Please provide your responses to the following 10 case study questions (i.e. hospital scenarios) in the boxes provided after each question. The size of the box does not indicate length of answer expected. The boxes are there to make it easier to navigate through each case study by making each individual question clearly visible. Please be concise with your responses and directly answer the question asked, information not relevant to the question will receive zero marks. Each set of case study questions are separated by a page
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1. Matthew is out paddle boarding and cuts his hand as he collides with some rocks along the river edge. He manages to stop the flow of blood by applying pressure and keeps his t-shirt wrapped around his hand while he paddles to shore. After several hours he notes swelling, pain, heat, and redness at the injury site. Matthew calls the hospital and would like to know why his body is responding this way despite giving the wound a good clean.
a) Explain the four signs of inflammation in terms of cellular and tissue events, include the purpose (benefit) of each response. In your answer, make it clear how swelling serves as a protective function (6 marks)
) Name two types of phagocytic cells and outline the importance of phagocytosis during the inflammatory process (2 marks)
c) Which steps are involved with haemostasis? Briefly describe the importance of the second step of haemostasis (2 marks)
2. You are working in a hospital where you see numerous patients with respiratory illnesses every day. Patients who have chronic obstructions in their airways run the risk of retaining ca
on dioxide in the body because they cannot exhale it properly from their body. A healthy respiratory system helps regulate ca
on dioxide levels in the body as part of the acid-base balance.
a) What effect does an increase in plasma ca
on dioxide levels have on hydrogen ion concentration? Does this result in an increase or decrease of plasma pH? (1.5 marks)
) Briefly outline the (normal) process of gas exchange in the lungs. Anatomically name the structures involved in gas exchange and describe how and why gases freely move across the respiratory mem
ane (2.5 marks)
c) Explain in detail the negative feedback loop activated when an increased level of ca
on dioxide is detected in the bloodstream. Include in your answer the names of the general components of a negative feedback loop and identify by name the specific parts of the body involved in regulating ca
on dioxide levels. Make it clear how a change in ventilation rectifies the imbalance and what makes the whole process an example of homeostasis (6 marks)
3. You have a young girl on your ward who is awaiting heart surgery. She is keen to know about the structure and function of the heart and asks you to explain the flow of blood through the heart from start to finish. She wants details and you know the more information you tell her, the more distracted she will be from thinking about her operation.
a) In your own words, describe the flow of blood through the heart, naming each of the vessels
inging and taking blood to and from the heart. Include chambers of the heart and name structures in the co
ect sequence along the blood’s pathway through the heart – beginning with blood returning to the heart from the body and ending with blood being ejected into the systemic circulation. Include the names of the valves and explain which valves are open and closed during the cardiac cycle. Describe, using terms like diastole and systole, the changes in ventricular pressure which create the heart sounds (10 marks)
4. A 77-year-old woman experiences dizziness upon standing and you instantly recognise this as a consequence of low blood pressure; her blood vessels do not respond to the redistribution of blood due to gravity when standing up because they do not have enough tone. There are two ways blood pressure is regulated in the body – the nervous system (short-term control) and hormonal regulation (long-term control).
Please answer the following questions in relation to blood pressure:
a) Make clear your understanding of the term ‘blood pressure’ (1 mark)
) How does vasoconstriction of an arteriole affect blood pressure? Briefly explain how the quick acting neural response to low blood pressure prevents a person from feeling dizzy upon standing from a seated position (3 marks)
The nervous system works with the cardiovascular system to
ing about rapid changes in blood pressure. However, for long term control of blood pressure, the kidneys are involved in maintaining adequate blood volume in the body whilst keeping fluid composition balanced.
