1.

The physician has asked you to explain to the patient the diagnosis and
the risk factors of the disease. What would you tell Ms. Davis about her
diagnosis and condition? (6 points)
As previously mentioned, Ms Davis’ diagnosis is osteoporosis, more specifically,
menopausal osteoporosis. We would first off tell Ms. Davis that the menopause she
experienced at the age of 51 resulted in a decrease in her estrogen levels, which is
normal. We would further explain that estrogen is a hormone which promotes bone
formation as well as prevents bone breakage. Estrogen reduces the production of the
receptor activator of Nf-kappa beta ligand (RANKL), which regulates osteoclast
formation; bone-dissolving cells that are present on the surface of the bone. Estrogen
also increases the production of osteoprotegerin (OPG), which inhibits bone resorption.
Thus, when estrogen levels drop RANKL increases, and OPG decreases, leading to an
increased risk of bone loss and for osteoporosis to develop. Osteoporosis in itself is
characterized by bones becoming more fragile as a result of decreased bone mass. The
fragility of bones leads to the body becoming more susceptible to fractures of the wrist,
vertebrae, and hips, explaining Ms Davis’ injury. Some common risk factors can include
family history, lifestyle, age, and medications. In Ms. Davis’ case, the two hip fractures
her mother experienced implies that there is some sort of a family history of osteoporosis,
suggesting that she could have a higher genetic risk. Ms Davis is also a smoker, does not
exercise regularly, has a diet low in calcium and vitamin D, all of which are lifestyle
factors that can increase the risk of osteoporosis. We would end off by telling Ms Davis
that there are many changes she can make to reduce the impacts of menopausal
osteoporosis. This can include regular exercise, the avoidance of smoking, supplementa
and an increase in calcium and vitamin D intake.

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2.
3.
4.
 5.
6.
7. The physician recommends to Viola Davis that she take the drug Prolia,
which binds to and inhibits the RANK Ligand. Is Prolia a good
recommendation for this patient? Explain how the actions of this drug
would help someone with Viola Davis's condition. (5 points)
Recommending Prolia for Ms. Davis would be a good option for her menopausal
osteoporosis. Prolia is a drug that is specifically used to treat women who lack estrogen. As
previously mentioned, when estrogen levels drop, RANKL increases. The drug works by
targeting RANKL and inhibiting its function. This stops pre-osteoclasts from forming into cells
called osteoclasts, which works to break bone tissue down. In turn, this slows down bone
resorption, which can increase bone density and decrease the risk of fractures. Thus, Prolia
is a good reccomendation for someone with Viola Davis’ condition.

Question 5.
- Prolia is a type of drug that specifically used to treat the aged women for that
lack of the estrogen this medicine would increase the bone density by
stopping the pre-osteoclast to grown into osteoclast but increase the risk of
infection
- This medicine is forbidden for the Hypocalcemia patient due to the fact that it
will significantly increase the consumption of the blood Calcium and cause slow
sensation and low consciousness
- The blood Calcium is at normal rate so it is fine to apply this treatment