MODULE 3 CASE STUDY

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casestudtyweek3.doc

Running Head: MODULE 3 CASE STUDY 1

MODULE 03 CASE STUDY 2

QUESTION 1

Alyssa is a 74-year-old female patient who presents to her primary care provider for a routine 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?

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Family history of cancer and obesity

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Weight loss and history of surgery

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A history of smoking and being post-menopausal

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Taking calcium supplements and intense daily exercise

QUESTION 2

Explain, in your own words, how Alyssa’s loss of height could be related to her possible osteoporosis diagnosis.

QUESTION 3

Alyssa’s provider orders a DEXA scan. Which of the following T-score outcomes would indicate a diagnosis of osteoporosis?

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+1.2

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-2.6

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-1.4

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0

QUESTION 4

Why might Alyssa’s provider ask her about her diet? Provide two reasons and explain how they are related to osteoporosis.

QUESTION 5

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.

QUESTION 6

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?

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Cholesterol-lowering statins

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Antibiotics

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Steroid medication

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Over-the-counter antacid medication

QUESTION 7

Alyssa’s doctor recommends that she increase her calcium intake. List at least five foods that have high calcium content.

QUESTION 8

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.

QUESTION 9

Which of the following choices has NOT been shown to cause a decrease in blood calcium levels?

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Alcohol

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Sodium

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Caffeine

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Cannabis

QUESTION 10

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?

QUESTION 11

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?

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Femur

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Humerus

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Tibia

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Metatarsals

QUESTION 12

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?

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Compound

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Greenstick

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Simple

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Colles

QUESTION 13

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.)

QUESTION 14

The time required for healing a fracture depends on all of the following except:

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Patient’s age

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Casting

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Nutrition

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Type of fracture

QUESTION 15

1. During bone healing, osteoclasts are by far the most active bone cells.

image29.wmf True

image30.wmf False

QUESTION 16

Which of the following may diminish Kaysee’s body’s ability to heal her fracture?

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Vitamin D supplements

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Her history of athletic activity

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Over-the-counter pain medications

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An increase in calcium intake

QUESTION 17

In your own words, describe the term “angiogenesis” and explain how it relates to fracture healing.

QUESTION 18

1. The first step in bone healing involves the formation of a:

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Soft callus

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Hemotoma

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Fibrous tissue

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Hard callous

QUESTION 19

1. Considering Kaysee’s age, could this injury impact bone growth at her epiphyseal plates? Why or why not?

QUESTION 20

1. Which of the following statements is true?

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A fibrocartilaginous callus is converted to bone tissue over time.

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Vascularization never returns to an injured bone site.

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The soft callus is composed of elastic tissue and collagen fibers.

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Formation of a soft callus is the first step in bone repair.

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