2 Discussion Questions (A&P)

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An 85-year-old woman who lived alone was found lying on her kitchen floor by her daughter, who had gone to check on her. The woman could not rise, even with help; when she tried, she experienced extreme pain in her right hip. Her daughter immediately dialed 911, and paramedics took her mother to the hospital.


The elderly womanâ€™s hip was x-rayed in the emergency room, and physicians determined that she had a fracture of the right femoral neck. A femoral neck fracture is commonly, but incorrectly, called a broken hip. Two days later, she received a partial hip replacement in which the head and neck of the femur were replaced, but not the acetabulum.

In the case of falls involving femoral neck fracture, it is not always clear whether the fall caused the femoral neck to fracture or a fracture of the femoral neck caused the fall.


Femoral neck fractures are among the most common injuries resulting in morbidity (disease) and mortality (death) in older adults. Four percent of women over age 85 experience femoral neck fractures each year. Despite treatment with anticoagulants and antibiotics, about 5% of patients with femoral neck fractures develop deep vein thrombosis (blood clot), and about 5% develop wound infections; either condition can be life-threatening. Hospital mortality is 1â€“7% among patients with femoral neck fractures, and nearly 20% of patients die within 3 months of the fracture. Only about 25% of victims ever fully recover from the injury.

Research and discuss 2 of the following:


1. The femoral neck is commonly injured and elderly women commonly affected.


2. The physiologic changes that occur with prolonged immobility.


3. The treatment and management of hip fracture.


4. Hip joint replacement consideration and post-operative management.


http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682414.html discusses medications and osteoporosis



Rheumatoid arthritis (RA) is the second most common type of arthritis. It affects about 3% of all women and about 1% of all men in the United States. RA is a general connective tissue disorder that affects the skin, vessels, lungs, and other organs, but it is most pronounced in the joints. RA is severely disabling and most commonly destroys small joints, such as those in the hands and feet.


The initial cause of RA is unknown but may involve a transient infection or an autoimmune disease an immune reaction to oneâ€™s own tissues that develops against collagen. A genetic predisposition may also exist. Whatever the cause, the ultimate course appears to be immunologic. People with classic RA have a protein, rheumatoid factor, in their blood. In RA, the synovial fluid and associated connective tissue cells proliferate, forming a pannus (clothlike layer), which causes the joint capsule to become thickened and destroys the articular cartilage. In advanced stages, opposing joint surfaces can become fused. 

Research and discuss 2 of the following:

1. RA is an immunologic disorder. Discuss its development and management.


2. Rheumatoid disease may affect structures other than those of the joints. Discuss these structures and the resulting disorders that may occur.


3. Discuss the surgical management of rheumatoid arthritis.


4. Discuss the medical management of rheumatoid arthritis.



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