Pathophysiology Exam 1 Questions & Answers

Etiology - ANSWERSthe cause of the disease Pathogenesis - ANSWERSthe start of development of disease evolution of disease Development or evolution of disease, from initial stimulus to ultimate expression of manifestations of disease Clinical Manifestations - ANSWERSsigns or symptoms Nosocomial - ANSWERSinfection r/t exposure in healthcare environment Ex: pt that developed UTI from catheter Idiopathic - ANSWERSunknown cause Iatrogenic - ANSWERSCause results from unintended or unwanted medical treatment (EX: hypothyroidism after thyroid surgery; alopecia [hair loss] after chemotherapy). Risk factor (predisposing factors) - ANSWERSA factor that when present increases the likelihood of disease: increases/risk probablity of contracting illness ex: smoking increases risk of lung cancer Precipitating factor - ANSWERSCauses pathologic event Ex: if someone is exposed to allergic event (bee sting) causes anaphylactic shock Etiology Disease Classification - ANSWERS symptoms - ANSWERSsubjective feeling of abnormality in the body Signs - ANSWERSobjective or observed manifestation of disease Acute - ANSWERSdisease that comes on quickly/suddenly- usually more severe but short lasting Chronic - ANSWERSdevelops slower-over months or years and can last a life time Exacerbation - ANSWERSwhen you have a sudden increase in signs/symptoms of disease or severity Ex: asthma- can live with it but if exposed to allergen can flair up Remission - ANSWERSDecline in severity of sign and symptoms of the disease More than 5 years= permanent remission Sequela - ANSWERSunwanted outcome of condition that is associated with an acute illness -paralysis from stroke what can cause red blood count would be higher - ANSWERShigh altitude The medical examiner report states that the etiology of the disease is overexposure to radiation. Etiology refers to - ANSWERSthe cause A person experiences stress when: - ANSWERSwhen a demand exceeds a person's coping abilities resulting in: - ANSWERSreactions such as disturbances of cognition, emotion, and behavior that can adversely affect well-being Individualized Influences on Stress Response: - ANSWERSAge: due to lifetime experiences- person can react different in different parts of life Gender? A lot of gender responses are due to hormonal level differences Biological Cycles: Culture: Personality characteristics: type A higher levels of stress Who Worked to discover a new sex hormone by Injecting ovarian extracts into rats - ANSWERSDr. Hans Selye He Witnessed structural changes in stress conditions such as: - ANSWERSEnlargement of the adrenal gland Thymic and other lymphoid structure atrophy got smaller- help body to maintain WBC response and immunity Development of bleeding ulcers in the stomach and duodenal lining General Adaptation Syndrome (GAS) is used to - ANSWERS The three stages of GAS are: - ANSWERSAlarm stage Stage of resistance or adaptation Stage of exhaustion Alarm stage: - ANSWERScan be physical/emotional positive/negative Arousal of body defenses Stage of resistance or adaptation - ANSWERSMobilization contributes to fight or flight Hypothalamus Activated sympathetic nervous system: tells body to take action Stage of exhaustion - ANSWERSProgressive breakdown of compensatory mechanisms Onset of disease Body can no longer return to homeostasis- when you see onset of disease GAS Activation: Alarm stage - ANSWERSStressor triggers the hypothalamic-pituitary-adrenal (HPA) axis Activates sympathetic nervous system Release of epinephrine GAS Activation: Resistance stage - ANSWERSBegins with the actions of adrenal hormones Allostasis: your body's ability to adapt GAS Activation: Exhaustion stage (allostatic overload) - ANSWERSOccurs only if stress continues and adaptation is not successful Endorphins provide momentary - ANSWERSpain relief when body tries to repair from surgery: - ANSWERSgrowth hormones increase Prolactin - ANSWERSthe hormone that releases breast milk Testosterone can be suppressed by - ANSWERSstress/anesthesia A patient experiences a stressor that activates the stress response. Which of the following initiates the stress response? - ANSWERScentral nervous system TABLE 8-3: GAS ACTIVATION - ANSWERS General Stress decreases: - ANSWERSImmunity PAGE 213 - ANSWERS Neuroendocrine Regulation - ANSWERS Reactive response - ANSWERSEx: Psychological Stressors (fear) Hands get sweaty Anticipatory response - ANSWERSEx: anticipation of homeostasis disruption Stomach clenches, heart pounds, etc Psychologic Mediators and Specificity***** - ANSWERS Psychoneuroimmunologic Regulation - ANSWERSNeuropeptide Y (NPY): some in lymphatic tissue. * Promotes vasoconstriction * Released/Produced with chronic stress Immune modulation by psychosocial stressors leads directly to ____ outcomes - ANSWERSHealth; The more stress the PT has, the harder it is for wound to heal Neuropeptide Y (NPY) - ANSWERSa sympathetic neurotransmitter- recently shown to be a stress mediator *because NPY is a growth factor for many cells, it is implicated in atherosclerosis and tissue remodeling NPY promotes - ANSWERSvasoconstriction NPY is released/produced with - ANSWERSchronic stress The more NPY you have the more stressed you are and more likely you are to produce neurosclerosis ??