Endocrine Physiology, Stress Response to Surgery and Thermoregulation — WACS Viva & Clinical Scenarios (Physiology and Applied Physiology)

Exam-style endocrine physiology, stress response to surgery and thermoregulation viva scenarios with examiner probes and model answers for ANAESTHESIA…

Scenarios covered

• SCENARIO 1: Describe the Neuroendocrine and Metabolic Stress Response to major surgical trauma. Detail the afferent triggers, the endocrine axes involved, the resulting alterations in carbohydrate, protein, and lipid metabolism, and the physiological mechanisms by which central neuraxial blockade modifies this response.
• SCENARIO 2: Outline the physiological control of human body temperature. Describe the afferent thermal inputs, central hypothalamic integration (POAH), and the autonomic and behavioural effector mechanisms activated during cold and heat stress. Explain how general and regional anaesthetics alter normal thermoregulatory thresholds.
• SCENARIO 3: Draw a graph of core body temperature changes over time during a four-hour general anaesthetic in an unwarmed patient. Detail the three distinct phases of intraoperative hypothermia, explaining the specific physical and physiological mechanisms underlying each phase.
• SCENARIO 4: Describe the synthesis, storage, physiological release, and cellular mechanism of action of Insulin. Detail how blood glucose concentration regulates insulin secretion at the pancreatic beta-cell membrane level, and describe the metabolic consequences of the acute insulin resistance seen in surgical stress and critical illness.
• SCENARIO 5: Write physiological notes on the Adrenal Cortex. Describe the functional histology of the adrenal cortex, the biosynthetic pathways and regulation of cortisol and aldosterone, and the physiological consequences of acute primary adrenal insufficiency (Addisonian crisis) during the perioperative period.