Pathophysiology Week 1

All the following stress-induced hormones increase blood glucose except a. aldosterone. b. cortisol. c. norepinephrine. d. epinephrine.

ANS: A Aldosterone results in water and sodium retention and potassium loss in the urine. It does not affect blood glucose. Cortisol is a glucocorticoid secreted by the adrenal cortex. Cortisol stimulates gluconeogenesis in the liver, thus increasing blood glucose. Norepinephrine inhibits insulin secretion, thus increasing blood sugar. Epinephrine increases glucose release from the liver and inhibits insulin secretion, thus increasing blood glucose.

The primary effect of aging on all body systems is a. decreased functional reserve. b. diseased function. c. programmed senescence. d. senility.

ANS: A All body systems show age-related changes that can be generally described as a decrease in functional reserve; aging leads to inability to adapt to (internal and external) environmental changes. Not all effects of aging are considered disease; some are considered a normal part of aging. Programmed senescence is currently only a theory of aging that states cells have a preprogrammed number of cell divisions before they will die. Senility is an outdated term used to describe the cognitive changes associated with dementia; dementia is a disease and is not a normal part of aging.

Selye's three phases of the stress response include all the following except a. allostasis. b. resistance. c. alarm. d. exhaustion.

ANS: A Allostasis is defined as the ability to successfully adapt to challenges. Allostasis may/may not occur in response to stress. Alarm, resistance, and exhaustion are the three phases of the stress response as described by Selye in the general adaptation syndrome.

Retroviruses are associated with human cancers, including a. Burkitt lymphoma. b. Hodgkin's lymphoma. c. pancreatic cancer. d. hepatic cancer.

ANS: A At least three retroviruses are thought to be causative factors in some human cancers: HIV Kaposi sarcoma, Epstein-Barr in Burkitt lymphoma, and human T-lymphocyte type I in T-cell leukemia-lymphoma. The other answer options are not associated with a retrovirus.

The effects of excessive cortisol production include a. immune suppression. b. hypoglycemia. c. anorexia. d. inflammatory reactions.

ANS: A Cortisol suppresses immune function and inflammation and stimulates appetite. Cortisol leads to hyperglycemia by stimulating gluconeogenesis in the liver.

Familial retinoblastoma involves the transmission of what from parent to offspring? a. Mutant tumor-suppressor gene b. Cancer-causing virus c. Oncogene d. Extra chromosome

ANS: A Familial retinoblastoma involves transmission of a mutant tumor-suppressor gene from parent to child. Familial retinoblastoma is not caused by a virus and does not involve an extra chromosome, but rather a single gene. Familial retinoblastoma is caused by a mutant tumor-suppressor gene, not an oncogene, which is a mutated proto-oncogene.

Metaplasia is a. the replacement of one differentiated cell type with another. b. the transformation of a cell type to malignancy. c. an irreversible cellular adaptation. d. the disorganization of cells into various sizes, shapes, and arrangements.

ANS: A Metaplasia is the replacement of one differentiated cell type with another secondary to persistent damage. Dysplasia transforms cells to preneoplastic lesions, which may become malignant. Metaplasia is reversible when the damage is stopped. Disorganization of cells into various sizes, shapes, and arrangements occurs in dysplasia.

All these cellular responses are potentially reversible except a. necrosis. b. metaplasia. c. atrophy. d. hyperplasia.

ANS: A Necrosis refers to death of cells/tissue and is not reversible. Metaplasia refers to the replacement of one differentiated cell type with another from persistent injury and is reversible when the injury stops. Atrophy occurs because of lack of use of an organ and is reversible. Hyperplasia is an increase in the number of cells from increased physiologic demands or hormonal stimulation and is reversible.

Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by a. norepinephrine. b. cortisol. c. glucagon. d. ACTH.

ANS: A Norepinephrine is secreted in response to activation of the sympathetic nervous system during stress by the adrenal medulla. Cortisol is secreted by the adrenal cortex. Glucagon is secreted by the pancreas. ACTH is secreted by the pituitary gland.

