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What is the difference between degenerative bone disease and osteoporosis? Explain the pathology of each.
Osteoporosis is porous bone (Huether & McCance 2018, p. 1437).  It is the most common bone disease characterized by low bond mineral density, impaired bond structural integrity, decreased bone strength, and risk of fracture (Huether & McCance 2018, p. 1437).  There is primary/idiopathic osteoporosis which is the most common.  Secondary osteoporosis is caused by other conditions such as endocrine diseases, medications, and other substances such as tobacco (Huether & McCance 2018, p. 1437).  Osteoporosis manifestations depend on the bones involved, but bone deformity is the most common (Huether & McCance 2018, p. 1437).  Pain usually accompanies a fragility fracture.  As bone lose volume, they become weak and brittle, causing collapse or become misshapen (Huether & McCance 2018, p. 1437).  The development of osteoporosis occurs when the remodeling cycle is disrupted.  The remodeling cycle is the process of bone formation and resorption (Huether & McCance 2018, p. 1437).  The disruption leads to an imbalance in the coupling process (Huether & McCance 2018, p. 1437).  Degenerative bone disease, such as osteoarthritis is more of a result from wear and tear on the bones destroying the structure.  OA is the loss and damage of articular cartilage and has been viewed as a mechanical problem (Huether & McCance 2018, p. 1445).

2.    What treatment options should be discussed with the patient?  Prevention of osteoporosis is important, but treatment is more common, and its focus is preventing fractures and maintaining optimal bone function (Huether & McCance 2018, p. 1437).  Calcium’s role to prevent and treat osteoporosis is controversial.  Yet, it is accepted that oral calcium intake to maintain normal balance of calcium is necessary during adolescence to ensure peak bone mass development (Huether & McCance 2018, p. 1437).  Diets deficient in calcium aggravates bone loss which is associated with aging and menopause.   Postmenopausal women should not increase calcium and vit d intake to prevent fractures (Huether & McCance 2018, p. 1437).  Higher fruit and vegetable take is correlated to a high BMD.  Other nutrients that appear to help include magnesium, vit k2, and docosahexaenoic acid (Huether & McCance 2018, p. 1437). 

3.    What lifestyle changes should be recommended to the patient?  The patient would be educated on stopping smoking and drinking.  Education would also include a diet stating that risk factors include low dietary calcium and vit d, low endogenous magnesium, excessive protein and sodium and high caffeine intake (Huether & McCance 2018, p. 1437).  Exercise would be encouraged, as a sedentary lifestyle is a risk factor.  
The risk of osteoporosis can be reduced through lifestyle changes (Rizzoli et al, 2014).  Adequate dietary intake of calcium, protein, and vit D is a lifestyle change needed along with exercise, smoking cessation, and alcohol reduction (Rizzoli et al, 2014).