While walking, a post-menopausal grandmother falls off a curb and lands hard on
ID: 3478737 • Letter: W
Question
While walking, a post-menopausal grandmother falls off a curb and lands hard on her outstretched right arm. Her physicians diagnose a fracture of the bone which forms the only bony connection between the uppe limb and the axial skeleton. They also note damage to the joint between the fractured bone and the axial skeleton. They perform surgery to realign the bone at the fracture to allow proper healing and they use a titanium plate to permanently secure the fractured bone to the axial skeleton at the injured joint. However, they are particularly concerned because her bone mass is quite low and due to her advanced age, she also has low osteoblast activity Using the above passage, which most likely caused her osteoporosis (low bone mass)? O O O O Too high calcitriol production Too high estrogen production Too high calcitonin production Too high PTH production 2 0.5 While walking, a post-menopausal grandmother falls off a curb and lands hard on her outstretched right arm. Her physicians diagnose a fracture of the bone which forms the only bony connection between the upper limb and the axial skeleton. They also note damage to the joint between the fractured bone and the axial skeleton. They perform surgery to realign the bone at the fracture to allow proper healing and they use a titanium plate to permanently secure the fractured bone to the axial skeleton at the injured joint. However, they are particularly concerned because her bone mass is quite low and due to her advanced age, she also has low osteoblast activity Using the above passage, what type of medication would most help her fracture heal faster? O A medication that stimulates mesenchyme formation A medication that stimulates collagen formation OA medication that inhibits blood vessel formation A medication that inhibits cartilage formationExplanation / Answer
1. Osteoporosis is characterized by bones that are thin and fragile. Hence, these bones are prone to fracture. Low calcium levels aid in osteoporosis, Parathyroid hormone enhances the release of calcium from its stores in the bone. Osteoblasts are cells that aid in bone formation as they form the osteoid matrix. Parathyroid hormone will reduce osteoblasts activity and increase osteoclast activity.
Calcitrol promotes absorption of calcium by increasing renal tubule absorption of calcium and reducing its loss through urine. Estrogen will promote intestinal absorption of calcium. Estrogen decreases the absorption of bone by osteoclasts. Calcitonin has a opposite effect to parathyroid hormone. It enhances storage of calcium in bone by increasing osteoblasts activity and decreasing osteoclast activity.
The postmenopausal women should have low estrogen levels. She had low osteoblastic activity. Hence, her parathyroid hormone levels are too high, causing osteoporosis. High PTH led to increased bone loss due to loss of calcium.
2. Healing of fraction involves various phases. Initially inflammatory cells will reach the site of fracture via blood vessels. Next, the mesenchymal stem cells reach the site of injury and proliferate. They differentiate into chondrocytes and osteoblasts. Osteoblasts will deposit bone via ossification while chondrocytes proliferate, hypertrophy, and mineralize the site. Hence, a new bone will be formed and deposited on a cartilaginous matrix. Bone remodeling will treate the fracture..
The grandmother had low bone mass, low osteoblastic activity, and suffered from osteoporosis. The medication that stimulates mesenchyme formation will provide osteoblasts and chondrocytes at the injury site due to proliferation and differentiation of mesenchymal stem cells. Hence, this is the medication. that should be prescribed.
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