A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of a. primary prevention. b. secondary prevention. c. tertiary prevention. d. disease treatment.

ANS: A Primary prevention is prevention of disease by altering susceptibility or reducing exposure for susceptible individuals by providing vaccination. Secondary prevention is the early detection, screening, and management of the disease. Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate disability and restore effective functioning. Disease treatment involves management of the disease once it has developed.

The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of a. tumor necrosis factor. b. angiogenesis. c. loss of ATP production. d. pain medications.

ANS: A Production of tumor necrosis factor (TNF) and other immune cytokines is thought to be important in producing the hypermetabolic state leading to cachexia in cancer. Angiogenesis is the development of new blood vessels to feed the tumor; it is not a cause of the hypermetabolic state leading to cachexia in terminal cancer. Loss of ATP production and pain medications is not causes of the hypermetabolic state leading to cachexia in terminal cancer.

Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following? a. It is a procedure for determining the extent of tumor spread. b. It is a histologic examination of tissues to determine the degree of tumor differentiation. c. It is based on exploratory surgery. d. It is biochemical testing of tumor cells to determine the genetic basis of the tumor.

ANS: A Staging describes the location and pattern of spread of a tumor. Staging does not involve biochemical testing of tumor cells, or the histologic examination of tissues, which is done with cancer grading. CT, MRI, and PET imaging techniques have allowed for noninvasive cancer detection.

Breast cancer in women who have the breast cancer gene a. occurs at an earlier age. b. is more likely to be unilateral. c. is more common than non-inherited breast cancer. d. is more responsive to treatment.

ANS: A The age of onset of inherited breast cancer is earlier than the onset of non-inherited forms and the prevalence of bilateral breast cancer is higher. Breast cancer in women who have the breast cancer gene is less common (only 5% to 10% of all cases) than non-inherited breast cancer and is more likely to be bilateral. Response to treatment is not affected by whether the cancer gene is present.

The primary adaptive purpose of the substances produced in the alarm stage is a. energy and repair. b. invoke resting state. c. produce exhaustion. d. set a new baseline steady-state.

ANS: A These resources are used for energy and as building blocks, especially the amino acids, for the later growth and repair of the organism. The substances do not produce a resting state. The substances can produce exhaustion if they continue, but that is not the adaptive purpose of these. Although a new baseline steady-state may result from the stress response that is not the adaptive purpose of the substances produced during the alarm stage.

Events which occur during the alarm stage of the stress response include secretion of (Select all that apply.) a. catecholamines. b. ACTH. c. glucocorticoids. d. immune cytokines. e. TSH.

ANS: A, B, C, D During the alarm stage, catecholamines (epinephrine, norepinephrine), ACTH, glucocorticoids, and immune cytokines are secreted. TSH is not secreted during the stress response.

Chronic activation of stress hormones can lead to (Select all that apply.) a. cardiovascular disease. b. depression. c. impaired cognitive function. d. autoimmune disease. e. overactive immune function.

ANS: A, B, C, D Excessive cortisol levels promote hypertension, atherosclerosis, and the development of cardiovascular disease. Chronic overactive stress hormones may result in atrophy and death of brain cells. Elevated levels of stress hormones are found in individuals with depressive disorders. Chronic stress leads to immune function impairment, rather than overactive immune function, and has been implicated in autoimmune disorders.

Bacteria cause injury to cells by (Select all that apply.) a. producing exotoxins. b. producing endotoxins. c. producing destructive enzymes. d. reproducing inside of host cells altering cellular function. e. evoking an immune reaction.

ANS: A, B, C, E Bacteria function in multiple ways to cause cell injury, including producing exotoxins that interfere with cellular function, producing endotoxins that cause fever and circulatory shock when the bacteria are lysed, producing enzymes that digest cellular membranes, or evoking an immune response with release of chemicals (e.g., histamines, kinins, lymphokines) that can injure cells. Bacteria do not reproduce inside host cells.

