Pauline is visiting her doctor because she fell and has suffered severe wrist pa
ID: 88301 • Letter: P
Question
Pauline is visiting her doctor because she fell and has suffered severe wrist pain. Her doctor determines that she has fractured a bone in her wrist.
a) describe at least 2 events that will occur to repair her bone.
Pauline is only 40 years old and did not suffer a severe fall. The doctor is concerned that most people would not and have fractured their wrists with this kind of fall. He suspects osteoporosis. He orders a blood Calcium test.
b) If her blood calcium is elevated, would you suspect hyperparathyroidism or dietary deficiency caused the osteoporosis? Explain why/how.
c) If her blood calcium is low normal, would you suspect hyperparathyroidism or dietary deficiency caused the osteoporosis? Explain why/how.
Her blood calcium is low normal. d) Is her PTH likely higher than baseline, lower than baseline, or baseline? Explain why.
Explanation / Answer
Answer a) Four events are taking place in repairing her bone. These are as follows
1. Hematoma formation: Because of the breakage of bone, the blood vessels tear and hemorrhage which results in the formation of blood clots or hematoma at the site of the fracture. The injured blood vessels are sealed and healed by the clotting process through white blood cells and lymphocytes.
2. Bone generation: After few days of fracture, the capillaries form in the hematoma while the dead cells begin to clear by the phagocytic cells. The fibroblasts and osteoblasts enter inside the fragments of the clotted blot and begin to reform bone. Fibroblasts are responsible for the production of collagen fibers that connect the broken bone ends, while osteoblasts regulate the formation of spongy bone. The repair tissue between the broken bone ends is made up of hyaline and fibrocartilage
3. Bone callus formation
4. Bone remodelling
Answer b) She is suffering from hyperparathyroidism which causes osteoporosis. The bones of the body store a large quantity of calcium that is regulated by the parathyroid gland. The overactivity of one or more parathyroid lobes causes the constant release of calcium into the blood stream. This results in the elevated blood calcium level and thereby, hyperparathyroidism. This further leads to the decreased calcium concentration in bones and result in osteoporosis. In osteoporosis, the density and hardness of the bone are reduced and makes bones more prone to breakage or fracture.