BSC 2346 Module 3 Case Study

• Question 1 BSC 2346 Module 3 Case Study Module 3 Case Study AP1 1 out of 1 points 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? Selected Answer: A history of smoking and being post-menopausal • Question 2 Explain, in your own words, how Alyssa’s loss of height could be related to her possible osteoporosis diagnosis. 1 out of 1 points Selected Answer: Respons e Feedbac k: There are no signs or symptoms of early bone density loss, but there are symptoms that can be felt and seen after the affects of osteoporosis have had on her bones. One symptom is height loss, which is one of the biggest signs that care providers look for. She also has accompanying back pain that could indicate a possible bone fracture in the spine. The loss of height would be an indication that osteoporosis is a possibility for this back pain. Reference Mayo Clinic. (2016, July 6). Osteoporosis - Diagnosis and treatment. Retrieved April 18, 2018, from Great job formatting the reference! • Question 3 Alyssa’s provider orders a DEXA scan. Which of the following T-score outcomes would indicate a diagnosis of osteoporosis? 1 out of 1 points Selected Answer: - 2.6 • Question 4 Why might Alyssa’s provider ask her about her diet? Provide two reasons and 1 out of 1 points explain how they are related to osteoporosis. Selected Answer: Alyssa's provider might ask her about her diet to see if she is taking in enough vitamin D and calcium, as well as seeing if she is intaking too much sodium in her diet. Calcium is the best thing you can have in your diet to help improve bone strength. You can get this in your meals through milk, yogurt, cheese, and green leafy vegetables. However, if she is not getting enough vitamin D as well from foods like, liver, fortified milk, orange juice or egg yolks, that calcium will not be absorbed into the bones. Another place to get vitamin D is the sun, if unable to get enough through foods or supplements. Her provider might be curious about her salt intake as well. A diet high in salt, or sodium, causes calcium loss in our body's, weakening out bones. If she is intaking too much sodium, regardless of the amount of calcium she is also intaking, it will affect the absorption. Reference Ward, E. M. (2008, January 9). Osteoporosis diet dangers - foods to avoid. Retrieved April 18, 2018, from Respons e Feedbac k: For the reference, the date should be (n.d.) as we do not use reviewed dates - only actual dates or if it would state 'updated on.' • Question 5 1 out of 1 points 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. Selected Answer: If calcium levels fall short in the blood, the parathyroid gland releases PTH (parathyroid hormone) to the osteoclast cells in the bone to release calcium from the surface layers of the bone. PTH also sends a signal to the kidney to absorb more calcium before it is excreted through the urine. If calcium levels are too high in the blood, another hormone called calcitonin is released. Calcitonin sends signals to the osteoclasts to stop, or slow down, the release of calcium from the bone. The osteoclasts are able to start and stop the release of calcium as soon as it receives these signals. Reference American Bone Health. (2017). How the body maintains calcium levels. Retrieved April 18, 2018, from Respons e Feedbac k: For the reference, the date should be (n.d.) as we do not use copyright dates in the footer of the web page - only actual dates or if it would state 'updated on.' • Question 6 Alyssa has been prescribed several medications over the past two decades for 1 out of 1 points various reasons. Which of the following may have had an impact on developing osteoporosis? Selected Answer: Steroid medication • Question 7 Alyssa’s doctor recommends that she increase her calcium intake. List at least five foods that have high calcium content. 1 out of 1 points Selected Answer: Five foods that Alyssa could eat or drink to increase her calcium intake are cheese, yogurt, milk, sardines, and dark leafy green vegetables (i.e. spinach, kale, turnips, collard greens). Reference WebMD. (2004). Top 10 calcium-rich foods. Retrieved April 18, 2018, from Response Feedback: For the reference, WebMD is not a corporate author so the web page title would lead it. Also, the date should be (n.d.). • Question 8 1 out of 1 points 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. Selected Answer: Peak bone mass is the maximum amount of strength and density a bone will have. In men 90% of their peak bone mass is acquired by age 18 and women will hit 90% of their peak bone mass by age 20. The amount of bone mass, or tissue in the bone, will continue to grow until about age 30 for both men and women. Reference National Institute of Health. (2016, June). Osteoporosis: Peak bone mass in women. Retrieved April 18, 2018, from Respons e Feedbac k: Nice job for the reference. The NIH is acceptable for the corporate author...but there is a more specific branch that should be used: National Institute of Arthritis and Musculoskeletal and Skin Diseases. Also, the date would be (n.d.) again as review dates are not used. • Question 9 1 out of 1 points Which of the following choices has NOT been shown to cause a decrease in blood calcium levels? Selected Answer: Cannabis • Question 10 If Alyssa does have osteoporosis, can she reverse its effects on her bone density? Explain 1 out of 1 points why or why not. What is the best