Chapter 2 Study Guide patho stress

(Name the stress-induced disease process for the following physiologic system) Cardiovascular System

Abnormal HR, rhythm; hypertension, stroke, coronary artery disease

(Fill in the blank) _____ _____ are an individual's behavioral adaptations to reduce feelings of distress

Coping mechanisms

(Name the stress-induced disease process for the following physiologic system) Immune System

Immune deficiency; autoimmune disease; frequent infections

(Name the stress-induced disease process for the following physiologic system) Genitourinary system

Irritable bladder, sexual dysfunction; menstrual irregularity

(Name the stress-induced disease process for the following physiologic system) Musculoskeletal System

muscle tension headache; autoimmune and inflammatory joint disorders; fibromyalgia

(Fill in the blank) _____ are chemicals released by the brain that cause euphoria, sedation, and elevation of the pain threshold

Endorphins

(True/False) All individuals will respond to an identical stressful situation in a similar physiologic manner.

False

(True/False) Allostasis is a simplified interpretation of homeostasis mechanisms

False

(True/False) Although the CNS is known to affect the immune system through various neurotransmitters, the immune system does not affect the CNS.

False

(True/False) Antidiuretic hormone is released during stress and serves to increase urine output and reduce BP

False

(True/False) Selye's three phases of the stress response include alarm, initiation and resistance

False

(True/False) The goal in caring for patients with stress related conditions is to eliminated stress

False

(Name the stress-induced disease process for the following physiologic system) Endocrine System

Hyperglycemia; diabetes mellitus

(Name the stress-induced disease process for the following physiologic system) Respiratory System

Hyperventilation; asthma; frequent upper respiratory infections

(Fill in the blank) The three major body systems involved in the stress response are the _____, _____, and _____ systems.

Nervous, Endocrine, Immune

(True/False) Adaptation to stress is successful when homeostasis is maintained or restored

True

(True/False) Allostatic overload can result in physical and/or psychosocial dysfunction.

True

(True/False) Cortisol is released during the stress response and serves to make more glucose available to the brain.

True

(True/False) Epinephrine and norepinephrine are catecholamines released by the SNS and adrenal medulla

True

(True/False) Homeostasis is a physiologic condition in which systems are functioning at a stable level.

True

(True/False) Hyperplasia of the adrenal cortex, lymphoid atrophy, and stomach ulceration are features of Seyle's general adaptation syndrome.

True

(True/False) Many of the signs and symptoms of an acute response to stress are attributable to activation of the SNS

True

(True/False) Most homeostatic feedback mechanisms function on the principle of negative feedback.

True

(True/False) The excessive release of cortisol in response to allostatic overload tends to suppress the immune system.

True

(Select the best answer) Growth hormone release is increased by stress, and one of its effects is a) increased glucose availability b) increased protein catabolism c) decreased perception of stress d) decreased endorphin release

a) increased glucose availability

(Select the best answer) A stressor that stimulated the release of endorphins in the CNS is likely to be interpreted as a) pleasurable b) painful c) unimportant d) noxious

a) pleasureable

(Select the best answer) Behavior indicators that coping is ineffective include all of the following except a) sleeping more b) major depression c) inability to concentrate d) anorexia

a) sleeping more

Jean reports that she seems to have been experiencing colds more frequently since her motor vehicle accident 6 years ago. Considering the physiologic effects of allostatic overload/ chronic stress, you know that a) the immune system may be suppressed b)this is unrelated to her chronic stress c) excessive secretion of endorphins increases sensitivity to viruses d) the pain medication for her back probably has affected her coping skills

a) the immune system may be suppressed Excessive cortisol secretion over time may inhibit various aspects of immune competence and predispose to more frequent infectious illnesses. Susceptibility to infections is not known to be related to endorphins or pain medications. Chronic, inadequately treated pain is likely to trigger stress-related problems.

(Fill in the blank) The biopsychosocial process of change in response to stress is called ____, whereas _____ is usually used for specific behavioral responses to stress.

adaptation; coping

Upon examination, Marge is noted to have elevated BP and heart rate. The most likely explanation for these signs is a) excessive release of glucocorticoids b) excessive release of catecholamines c) excessive release of growth hormone d) excessive release of insulin

b) excessive release of catecholamines catecholamines include epinephrine and norepinephrine, which are released during acute stress and acute pain. They bind to beta receptors in the heart to increase the heart rate and bind to alpha receptors to increase the blood pressure

