BIOM3020 (2022) Exam SAQs Flashcards
Spinal cord injury (SCI) is a devastating neurological condition where connections between the brain and body are severed. Inability to move and feel are major hallmarks of this condition, but it is now well recognised that, depending on the anatomical level of injury, many other body systems and/or organs are also affected, including endocrine glands and the immune system. Stress signals from the adrenal gland are otherwise also well known to regulate the immune system. Lastly, it is widely reported in the scientific literature that many SCI patients have weakened immunity and impaired
wound healing.
Briefly describe how a lesion to the spinal cord at different anatomical levels may differentially affect the functioning of the adrenal gland, explaining why and giving at least ONE example of a functional consequence that may arise from it.
A lesion to the spinal cord at different anatomical levels can have varying effects on the functioning of the adrenal gland. Higher-level spinal cord injuries, such as those occurring in the cervical region, can result in disrupted communication between the brain and the adrenal gland, leading to impaired activation of the hypothalamic-pituitary-adrenal (HPA) axis. This disruption can result in reduced secretion of stress hormones like cortisol from the adrenal gland.
One functional consequence that may arise from impaired adrenal gland functioning in SCI patients is a weakened immune system. Cortisol, a stress hormone regulated by the adrenal gland, plays a role in modulating immune responses. Reduced cortisol production and secretion due to spinal cord injury can lead to an imbalance in immune function, making SCI patients more susceptible to infections and impairing their ability to mount effective immune responses.
Upon routine screening, a pregnant patient is identified as having gestational diabetes mellitus.
a) Describe the underlying pathophysiology associated with the development of gestational
diabetes mellitus
b) Describe TWO (2) likely adverse birth outcomes.
c) List TWO (2) long-term health risks for the mother and baby.
a) The underlying pathophysiology associated with the development of gestational diabetes mellitus (GDM) involves a combination of hormonal and metabolic changes during pregnancy. During pregnancy, the placenta produces hormones that help the baby develop but can also interfere with insulin action in the mother’s body. As the pregnancy progresses, the placenta produces increasing amounts of hormones like human placental lactogen, progesterone, and cortisol, which can lead to insulin resistance in the mother. Insulin resistance impairs the ability of cells to efficiently utilize glucose, resulting in elevated blood glucose levels.
b) Two likely adverse birth outcomes associated with gestational diabetes mellitus are:
Macrosomia: Gestational diabetes can lead to excessive fetal growth, causing the baby to be larger than average. This condition, known as macrosomia, increases the risk of birth complications such as shoulder dystocia (difficulty delivering the baby’s shoulders), birth injuries, and the need for a cesarean section.
Hypoglycemia: After birth, infants of mothers with gestational diabetes may experience low blood sugar levels (hypoglycemia) due to the sudden withdrawal of high levels of glucose from the mother. This can occur because the baby’s insulin production may remain high initially, leading to a rapid drop in blood sugar levels. Hypoglycemia in newborns may require close monitoring and treatment to stabilize their blood sugar levels.
c) Two long-term health risks for the mother and baby associated with gestational diabetes mellitus are:
Long-term health risks for the mother:
Increased risk of developing type 2 diabetes: Women who have had gestational diabetes are at a higher risk of developing type 2 diabetes later in life. It is important for these women to undergo regular follow-up and lifestyle modifications to reduce their risk.
Increased risk of cardiovascular disease: Women with a history of gestational diabetes have an increased risk of developing cardiovascular diseases such as hypertension, heart disease, and stroke in the long term. Regular monitoring of blood pressure and lipid levels, along with a healthy lifestyle, is crucial to manage this risk.
Long-term health risks for the baby:
Increased risk of obesity and type 2 diabetes: Babies born to mothers with gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life. Monitoring the child’s weight, promoting a healthy diet, and encouraging regular physical activity are essential for reducing these risks.
Higher risk of metabolic syndrome: Metabolic syndrome, characterized by a combination of obesity, high blood pressure, high blood sugar, and abnormal cholesterol levels, is more common in individuals exposed to gestational diabetes. These babies may be more susceptible to metabolic disorders as they grow older.
It is important for individuals with gestational diabetes to receive appropriate prenatal care, closely monitor blood glucose levels, follow a balanced diet, engage in regular physical activity, and receive necessary medical interventions to minimize the risks associated with the condition.
