Quiz 105: Stress and Disease
McCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th Edition
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1. Exhaustion occurs if stress continues when which stage of the general adaptation syndrome is not successful?
a. Flight or fight
2. Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?
a. Adrenal cortex
c. Anterior pituitary
d. Limbic system
3. During an anticipatory response to stress, what is the reaction from the limbic system stimulated by?
a. The retronucleus of the anterior pituitary
b. The anterior nucleus of the hippocampus
c. The paraventricular nucleus of the hypothalamus
d. The prefrontal nucleus of the amygdala
4. Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?
d. Adrenocorticotropic hormone (ACTH)
5. Perceived stress elicits an emotional, anticipatory response that begins where?
a. Prefrontal cortex
b. Anterior pituitary
c. Limbic system
6. A student asks the healthcare professional how immunity is decreased by stress. The professional responds that during a stress response, the helper T (Th) 1 response is suppressed by which hormone?
d. Growth hormone
7. Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of what?
a. Epinephrine and aldosterone
b. Norepinephrine and cortisol
c. Epinephrine and norepinephrine
d. Acetylcholine and cortisol
8. A severely stressed patient has cold, clammy skin. The healthcare professional quizzes the student about this effect. The student correctly answers that this effect is directly from which action?
a. Epinephrine dilating blood vessels leading to the vital organs
b. Norepinephrine constricting blood vessels in the skin
c. Dilating the airways to increased oxygenation of the tissues
d. Dysfunctional temperature regulation from cortisol secretion
9. Released stress-induced cortisol results in the stimulation of gluconeogenesis by affecting which structure?
a. Adrenal cortex
d. Anterior pituitary
10. What effect of increased secretions of epinephrine, glucagon, and growth hormone would the healthcare professional assess for?
d. Pupil dilation
11. A severely stressed patient has hypoglycemia each time the patient’s blood glucose is checked. The healthcare professional should order laboratory tests to measure which hormone in the patient’s blood?
d. Growth hormone
12. What effect do androgens have on lymphocytes?
a. Suppression of B-cell responses and enhancement of T-cell responses
b. Suppression of T-cell responses and enhancement of B-cell responses
c. Suppression of B- and T-cell responses
d. Enhancement of B- and T-cell responses
13. The action of which hormone helps explain increases in affective anxiety and eating disorders, mood cycles, and vulnerability to autoimmune and inflammatory diseases in women as a result of stimulation of the CRH gene promoter and central norepinephrine system?
14. Which statement is true concerning the differences between stress-induced hormonal alterations of men and women?
a. After injury, women produce more proinflammatory cytokines than men, a profile that is associated with poor outcomes.
b. Androgens appear to induce a greater degree of immune cell apoptosis after injury, creating greater immunosuppression in injured men than in injured women.
c. Psychologic stress associated with some types of competition decreases both testosterone and cortisol, especially in athletes older than 45 years of age.
d. After stressful stimuli, estrogen is increased in women, but testosterone is decreased in men.
15. A patient perceives living in a state of chronic stress. What will diagnostic blood work ordered by the healthcare professional likely demonstrate?
a. Decreased Th lymphocytes
b. Increased erythrocytes
c. Decreased Tc cells
d. Increased platelets
16. What are the signs that a patient is in the adaptive stage of the general adaptation syndrome?
a. He or she begins to experience elevated heart and respiratory rates.
b. He or she finds it difficult to concentrate on a solution for the stress.
c. The patient perceives his or her only options are to run away or fight back.
d. The patient has exceeded his or her ability to cope with the current situation.
17. What is the most influential factor in whether a person will experience a stress reaction?
a. General state of physical health
b. Spiritual belief system
c. Intellectual abilities
d. Ability to cope
18. A reduction in an individual’s number of natural killer (NK) cells appears to correlate with an increased risk for the development of what?
b. Type 1 diabetes
c. Obsessive compulsive disorder (OCD)
d. Gastroesophageal reflux disorder (GERD)
1. The effect epinephrine has on the immune system during the stress response is to increase which cells? (Select all that apply.)
a. NK cells
d. T cells
e. Th cells
2. The increased production of proinflammatory cytokines is associated with which considerations? (Select all that apply.)
a. Chronic respiratory dysfunction
b. Elevated anxiety levels
c. Immune disorders
d. Age and gender
3. Which statements are true regarding lymphocytes? (Select all that apply.)
a. Lymphocytes are involved in the production of the human growth hormone.
b. Elevated catecholamine levels influence lymphocytes.
c. Lymphocytes are synthesized in the anterior pituitary gland.
d. Lymphocytes have receptors for the hormone prolactin.
e. Lymphocytes produce endorphins in large amounts.
4. Which cytokines initiate the production of corticotropin-releasing hormone (CRH)? (Select all that apply.)