Musculoskeletal Function Family Practice Clinic Case Study:
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 this summer, though,” she states. Discomfort in the left knee is more significant 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 and 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 gaining 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. However, nonclinical manifestations of osteoporosis have developed.
Case Study Questions
- Define osteoarthritis and explain the differences between osteoarthrosis. List and analyze the risk factors presented in the case that contribute to the diagnosis of osteoarthritis.
- Specify the main differences between osteoarthritis and rheumatoid arthritis, including clinical manifestations, significant characteristics, affected joints, and diagnostic methods.
- Describe the treatment alternatives available, including non-pharmacological and pharmacological that you consider appropriate for this patient and why.
- How would you handle the patient 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 two years ago due to complications of a CVA—past medical history: hypertension controlled with Olmesartan 20 mg by mouth daily. 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 was having problems focusing when talking to her. She is not keeping things at home as she used to, often repeating and asking the same question several times, and yesterday she had 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, and Frontotemporal dementia.
- Define and describe explicit and implicit memory.
- Describe the diagnostic 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 for C.J?