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Osteoporosis: Marissa, Jeremy and Eleanor
Scenario A

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. Herhappily married parents were killed in a car crash nine months earlier on the way home from their 16th 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. Allshe 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 theclass. 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 howthe 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, bothcontrollable and uncontrollable.

Signs and Symptoms:
7. What are the symptoms or telltale signs of osteoporosis?

1. Bone tissue makes up most of the skeleton, the framework that supports our body and protects our bodies and allow our movements. High strength and lightness, the skeletal system is a dynamic tissue, continually the process of remodelation. it consists of proteccion,movement, support and the homeostasis cellular. The bone have features: Epiphysis (Ends of the bone), Diaphysis (The shaft of the bone which surrounds the medullary cavity), Articular Cartilage (Cushions the ends of the bones and allows for smooth movement) and Areas made of cartilage allowing for the growth of the bone.

The bone tissue is divided in: Compact bone – hard strong layer (Bone cells,blood vessels, protein with Ca and P) and Spongy bone (at ends of long bones, Has small open spaces to lighten weight).

For the remodelling of the bone 2 types of cells:

• Osteoclasts: are responsible for the "bone lysis, (dissolution and demineralization) of the bone at the microscopic level. Osteoclasts are activated by the body as mechanical stresses on the skeletal structure,and they allow the body to "make room for free" for other cells, the osteoblasts form new bone tissue can be distributed in places where we must strengthen the skeleton for adapt to the demands of exercise”

• Osteoblasts: synthesize the basic fabric of the bone: collagen. They are capable of synthesizing new bone tissue, more suitable for the stresses and physical stresses to the bone...
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