(Select the best answer) Indicators that a person who is experiencing stress has achieved resistance include a) elevated levels of serum cortisol b) heart rate returned to baseline c) sleepiness d) absence of catecholamine secretion

b) heart rate returned to baseline

Jean's preoperative laboratory tests show a slightly elevated blood glucose level. This may be attributed to a) her norma saline infusion b) increased cortisol release in response to stress c) decreased physical activity while in the hospital d) a side effect of her pain medication

b) increased cortisol release in response to stress a primary function of cortisol is to elevate blood glucose levels through hepatic mechanisms. An acute decrease in physical activity activity might contribute to elevated blood glucose in insulin-dependent diabetes, but this is an unlikely reason in a non diabetic individual. Pain medication are not known to have direct effects on blood glucose metabolism

Marge indicates that she does not think her migraines are a result of stress because her sister is in a much worse life situation than she is and does not get migraines. Which of the following statements is the best basis for a reply? a) perhaps your sister's situation is not as bad as you think it is b) people respond to stressful situations in different ways c) migraines are always stress related d) perhaps your sister has better coping skills

b) people respond to stressful situations in different ways the perception of a stressor and one's physiologic state greatly affect response. Although migraines can be triggered by stress in susceptible individuals, the degree of stress is not linearly related ad neither are all migraines related. Although the patient may benefit from better coping skills, the suggestion that her sister's are better than hers as the reason for her migraines is not correct.

(Select the best answer) The effects of gender on the stress response are a) greatest in the elderly b) related to the effect of sex hormones c) noncontributory d) consistent across the lifespan

b) related to the effect of sex hormones

(Select the best answer) Which of the following findings would indicate that a patient may be experiencing a "fight-or-flight" reaction to a stressor? a) Constricted pupils b) low BP c) Increased HR d) Frequent sighing or yawning

c) Increased HR

According to Selye, because Marge is experiencing severe migraine headaches and is seeking medical care, she is in the stage of a) alarm b) resistance c) exhaustion d) symptom emergence

c) emergence once a stress related disorder is present, the alarm stage has passed and resistance has not been achieved. Symptom emergence is not a part of Seyle's model of stress

(Select the best answer) In which of Seyle's stages of stress would a patient be if he or she were experiencing GI bleeding secondary to a peptic ulcer disease? a) Alarm b) Resistance c) Exhaustion d) Illness

c) exhaustion

(Select the best answer) Cortisol a) is released from the anterior pituitary gland b) has an anabolic effect on the somatic muscle c) promotes the creation of glucose from amino acids d) increases lactate formation

c) promotes the creation of glucose from amino acids

(Fill in the blank) Both the _____ and _____ arms of the immune system are suppressed by chronic or prolonged stress.

cellular; humoral

(Fill in the blank) Most of the detrimental effects of chronic stress are attributed to dysregulation of the hormone

cortisol

Jean indicates that she would like the television to be turned on to distract her from thinking about the upcoming surgery. This is an example of a) ineffective coping b) Selye's stage of exhaustion c) resolving the stressor d) functional coping

d) functional coping distraction from a non-life-threatening stressor can reduce physiologic stress responses; however, the stressor itself is not resolved. This is not the stage of exhaustion, which implies the onset of physiologic dysfunction. Coping strategies that reduce stress responses, and do not produce harm, can be considered effective.

Because stress or allostatic overload is believed to be a significant factor in the etiologic progression of migraine headache, it may be helpful to suggest that Marge a) avoid medicated her headaches b) eliminate stressful situations c) cope more effectively d) identify precipitating stressors and initiate preventative measures

d) identify precipitating stressors and initiate preventative measures once identifies, avoiding exposure to a known stressor may prevent triggering of the stress response. Avoiding treatment may contribute to progression of the stress response. It is not helpful to recommend elimination of the treatment may contribute to progression of the stress response. It is not helpful to recommend elimination of the stressor or more effective coping, because often these are not possible or not under the individual's control.

(Select the best answer) Several hormones are released during stress and serve to increase blood glucose levels. These includes all of the following except a) cortisol b) growth hormone c) epinephrine d) testosterone

d) testosterone

(Name the stress-induced disease process for the following physiologic system) GI System

gastritis, irritable bowel syndrome, ulcerative colitis, Chron's Disease

(Fill in the blank) The release of catecholamines, cortisol, and growth hormone during an acute stress response is helpful because they all increase blood _____ levels to support brain metabolism.

glucose

(Name the stress-induced disease process for the following physiologic system) Integumentary System

hair loss; rash

(Fill in the blank) Desensitization involves altering how the _____ responds to selected perceived threats.

hypothalamus

(Fill in the blank) A moderate amount of stress is helpful in learning and consolidation of _____.

memory

(Name the stress-induced disease process for the following physiologic system) Nervous System

nervous tic; fatigue, anxiety; depression; insomnia; headaches