- PATHOPHYSIOLOGIES -

Question 1

Outline the pathophysiology of DKA

Answer 1

A hyperglycaemic syndrome resulting in severe:

• Acidosis
• Dehydration
• Electrolyte imbalance (Na+, K+, glucose)
• Autoimmune attack on B cells in the pancreas causing a decrease in insulin production
• Lack of insulin increases gluconeogenesis and glycogenolysis and a decrease in glycolosis
• This all together results in an increased amount of glucose in the bloodstream (hyperglycaemia)
• This results in Glucosuria, Polyuria, and polydipsia
• Lack of insulin production also results in the breakdown of fats (lipolysis)
• the fats are broken down from adipose tissue to form free fatty acids
• These FFA go to the liver and undergo ketogenesis to make more ketone bodies
• This is to obtain a second energy source as glucose is not working or not present in this case
• This results in a high amount of ketones in the blood (hyperketonaemia) and thus ketones in the urine (ketonuria)
• Ketones are acidic and reduce the pH of the blood and the urine

Question 2

Outline the pathophysiology of Shock

Answer 2

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Question 3

Outline the pathophysiology of AKI

Answer 3

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Question 4

Outline the pathophysiology of CKD

Answer 4

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Question 5

Outline the pathophysiology of Neurogenic shock

Answer 5

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Question 6

Outline the pathophysiology of Hypovolaemic shock

Answer 6

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Question 7

Outline the pathophysiology of Distributive shock

Answer 7

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Question 8

Outline the pathophysiology of Cardiogenic shock

Answer 8

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Question 9

Outline the pathophysiology of Heart failure

Answer 9

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Question 10

Outline the pathophysiology of Asthma

Answer 10

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Question 11

Outline the pathophysiology of Bronchiolitis

Answer 11

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Question 12

Outline the Pathophysiology of Croup

Answer 12

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Question 13

Outline the Pathophysiology of Acute Rheumatic Fever

Answer 13

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Question 14

Outline the Pathophysiology of Pre-renal causes of AKI

Answer 14

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Question 15

Outline the Pathophysiology of Intra-renal causes of AKI

Answer 15

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Question 16

Outline the Pathophysiology of Post-renal causes of AKI

Answer 16

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Question 17

Outline the Pathophysiology of Rhabdomyolysis

Answer 17

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Question 18

Outline the Pathophysiology of the RAAS

Answer 18

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Question 19

Outline the role of ADH

Answer 19

• ADH is made in the hypothalamus and stored in the pituitary gland
• The stimuli for release of ADH are:
  - low blood pressure (presence of angiotensin II, from RAAS pathway)
  - high plasma osmolality (blood is hypertonic, low amount of water in the blood and high solutes)
• osmoreceptors on the hypothalamus are stimulated by high plasmaosmolality, and there are also receptors for angiotensin II
• This stimulates the release of ADH
• ADH travels to the kidneys and acts on the cells in the collecting duct by binding to vasopressor receptors
• This activates an intracellular cascade that results in the activation of Protein kinase A
• PKA stimulates Aquaporin II protein channels to fuse with the cell membrane absorb water from the filtrate that otherwise would have been secreted
• This water travels into the cell and into the blood stream via Aquaporin III and IV channels
• This incease in water in the blood stream causes and increase the plasma volume and thus blood pressure and also decreases the osmolality of the blood
• ADH can also bind onto the vasopressin receptors of the smooth muscle cells of the blood vessel
• Stimulating the GQ mechanism resulting in high amounts of calcium, causing the cell to contract -> vasoconstriction -> increase in peripheral resistance -> increase in blood pressure

Question 20

Discuss the pathophysiology of Type 1 DM

Answer 20

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Question 21

Discuss the pathophysiology of Type 2 DM

Answer 21

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Question 22

Discuss the pathophysiology of Hyperosmolar hyperglycaemic non-ketotic syndrome (HHNS)

Answer 22

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Question 23

Discuss the pathophysiology of Hypoglycaemia

Answer 23

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Question 24

Discuss the pathophysiology of Type 1 respiratory disorders

Answer 24

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Question 25

Discuss the pathophysiology of Type II respiratory disrders

Answer 25

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