Pathophysiology for OSCE

Question 1

Diabetes Mellitus means there is too much _________ in the ___________, and not enough in the ____________.

Answer 1

GLUCOSE, BLOOD, CELLS

Question 2

What does insulin do to blood glucose?

Answer 2

REDUCES

Question 3

What does glucagon do to blood glucose?

Answer 3

INCREASES

Question 4

What are the islets of langerhans?

Answer 4

Cells in the pancreas that secrete hormones like glucagon and insulin

Question 5

What do BETA cells secrete

Answer 5

INSULIN

Question 6

What do ALPHA cells secrete

Answer 6

GLUCAGON

Question 7

What is type 1 diabetes?

Answer 7

Destruction of beta cells, so not enough insulin is secreted
Usually diagnosed early in life

Question 8

Symptoms of type 1 diabetes?

Answer 8

Polyphagia- increased hunger
Glycosuria- glucose spills into urine
Polyuria- increased urination
Polydipsia- increased thirst

Question 9

What is common in type 1 diabetes?

Answer 9

DKA!!!

Question 10

What is DKA?

Answer 10

When blood sugar is > 22 mmol/L
In stress/infection, body releases epinephrine, stimulates release of glucagon = high blood sugar

Question 11

Symptoms of DKA

Answer 11

kussumaul respirations
nausea, vomiting, diarrhea
fruity smell to breath

Question 12

Treatment of DKA

Answer 12

Fluids

Question 13

What is type 2 diabetes?

Answer 13

The body still produces the normal amount of insulin, but cells do not move their glucose transmitters to respond.
Cells are insulin resistant
Usually diagnosed later in life due to poor lifestyle choices

Question 14

Common medications for type 2 diabetes?

Answer 14

metformin, glyburide

Question 15

What happens in a myocardial infarction?

Answer 15

Most commonly from plaque buildup in the coronary arteries
Blood will rupture the plaque- clot
Heart muscles do not get oxygen

Question 16

Why is there pain in the arm when someone is having an MI?

Answer 16

Because some of the nerves that are connected to the heart have the same origin

Question 17

What eventually happens in an MI after time?

Answer 17

The artery becomes completely blocked off, cardiac cells stop working so heart beats faster to compensate, leaks troponin into blood stream from heart muscle cells

Question 18

What main arteries supply blood to the inferior part of the heart?

Answer 18

RCA, LCx

Question 19

What main arteries supply blood to the inferior RVI part of the heart?

Answer 19

RCA

Question 20

What main arteries supply blood to the anterior part of the heart?

Answer 20

LAD

Question 21

What main arteries supply blood to the posterior part of the heart?

Answer 21

RCA, LCx

Question 22

What main arteries supply blood to the septal part of the heart?

Answer 22

LAD

Question 23

Where is the infarct and reciprocal for a lateral STEMI?

Answer 23

Infarct: I, aVL, V5, V6
Reciprocal: II, III, aVF

Question 24

Where is the infarct and reciprocal for Anterolateral STEMI?

Answer 24

Infarct: I, aVL, V3, V4, V5, V6
Reciprocal: II, III, aVL

Question 25

Where is the infarct and reciprocal for inferior STEMI?

Answer 25

Infarct: II, III, aVF
Reciprocal: I, aVL

Question 26

Where is the infarct and reciprocal for posterior STEMI?

Answer 26

Infarct: None
Reciprocal: V1, V2, V3, V4

Question 27

Pathophysiology of Asthma?

Answer 27

Bronchi and bronchioles respond to stimuli in three ways:
- Inflammation of mucosa with edema
- Constriction of smooth muscle
- Increased secretions of thick mucous in the passages

Question 28

Signs and Symptoms of Asthma

Answer 28

• Cough
• Dyspnea
• Tightness in chest
• Agitation
• Wheezing
• Rapid laboured breathing with accessory muscle use