Question:
Discuss about the Pathophysiology of Osteoporosis.
Osteoporosis is a condition which affects borne by weakening them and also making them more fragile that they can break. The condition develops slowly and leads to abnormal porous born which is compressible like a sponge. The condition usually results in fractures and it affects one in two white women and also one in two of white men in their lifetime (Salam et al., 2014). The consequences of fractures encompass the loss of function, increased mortality and significant cost. The key factors of the condition are genetic, lack of calcium and vitamin D and also lack of exercise. Cigarette smoking, alcohol consumption, family history of the condition, history of rheumatoid arthritis and low body weight. The patients with osteoporosis have no symptoms till the occurrence of fractures. The condition can be diagnosed by the X-rays and also the confirmed tests aimed at measuring the density of the bone. The study focuses on Marika who is approximated to have 80 years and is complaining to be suffering from osteoporosis.
The basic mechanisms which are responsible for the development of osteoporosis are linked to mass acquisition at the time of development and growth and enhanced bone loss in the time after peak bone mass is attained. All these processes are modulated by environmental and genetic factors (Mirza and Canalis, 2015). Nearly 66 percent of the fracture risks in postmenopausal women is usually determined by peak bone mass. However, the peak bone mass is higher in black people as compared to Asians and whites. Studies have shown that half of the bone mass is amassed during pubertal development and it is linked to the high levels of sex hormones. Accumulation of the materials of bone is minimal at during the next 5 to 15 years. However, the peak bone mass is attained at 30 years of life. This condition is multifactorial in pathophysiology. The fractures of the condition happen due to a combination of intrinsic bone fragility and injury (Salam et al., 2014). The injuries are associated with poor postural reflexes which fail to protect bony parts from any impacts, falls, and minimized padding of soft tissue over bony prominences.
Furthermore, the fragility is a combined geometry with the severance of micro-architectural links, low mass density in tabular structures and changed bone material quality. Bone quality is due to the accumulated fatigue damage but minimized collagen cross-links and some other essential material faults can also have a big role (Salam et al., 2014). The reduction in the mass of the bone is a result of combinations such as deficiency in calcium and vitamin D, reduced physical tasks, defects of medicines used to treat other conditions and comorbidity. In addition, the poor result of hip fractures in old people is as a result of linked protein-calorie malnutrition. The caloric and protein malnutrition predisposes to falls and reduces the soft tissue cover on the bony eminences. The history of weighing of women and girls having anorexia nervosa is a crucial predictor for osteoporosis development. The chronic use is linked to the reduced BMD in lumbar spine and femoral neck (Salam et al., 2014). It is one of the risk factors for osteoporosis. Some other deficiencies linked to the alcohol abuse have a big role in osteoporosis development.
Female being the most vulnerable people to osteoporosis is a factor which risked Marika from falling sick. However, being at the age of 80 years is another factor. Marika had hypertensions which is also another risk which could have made her have the condition. Since she lost her husband and left with responsibilities of looking after Bronco, life might have been hard to an extent that she did not get balance diet food to assist in building her bones.
Marika should undergo a test to examine her conditions. The tests she should undergo are mentioned below.
This is the only test which can diagnose osteoporosis prior to fractures. The test assists to get rid of the bone densities and the chance of her to break a bone (Lorentzon and Cummings, 2015). The test uses a machine to examine the bone density of Marika and also estimates the amount of hip bone, spine bone and other types of bones. I believe that this kind of test is suitable for Marika due to her age. The health care providers recommend that the bone density of hip and spine should be done for many reasons. For instance, people with such kinds of diseases have the ability to fractures these bones easily (Lorentzon and Cummings, 2015). However, these fractures can cause serious issues the common X-rays cannot be used due to the fact that they are not able to show osteoporosis till when it is in advance stages. Furthermore, an X-ray can be employed with density tests to detect cases of broken bones. Screening test also falls under density tests and it is meant to measure the density of the bone in the finger, lower arm and wrist. These tests will assist Marika to identify if the show will be likely to benefit from further bone density examinations.
One of the noticeable symptoms which Marika had is the pain. This could have been due to some fractures in her bones. However, due to lack of calcium in the body, it leads to high blood pressure and this has been a problem Marika have been battling with (Kling et al., 2014). Marika also was not able to perform duties to mean that her bones were weak.