Deficits in immune system function occur in cancer as a result of (Select all that apply.) a. chemotherapy. b. cancer cells. c. cancer metastasis to bone marrow. d. immunotherapy. e. malnutrition.

ANS: A, B, C, E Cancer cells secrete substances that suppress the immune system. Bone marrow suppression may be because of invasion of blood-forming cells in the bone marrow, poor nutrition, and chemotherapeutic agents. By contrast, immunotherapy is a method of harnessing the immune system in the treatment of cancer.

Infectious injury often results from (Select all that apply.) a. exotoxins. b. endotoxins. c. self-destruction of cells. d. anti-inflammatory reactions. e. enzymes from white blood cells.

ANS: A, B, C, E Exotoxins produced by bacteria interfere with cellular functions. Endotoxins are a component of some bacteria; when the bacteria are lyses, endotoxins are released, causing fever and even circulatory shock. Virally infected cells may trigger their own destruction. Enzymes from white blood cells can harm cells in the area of inflammation. Infectious injury promotes inflammation; inflammation can cause more damage than the infecting agent.

Your patient's red blood cell is slightly elevated today. This might be explained by (Select all that apply.) a. gender difference. b. situational factors. c. normal variation. d. cultural variation. e. illness.

ANS: A, B, C, E Gender, situations (e.g., altitude), normal variations, and illness may all determine red blood cell count. Culture affects how manifestations are perceived (normal versus abnormal).

Characteristics of telomerase include (Select all that apply.) a. repairs the end caps of chromosomes. b. contributes to cancer cell immortality. c. is deficient in cancer cells. d. activity allows a cell to replicate indefinitely.

ANS: A, B, D Telomerase functions to repair the end caps of chromosomes. It contributes to cancer cell immortality by allowing a cell to replicate indefinitely. Telomerase is present in cancer cells at higher than normal levels.

Side effects of chemotherapy include (Select all that apply.) a. anemia. b. nausea. c. leukocytosis. d. bleeding. e. infections.

ANS: A, B, D, E Chemotherapy leads to anemia, bleeding, and infections from bone marrow suppression and deficient production of RBS, platelets, and WBCs, respectively. Chemotherapy also causes nausea, a frequent and debilitating side effect. Chemotherapy causes leukopenia (reduction of WBCs).

Aldosterone may increase during stress, leading to (Select all that apply.) a. decreased urinary output. b. increased blood potassium. c. increased sodium retention. d. increased blood volume. e. decreased blood pressure.

ANS: A, C, D Aldosterone increases water and sodium reabsorption and potassium excretion by the renal distal tubules and collecting ducts, thus leading to decreased urinary output, sodium retention in the body, and increased extracellular fluid volume. Because it leads to potassium excretion, aldosterone leads to decreased blood potassium.

Viruses differ from most bacteria in that they (Select all that apply.) a. enter the host cell. b. directly produce free radicals. c. use the host's metabolic processes to survive and replicate. d. do not induce an immune response. e. do not produce toxins.

ANS: A, C, E Viruses are able to enter the host cell and use host metabolic processes to survive and replicate. Viruses do not produce toxins. Viruses do not directly produce free radicals, although these can be produced indirectly by the immune response that follows viral infection. Both viruses and bacteria produce an immune response.

A disease that is native to a particular region is called a. epidemic. b. endemic. c. pandemic. d. ethnographic.

ANS: B A disease that is native to a particular region is called endemic. An epidemic is a disease that spreads to many individuals at the same time. Pandemics are epidemics that affect large geographic regions, perhaps spreading worldwide.

Apoptosis is a process that results in cellular a. atrophy. b. death. c. proliferation. d. mutation.

ANS: B Apoptosis results in death of a cell when it is no longer needed. Atrophy refers to reduction in size of an organ because of cellular shrinkage. Proliferation refers to growth of new cells. Mutation refers to alteration in the genetic structure of cellular DNA

After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor a. is benign. b. is malignant. c. is secondary to cancer elsewhere in the body. d. has spread.