****CHECK PAGE 215 - ANSWERS Hormones that influence stress response **Table 8-4 - ANSWERS Psychologic distress - ANSWERSGeneral state of unpleasant arousal after life events that manifests as physiologic, emotional, cognitive, and behavior changes Ex: divorce may leave you at risk for illness or depression FIGURE 8-8 PAGE 218**** - ANSWERS Stress-age syndrome - ANSWERSExcitability changes in the limbic system and hypothalamus Increased: - ANSWERScatecholamines, ADH, ACTH, and cortisol Decreased: - ANSWERStestosterone, thyroxine, and other hormones Immunodepression - ANSWERSDecreased response to viral, fungal, and bacterial antigens Decreased speed of tissue damage repair Which of the following is responsible for elevation of heart rate due to stress? - ANSWERSEpinephrine degenerative - ANSWERSResults from the degenerative changes that occur in tissue and organs (EX: osteoporosis, osteoarthritis). Neoplastic - ANSWERSDue to abnormal or uncontrolled growth of cells. (EX: cancer) (Neo= new; Plasm= cancer). Congenital - ANSWERSDue to a defect in the development, hereditary factors, or prenatal infection; present at birth (EX: cleft lip, cleft palate). Corticotropin-releasing hormone (CRH) is released by the - ANSWERSHypothalamus Stress may defined as any factor that stimulates the - ANSWERSHypothalamus to release CRH Which of the following is true? a. Stressors initially stimulate the adrenal cortex b. Stressors stimulate immunity c. The emotions, fear, anxiety, and grief can act as stressors d.Stressors are the same for all individuals - ANSWERSC Glucocorticoids are highest during the stage of - ANSWERSresistance The physiologic response to the stress of a students final exam may be - ANSWERSReactive The production of cortisol in response to stress can be initiated by - ANSWERSthe hypothalamus, anterior pituitary, and adrenal cortex. Cortisol - ANSWERSaffects protein catabolism What can occur in response to stress? - ANSWERSincreased systolic blood pressure In response to stress, the adrenal cortex secretes - ANSWERScortisol and aldosterone Coping - ANSWERSmanages stressful demand exceeding an individuals resources Biochemicals secreted by the adrenal cortex in response to stress are ___________________ - ANSWERScorticoids ____________ cause disturbances in cognition, emotion, and behavior. - ANSWERSstressors The bodily changes initiated by the noxious stimuli cause the______________. - ANSWERSstress response The stage of GAS wherein the immunity of an individual is most impaired is the ______________________. - ANSWERSexhaustion stage The stage of GAS that triggers the sympathetic nervous system is the _______________. - ANSWERSalarm stage The cytokine produced by macrophages stimulating release of CRH is ____. - ANSWERSIL-1 An interleukin that increases ACTH levels is ____. - ANSWERSIL-2 A neurotransmitter augmenting the action of catecholamines is ___. - ANSWERSNPY A substance produced by lymphocytes, macrophages, and firbroblasts that enhances phagocytic activity is ___. - ANSWERSIFN __________ inhibit pain, CRH secretion, and blood pressure increases. - ANSWERSEndorphins What did Dr. Hans Selye call the physical changes he saw in the rats? - ANSWERSstressors What are two types of Catecholamines? - ANSWERS1) Epinepherine - large amounts 2) Norepinepherine - small amounts - released from chromaffin cells of the adrenal medulla What does Epinepherine do? - ANSWERSIncreased heart rate and force of contraction, increased metabolism -works on alpha 1 and 2, and beta 1 and 2 receptors What does Norepinepepherine do? - ANSWERSIncreases blood pressure, dilates pupils, causes pilloerection, increases sweat in armpits and palms. -works on alpha 1 and 2 receptors Describe what Cortisol (Hydrocortisone) does - ANSWERS-Activated by ACTH Adrenocorticotropic Hormone -Stimulates gluconoegenesis -Elevates the blood glucose level -Powerful anti-inflammatory and immunosuppresent -Slower that nori and epi, but lasts longer -steroid -increases appetite -breaks down stuff to get amino acids to be used for other stuff