WGU D236 PATHOPHYSIOLOGY OA AND PA 2025/ BANK VERSION
AND STUDY GUIDE | ACTUAL EXAM /BRAND NEW 2026-2027
Describe the laboratory findings associated with metabolic acidosis, metabolic
alkalosis, respiratory acidosis and respiratory alkalosis. (ie relative pH and CO2
levels).
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?
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)?
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
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
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?
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?
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
AND STUDY GUIDE | ACTUAL EXAM /BRAND NEW 2026-2027
Describe the laboratory findings associated with metabolic acidosis, metabolic
alkalosis, respiratory acidosis and respiratory alkalosis. (ie relative pH and CO2
levels).
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?
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)?
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
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
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?
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?
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