ANS: B Bronchial carcinoma is a malignant cancer of the epithelial lining of the bronchi. Carcinoma refers to a malignant tumor. Primary indicates that the cancer began in the lungs and did not metastasize from another site. A staging procedure must be done before knowing if the lung cancer has spread.

Carbon monoxide injures cells by a. destruction of cellular membranes. b. reducing oxygen level on hemoglobin. c. promotion of free radicals. d. crystallization of cellular organelles.

ANS: B Carbon monoxide binds tightly to hemoglobin preventing the red blood cell from carrying adequate oxygen, leading to hypoxic injury. Other chemicals such as carbon tetrachloride promote free radicals, which injure cells and destroy cellular membranes. Crystallization of cellular organelles is caused by hypothermia.

The cellular component that is most susceptible to radiation injury is the a. membrane. b. DNA. c. RNA. d. ribosomes.

ANS: B Cellular DNA is particularly susceptible to damage from radiation via breakage of the bonds holding the linear DNA together. Cell membranes, RNA, and ribosomes are not the most susceptible to radiation injury.

The cellular change that is considered preneoplastic is a. anaplasia. b. dysplasia. c. metaplasia. d. hyperplasia.

ANS: B Dysplastic cells have the potential to become cancerous and are therefore referred to as preneoplastic. Anaplasia, metaplasia, and hyperplasia are not considered preneoplastic.

C.Q. was recently exposed to group A hemolytic Streptococcus and subsequently developed a pharyngeal infection. His clinic examination reveals an oral temperature of 102.3°F, skin rash, dysphagia, and reddened throat mucosa with multiple pustules. He complains of sore throat, malaise, and joint stiffness. A throat culture is positive for Streptococcus, and antibiotics have been prescribed. The etiology of C.Q.'s disease is a. a sore throat. b. streptococcal infection. c. genetic susceptibility. d. pharyngitis.

ANS: B Etiology refers to the proposed cause or causes of a particular disease process. A sore throat is the manifestation of the disease process. Genetic susceptibility refers to inherited tendency to develop a disease. Pharyngitis refers to inflammation of the throat and is also a clinical manifestation of the disease process.

Persistence of the alarm stage will ultimately result in a. stress reduction. b. permanent damage and death. c. movement into the resistance stage. d. exhaustion of the sympathetic nervous system.

ANS: B If the alarm stage were to persist, the body would soon suffer undue wear and tear and become subject to permanent damage and even death. Actions taken by the individual during the resistance stage lead to stress reduction. The resistance stage may or may not occur following the alarm stage, based on resource availability. The sympathetic nervous system will continue to function, resulting in continued release of stress hormones.

In general, with aging, organ size and function a. increase. b. decrease. c. remain the same. d. are unknown.

ANS: B In general, with aging, organ size and function decrease.

An increase in organ size and function caused by increased workload is termed a. atrophy. b. hypertrophy. c. metaplasia d. inflammation.

ANS: B Increased function of an organ such as the heart or skeletal muscle results in organ hypertrophy because of cellular enlargement. Atrophy refers to reduction in size of an organ because of cellular shrinkage. Metaplasia refers to replacement of one differentiated cell type with another. Inflammation results from immune response rather than workload.

A patient has been exposed to meningococcal meningitis, but is not yet demonstrating signs of this disease. This stage of illness is called the _____ stage. a. prodromal b. latent c. sequela d. convalescence

ANS: B Incubation refers to the interval between exposure of a tissue to an injurious agent and the first appearance of signs and symptoms. In infectious diseases, this period is often called the incubation (latent) period. Prodromal refers to the appearance of the first signs and symptoms indicating the onset of a disease. These are often nonspecific, such as headache, malaise, anorexia, and nausea, which are associated with a number of different diseases. Sequela refers to subsequent pathologic condition resulting from a disease. Convalescence is the stage of recovery after a disease, injury, or surgical operation.

