Reference no: EM132669306

Read this article and answer the question at the bottom of this articleThe Bike Rider with a Broken Hip Susan is a 55 year-old woman who regularly exercises by riding her bicycle around her neighborhood and on trails in a nearby park. One day while she is riding, a dog runs across her path, causing her to fall. Susan lands heavily on her right side and feels a sharp pain in her hip as she tries to move. When she attempts to stand, she cannot put any weight on her right leg. Some joggers help her to a nearby bench and call for assistance.

When the emergency medical technicians arrive, they immobilize Susan's leg and check for additional injuries. Upon initial examination, it appears that Susan has some abrasions on her right side and a broken hip. The emergency team transports her to the hospital. There, the emergency room physician notes that Susan's vital signs are stable and that, with the exception of her injuries, she is in relatively good health.

Suspecting a fracture of the femur, the physician orders a series of X-rays to determine the site and extent of the injury. Results show a nondisplaced oblique fracture of the neck of the femur. In reviewing her medical history, the physician notes that Susan is postmenopausal and not using steroid hormone (estrogen and progestin) replacement therapy. But because she is physically active, the physician believes the fracture may be pathological and suggests further testing. When Susan asks why he suspects a problem, he tells her that, considering her age, the fracture could have resulted from either osteoporosis or a bone tumor. The only way to confirm either diagnosis is to conduct further tests. Susan consents to both a CT scan and bone densitometry. These scans reveal no tumors but a loss of bone mass, specifically spongy bone. The physician advises her to increase her dietary calcium intake to 1,500 mg/day, take vitamin D supplements, and decrease her intake of soft drinks, alcohol, caffeine, and nicotine. In addition, the physician recommends steroid replacement therapy to slow bone loss and other drugs to facilitate calcium absorption. He also encourages Susan to continue exercising once she recovers from the fracture.

The following day, surgery is performed to insert screws to internally fix the position of the femur and allow proper healing. The surgery is successful and after a period of observation, Susan is released from the hospital. But approximately one week after the surgery, she begins to experience an increasing amount of pain in her hip. The surgical area feels warm to the touch and is redder than the surrounding tissue. Because she has an appointment with the surgeon the following day, Susan does not think she needs to visit the emergency room. But the next day at the surgeon's office, it is noted that her temperature is elevated and her lymph nodes are swollen. Blood drawn for evaluation shows an elevated concentration of lymphocytes. The surgeon orders a CT scan, which reveals a subperiosteal abscess at the surgical site.

The surgeon immediately hospitalizes Susan and prescribes antibiotics to fight the infection. In addition, a tube is inserted in the abscess to allow drainage. The surgeon tells Susan that if her condition worsens, a second surgery may be necessary to replace the screws. However, he feels that at this time antibiotics and drainage will suffice.

Question

1. What is the significance of Susan's age? (Hint: What usually happens to women when they turn 50 years old?)

2. Which bone disorder(s) is(are) Susan at risk of developing due to her age?

3. Which bone(s) has Susan fractured?

4. Which of the scans that Susan took would reveal reduced bone mass?

5. Predict why the physician didn't order an MRI scan.

6. Why does the physician suspect that Susan's fracture is caused by a disease?

7. What benefit does taking vitamin D provide Susan?

8. Predict why the physician advises Susan to avoid soft drinks, alcohol caffeine, and nicotine.

9. What disease does Susan develop after her surgery? Defend your answer.

10. Predict how taking antibiotics helps Susan recover.