Osteoporosis: Marissa, Jeremy and Eleanor Scenario A by Lisa Rubin University at Buffalo State University of New York

Marissa

Marisa, a petite, Caucasian, 15-year-old, just learned this morning that her 55-year-old grandmother, with whom she has lived since the death of her parents, was diagnosed with osteoporosis after visiting her doctor because of chronic hip and wrist pain.

For the past year, Marisa's life has been one tragedy after another. Her happily married parents were killed in a car crash nine months earlier on the way home from their 16^th anniversary surprise party. Her boyfriend of two years moved to a different state a few months back and ended their relationship shortly after. To make things worse, her first year in high school was disastrous. Not only did she fail algebra, she didn't make the soccer team, as she had hoped.

Marisa's grandmother lives far from where Marisa used to, and because she is an only child, Marisa often finds herself feeling lonely and on the brink of depression. The only person she feels she can count on besides her grandmother is her best friend, Tara. She told Tara about her grandmother's disease as soon as she found out. Marisa has no idea what osteoporosis is or what it does to the body. All she knows is that her grandmother is the only close living relative she has and she can't fathom losing another loved one.

Assignment for Group 1

Everyone in Group 1 must be capable of defining osteoporosis and its general effects on the body. In addition, the following concepts must be addressed in detail. It is up to the group to divide the necessary research. Research will be shared with the class. Ultimately, you must address the specific type of therapy, if any, that Marisa's grandmother might use and the risks and benefits of her choice.

Bone Physiology:

1. Describe bone physiology and the bone remodeling cycle. Be sure to emphasize the two types of bone tissue and the roles of osteoblasts and osteoclasts.
    
2. Explain the relationship between calcium and bones.
    
3. Explain how the body controls calcium levels in the bones and blood. Be sure to describe the roles of parathyroid hormone (PTH) and calcitonin in detail.
    
4. Explain specifically how osteoporosis affects the bone matrix and the normal bone remodeling cycle.

Risk Factors:

5. Discuss what scientists know about the genetics behind osteoporosis.
    
6. List as many risk factors for this disease as you can, both controllable and uncontrollable.

Signs and Symptoms:

7. What are the symptoms or telltale signs of osteoporosis?

Image Credit:  Trabecular bone architecture of a lumber spine bone biopsy of a 42-year-old male (left) vs. that of an 84-year-old woman having clinically manifested osteoporosis (right). Images used with permission, courtesy of Ralph Mueller, Ph.D., ETH Zuerich and Harvard Medical School, Boston.

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