ANSWER
This is an organized, APA-formatted response to the case studies:
Case Study on Musculoskeletal Function
In addition to osteoarthritis, osteoarthrosis
Osteoarthritis (OA) is a degenerative joint disease that causes pain and stiffness due to inflammation, bone remodeling, and cartilage degradation. An older name that is frequently used interchangeably is osteoarthrosis, which highlights the condition’s non-inflammatory features. Age, obesity, and joint mechanical stress, especially from weight gain, are risk variables from the case.
Osteoarthritis and Rheumatoid Arthritis Distinctions
Osteoarthritis: A non-inflammatory, degenerative disease. frequently impacts weight-bearing joints such as the hips and knees. Reduced range of motion, stiffness after rest, and soreness that gets worse with movement are some of the symptoms. Clinical presentation and imaging (such as X-rays) are used to make the diagnosis.
An autoimmune inflammatory condition that frequently affects smaller joints, such as the hands and wrists, is rheumatoid arthritis. Symmetric joint pain, stiffness in the morning that lasts more than an hour, and systemic symptoms like exhaustion are among the symptoms. Imaging and blood tests (such as RF and anti-CCP) are used in the diagnosis process.
Alternatives to Treatment
Non-pharmacological: Physical treatment to strengthen muscles surrounding joints, weight control, and low-impact activities like swimming.
Pharmacological: topical NSAIDs for regional relief, intra-articular corticosteroid injections for acute flares, and acetaminophen as first-line treatment.
Topical treatments or a recommendation for hyaluronic acid injections may be suitable in light of G.J.’s resistance to oral NSAIDs. If the discomfort doesn’t go away, surgical treatments (such knee replacement) might be considered.
Resolving Osteoporosis Issues
In addition to weight-bearing activities, preventing osteoporosis involves consuming enough calcium (1,200 mg/day) and vitamin D (800–1,000 IU/day). Fall prevention techniques and routine bone density testing (DEXA scan) for early detection should be covered in education.
Case Study on Neurological Function and Alzheimer’s Disease (AD) Risk Factors
Age, cardiovascular disease, genetic predisposition (e.g., APOE-ε4 allele), low educational attainment, and lifestyle variables (e.g., physical inactivity) are common risk factors.
Comparing Different Dementias
Progressive memory loss, confusion, and language impairments are symptoms of Alzheimer’s disease.
Cerebrovascular injury causes vascular dementia, which manifests as a progressive loss of cognitive function.
Lewy body dementia is characterized by Parkinson-like movement symptoms, visual hallucinations, and fluctuating cognition.
Language and conduct are impacted by frontotemporal dementia before memory.
Memory Types: Explicit and Implicit
Conscious recall of information and events, such as an address, is known as explicit memory.
Implicit Memory: Learning routines and abilities (like riding a bike) without realizing them.
In its early stages, AD mostly affects explicit memory.
The criteria used to diagnose Alzheimer’s disease
Criteria include objective testing and patient history to confirm evidence of cognitive loss in memory and at least one other domain (e.g., executive function). The MMSE, neuroimaging (MRI/CT), and biomarker analysis (e.g., amyloid-beta levels in CSF) are diagnostic methods.
Therapeutic Approach for H.M. Cognitive deterioration may be slowed by donepezil and other cholinesterase inhibitors. Cognitive stimulation, routine maintenance, and caregiver education are examples of non-pharmacological therapies. Her social and emotional health can also be improved by early participation in support groups.
Citations
Alzheimer’s Association and the National Institute on Aging (2011). Guidelines for Alzheimer’s disease diagnosis. The Journal of the Alzheimer’s Association, 7(3), 263-269, discusses dementia and Alzheimer’s disease. 10.1016/j.jalz.2011.03.005 https://doi.org
Zhang, Y., and D. T. Felson (1998). An update on the epidemiology of osteoarthritis in the knee and hip with an emphasis on prevention. 1343–1355 in Arthritis & Rheumatism, 41(8). In 1998, https://doi.org/10.1002/1529-013143::AID-ART3> 41:8<13433.0.CO; 2–9
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QUESTION
Musculoskeletal Function:
G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn’t improved a bit this summer though,” she states. Discomfort in the left knee is greater than in the right knee. She has also suffered from low back pain for many years, but recently it has become worse. She is having difficulty using the stairs in her home. The patient had recently visited a rheumatologist who tried a variety of NSAIDs to help her with pain control. The medications gave her mild relief but also caused significant and intolerable stomach discomfort. Her pain was alleviated with oxycodone. However, when she showed increasing tolerance and began insisting on higher doses of the medication, the physician told her that she may need surgery and that he could not prescribe more oxycodone for her. She is now seeking medical care at the Family Practice Clinic. Her knees started to get significantly more painful after she gained 20 pounds during the past nine months. Her joints are most stiff when she has been sitting or lying for some time and they tend to “loosen up” with activity. The patient has always been worried about osteoporosis because several family members have been diagnosed with the disease. However, nonclinical manifestations of osteoporosis have developed.
Case Study Questions
- Define osteoarthritis and explain the differences with osteoarthrosis. List and analyze the risk factors that are presented on the case that contribute to the diagnosis of osteoarthritis.
- Specify the main differences between osteoarthritis and rheumatoid arthritis, make sure to include clinical manifestations, major characteristics, joints usually affected and diagnostic methods.
- Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why.
- How would you handle the patient concern about osteoporosis? Describe your interventions and education you would provide to her regarding osteoporosis.
Neurological Function:
H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week.
Her daughter start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store.
Case Study Questions
- Name the most common risks factors for Alzheimer’s disease
- Name and describe the similarities and the differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia.
- Define and describe explicit and implicit memory.
- Describe the diagnosis criteria developed for the Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association
- What would be the best therapeutic approach on C.J.
500 words
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2 academic resources