Week 9 Flashcards
What is osteoporosis?
Osteoporosis is characterised by a reduction in bone mass and skeletal strength, and has not symptoms
What is osteoarthritis?
Osteoarthritis is characterised by progressive joint pain and mobility impairment associated with the loss of cartilage and involvement of the underlying bone.
What is the impact of disease on quality of life?
- pain
- anxiety
- loss of control
- helplessness
- impaired social function
- role change
- employment status
- financial status changed
- depression
- guilt
- anger
How do we reduce the risk of vitamin D deficiency with non pharmacological interventions?
- avoid tobacco use
- supplements
- good diet
- sunlight
List some non surgical interventions for pain relief.
- TENS
- acupuncture
- patellar taping
- massage therapy
- Thai chi
- laser therapy
- leech therapy
- magnetic therapy
- thermotherapy
how do we diagnose osteoporosis?
- medical hx
- physical assessment
- bone density test
- rick assessment for fractures
- lab tests
- xray
- bone scan
- vertebral fracture assessments
how do we diagnose osteoarthritis?
- physical assessment
- xray
- blood tests
- synovial fluid aspiration from joint
Case-study: Mrs. Kingston
Presented to ED
She is a 75-year-old Caucasian female
Fall on a wet laundry floor
Left leg is externally rotated
Is in extreme Pain
Appears frail and dehydrated
When asked about height she states she used to be 5 foot 4 inches but now is only 5 foot 2
When weighed she is 49 kgs: her BMI is 21
She has a history of fractures:
-right hip fracture 18 months ago
-right forearm fracture following a fall 8 months ago
-a vertebral fracture following bending to pick up her eyeglasses 5 months ago
She has been a one-pack-a-day cigarette smoker for 35 years
She has chronic bronchitis and emphysema
She has hypothyroidism
She has osteoarthritis in her knees, and this is very painful. It limits her movements at home
She has a positive family history for fractures (mother and two sisters) – and is fearful about her future
She manages to look after herself
She will catch public transport to the shops
Cannot do the housecleaning as the house is too big, her knees are too painful
Family say she is not coping with her garden and want her to sell
It is difficult to work with a walking stick
Pain in knees makes it difficult to attend toileting, bathing, dressing, eating and mobilising.
MedicationParacetamol
Fosamax
Calcium
Thyroxin
Calcitriol
Pulmicort
Ventolin
Voltaren Gel
what is the complications that she has experienced as a result of her osteoporosis?
Fractures
What are the risk factors for osteoporosis in this patient?
Post-menopausal, and age-related, smoking, hyperthyroidism, levothyroxine, and prednisone
What are the modifiable risk factors associated with osteoporosis in this patient?
Is a Smoker, is housebound (low sun exposure), poor vitamin D intake, physical inactivity and prednisone medication
Identify the comorbidities that she has.
Chronic bronchitis, emphysema, hypothyroidism, hypertension, rheumatoid arthritis
What medications are essential for managing osteoporosis?
Vitamin D- build bone strength (Calcitonin also provides pain relief). Calcium supplements if needed (calcium carbonate, calcium citrate – more expensive, but absorption is easier). Paracetamol – analgesia relief for stronger pain, 4 grams only per day over 24 hours. Biphosphanate – (Fosamax) reduces bone loss but is painful after swallowing – sit up for 30 minutes post medication.
What strategies would someone with osteoporosis need to consider in order to enable them to self-manage their condition?
Take Vitamin D- go into sunlight 4-6 times a week for 5 – 20 minutes, Exercise for 30 minutes a day and do weight bearing exercise, Limit alcohol and caffeine use, discontinue smoking
True or False. Parathyroid hormone (PTH), vitamin D, and calcitonin play major roles in bone remodelling and maintaining bone mass.
True
