WGU
pathophysiology
D236
LATEST
2024
||
A+
GOLD
RATED
{QUESTIONS
&
ANSWERS}VERIFIED
ANSWERS
What
is
Starling's
Law
of
Capillary
forces?
How
does
this
explain
why
a
nutritionally
deficient
child
would
have
edema?
-
ANS
Starling's
Law
describes
how
fluids
move
across
the
capillary
membrane.
There
are
two
major
opposing
forces
that
act
to
balance
each
other,
hydrostatic
pressure
(pushing
water
out
of
the
capillaries)
and
osmotic
pressure
(including
oncontic
pressure,
which
pushes
fluid
into
the
capillaries).
Both
electrolytes
and
proteins
(oncontic
pressure)
in
the
blood
affect
osmotic
pressure,
high
electrolyte
and
protein
concentrations
in
the
blood
would
cause
water
to
leave
the
cells
and
interstitial
space
and
enter
the
blood
stream
to
dilute
the
high
concentrations.
On,
the
other
hand,
low
electrolyte
and
protein
concentrations
(as
seen
in
a
nutritionally
deficient
child)
would
cause
water
to
leave
the
capillaries
and
enter
the
cells
and
interstitial
fluid
which
can
lead
to
edema.
How
does
the
RAAS
(Renin-Angiotensin-Aldosterone
System)
result
in
increased
blood
volume
and
increased
blood
pressure?
-
ANS
A
drop
in
blood
pressure
is
sensed
by
the
kidneys
by
low
perfusion,
which
in
turn
begins
to
secrete
renin.
Renin
then
triggers
the
liver
to
produce
angiotensinogen,
which
is
converted
to
Angiotensin
I
in
the
lungs
and
then
angiotensin
II
by
the
enzyme
Angiotensin-converting
enzyme
(ACE).
Angiotensin
II
stimulates
peripheral
arterial
vasoconstriction
which
raises
BP.
Angiotensin
II
is
also
stimulating
the
adrenal
gland
to
release
aldosterone,
which
acts
to
increase
sodium
and
water
reabsorption
increasing
blood
volume,
while
also
increased
potassium
secretion
in
urine.
How
can
hyperkalemia
lead
to
cardiac
arrest?
-
ANS
Normal
levels
of
potassium
are
between
3.5
and
5.2
mEq/dL.
Hyperkalemia
refers
to
potassium
levels
higher
that
5.2
mEq/dL.
A
major
function
of
potassium
is
to
conduct
nerve
impulses
in
muscles.
Too
low
and
muscle
weakness
occurs
and
too
much
can
cause
muscle
spasms.
This
is
especially
dangerous
in
the
heart
muscle
and
an
irregular
heartbeat
can
cause
a
heart
attack The
body
uses
the
Protein
Buffering
System,
Phosphate
Buffering
System,
and
Carbonic
Acid-Bicarbonate
System
to
regulate
and
maintain
homeostatic
pH,
what
is
the
consequence
of
a
pH
imbalance
-
ANS
Proteins
contain
many
acidic
and
basic
group
that
can
be
affected
by
pH
changes.
Any
increase
or
decrease
in
blood
pH
can
alter
the
structure
of
the
protein
(denature),
thereby
affecting
its
function
as
well
Describe
the
laboratory
findings
associated
with
metabolic
acidosis,
metabolic
alkalosis,
respiratory
acidosis
and
respiratory
alkalosis.
(ie
relative
pH
and
CO2
levels).
-
ANS
Normal
ABGs
(Arterial
Blood
Gases)
Blood
pH:
7.35-7.45
PCO2:
35-45
mm
Hg
PO2:
90-100
mm
Hg
HCO3-:
22-26
mEq/L
SaO2:
95-100%
Respiratory
acidosis
and
alkalosis
are
marked
by
changes
in
PCO2.