A patient with metastatic lung cancer wants to know her chances for survival. Which response is correct? a. "Lung cancer is always fatal." b. "Lung cancer has about a 15% survival rate." c. "Lung cancer is highly curable when diagnosed early." d. "Lung cancer death rate has decreased significantly, as with all other cancers."

ANS: B Lung cancer has a 15% survival rate. Lung cancer is not always fatal, but is not highly curable at any stage of diagnosis. The death rate from lung cancer has increased dramatically.

Proto-oncogenes a. are the same as oncogenes. b. are normal cellular genes that promote growth. c. lead to abnormal tumor-suppressor genes. d. result from severe mutational events.

ANS: B Proto-oncogenes are normal cellular genes that promote growth. Proto-oncogenes are not the same as oncogenes, which are mutant proto-oncogenes. They are different from tumor-suppressor genes and do not alter tumor-suppressor genes. Mutational events lead to oncogenes, a mutated proto-oncogene.

An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise program. This is an example of a. primary prevention. b. secondary prevention. c. tertiary prevention. d. disease treatment.

ANS: B Secondary prevention is the early detection, screening, and management of the disease such as prescribing diet and exercise for an individual who has already developed obesity. Primary prevention is prevention of disease by altering susceptibility or reducing exposure for susceptible individuals. Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate disability and restore effective functioning. Disease treatment involves management of the disease once it has developed

A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium intake. This is an example of a. primary prevention. b. secondary prevention. c. tertiary prevention. d. disease treatment.

ANS: B Secondary prevention is the early detection, screening, and management of the disease, such as by prescribing sodium restriction for high blood pressure. Primary prevention is prevention of disease by altering susceptibility or reducing exposure for susceptible individuals. Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate disability and restore effective functioning. Disease treatment involves management of the disease once it has developed.

Somatic death refers to death a. of a body organ. b. of the entire organism. c. of nerve cells. d. secondary to brain damage.

ANS: B Somatic death refers to death of an entire organism. Somatic death is not simply death of one body organ. Somatic death involves death of all cells in the body. Brain death refers to death of the brain only, but organ systems can remain living with mechanical assistance.

The most common tumor-suppressor gene defect identified in cancer cells is a. Rb. b. P53. c. DCC. d. APC.

ANS: B The most common tumor-suppressor gene defect identified in cancer cells involves P53. More than half of all types of human tumors lack functional P53, which inhibits cell cycling. Rb, DC, and APC are not the most common tumor-suppressor gene defects identified in cancer cells.

The stage during which the patient functions normally, although the disease processes are well established, is referred to as a. latent. b. subclinical. c. prodromal. d. convalescence.

ANS: B The stage during which the patient functions normally, although the disease processes are well established, is called the subclinical stage. The interval between exposure of a tissue to an injurious agent and the first appearance of signs and symptoms may be called a latent period or, in the case of infectious diseases, an incubation period. The prodromal period, or prodrome, refers to the appearance of the first signs and symptoms indicating the onset of a disease. Convalescence is the stage of recovery after a disease, injury, or surgical operation

Socioeconomic factors influence disease development because of (Select all that apply.) a. genetics. b. environmental toxins. c. overcrowding. d. nutrition. e. hygiene.

ANS: B, C, D, E Socioeconomic factors influence disease development via exposure to environmental toxins (occupational) and overcrowding, nutrition (over- or undernutrition), and hygiene (e.g., in developing countries). Genetics is not influenced by socioeconomic factors.

Tumor markers (Select all that apply.) a. are found only in the blood. b. are produced by normal cells. c. help determine cancer origin. d. help identify progression of cancer. e. include prostatic-specific antigen.

ANS: B, C, D, E Tumor markers are substances associated with tumor cells that may be helpful in identifying their tissue of origin and progression and proliferation of cancer cells. Most tumor markers are not very specific for cancer since normal cells in the tissue of origin also produce them. Tumor markers include prostatic-specific antigen. Some tumor cell markers are released into the circulation, but others must be identified through biopsy of metastatic tissue.