c) Discuss the negative feedback pathway known as the Renin-Angiotensin-Aldosterone System (RAAS) which helps regulate systemic blood pressure. Include all of the events that occur from the detection of the stimulus through to the overall response. Clearly identify the parts of the body involved and explain the actions of the hormones at their target tissues (6 marks)
5. The duty doctor notices you looking at a patient’s chart at some distance from your eyes, she jokes and asks you if you’d like longer arms. You need reading glasses, it’s on your list of things to do. You share a knowing look – who has time! However, you’re about to go on your lunch
eak and call the ophthalmologist your colleague recommended, but first you sit down for a minute and tune out for a moment or two…
a) As you stare thoughtfully into the distance which intrinsic eye muscle is relaxing and what does the relaxation of this muscle do to the shape of the lens? (2 marks)
) Your colleague’s phone beeps, she has no problem reading the text up close. What happens to the shape of the lens to ensure she sees the words clearly? Explain how this happens. What is this process called? (3 marks)
c) Still relating to the eye, what creates the ‘blind spot’ at the back of the eye? Make your understanding of anatomy clear with a
ief explanation of what the blind spot consists of (2 marks)
d) In relation to the ear, how do the auditory ossicles facilitate the physiology of hearing? (3 marks)
6. Jeremy is a diabetic. He needs to administer insulin every day to ensure his plasma glucose levels are managed in his body after each meal. You wish to educate Jeremy’s family, so together they can understand how blood glucose levels are regulated in the body and how best to support Jeremy with his new diagnosis.
a) What is the role of insulin in the body? What are the target cells for insulin? What makes these cells ‘targets’ for the hormone insulin? (3 marks)
) Which metabolic processes are promoted in the target cells (named above) once glucose enters these cells (1 mark)
c) In terms of the systemic response to increased plasma glucose levels, what circumstances in the body cause the reduction of insulin release? (2 marks)
d) Which hormone is released in the fasted state? Where is this hormone released from, be specific? What are the target cells for this hormone? Briefly explain one cellular response occu
ing in the target cells during the fasted state (3 marks)
e) In a healthy person, is glucose present in the urine? Briefly explain why or why not (1 mark)
7. Your patients are learning a lot about the immune system from the media ever since COVID-19 began. Nowadays, many of your patients look to you to explain how the immune system works to protect them against pathogens, such as viruses and bacteria.
a) List and
iefly discuss the first line defenses in place to resist pathogens entering the body and potentially infecting cells (4 marks)
) How does the structure of a lymph node allow immune cells residing within the node to perform their protective function? (2 marks)
c) The adaptive (specific) immune system is activated when innate defenses are unsuccessful in capturing and/or destroying a pathogen, such as bacteria. Describe the role B-cells have in protecting the body against substances with foreign antigens (3 marks)
d) What does MALT refer to? (1 mark)
8. You leap into action when an alarm sounds from a room down the hall. Once the emergency has subsided, you think back to your days as a student nurse and remember fondly when you learned about cardiac output equaling heart rate multiplied by stroke volume (CO = HR x SV).
a) What does the term ‘cardiac output’ (CO) refer to? Explain the benefit of CO changing rapidly during an emergency, and identify how the changes in CO occur physiologically (3 marks)
) What is venous return? Identify and
iefly explain two ways venous return can be increased by the body’s own intrinsic mechanisms (3 marks)
c) How does an increased venous return affect stroke volume? What effect does this have on cardiac output? Explain the mechanism clearly (4 marks)
9. The digestive system is an incredible feat of structure supporting function. The gastrointestinal tract (GIT) runs from the mouth to anus and numerous accessory organs assist in the digestion of nutrients. All areas of the digestive tract are specialised in one way or another and ca
y out specific functions. It is often not until something goes wrong that we gain a full appreciation and awareness of what our intestines do, day-in day-out!
a) Define the term ‘digestion’ – be specific in your answer (2 marks)
) Can the stomach secrete substances before food has entered? Explain your answer (2 marks)
c) Identify and
iefly explain two ways the large intestine is well suited for its purpose (2 marks)
d) How do
ush border enzymes contribute to digestion? Where exactly are these enzymes located? (2 marks)
e) Identify two roles the liver has in aiding digestion and absorption of nutrients (2 marks)
10. A pregnant patient has lots of questions about sexual reproduction and genetic variation. This is Michelle’s first child; she has been told lots of information from friends and relatives and she is keen to clarify some points of interest.
a) What are the key differences between mitosis and meiosis (2 marks)
) How does meiosis vary between males and females? Make clear the differences in sex cell production before and after puberty (3 marks)
c) What accounts for genetic variance amongst siblings with the same parents? (3 marks)
d) During which part of the menstrual cycle is the endometrium being regenerated? Name the hormone which dominates during this time (2 marks)