Drug Abuse

Peta is a retired, 65-year-old woman, who has been drinking a couple of alcoholic beverages every night whilst relaxing with her husband. She has also started smoking again, which she has not done since prior to her marriage 40 years ago. In fact, what started as a couple of cigarettes every day has now become a packet a day.
More recently, her friends have noticed that she stumbles quite often, forgets things, is moody, and is flushed in the face almost all the time. When questioned about the amount she drinks, she denies excessive use and states that she has only 3–4 glasses of vodka every night. Further, because she has noticed that she no longer gets the same pleasurable feelings from a couple of glasses as before, she doesn’t think the alcohol affects her as much as her friends suggest.
Peta has also lost interest in many things she once enjoyed; dancing, going to the movies, and her art class. She cries at the drop of a hat, finds it difficult falling asleep at night, and this led her to drink even more—often until she passes out. She has no energy to get up and just wants to stay in bed all day.
After several unsuccessful attempts, her husband, Ken, finally could convince her to seek professional help about her condition. At the medical clinic, the GP listens to Peta’s signs and symptoms, conducts a thorough physical examination, and then prescribes a benzodiazepine (Xanax) and a selective serotonin reuptake inhibitor (Zoloft) for her. Peta is also given information on counselling and is referred to a professional counsellor to talk through her problems and help her with finding adequate coping strategies.

Question 1/1 Based on the scenario outlined above, identify two diseases/conditions Peta has, and justify your answer by stating relevant facts from the case study. (3 marks)

Question 1/2 For one of the diseases/conditions you have identified in Question 1/1, link the pathophysiology to the characteristic signs and symptoms of the disease. (2 marks)

Question 1/3 For the disease you have selected in Question 1/2, describe the mechanism of action of the relevant drug Peta is prescribed with, and explain how these drug actions help mitigate some of her symptoms. In your answer, relate the drug’s mechanism of action to the pathophysiology of the disease. (3 marks)

Peta’s family was happy with the management plan established by the doctor as Peta was progressing quite well. Unfortunately, however, on a quiet Sunday morning, Peta tripped and fell, which resulted in excruciating pain in her hip. She could not even get up; her husband called the ambulance and tried to comfort her until they arrived. She was taken to hospital, where the X-ray confirmed that she suffered hip fracture. The examination also revealed that although the fracture had not breached the integrity of the skin, it resulted in numerous fragments of bone at the site of the injury. A bone density test was also completed, which indicated that Peta had a T-score of −2.7.

Question 1/4 Interpret the result of the bone density measurement, indicate what reading would be considered physiological, and name the condition Peta’s finding is associated with. (3 mark)

Question 1/5 Describe the aetiology and pathogenesis of the disease you specified in the previous question. (5 marks)

Question 1/6 Name the structure where Peta’s fracture occurred and—based on the information provided and considering her history—characterize the fracture and describe the most likely link between the condition you named under Question 1/4 and her current injury. (4 marks)