27 Oct One sunny day, Mrs. G decides to go for a walk in the gardens of the retirement home, when she stumbles over a branch and falls.

One sunny day, Mrs. G decides to go for a walk in the gardens of the retirement home, when she stumbles over a branch and falls. She feels excruciating pain in her hip. A fellow resident calls out to the nursing staff, and Mrs. G is taken to the emergency department at the Royal Melbourne Hospital. An X-ray reveals that she had hip fracture and must have surgery to repair it. Mrs. G wonders whether this is linked to the pain she had been experiencing in her left knee the last few years. The specialist explains to Mrs G that the pain in her left knee is due to loss of cartilage between bones at the knee joint and that the fracture might have been due to weakened bones. A blood test shows negative for rheumatoid factor. He tells her he would like her to have a bone mineral density test to measure her bone density. The DEXA scan gave a T-score of −3.0. Mrs. G is now given bisphosphonates and told to increase her daily intake of calcium and take vitamin D supplements.

Question 6 

Name the most likely condition Mrs. G had on her left knee and list two clinical signs/ symptoms of the condition that support your claim. Describe the pathogenesis of your diagnosed condition.

Question 7 

Considering Mrs. G’s T-score, identify the disease she suffers from, briefly describe the pathogenesis of this disease, describe the mechanism of action of bisphosphonate, and explain the benefits of this treatment in her present condition.

Question 8 

Based on its aetiology and considering Mrs. G’s DEXA scan as well as the condition you identified under Question 6, identify the type of fracture she most likely suffered from as the result of her recent accident.

Name and discuss changes in TWO physiological factors associated with aging that make bone fracture healing in elderly more difficult and slower than in younger individuals.