Quiz 11: Stress and Disease
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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 c. Adaptation
b. Alarm d. Arousal
2. Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?
a. Adrenal cortex c. Anterior pituitary
b. Hypothalamus d. Limbic system
3. During an anticipatory response to stress, the reaction from the limbic system is stimulated by the:
a. Retronucleus of the anterior pituitary
b. Anterior nucleus of the hippocampus
c. Paraventricular nucleus of the hypothalamus
d. 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 c. Limbic system
b. Anterior pituitary d. Hypothalamus
6. During a stress response, the helper T (Th) 1 response is suppress by which hormone?
a. ACTH c. Prolactin
b. Cortisol d. Growth hormone
7. What is the effect that low-serum albumin has on the central stress response?
a. Impaired circulation of epinephrine and norepinephrine
b. Impaired wound healing
c. Lessened circulation of cortisol
d. Diminished oncotic pressure
8. Stress-age syndrome directly results in depressed function of which system?
a. Respiratory c. Digestive
b. Endocrine d. Immune
9. Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of:
a. Epinephrine and aldosterone c. Epinephrine and norepinephrine
b. Norepinephrine and cortisol d. Acetylcholine and cortisol
10. Stress-induced norepinephrine results in:
a. Pupil constriction c. Increased sweat gland secretions
b. Peripheral vasoconstriction d. Decreased blood pressure
11. Released stress-induced cortisol results in the stimulation of gluconeogenesis by affecting which structure?
a. Adrenal cortex c. Liver
b. Pancreas d. Anterior pituitary
12. What is the effect of increased secretions of epinephrine, glucagon, and growth hormone?
a. Hyperglycemia c. Bronchodilation
b. Hypertension d. Pupil dilation
13. Which hormone increases the formation of glucose from amino acids and free fatty acids?
a. Epinephrine c. Cortisol
b. Norepinephrine d. Growth hormone
14. 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
15. Which gland regulates the immune response and mediates the apparent effects of circadian rhythms on immunity?
a. Anterior pituitary c. Basal ganglia
b. Adrenal d. Pineal
16. Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?
a. IL–1 and IL-6 c. IFN and IL-12
b. IL-2 and TNF- d. TNF-ß and IL-4
17. The release of which cytokines is triggered by bacterial or viral infections, cancer, and tissue injury that, in turn, initiate a stress response?
a. IL-1 and IL-2
b. IL-12, TNF-, and colony-stimulating factor
c. IFN, TNF-ß, and IL-6
d. IL-4 and IL-24
18. 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?
a. Progesterone c. Estrogen
b. Cortisol d. Prolactin
19. What effect does estrogen have on lymphocytes?
a. Depression of B-cell functions and enhancement of T-cell functions
b. Depression of T-cell functions and enhancement of B-cell functions
c. Depression of B- and T-cell functions
d. Enhancement of B- and T-cell functions
20. 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.
21. Diagnostic blood work on individuals who perceive themselves to be in a chronic stress state will likely demonstrate:
a. Decreased Th lymphocytes c. Decreased Tc cells
b. Increased erythrocytes d. Increased platelets
22. 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.
23. The most influential factor in whether a person will experience a stress reaction is his or her:
a. General state of physical health c. Intellectual abilities
b. Spiritual belief system d. Ability to cope
24. A reduction is an individual’s number of natural killer (NK) cells appears to correlate with an increased risk for the development of:
b. Type 1 diabetes
c. Obsessive compulsive disorder (OCD)
d. Gastroesophageal reflux disorder (GERD)
25. A nurse is providing care to a terminally ill adult who has been with his life partner for over 56 years. Research supports the nurse’s assessment of the life partner for signs of:
a. Suicidal ideations c. Severe stress reaction
b. Cardiac dysrhythmia d. Anorexia induced weight loss
26. 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
27. Which immune cells are suppressed by the corticotropin-releasing hormone (CRH)? (Select all that apply.)
a. Monocyte-macrophage cells
c. Tc cells
d. Th cells
e. B cells
28. 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
29. 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.
Match the hormone with its effects during a stress response. Hormones may be used more than once.
______ A. Epinephrine
______ B. Norepinephrine
______ C. Cortisol
30. Constricts peripheral vessels to increase blood pressure.
31. Increases cardiac output by increasing heart rate and myocardial contractility.
32. Increases gastric secretions.