File: chap27, Chapter 27
Multiple Choice
1. Which of the following statements related to osteoporosis is INCORRECT?
A. It is manifested by progressive decalcification of bones.
B. It predisposes to fracture.
C. Supplementary calcium intake may retard or prevent progression of the disease.
D. It occurs with equal frequency in both men and women.
Ans: D
Page: 732
2. Which of the following statements related to herniated intervertebral disk is INCORRECT?
A. Protrusion of the disk material may impinge on nerve roots that exit through intervertebral foramina.
B. It usually results from chronic infection of the disk, which predisposes to the herniation.
C. Protrusion of disk material may be detected by CT scan or myelogram.
D. Part
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A. The blood and synovial tissues of RA patients contain an autoantibody directed against the patient’s own gamma globulin.
B. Immune complexes composed of gamma globulin and autoantibody are deposited in joints of RA patients.
C. Antigen-antibody complexes activate complement and generate an inflammation within the joints.
D. Lymphocytes and macrophages attracted to the joints by the inflammatory process secrete cytokines (tumor necrosis factor) that damage the joints.
E. Drugs that block the effect of tumor necrosis factor have not been useful or effective for treating RA patients.
Ans: E
Page: 724
14. All of the following conditions predispose to osteoporosis or increase the risk of osteoporosis EXCEPT:
A. Overweight
B. Low intake of calcium in the diet
C. Vitamin D deficiency
D. White race
E. Female gender
Ans: A
Page: 732, 734
15. All of the following drugs are useful and are recommended for treatment of osteoporosis EXCEPT:
A. Bisphosphonate drugs (such as alendronate)
B. Selective estrogen receptor modulator drugs (such as raloxifene)
C. Sodium fluoride
D. Calcitonin
E. Drugs having parathyroid-like hormone activity
Ans: C
Page: 733
16. In bone structure, the cortex can best be described as which of the following?
A. The expanded ends of the shaft
B. The hollowed out center of the shaft
C. The compact bone that forms the outer layer
D. Blood and blood-forming tissue
Ans: C
Page: 716
17. The
1. A 12 year-old boy fell while playing basketball. The physician explained that the head
Before starting pharmacological medication preventive measures should be taken. For example, weight-bearing exercise, calcium and vitamin D intake, quit smoking and alcohol. After that start osteoporosis medication if it is primary, but if it is secondary treat the underlying cause first. These drugs do not treat osteoporosis, but decrease further loss of BMD which include Bisphosphonates (Alendronate- Risedronate- Ibandronate- Zoledronic acid), Raloxifene (Selective estrogen receptor modulators), Calcitonin (hormone decreases bone resorption by inhibiting osteoclast activity), Denosumab, Teriparatid(Parathyroid hormone). The first drug used is alendronate because of its high efficacy in preventing fractures and low cost. If the first line drug failed other bisphosnates or denosumab can be used. Ralaxofeine used as third line drug because it has a risk of developing blood clot diseases, yet it decreases the risk of breast cancer . Calcitonin is used for those who are contraindicated to the previous drugs because of its low efficacy. Teriparatid is the only drug that works by increasing BMD, but is the last drug used. It is taken for a maximum 2 years and expensive and contraindicated in those who have history or having a bone cancer. For those patients who complain of sever back pain surgery might be suitable for them as a last solution although the efficacy and safety
Osteoporosis is a major public health concern that greatly affects the elderly population. Osteoporosis is typically diagnosed and most prevalent in the older population due to the natural aging process. As one ages, bone integrity begins to decline and can influence many aspects of one’s life. As the prevalence continues to increase, focus is placed not only on treatment methods for those diagnosed, but also early prevention methods for those at an early age.1 These treatment and prevention methods of osteoporosis, specifically exercise testing and prescription, will be continue to be discussed in more detail, as well as the scope, pathophysiology, clinical considerations, and recent topics in research.
