WGU D236 Objective Assessment Pathophysiology Exam (Latest 2023/ 2024 Update) Questions and Verified Answers| Grade A

WGU D236 Objective Assessment Pathophysiology Exam (Latest 2023/ 2024 Update) Questions and Verified Answers| Grade A Q: What is Spina Bifida? Why are relative deficiencies in Folic acid or B12 associated with Spina Bifida? Answer: Failure to close the neural tube early in gestation due to low folic acid and B-12 These vitamins help activate DNA synthesis in the developing fetus in the first 4 weeks of pregnancy, that are responsible for closing up the spinal column. Three types of spina bifida. 1) spina bifida occulta (most common, less severe) 2) Meningocele (least common) 3) Myelomeningocele (most severe). Q: How does the body's cellular responses and adaptations react to disrup- tions? Answer: The body uses the RAAS system to regulate blood volume and pressure, the immune response reacts to fight infection, the inflammatory response reacts to injury Q: Describe how calcitonin, parathyroid hormone, and calcitriol (Vitamin D) work together to maintain normal blood calcium levels. Answer: Vitamin D: UV light stimulates formation of cholecalciferol, which is hydroxylated in the liver and the kidney into the active form of Vitamin D, calcitriol. Calcitriol stimulates absorption of calcium and phosphorus from the GI tract in the intestine and phosphate in the kidney. Calcitriol increases the calcification of osteoid. Calcitriol also stimulates the formation of bone by raising the levels of calcium and phosphorus in the blood. Low vitamin D levels can cause hypocalcemia, which stimulates the parathyroid gland to release parathyroid hormone (PTH). PTH stimulates osteoclasts to resorb bone calcium to increase blood calcium levels. PTH also stimulates osteoblasts to form bone. PTH stimulates kidneys to reabsorb calcium into the blood and to synthesize vitamin D. When blood calcium gets too high, the thyroid is stimulated to release calcitonin (suppresses osteoclast activity and calcium will be used to form bone). Q: Describe the function of osteocytes within lacunae of bone Answer: Osteocytes absorb nutrients from the bloodstream and distribute them within the bone struc- ture. Osteocytes absorb waste products from the bone and excrete them into the bloodstream. Q: Describe bone remodeling. Which cells are involved in this process and what is their function? Answer: Osteoclasts breakdown older bone structure and secrete the release calcium into the bloodstream. Osteoblasts absorb calcium from the bloodstream and use it to build new bone structure. Working together, these two cell types allow for regeneration of damaged bone structure. Q: Describe the process of articular degeneration. Which cells are involved in this process and what is their function? Answer: Articular Degeneration is the thinning and breakdown of the articular cartilage that covers joints and acts as a lubricant and cushion. This articular cartilage is comprised of chondrocytes in a matrix of collagen and aggrecan. The chondrocytes produce enzymes and other proteins that slowly break down and reform the matrix, allowing for regeneration. Stress caused by being overweight or physical trauma can cause chondrocytes to speed up the matrix breakdown process relative to the reformation process, leading to a thinning of the articular cartilage. Q: What is rickets? How does it develop? Who usually develops rickets? How can rickets be treated? Answer: Rickets is, primarily, due to a deficiency of vitamin D (due to sunlight exposure), which leads to a deficiency of blood calcium. Rickets can lead to bone weakness, deformity, and susceptibility to fracture. Rickets results from a failure to calcify osteoid due to low amounts of blood calcium and low vitamin D (typically). There are many different types of rickets. Children, especially under age 2, are most likely to be diagnosed with rickets. Infants can develop rickets if their mother's diet was low in vitamin D or in calcium, and breastmilk is low in vitamin D, so mother and baby need to supplement vitamin D (and calcium). The best way to treat rickets is to prevent it by taking supplements of vitamin D and calcium, eating food/drink containing vitamin D/calcium, and getting sufficient sunlight. Physical therapy with weight-bearing exercise can help to treat rickets, as well. It is a multi step process to make the active form of Vit D Q: How does Denosumab treat osteoporosis? Answer: Denosumab is a monoclonal antibody that binds to osteoclasts and inhibits their Calcium-withdrawing capability. Q: Distinguish between open reduction and internal fixation (ORIF) and hip replacement surgery. Answer: Open reduction and internal fixation involves "surgical open- ing' and insertion of hardware into the patient that assists with maintaining proper bone alignment during the healing process. Hip replacement involves replacement of a fractured hip joint with a prosthesis. Q: What is degenerative disc disease? What are some of the anatomical features of degenerative disc disease? What are some symptoms of lumbar vs. cervical degenerative disc disease? Answer: Degenerative disc disease (DDD) is a disorder of the intervertebral discs. When the discs deteriorate, they cause improper alignment of the spinal column. Some anatomical issues that result are thinning discs, herniated discs (nucleus pulposus leaking through annulus fibrosus cartilage), bulging discs, and degenerated discs (possible with the formation of osteophytes). Lumbar DDD results in pain in the buttock and thighs that gets worse with sitting, bending, lifting or twisting; weakness and numbness in the lower body, such as sciat- ica. Cervical DDD can result in chronic neck pain that radiates to shoulders and down the arms, weakness of arms/hands, and numbness and tingling in arms/hands.