WGU PATHOPHYSIOLOGY D236 COMPLETE QUESTIONS AND ANSWERS

WGU PATHOPHYSIOLOGY D236
COMPLETE QUESTIONS AND
ANSWERS


What is Starling's Law of Capillary forces?
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How does this explain why a nutritionally deficient child would hav
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e edema? - CORRECT ANSWER-
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Starling's Law describes how fluids move across the capillary me
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mbrane. There are two major opposing forces that act to balance
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each other, hydrostatic pressure (pushing water out of the capillar
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ies) and osmotic pressure (including oncontic pressure, which pu
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shes fluid into the capillaries).
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Both electrolytes and proteins (oncontic pressure) in the blood aff
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ect osmotic pressure, high electrolyte and protein concentrations
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in the blood would cause water to leave the cells and interstitial sp
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ace and enter the blood stream to dilute the high concentrations.
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On, the other hand, low electrolyte and protein concentrations (as
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seen in a nutritionally deficient child) would cause water to leave t
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he capillaries and enter the cells and interstitial fluid which can lea
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d to edema.
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How does the RAAS (Renin-Angiotensin-
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Aldosterone System) result in increased blood volume and increa k k k k k k k k


sed blood pressure? - CORRECT ANSWER-
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A drop in blood pressure is sensed by the kidneys by low perfusio
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n, which in turn begins to secrete renin.
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Renin then triggers the liver to produce angiotensinogen, which is
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kconverted to Angiotensin I in the lungs and then angiotensin II by
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the enzyme k k

,Angiotensin-
converting enzyme (ACE). Angiotensin II stimulates peripheral ar
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terial vasoconstriction which raises BP.
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Angiotensin II is also stimulating the adrenal gland to release aldo
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sterone, which acts to increase sodium and water reabsorption in
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creasing blood volume, while also increased potassium secretion
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in urine.
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How can hyperkalemia lead to cardiac arrest? -
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CORRECT ANSWER-
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Normal levels of potassium are between 3.5 and 5.2 mEq/dL. Hy
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perkalemia refers to potassium levels higher that 5.2 mEq/dL.
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A major function of potassium is to conduct nerve impulses in mu
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scles. Too low and muscle weakness occurs and too much can c
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ause muscle spasms. k k k




This is especially dangerous in the heart muscle and an irregular
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heartbeat can cause a heart attack k k k k k




The body uses the Protein Buffering System, Phosphate Bufferin
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g System, and Carbonic Acid-
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Bicarbonate System to regulate and maintain homeostatic pH, w k k k k k k k k


hat is the consequence of a pH imbalance -
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kCORRECT ANSWER- k


Proteins contain many acidic and basic group that can be affecte
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d by pH changes. Any increase or decrease in blood pH can alter
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the structure of the protein (denature), thereby affecting its functio
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n as well
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Describe the laboratory findings associated with metabolic acido
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sis, metabolic alkalosis, respiratory acidosis and respiratory alkal
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osis. (ie relative pH and CO2 levels). - CORRECT ANSWER-
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Normal ABGs (Arterial Blood Gases) Blood pH: 7.35-
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,7.45 PCO2: 35-45 mm Hg PO2: 90-100 mm Hg HCO3-: 22-
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26 mEq/L SaO2: 95-100%
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Respiratory acidosis and alkalosis are marked by changes in PC k k k k k k k k k


O2. Higher = acidosis and lower = alkalosis
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Metabolic acidosis and alkalosis are caused by something other t
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han abnormal CO2 levels. This could include toxicity, diabetes, re
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nal failure or excessive GI losses.
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Here are the rules to follow to determine if is respiratory or metab
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olic in nature. -
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If pH and PCO2 are moving in opposite directions, then it is the p
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CO2 levels that are causing the imbalance and it is respiratory in
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nature. k




-
If PCO2 is normal or is moving in the same direction as the pH, th
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en the imbalance is metabolic in nature.
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The anion gap is the difference between measured cations (Na+
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and K+) and measured anions (Cl- and HCO3-
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), this calculation can be useful in determining the cause of metab
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olic acidosis. k k




Why would an increased anion gap be observed in diabetic ketoa
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cidosis or lactic acidosis? - CORRECT ANSWER-
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The anion gap is the calculation of unmeasured anions in the bloo
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d. k




Lactic acid and ketones both lead to the production of unmeasure
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d anions, which remove HCO3-
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k(a measured anion) due to buffering of the excess H+ and therefo
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re leads to an increase in the AG.
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Why is it important to maintain a homeostatic balance of glucose i
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n the blood (ie describe the pathogenesis of diabetes)? -
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, kCORRECT ANSWER- k


Insulin is the hormone responsible for initiating the uptake of gluc
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ose by the cells. Cells use glucose to produce energy (ATP).
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In a normal individual, when blood glucose increases, the pancre
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as is signaled to produced in insulin, which binds to insulin recept
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ors on a cells surface and initiates the uptake of glucose.
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Glucose is a very reactive molecule and if left in the blood, it can s
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tart to bind to other proteins and lipids, which can lead to loss of fu
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nction. k




AGEs are advanced glycation end products that are a result of glu
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cose reacting with the endothelial lining, which can lead to damag
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e in the heart and kidneys.
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Compare and contrast Type I and Type II Diabetes - k k k k k k k k k


kCORRECT ANSWER- k


Type I diabetes is caused by lack of insulin. With out insulin signal
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ing, glucose will not be taken into the cell and leads to high blood
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glucose (hyperglycemia). Type I is usually treated with insulin inje
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ctions. k




Type II diabetes is caused by a desensitization to insulin signalin
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g. The insulin receptors are no longer responding to insulin, whic
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h also leads to hyperglycemia.
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Type II is usually treated with drugs to increase the sensitization t
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o insulin (metformin), dietary and life-
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style changes or insulin injections.
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Describe some reasons for a patient needing dialysis - k k k k k k k k


CORRECT ANSWER-AEIOU-
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acidosis. Electrolytes, Intoxication/Ingestion, overload, uremia. P
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atients with kidney or heart failure. k k k k k k