Question

Mary-Lou’s family was happy with the management plan established by the doctor as Mary-Lou was progressing quite well. She was using notepads to jot down reminders, a pillbox to keep her medication organized and a calendar to record appointments. Her family members were helping her with routine tasks such as cooking and paying bills. She was feeling much happier and did not have to rely on alcohol to go to sleep. On one particular day she was feeling so good she decided to walk to her GP appointment alone. On her way there she stumbled over a branch and fell. She felt excruciating pain in her hip. A passer-by called an ambulance and she was taken to the emergency department at the Royal Melbourne hospital. An X-ray revealed that she had broken the neck of her femur and had to have surgery to repair it. Mary-Lou wondered whether this was linked to the crepitus she had been experiencing in her joints. Her joints did feel quite stiff and painful lately. The specialist explained to Mary-Lou that the crepitus was likely due to degeneration of her cartilage and said that the fracture might have been due to weakened bones. He told her he would like her to have a bone mineral density test to measure her bone density. The DEXA scan gave a T-score of -3.0. Mary-Lou is now given bisphosphonates and told to increase her daily intake of calcium.

Q. Discuss the pathophysiology of the condition causing the crepitus Mary-Lou is experiencing in her joints. In your answer, list at least two more signs and symptoms associated with the disease.

Can you please answer this question for above case study

Answer 1

Osteoporosis: the weakness in bones occurs due to lack of Calcium and Phosphate, which even make them brittle and such brittle and weak bones known as osteoporosis.
Osteoporosis is prevalent in females, usually after menopause because the female sex hormone estrogen gets lowered after menopause, and the same hormone plays a vital role in pumping calcium in bones. Estrogen hormone is crucial as it helps to add minerals to the bone to make the bone more robust and prevent bone resorption.
There are several more other factors for this disease, such as insufficient hormones level, Vitamin D deficiency, improper dietary intake, consumptions of zero nutritional value products, and an unhealthy lifestyle. The parathyroid gland's uncontrolled production of PTH (parathormone) causes more bone resorption, leading to decreased bone density.
Osteoblasts are necessary to bone cells, which help build bone, and osteoclast cells help in the absorption of bone mass. The hormone estrogen prevents the activity of osteoclast, leading gain of bone density. Osteoclast activity can also be prevented by biphosphates and hence make bone stronger by increasing bone mass because osteoclast base bone resorption is found more reasonable for osteoporosis.