Higher
=
acidosis
and
lower
=
alkalosis
Metabolic
acidosis
and
alkalosis
are
caused
by
something
other
than
abnormal
CO2
levels.
This
could
include
toxicity,
diabetes,
renal
failure
or
excessive
GI
losses.
Here
are
the
rules
to
follow
to
determine
if
is
respiratory
or
metabolic
in
nature.
-If
pH
and
PCO2
are
moving
in
opposite
directions,
then
it
is
the
pCO2
levels
that
are
causing
the
imbalance
and
it
is
respiratory
in
nature.
-If
PCO2
is
normal
or
is
moving
in
the
same
direction
as
the
pH,
then
the
imbalance
is
metabolic
in
nature.
The
anion
gap
is
the
difference
between
measured
cations
(Na+
and
K+)
and
measured
anions
(Cl-
and
HCO3-),
this
calculation
can
be
useful
in
determining
the
cause
of
metabolic
acidosis.
Why
would
an
increased
anion
gap
be
observed
in
diabetic
ketoacidosis
or
lactic
acidosis?
-
ANS
The
anion
gap
is
the
calculation
of
unmeasured
anions
in
the
blood.
Lactic
acid
and
ketones
both
lead
to
the
production
of
unmeasured
anions,
which
remove
HCO3-
(a
measured
anion)
due
to
buffering
of
the
excess
H+
and
therefore
leads
to
an
increase
in
the
AG.
Why
is
it
important
to
maintain
a
homeostatic
balance
of
glucose
in
the
blood
(ie
describe
the
pathogenesis
of
diabetes)?
-
ANS
Insulin
is
the
hormone
responsible
for
initiating
the
uptake
of
glucose
by
the
cells.
Cells
use
glucose
to
produce
energy
(ATP).
In
a
normal
individual,
when
blood
glucose
increases,
the
pancreas
is
signaled
to
produced
in
insulin,
which
binds
to
insulin
receptors
on
a
cells
surface
and
initiates
the
uptake
of
glucose.
Glucose
is
a
very
reactive
molecule
and
if
left
in
the
blood,
it
can
start
to
bind
to
other
proteins
and
lipids,
which
can
lead
to
loss
of
function. AGEs
are
advanced
glycation
end
products
that
are
a
result
of
glucose
reacting
with
the
endothelial
lining,
which
can
lead
to
damage
in
the
heart
and
kidneys.
Compare
and
contrast
Type
I
and
Type
II
Diabetes
-
ANS
Type
I
diabetes
is
caused
by
lack
of
insulin.
With
out
insulin
signaling,
glucose
will
not
be
taken
into
the
cell
and
leads
to
high
blood
glucose
(hyperglycemia).
Type
I
is
usually
treated
with
insulin
injections.
Type
II
diabetes
is
caused
by
a
desensitization
to
insulin
signaling.
The
insulin
receptors
are
no
longer
responding
to
insulin,
which
also
leads
to
hyperglycemia.
Type
II
is
usually
treated
with
drugs
to
increase
the
sensitization
to
insulin
(metformin),
dietary
and
life-style
changes
or
insulin
injections.
Describe
some
reasons
for
a
patient
needing
dialysis
-
ANS
AEIOU-acidosis.
Electrolytes,
Intoxication/Ingestion,
overload,
uremia.
Patients
with
kidney
or
heart
failure.
A
build
up
of
phosphates,
urea
and
magnesium
are
removed
from
the
blood
using
a
semi-permeable
membrane
and
dialysate.
AEIOU:
A—acidosis;
E—electrolytes
principally
hyperkalemia;
I—ingestions
or
overdose
of
medications/drugs;
O—overload
of
fluid
causing
heart
failure;
U—uremia
leading
to
encephalitis/pericarditis
Compare
and
contrast
hemodialysis
and
peritoneal
dialysis.
What
are
some
reasons
for
a
patient
choosing
one
over
the
other?
