Chapter 9: Musculoskeletal System Disorders

Chapter 9: Musculoskeletal System Disorders

Case Studies

Mrs. L is a 63-year-old woman who reports constant back pain. Further inquiry into her medical history revealed that over the past 3 years, she has suffered fractures of her femur and wrist after minor falls. She experienced menopause at age 49. Mrs. L has a secretarial job, drives to work, and she “does not have time for exercise.” She reports that she consumes 8 to 10 cups of coffee a day and has been a smoker most of her adult life. She has not seen her physician recently nor had a recommended bone density test because of the time and cost involved.

Discussion Questions

1. Relate Mrs. L’s history to the diagnosis of osteoporosis. What risk factors are present, and how does each predispose to decreased bone density? (See Osteoporosis—Pathophysiology.)
2. Explain the cause of pathological fractures in this patient.
3. How could osteoporosis have been prevented in Mrs. L?
4. Discuss the treatments available to the patient. (See Osteoporosis—Treatment.)

Case Study 2

Mr. F is a 38-year-old man in overall good health who has been complaining about an aching pain in his knees when working around the house and often when simply walking. He has noticed that his knees feel “hard” and tight. His history indicates that he has always been involved in athletics and was on the college football team, but recently family responsibilities and work have not made it easy for him to exercise.

Discussion Questions

1. Relate Mr. F’s case history to the pathophysiology of osteoarthritis. (See Osteoarthritis.)
2. How do anti-inflammatory drugs and analgesics help Mr. F deal with this form of arthritis? Why is moderate, non–weight-bearing exercise recommended? (See Osteoarthritis—Pathophysiology, Etiology, Treatment.)
3. What is the probable prognosis for Mr. F?

Chapter 10: Blood and Circulatory System Disorders

Case Studies

Mr. X, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. Lately he also has been experiencing a tingling feeling in his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes, including many large, hyper segmented cells. Hemoglobin and serum levels of vitamin B₁₂ were below normal. Additional tests confirm pernicious anemia.

Discussion Questions

1. Relate the pathophysiology of pernicious anemia to the manifestations listed above. (See Pernicious Anemia.)
2. Discuss how the gastric abnormalities contribute to vitamin B₁₂ and iron deficiency and how vitamin B₁₂ deficiency causes complications associated with pernicious anemia. (See Pernicious Anemia—Pathophysiology, Etiology.)
3. Discuss other tests that could be performed to diagnose this type of anemia. (See Pernicious Anemia—Diagnostic Tests.)
4. Discuss the treatment available and the limitations.

Chapter 11: Lymphatic System Disorders

Case Studies

Ms. Y is a 31-year-old woman who reported to her physician that she has recently lost weight, always seems tired, and has experienced night sweats. A few months ago, she had noticed a small firm lump on her neck that was painless and not tender, so she ignored it. Closer physical examination revealed a swelling of several lymph nodes in the neck and throat region. A blood test indicated a decreased lymphocyte count and a lymph node biopsy revealed the presence of Reed-Sternberg cells, confirming the diagnosis of Hodgkin’s lymphoma.

Discussion Questions

1. Relate the pathophysiologic changes to the manifestations and lab results. (See Hodgkin’s Disease/Lymphoma—Pathophysiology, Signs and Symptoms.)
2. Discuss the four stages of the disease based on the Ann Arbor staging system, and determine which stage the patient is probably in. Discuss the prognosis. (See Pathophysiology—Staging Systems.)
3. Discuss the treatment options for this patient. (See Treatment.)
4. Discuss the differences between Hodgkin’s and non-Hodgkin’s Lymphomas. (See Non-Hodgkin’s Lymphoma.)

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. Chapter 9: Musculoskeletal System Disorders

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. Chapter 9: Musculoskeletal System Disorders

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