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.

Discussion 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? (See Osteoporosis—Pathophysiology.)
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. (See Osteoporosis—Treatment.)

Case Study 2

Mr. F is a 38-year-old man in overall good health who has been complaining about an aching pain in his knees when working around the house and often when simply walking. He has noticed that his knees feel “hard” and tight. His history indicates that he has always been involved in athletics and was on the college football team, but recently family responsibilities and work have not made it easy for him to exercise.

Discussion Questions

Relate Mr. F’s case history to the pathophysiology of osteoarthritis. (See Osteoarthritis.)
How do anti-inflammatory drugs and analgesics help Mr. F deal with this form of arthritis? Why is moderate, non–weight-bearing exercise recommended? (See Osteoarthritis—Pathophysiology, Etiology, Treatment.)
What is the probable prognosis for Mr. F?


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