Malignant neoplasms of epithelial origin are known as a. lymphoma. b. sarcomas. c. carcinomas. d. adenomas

ANS: C Carcinoma refers to malignant tumors of epithelial origin. Lymphoma refers to cancer of the lymphatic tissue. Sarcoma refers to malignant tumors of mesenchymal (nerve, bone, muscle) origin. Adenoma is a benign tumor of glandular tissue.

Of the statements below, the accurate statement regarding nutrition and cellular health is a. the body can generally produce elements essential for nutritional balance. b. obese individuals are generally nutritionally healthy. c. deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types. d. a normal BMI indicates nutritional health.

ANS: C Deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types such as in diabetes mellitus. Most of these essential nutrients must be obtained from external sources, because the cell is unable to manufacture them. Obesity involves an excess of caloric intake. The BMI is a measure for obesity, but does not indicate if a nutritional imbalance is present.

Cancer grading is based on a. tumor size. b. local invasion. c. cell differentiation. d. metastasis.

ANS: C Grading refers to the histologic characterization of tumor cells and is basically a determination of the degree of anaplasia (lack of differentiation). The other answer options are associated with tumor staging.

Extreme cold injures cells by all the following except a. ischemic injury from vasoconstriction. b. peripheral nerve damage from rebound vasodilation. c. decreased blood viscosity. d. crystallization of cellular components.

ANS: C Hypothermia causes increased blood viscosity, which can result in ischemic injury. Initial vasoconstriction causes ischemic injury. Rebound vasodilation leads to intense swelling which damages peripheral nerves. Crystallization of cellular components leads to rupture of these components.

Necrotic death of brain tissue usually produces _____ necrosis. a. coagulative b. caseous c. liquefactive d. fat

ANS: C Liquefactive necrosis is produced when brain tissue dies, as it is rich in enzymes and has little connective tissue. Coagulative necrosis occurs from ischemic injury in any tissue. Caseous necrosis occurs in lung tissue damaged by tuberculosis. Fat necrosis occurs in adipose (fat) tissue.

After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering medication. This is an example of a. primary prevention. b. secondary prevention. c. tertiary prevention. d. disease treatment.

ANS: C Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate disability and restore effective functioning such as prescribing a cholesterol-lowering medication following a heart attack. Primary prevention is prevention of disease by altering susceptibility or reducing exposure for susceptible individuals. Secondary prevention is the early detection, screening, and management of the disease. Disease treatment involves management of the disease once it has developed.

Allostasis is best defined as a. steady-state. b. a state of equilibrium, of balance within the organism. c. the process by which the body heals following disease. d. the overall process of adaptive change necessary to maintain survival and well-being.

ANS: D Allostasis refers to the overall process of adaptive change necessary to maintain survival and well-being.

After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will a. selectively kill tumor cells. b. stimulate immune cells to fight the cancer. c. have minimal side effects. d. kill rapidly dividing cells.

ANS: D Chemotherapy kills rapidly dividing cells. Chemotherapy does not selectively kill tumor cells, but affects all rapidly dividing cells. Chemotherapy has many damaging side effects. Immunotherapy uses the power of the immune system and has the potential for targeting cancer cells.

Coagulative necrosis is caused by a. dissolving of dead cells and cyst formation. b. trauma or pancreatitis. c. lung tissue damage. d. interrupted blood supply.

ANS: D Coagulative necrosis results from interrupted blood supply leading to ischemic cell injury. Liquefactive necrosis results from dissolving of dead cells and cyst formation. Fat necrosis is caused by trauma or pancreatitis. Caseous necrosis is caused by lung tissue damage such as that caused by tuberculosis

Paraneoplastic syndromes in cancer involve excessive production of substances by multiple means. A common substance found in excessive amounts resulting from cancer paraneoplastic syndromes is a. insulin. b. tumor necrosis factor. c. potassium. d. calcium.