Marika is in the acute stage of osteoporosis. This due to the development of pains which could be as a result of bone fractures in the spine, wrist, neck, and hip. The broken bone could have landed on the nerve causing lots of pain (Kling et al., 2014). She is also unable to perform tasks.
Treatment for osteoporosis is a right direction for the bone health. The common medication for this condition are bisphosphates which include zoledronic acid, alendronate, and ibandronate. The hormone-like estrogen plays a role in prevention and treatment of osteoporosis but there have been concerned side effects (Adler et al., 2016). They should be the lowest dose of these hormones for a short period. Women who are menopausal conditions can weigh the advantage of improved health condition. The hormone-like medications, however, have been approved for treating this condition an example is raloxifene. Furthermore, denosumab is one of the new medication which has been found to reduce the risks of the osteoporosis fracture in both women and men. Denosumab can also be used for individuals who are not in a position to take a bisphosphonate, an example is the ones with reduced kidney failure.
Teriparatide is commonly used for men and also for postmenopausal women having low bone density, those whose their condition was caused by steroid medication or who have fractures this kind of drug is suitable for Marika and it is potential to rebuild the bone(Black and Rosen, 2016). In addition, another newest medication for osteoporosis is abaloparatide. Just like teriparatide, this kind of drug has the potential to rebuild the bone, research has shown that abaloparatide is more effective as compared to teriparatide but it is not likely to cause additional calcium. The medication of osteoporosis put a brake on the progress. The very drugs to treat this condition maintain the density of the bone and reduce the risk of bone fracture due to osteoporosis.
Strepntium renelate have a potential effect on the cells which break down bone and also the cells which develop new bones. The drug can be employed as an alternative for bisphosphates.it is administered in powder which is dissolved in water. The use of SERMs is also applicable for treatment of osteoporosis. These are kinds of medications which have similar effects on the bone like estrogen (Black and Rosen, 2016). The assist in maintaining the bone density and also minimize the risk of a spine fracture. Osteoporosis also can be treated by use of vitamin D and calcium supplements calcium is one of the component minerals of the bone which is necessary for marinating healthy bones. Having osteoporosis means that one needs more calcium in supplement form. However, vitamin D is required in the body to assist in the absorption of calcium. Due to the fact that vitamin D is found in few types of foods, the osteoporosis patients should consider taking daily supplements that contain 10mcg. It is advisable that people should consider balanced diets particularly the ones which help in rebuilding bones in order to avoid osteoporosis in future.
Conclusions
Osteoporosis is a condition which affects bones. Older women are more susceptible to the disease and nutrition and behavioural factors can contribute it. Marika being a victim the condition is at the acute stage of osteoporosis. She might have lacked bone rebuilding foods thus making her susceptible to the condition. She had to undergo bone density tests to evaluate if she really had the disease. The treatments for the condition varies. For instance, bisphosphates, Teriparatide which is commonly used for men and also for postmenopausal women having low bone density, the Strepntium relate is employed as an alternative for bisphosphates, vitamin D, and calcium supplements calcium. However, the hormone-like estrogen can also be used and it plays a role in prevention and treatment of osteoporosis.
References
Mirza, F. and Canalis, E., 2015. Management of endocrine disease: secondary osteoporosis: pathophysiology and management. European Journal of Endocrinology, 173(3), pp.R131-R151.
Salam, S.N., Eastell, R. and Khwaja, A., 2014. Fragility fractures and osteoporosis in CKD: pathophysiology and diagnostic methods. American Journal of Kidney Diseases, 63(6), pp.1049-1059.
Lorentzon, M. and Cummings, S.R., 2015. Osteoporosis: the evolution of a diagnosis. Journal of internal medicine, 277(6), pp.650-661.
Black, D.M. and Rosen, C.J., 2016. Postmenopausal osteoporosis. New England Journal of Medicine, 374(3), pp.254-262.
Adler, R.A., El?Hajj Fuleihan, G., Bauer, D.C., Camacho, P.M., Clarke, B.L., Clines, G.A., Compston, J.E., Drake, M.T., Edwards, B.J., Favus, M.J. and Greenspan, S.L., 2016. Managing Osteoporosis in Patients on Long?Term Bisphosphonate Treatment: Report of a Task Force of the American Society for Bone and Mineral Research. Journal of Bone and Mineral Research, 31(1), pp.16-35.
Kling, J.M., Clarke, B.L. and Sandhu, N.P., 2014. Osteoporosis prevention, screening, and treatment: a review. Journal of women’s health, 23(7), pp.563-572.
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