-
ANS
Hemodialysis
uses
a
machine
to
pump
blood
from
the
body
in
one
tube
while
dialysate
(made
of
water,
electrolytes
and
salts)
is
pumped
in
the
separate
tube
in
the
opposite
direction.
Waste
from
the
blood
diffuses
through
the
semipermeable
membrane
separating
the
blood
from
the
dialysate.
Peritoneal
Dialysis
does
not
use
a
machine,
but
instead
injects
a
solution
of
water
and
glucose
into
the
abdominal
cavity.
The
peritoneum
acts
as
the
membrane
instead
of
dialysis
tubing.
The
waste
products
diffuse
into
the
abdominal
cavity
and
the
waste
solution
is
then
drained
from
the
body.
Peritoneal
dialysis
offers
continuous
filtration
and
is
less
disruption
to
the
patient's
daily
routines.
However,
it
does
require
some
training
of
the
patient
and
is
not
recommended
for
individuals
who
are
overweight
or
have
severe
kidney
failure.
Hemodialysis
provides
medical
care,
but
3
times
a
week
for
several
hours
sitting
at
a
hospital
or
clinic.
Individuals
with
acute
kidney
failure
are
recommended
to
use
hemodialysis. How
does
homeostasis
and
maintaining
optimal
physiological
health
impact
your
wellbeing?
-
ANS
Homeostasis
acts
to
create
a
constant
and
stable
environment
in
the
body
despite
internal
and
external
changes.
Proteins
and
other
cellular
processes
require
optimal
conditions
in
order
to
carry
out
their
functions.
Alterations
in
pH,
salt
concentration,
temperature,
glucose
levels,
etc.
can
have
negative
effects
on
health,
so
it
is
vital
for
mechanisms
that
regulate
homeostasis
to
function
properly
for
maintaining
good
health
Differentiate
between
Innate
Immunity
and
Adaptive
Immunity
?
-
ANS
The
innate
immune
system
encompasses
physical
barriers
and
chemical
and
cellular
defenses.
Physical
barriers
protect
the
body
from
invasion.
These
include
things
like
the
skin
and
eyelashes.
Chemical
barriers
are
defense
mechanisms
that
can
destroy
harmful
agent.
Examples
include
tears,
mucous,
and
stomach
acid.
Cellular
defenses
of
the
innate
immune
response
are
non-specific.
These
cellular
defenses
identify
pathogens
and
substances
that
are
potentially
dangerous
and
takes
steps
to
neutralize
or
destroy
them.
Adaptive
immunity
is
an
organism's
acquired
immunity
to
a
specific
pathogen.
As
such,
it's
also
referred
to
as
acquired
immunity.
Adaptive
immunity
is
not
immediate,
nor
does
it
always
last
throughout
an
organism's
entire
lifespan,
although
it
can.
The
adaptive
immune
response
is
marked
by
clonal
expansion
of
T
and
B
lymphocytes,
releasing
many
antibody
copies
to
neutralize
or
destroy
their
target
antigen
What
is
a
way
that
Adaptive
Immunity
can
recruit
innate
immunity?
-
ANS
The
innate
immune
response
to
microbes
stimulates
adaptive
immune
responses
and
influences
the
nature
of
the
adaptive
responses.
Conversely,
adaptive
immune
responses
often
work
by
enhancing
the
protective
mechanisms
of
innate
immunity,
making
them
more
capable
of
effectively
combating
pathogenic
microbes
Why
are
some
infections
harder
on
children
while
other
infections
are
harder
on
the
elderly?
-
ANS
Children
have
not
been
exposed
to
many
pathogens
yet,
so
they
lack
memory
cells
and
have
not
built-up
immunity
yet.
The
elderly
have
a
depleted
naïve
T
cell
population
from
years
of
battling
infections,
so
the
likelihood
of
getting
a
match
is
less.
Describe
how
and
why
our
injury
response
results
in
the
signs
of
redness,
swelling,
heat,
and
pain?