productivity through lowered cost of production by lowering the cost of labour and increasing relative labour productivity. According to comparative advantage theory by Ricardo, a ‘country should concentrate on production of goods that is best suited at lowered cost in order to improve productivity and economy through export to a second country that is not good in production’ (Bento, 2009 p. 28). Developing countries have been able to achieve improved productivity and specialization through adoption of technologies that have been introduced in their countries by other developed countries through trade liberalization. For example, India h

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