Define osteoarthritis and explain the differences with osteoarthrosis

Define osteoarthritis and explain the differences with osteoarthrosis

Define osteoarthritis and explain the differences with osteoarthrosis 150 150 Peter

Define osteoarthritis and explain the differences with osteoarthrosis

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 a bit this summer though,” she states. Discomfort in the left knee is greater 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 but also 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 she gained 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 with the disease. However, nonclinical manifestations of osteoporosis have developed.

Case Study Questions

  1. Define osteoarthritis and explain the differences with osteoarthrosis. List and analyze the risk factors that are presented on the case that contribute to the diagnosis of osteoarthritis.
  2. Specify the main differences between osteoarthritis and rheumatoid arthritis, make sure to include clinical manifestations, major characteristics, joints usually affected and diagnostic methods.
  3. Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why.
  4. How would you handle the patient concern about osteoporosis? Describe your interventions and education you would provide to her regarding osteoporosis.

Neurological Function:
H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no 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 start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store.

Case Study Questions

  1. Name the most common risks factors for Alzheimer’s disease
  2. Name and describe the similarities and the differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia.
  3. Define and describe explicit and implicit memory.
  4. Describe the diagnosis criteria developed for the Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association
  5. What would be the best therapeutic approach on C.J.

Instruction: complete both case studies.

  • Your initial post should be at least 500 words each case, formatted and cited in current APA style with support from at least 2 academic sources from year 2017-now.

Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.

Sample Paper

Definition of Osteoarthritis, Comparison with Osteoarthrosis & Risk Factors for G.J.

Osteoarthritis (OA) is defined as the deterioration of cartilage, it’s underlying bone and bony overgrowth (Dlugasch & Story, 2020). When it comes to OA the cartilage’s surface changes due to wearing, becoming rough and effecting the joints movement ability; tissue damage activates an inflammatory response and cell death in which eventually cannot be repaired. According to Dlugasch and Story (2020), signs of OA start with joint pain, stiffness and a decrease in the range of motion, usually starting in hands and knees before moving to the back and hips. G. J. is presenting with these symptoms as well as it is noted she has stiffness that worsens with inactivity that alleviates with movement (Dulagsch & Story, 2020). Osteoarthrosis is different from OA because this is considered the degeneration of the joint and just an inflammatory response that can change the joint.

Differences Between Osteoarthritis & Rheumatoid Arthritis

Unlike OA, rheumatoid arthritis (RA) is a systemic condition that involves multiple joints and is autoimmune related; mostly affecting synovial membranes like OA but also has the ability to affect organs such as the heart and skin (Delugasch & Story, 2020). OA is not a systemic disease but it one in which can only affect cartilage and bone. It is mentioned that the main difference between OA and RA is that OA is a disorder of movable joints characterized by its deterioration of the cartilage and the formation of new bone in surrounding joints (Attur et.al., 2002).

According to Delugasch and Story (2020), RA is diagnosed using blood testing of serum
rheumatoid factor and anticyclic citrullinated peptide antibodies tests as well as x-rays to view
joint space narrowing, bone erosion and osteopenia. Both diagnoses start with a history and
physical, unlike RA, OA does not require any scans, mostly laboratory testing is completed to
rule out other diagnosis (Delugasch & Story, 2020).

Non-pharmacological & Pharmacological treatment options for G.J.

As it is noted that the patient has developed a high tolerance for analgesics, I would only
recommend trying corticosteroids injection to attempt to help with the inflammation. As for non-pharmacological interventions the patient could try physical therapy, ambulatory aids, herbal remedies, heat/cold applications, topical agents or even water therapy (Delugasch & Story, 2020).

Patient Concerns about Osteoporosis – Interventions & Education

Regarding the patients concern for osteoporosis I would recommend the patient attend for
screening, a DEXA scan to determine bony density, this is usually completed every two years or
so. Education for the patient to prevent bone loss and attempt to restore
bone density if feasible would include managing nutrition, adding more calcium and vitamin D,
increase weight-bearing activities, limit caffeine as well as stopping drinking and smoking if
patient participates in these recreations (Delugasch & Story, 2020).

Common Risk Factors for Alzheimer’s Disease

Risk factors for Alzheimer’s disease (AD) include family history, hypertension,
hypercholesterolemia, diabetes mellitus, obesity or a history of tuberculosis infection; it is also
mentioned that those with a lower IQ who do not frequently exercise their brain are more likely
to develop AD (Delugasch & Story, 2020).

Similarities & Differences of Alzheimer’s, Vascular Dementia, Dementia with Lewy Bodies & Frontotemporal Dementia

All these diseases affect the cognitive abilities of the brain, they all eventually lead to the diagnosis of dementia. Alzheimer’s disease is caused by an overproduction of beta amyloid peptides with or without the ability to clear it; AD is like dementia with Lewy bodies as it can contain amyloid plaques and neurofibrillary tangles. According to Delugasch and Story (2020), vascular dementia results from disorders that impair blood flow, while dementia with Lewy bodies is thought to be caused by dysfunction of alpha-synuclein proteins; frontotemporal dementia is different as it is a range of disorders that cause focal degeneration of frontal and temporal lobes and thought to be inherited.

Definition of Explicit & Implicit Memory

Explicit memory is thought to evolve around factual knowledge involving awareness and consciousness; this requires the use of the hippocampus, parts of the temporal lobe and cortex to have retention. Explicit memory includes sematic memory which is for facts such as words and language, as well as episodic memory that is for memories and events such as personal history (Delugasch & Story, 2020).

Implicit memory is more unconscious based and requires an intact amygdala, cerebellum,
striatum and parts of the cortex; this involves procedural memory which refers to skills that
become automatic once learned (Delugasch & Story, 2020). Implicit memory refers to priming
and perceptual learning such as words and object association, associative learning which is
stimulus relationships and motor responses as well as nonassociative learning such as our habits.

Diagnosis Criteria for Alzheimer’s by National Institute of Aging & Alzheimer’s Association

According of the National Institute on Aging (n.d), the diagnostic criteria evolve around the
process of staging the disease, whether early, preclinical, mild cognitive impairment and final
stage with symptoms of dementia. The patient is evaluated not only on memory loss but also in
regard to other cognitive functions such as judgement and word finding; the use of biomarkers is
now used to indicate underlying brain disease, but this is mostly used in research not clinical
settings (National Institute on Aging, n.d.).

Best Therapeutic Approach for C.J.

According to Delugasch and Story (2020), the best therapeutic approaches for C.J. include
medications such as cholinesterase inhibitors to attempt to improve neurotransmitter levels;
alternative therapies include various vitamin B supplements, vitamin E, ginko, the use of
memory aids, nutritional support, cognitive activities, social interactions and implementing
safety precautions (Delugasch & Story, 2020).

References
Attur, M. G., Dave, M., Akamatsu, M., Katoh, M., & Amin, A. R. (2012). Osteoarthritis or osteoarthrosis: the definition of inflammation becomes a semantic issue in the genomic era of molecular medicine. Osteoarthritis and Cartilage, 10(1), 1–4. https://doi.org/10.1053/joca.2001.0488

Dlugasch, L. & Story, L. (2020). Applied pathophysiology for the advanced practice nurse. Burlington, MA: Jones and Bartlett Learning.

McCance, K. L. & Huether, S. E. (2014). Pathophysiology: The biologic basis of disease in adults and children (7th ed.). St. Louis, MO.

National Institute on Aging. (n.d.). Alzheimer’s disease diagnostic guideline. U.S. Department of Health and Human Services. https://www.nia.nih.gov/health/alzheimers-disease-diagnosticguidelines