Question

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 from 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.

1. Relate Mrs. L’s history to the diagnosis of osteoporosis. What risk factors are present, and how does each predispose to decreased bone density? what are the 3 risk factors and its predisposition?

Answer 1

Osteoporosis is a bone degenerative disorder, in which desorption of bone is not keep in pace with bone resorption. The bone deformation releases calcium into the circulation if the calcium is not replaced back, the bone density decreases and bones become more fragile. The bones most susceptible to fractures in osteoporosis are,

• Hip bones
• Bone of the vertebral column
• Wrist bones

The risk factors of osteoporosis include,

• Body height (shorter females are at shorter risk due to their lower bone mass)
• Females with less body weight, and those that do over exercise
• Smoking
• Deficiency of calcium, or malabsorption
• Vitamin D deficiency
• Sedentary life style
• Menopause
• Family history of osteoporosis

The risk factors of osteoporosis observed in the given case are,

1. Menopause (63-year old women, ahd menopause at 49 years) - Reduced estrogen levels after menopause reduce the bone density

2. Smoking - Reduce the bone mineral density

3. Lack of physical exercise - Reduce the bone mineral density (smoking causes menopause to occur earlier than the non-smokers, thus, increase the risk of osteoporosis)