A Comprehensive Exam Study Guide Covering Chapter 22 on Metabolic Stress and the Critically Ill. Latest Updated version 2026/2027

Chapter 22 - Metabolic Stress and the Critically Ill
1. What is the key difference between the body’s physiological reaction to starvation and metabolic stress?
a. adaptation occurs during metabolic stress
b. adaptation occurs during starvation
c. starvation can lead to death
d. weight loss occurs with starvation
e. metabolic stress is not related to diet
ANSWER: b
DIFFICULTY: Bloom’s Remember
REFERENCES: Physiological Response to Starvation

2. What happens to the basal metabolic rate during starvation?
a. no change
b. increases
c. reduces
d. wildly fluctuates
e. unpredictable
ANSWER: c
DIFFICULTY: Bloom’s Remember
REFERENCES: Physiological Response to Starvation

3. What protein is released in response to inflammation?
a. insulin
b. cysteine
c. histamine
d. C-reactive protein
e. lipase
ANSWER: d
DIFFICULTY: Bloom’s Remember
REFERENCES: Glossary

4. What protein is used in copper transport?
a. ceruloplasmin
b. serum amyloid A
c. VLDL
d. C-reactive protein
e. fibronectin
ANSWER: a
DIFFICULTY: Bloom’s Remember
REFERENCES: Glossary

5. What is the metabolic pathway through which glucose is formed from non-carbohydrate sources?
a. glycolysis
b. glucogenesis
c. glycogenesis
d. glycogenolysis
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,Chapter 22 - Metabolic Stress and the Critically Ill

e. gluconeogenesis
ANSWER: e
DIFFICULTY: Bloom’s Remember
REFERENCES: Glossary

6. What is the term for a systemic inflammatory response and immunosuppressive process that prevents an adequate
response to infection or trauma?
a. allergic reaction
b. sepsis
c. hypoxic injury
d. necrotizing fasciitis
e. multiorgan distress syndrome
ANSWER: b
DIFFICULTY: Bloom’s Remember
REFERENCES: Glossary

7. What is the term for reduced blood flow?
a. hypotension
b. cyanosis
c. alkalosis
d. hypoperfusion
e. vasoconstriction
ANSWER: d
DIFFICULTY: Bloom’s Remember
REFERENCES: Glossary

8. During periods of starvation, what is the primary source of fuel?
a. protein
b. glucose
c. lipids
d. amino acids
e. connective tissue
ANSWER: c
DIFFICULTY: Bloom’s Remember
REFERENCES: Physiological Response to Starvation

9. During metabolic stress, what supplies the substrate used for gluconeogenesis?
a. breakdown of muscle tissue
b. breakdown of body fat
c. breakdown of connective tissue
d. breakdown of bone minerals
e. breakdown of brain tissue
ANSWER: a
DIFFICULTY: Bloom’s Remember
REFERENCES: Physiological Response to Starvation
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, Chapter 22 - Metabolic Stress and the Critically Ill


10. What are the three phases of the stress response?
a. ebb phase, flow phase, recovery or resolution phase
b. injury phase, healing phase, recovery phase
c. reaction phase, adjustment phase, resolution phase
d. hyper-stress phase, moderation phase, reduction phase
e. reaction phase, healing phase, recovery phase
ANSWER: a
DIFFICULTY: Bloom’s Remember
REFERENCES: Physiological Response to Stress

11. Catecholamines (epinephrine, norepinephrine) increase energy availability by stimulating glycogenolysis and
increasing the release of what alternative fuel source?
a. glucose
b. galactose
c. amino acids
d. polypeptides
e. fatty acids
ANSWER: e
DIFFICULTY: Bloom’s Remember
REFERENCES: Physiological Response to Stress

12. What amino acid is the primary substrate required for gluconeogenesis?
a. lysine
b. arginine
c. alanine
d. glutamine
e. cysteine
ANSWER: c
DIFFICULTY: Bloom’s Remember
REFERENCES: Physiological Response to Stress

13. What amino acid is the primary fuel for enterocytes within the gastrointestinal tract and for T lymphocytes?
a. lysine
b. arginine
c. alanine
d. glutamine
e. cysteine
ANSWER: d
DIFFICULTY: Bloom’s Remember
REFERENCES: Physiological Response to Stress

14. What condition causes the highest excretion of nitrogen per day from the body?
a. major trauma
b. major burn
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