ANS: D Common paraneoplastic syndromes include hypercalcemia associated with abnormal production of parathyroid hormone-related protein by tumor cells. Insulin is a general growth factor for a number of tissues and may be implicated in development of some cancers, but it is not a cause of paraneoplastic syndromes. Tumor necrosis factor is associated with cachexia in cancer, but it is not associated with paraneoplastic disorders of cancer. Potassium is not found in excess amounts in cancer.

Reperfusion injury to cells a. results in very little cellular damage. b. results from calcium deficiency in cells. c. occurs following nutritional injury. d. involves formation of free radicals.

ANS: D Free radicals are formed when high-energy electrons partially reduce oxygen in reperfusion injury. Reperfusion injury usually causes more cell damage than the original hypoxia. It results from calcium overload in the cells. Reperfusion injury results from hypoxic injury, rather than from nutritional injury.

Which is not normally secreted in response to stress? a. Norepinephrine b. Cortisol c. Epinephrine d. Insulin

ANS: D Insulin secretion is impaired during stress to promote energy from increased blood glucose. Norepinephrine is secreted during stress as a mediator of stress and adaptation. Cortisol is secreted during stress as a mediator of stress and adaptation and stimulates gluconeogenesis in the liver to supply the body with glucose. Epinephrine is secreted during stress as a mediator of stress and adaptation and increases glycogenolysis and the release of glucose from the liver.

The cellular response indicative of injury because of faulty metabolism is a. hydropic swelling. b. lactate production. c. metaplasia. d. intracellular accumulations.

ANS: D Intracellular accumulations result from faulty metabolism of lipids, carbohydrates, glycogen, and proteins. Hydropic swelling results from malfunction of the sodium-potassium pump. Lactate production results from anaerobic glycolytic pathway. Metaplasia occurs from persistent cell injury.

The effect of stress on the immune system a. is unknown. b. has been demonstrated to be non-existent in studies. c. most often involves enhancement of the immune system. d. may involve enhancement or impairment the immune system.

ANS: D Many studies demonstrate that long-term stress impairs the immune system, but many researchers identify that short-term stress may enhance the immune system.

Indicators that an individual is experiencing high stress include all the following except a. tachycardia. b. diaphoresis. c. increased peripheral resistance. d. pupil constriction.

ANS: D Pupils dilate during stress from the effects of catecholamines. Tachycardia, diaphoresis, and increased peripheral resistance are indicators of stress and also occur because of catecholamine release.

In general, a cancer cell that is more tissue-specific differentiated is more likely to be aggressive.

ANS: F The degree of tissue-specific differentiation predicts malignant potential. A lack of differentiated features in a cancer cell is called anaplasia, and a greater degree of anaplasia is correlated with a more aggressively malignant tumor.

When the cause is unknown, a condition is said to be idiopathic

ANS: T Many diseases are idiopathic in natur

The nurse is swabbing a patient's throat to test for streptococcal pharyngitis. The nurse must understand that tests such as this differ in the probability that they will be positive for a condition when applied to a person with the condition; this probability is termed sensitivity.

ANS: T The sensitivity of any test refers to the probability that the test will be positive when applied to a person with the condition and will not provide a false negative result. In contrast, specificity is the probability that a test will be negative when applied to a person who does not have a given condition.

Your patient eats "lots of fat," leads a "stressful" life, and has smoked "about two packs a day for the last 40 years." Her chronic morning cough recently worsened, and she was diagnosed with a lung mass. The most likely contributing factor for development of lung cancer in this patient is a. high-fat diet. b. urban pollutants. c. stressful lifestyle. d. cigarette smoking.

The most likely contributing factor for the development of lung cancer is cigarette smoking. Tobacco smoke contains hundreds of compounds, many of which have known genotoxicity and probably serve as initiators. Tobacco smoke also contains promoters, which spur the mutant cells to proliferate. Although a high-fat diet, urban pollutants, and a stressful lifestyle have been implicated in some types of cancer, they are not the likely contributing factor in your patient's lung cancer.