course of action she can take to keep her bones as healthy as possible? Selected Answer: Unfortunately Alyssa cannot reverse osteoporosis. What she can do is keep it from getting worse and improve her bone density and slow it down. To do this she will have to be active and do low weight bearing exercises, and low impact exercises like walking and jogging. Increasing her intake of vitamin D and calcium either by diet or taking supplements would help improve her bone density. Also by taking osteoporosis drugs. These drugs have to be prescribed by a doctor and can either slow down the bone breakdown, or spur new bone growth. Reference Martin, L. J. (Ed.). (2010, July 15). Can you reverse osteoporosis? Retrieved April 18, 2018, from Respons e Feedbac k: For the reference, for web pages, editors are not used. There was an author given: Doheny, K. The date would be (n.d.). • Question 11 1 out of 1 points 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? Selected Answer: Tibia • Question 12 The x-ray shows that both lower leg bones have been fractured. There is no break in the 1 out of 1 points skin tissue. Which of the following terms describes the type of fracture that has occurred? Selected Answer: Simpl e • 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 0.5 out of 1 points relatively mild trauma. List and describe three possible underlying conditions that would increase Kaysee’s risk of fracture. (Keep her age in mind.) Selected Answer: Kaycee could have a metabolic disorder such as a decrease in thyroid or parathyroid hormone secretion from the thyroid gland, this would cause he body to not know when to increase or decrease the amount of calcium being taken from the bones to the blood by osteocyte. With her age, it is not unlikely that Kaysee could also be suffering from anorexia nervousa. For teenage girls, especially those active in sports, there is a high pressure for them to be tiny as well as fit, so regardless of how much exercise she might be getting, if her body weight is lower than it should be, this could also cause brittle bones. Finally Kaysee could have juvenile osteoporosis, this can occur because of the two reasons listed above, or for other reasons entirely. The best way to know is for Kaysee to have a bone density test done. Reference Doyle, S. M. (2009, June 26). Low bone density and osteoporosis in children. Retrieved April 18, 2018, from Respons e Feedbac k: A concern you also had to mention was bone tumor or cancer. Low bone mineral density Low calcium and vitamin D intake Bone tumors or underlying cancers • Question 14 The time required for healing a fracture depends on all of the following except: 1 out of 1 points Selected Answer: Casting • Question 15 During bone healing, osteoclasts are by far the most active bone cells. 0 out of 1 points Selected Answer: Tru e • Question 16 Which of the following may diminish Kaysee’s body’s ability to heal her fracture? 1 out of 1 points Selected Answer: Over-the-counter pain medications • Question 17 In your own words, describe the term “neoangiogenesis” and explain how it relates to fracture healing. Selected Neoangiogenesis is the formation of new blood vessels in cancerous 0.5 out of 1 points Answer: tumors that help them to grow. Angiogensis is the process of forming new blood vessels in the whole body except for tumors. Blood vessels are key in cell development, helping carry blood and nutrients to the cells, which then go to the injury site and create new bone tissue in fractures. Respons e Feedbac k: Reference Synergie Lyon Cancer. (2013). Neoangiogenesis. Retrieved April 18, 2018, from Neoangiogenesis: neo = new; angio = blood vessels and genesis = birth or growth. This term means “new vessel growth” and refers to how the body develops new blood vessels in and around fractures to deliver healing elements (like blood cells) to the area of injury. For the reference, you do not have a corporate author so the title should lead the reference. Also, the date should be (n.d.). • Question 18 1 out of 1 points The first step in bone healing involves the formation of a: Selected Answer: Hemotoma • Question 19 Considering Kaysee’s age, could this injury impact bone growth at her epiphyseal plates? Why or why not? 1 out of 1 points Selected Answer: Considering Kaysee's age, this injury could, or could not impact bone growth at her epiphyseal plates. This reason being, her fracture was considered a traumatic fracture, where too much pressure was placed on the bone, and it could not handle it. The fractures to both bones in her lower leg could have actually damaged the epiphyseal plates without us knowing. If she did damage her epiphyseal plate in the fracture, the bone itself could stop growing, which is called growth arrest. If only part of it is damaged and stops working, the bone may continue to grow, but unevenly. Even injuries considered minor, such as a sprain, can cause damage to the epiphyseal plate, and cause bone to stop growing. However, if no damage was done to the epiphyseal plates, then bone growth should not be impacted by this fracture. Reference Seattle Children's Hospital. (2018). Fractures and growth plate injuries. Retrieved April 18, 2018, from Respons e Feedbac k: For the reference, the date should be (n.d.). • Question 20 Which of the following statements is true? 1 out of 1 points Selected Answer: A fibrocartilaginous callus is converted to bone tissue over time.