Rheumatoid Arthritis(RA) is the most common type of autoimmune arthritis. RA is a progressive and debilitating musculoskeletal disorder that affects the joints symmetrically, causing a range of systemic effects. What it causes is still not well known; nevertheless, findings of new research points towards a believe that it is triggered by a defective immune system, which causes the release of inflammatory chemicals. These chemicals cause damage to cartilage and bone, usually affecting the wrists, the joints of the hand, including the knuckles, the middle joints of the fingers and feet. While this condition can affect any joints, besides, important body organs such as the eyes and the lungs can also be affected by the inflammation that occurs as a result of this chronic condition. Only in America 1.3 million of people are affected by this ailment, and 75 % of them are mainly women. Its onset usually occurs between fourth and sixth decades; however, RA can occur at any age("Diseases And
Rheumatoid Arthritis has been subject of numerous studies and researches in the look for a better understanding of how it effects the individuals diagnosed with it. There is a higher incident of females diagnosed with RA than male as well as a relationship with genetic and environmental factors involved. Around one percent of the world population is affected by RA; therefore, diverse studies have been performed to understand how the lives of the diagnosed patients can be impacted by the disease. For example, how RA affects the mobility, safety and activities of daily living in general as well as the development of interventions to better approach RA. On
Osteoporosis is a medical condition in which the bones become brittle from the loss of tissue, generally as a result of specific changes. Risk factors that take part in the disease are things such as unchangeable risks like sex, age, race, family history and the size of the individual. Other risk factors include hormone levels and medication as well as dietary factors and life choices. Life choices that play a role are sedentary lifestyle these are people who spend a lot of time sitting have a higher risk of osteoporosis than do their more-active counterparts, weight-bearing exercise is beneficial for your bones to ensure the bone remolding cycle ensures them to grow strong (MayoClinic, 2013). Common symptoms that one should take into
Rheumatoid arthritis is a chronic syndrome that is characterized by inflammation of the peripheral joints, but it may also involve the lungs, heart, blood vessels, and eyes. The prevalence of this autoimmune disease is between 0.3% to 1.5% of the population in the United States (Feinberg, pp 815). It affects women two to three times more often than men, and the onset of RA is usually between 25 and 50 years of age, but it can occur at any age (Reed, pp 584). RA can be diagnosed by establishing the presence of persistent joint pain, swelling in a symmetric distribution, and prolonged morning stiffness. RA usually affects multiple joints, such as the hands, wrists, knees, elbows, feet, shoulders, hips, and small
Autoimmune diseases materializes when the immune system becomes perplexed and vicious assault the human body, devastating tissue. Thus, both Lupus and RA (Rheumatoid arthritis) are destructive autoimmune diseases. Nevertheless, it is currently undetermined what activates these diseases, but they are regrettably genetic in nature. Both diseases coalesced affect approximately 24.2 million Americans. Though they share similar symptoms, each has its unique way of inflicting excruciating and debilitating discomfort to the human body. This essay will explore the similarities and variances between the two.
Diet and exercise are pivotal in the maintenance of bone mass density (BMD), there now several bisphosphonates that can be used to improve BMD. An increase of dietary vitamin D, K and Calcium will also help to strengthen the tight coupling relationship between osteoclasts and osteoblasts which will help to maintain healthy bone structure.
Cytokine came into interest to (Feldmman and Maini, 2003) when they found in a pattern to autoimmune diseases such as RA that abnormal amounts of antigen molecules expressed on the cell surface. Cytokine seemed to regulate Major histocompatibility complex expression and further studies were carried out to study cytokine in the disease state by isolating pieces of human tissue with RA and cloning cDNA of cytokines. It was revealed that many different pro & anti-inflammatory cytokines are expressed (Figure 1) but these were overexpressed
Rheumatoid Arthritis or (RA) is an autoimmune disease that attacks the joints and connective tissue. The result is inflammation that produces permanent damage in the joints. Rheumatoid arthritis is a chronic syndrome that tends to be progressive and destructive as compared to Osteoarthritis or (OA), which is more of an age related disease caused by “wear and tear” of the joints. In contrast to (OA), rheumatoid arthritis is characterized by inflammation mostly of the joints, but is a general body disease.
The immune system helps protect the body from foreign substances and infections that could potentially harm it. One byproduct of the immune system that can cause Arthritis is the inflammatory process. “Two important components of the immune system that play a role in the inflammation associated with rheumatoid arthritis are B and T cells, both of which belong to a family of immune cells called lymphocytes, a type of white blood cell” (Maryland). The T and B cells flow in the bloodstream searching for substances that are not part of the body. If the T cell notices a foreign substance it will secrete a chemical that allows the B cells to release protein to the area with the foreign substance. These proteins fight against the virus and rid it
The inflammatory reaction also stimulates a papillary overgrowth of the synovium, known as proliferative synovitis. The Epstein-Barr virus is suspected of triggering a T-lymphocyte autoimmune reaction that attacks the synovial membrane. Also, the immune reaction in RA includes not only T lymphocytes, but also B lymphocytes, which is evidence by the fact that about 75% of patients with RA have in their blood an antibody complex, rheumatoid factor (RF). If the inflammation of the synovial membrane cannot be suppressed it will result in increasing damage to the joint, due to the release of protein-degrading enzymes from inflammatory and other cells, and a conversion of parts of the synovial membrane into an inflammatory tissue called pannus which can invade the bone and cartilage at the margins of the
Furthermore, RA is by far the most serious, painful, and potentially crippling form of arthritis. Thus, “the great crippler” is the name for this form of arthritis because it can lead to life-threatening deformities and horrendous impairment (Krishna et al 1988). Although, some sufferers have unyielding forms of the malady it can endure for many years or a lifespan. Subsequently, this mode of the ailment generates considerable joint mutilation. RA is a chronic autoimmune disease where in both genetic and environmental factors contribute to the disease process. Even though, there is no cure for RA, but new effective drugs are increasingly available to treat the disease and prevent deformed joint. Additionally, joint health can often progress with exercise, medication, and the right lifestyle habits.
Discussion RA is a common autoimmune disease associated with progressive disability, systemic complications, early death, and high socioeconomic costs. RA is characterized by synovial infl ammation and hyperplasia (swelling), autoantibody production (RF and anti-CCP antibody), cartilage and bone destruction (deformity), and systemic features, including cardiovascular, pulmonary, psychological, and skeletal disorders [4]. A number of genetic and environmental factors contribute to disease onset and severity [8] In addition, a number of viral and bacterial pathogens, such as Epstein–Barr virus, parvovirus B19, hepatitis C virus, Proteus mirabilis, and Mycobacterium tuberculosis, may have a role in disease pathogenesis as well [9].Th e