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 1 Questions:
- Define osteoarthritis and explain the differences with osteoarthrosis.
- List and analyze the risk factors that are presented in the case that contribute to the diagnosis of osteoarthritis.
- Specify the main differences between osteoarthritis and rheumatoid arthritis, and 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’s concern about osteoporosis? Describe the interventions and education you would provide to her regarding osteoporosis.
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 includes hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history is not 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 started noticing that her mother is having problems focusing when talking to her. She is not keeping things at home as she used to, and often she is repeating and asking the same question several times. Yesterday, she had issues remembering her way back home from the grocery store.
Case Study 2 Questions:
- Name the most common risk factors for Alzheimer’s disease.
- Name and describe the similarities and differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, and Frontotemporal Dementia.
- Define and describe explicit and implicit memory.
- Describe the diagnosis criteria developed for Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association.
- What would be the best pharmacological and non-pharmacological therapeutic approaches for H.M.?
- This assignment has 2 case studies. You must work and include both case studies in your initial post.
- Your initial post should be at least 500 words for each case study, formatted and cited in the current APA style with support from at least 2 academic sources other than your textbook. Your initial post is worth 8 points.
- You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Use at least 1 academic source for each response to your peers other than your textbook. Your reply posts are worth 2 points (1 point per response).
- All replies must be constructive and literature must be used accordingly. Your replies must be at least 150 words each.
- Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
- You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.