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Cracking the Case

The Relationship Between Bones and Hormones


Breanna N. Harris
Biological Sciences
Texas Tech University


In this directed case study, students shadow Dr. Lee in diagnosing two patients with osteoporosis. The students are given patient history and an initial panel of test results, which they discuss in small groups. After diagnosis, they are asked specific questions about bone remodeling, bone physiology, and the drugs prescribed by Dr. Lee. The ultimate goal is to understand how osteoporosis developed in Shino Yang (post-menopausal osteoporosis) and Eleanor Davis (glucocorticoid-induced osteoporosis), and to understand the mechanism of action of the prescribed treatments. The case study data are fabricated, but the values provided are within physiological ranges and should thus be a good representation of what students would see in patients with these actual diagnoses. This case study was developed for college-level, pre-nursing students in a non-majors anatomy and physiology course, but would also be suitable for majors physiology, animal physiology, pharmacology, pre-medical or exercise physiology students, or likely any biology students with a basic knowledge of bone remodeling.

  • Explain why calcium and vitamin D are important in bone health and maintenance.
  • Compare and contrast two different ways in which osteoporosis can develop.
  • Explain the actions of estrogen and glucocorticoids on bone remodeling.
  • Diagram the role of RANK, RANKL, and OPG in bone remodeling.
  • Explain how two osteoporosis drugs function at the cellular level.
  • Gain practice in integrating and synthesizing laboratory data and patient history information in order to diagnose two patients.
Keywords: osteoporosis; clinical; drug mechanism; prolia; alendronate; bone; remodeling; RANK; RANKL; OPG; calcium; cortisol; fosamax; skeleton; estrogen; glucocorticoid; menopause; denosumab
Topical Area: N/A
Educational Level: Undergraduate lower division, Undergraduate upper division, Clinical education
Formats: PDF
Type/Method: Analysis (Issues), Directed
Language: English
Subject Headings: Biology (General)   Epidemiology   Anatomy   Physiology   Medicine (General)   Sports Science   Nursing  
Date Posted: 8/4/2016
Date Modified: N/A
Copyright: Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

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