FINAL EXAM STUDY GUIDE

FINAL EXAM STUDY GUIDE

Stress

• 3 stages of Selye’s General Adaptation Syndrome

Alarm-fight or flight response due to stressful stimulus Resistance – Allostasis Exhaustion- allostatic overload/disease

• role of hypothalamus and function of corticotropin releasing hormone

Hypothalamus senses stressor and release corticotropin releasing hormone which then causes the adrenal medulla to release catecholamines (epinephrine and norepinephrine)

• role of anterior pituitary and function of adrenocorticotropic hormone (ACTH)

Anterior pituitary secretes adrenocorticotropic hormone and adrenal cortex secretes glucocorticoids (cortisol and aldosterone)

• role of posterior pituitary and function of antidiuretic hormone/vasopressin (ADH)

Posterior pituitary releases ADH- which causes water to be reabsorbed, increases blood volume and BP

• role of adrenal glands and functions of catecholamines and corticosteroids

Play an integral role in allostasis, sympathico-adrenal system response mediates the fight or flight response Norepinephrine-constricts blood vessels, raises BP, reduces gastric secretions, increases night/far vision Epinephrine-enhances myocardial contractility, increases heart rate, increases cardiac output, causes bronchodilation, increases release of glucose from the liver (glycogenolysis) and elevate glucose levels.-corticosteriods-cortisol, aldosterone Critical to maintenance of homeostasis, may energize or antagonize effects of catecholamines Cortisol-primary glucocorticoid, affects protein metabolism, promotes appetite and food seeking behavior, has anti-inflammatory effects Aldosterone-primary mineralcorticoid, promotes reabsorption of sodium and water, increases blood pressure

• functions of endorphins/enkephalins and immune cytokines

Endogenous opioids (body’s natural pain relievers) raise pain threshold, produce sedation and euphoria.Immune cytokines Secreted by macrophages during stress response. Enhance immune system response, prolonged stress can suppress immune functioning. Example interlukin-1.

• allostatic overload 1 / 3

Results in inability to maintain homeostasis, leads to various illnesses and disorders, both physical and emotional

- explain why each of the following can occur due to stress:

Hypertension-epinephrine increases BP Stroke-increases in BP Coronary Artery Disease-increases in BP Gastrointestinal Problems-norepi-vasoconstriction Immune suppression-cortisol-decreases inflammatory response/immune response Diabetes Mellitus -cortisol and epi increase blood glucose Which is a true statement regarding cortisol?It produces stress response effects similar to those of epinephrine.Its activity is shorter than that of epinephrine.It has no known effect on the immune system.It is associated with the alarm stage.Which cardiovascular disorder has not been linked to excessive catecholamine levels in the blood?Stroke Hypertension Myocardial Infarction Heart valve dysfunction Which statement is true regarding epinephrine?It has the exact same effects as norepinephrine.It causes a decrease in glycogenolysis.It causes a decrease in muscle strength.It results in increased cardiac output.What stage is defined by “fight or flight”?Alarm Resistance Exhaustion Adaptation Which is true regarding catecholamines?They are from the parasympathetic nervous system.They include epinephrine and norepinephrine.They cross the blood-brain barrier.They cause a decrease in heart rate.------------------------------------------------------------------------------------------------------------------------------- 2 / 3

Anemia

• description

Deficit of red cells Low oxygen-carrying capacity leads to hypoxia Relative anemia—normal total red cell mass with disturbances in regulation of plasma volume Absolute anemia—actual decrease in numbers of red cells Decreased production Increased destruction

• general effects

Reduction in oxygen-carrying capacity Tissue hypoxia Compensatory mechanism to restore tissue oxygenation Increased heart rate, cardiac output, circulatory rate, and flow to vital organs Increase in 2,3-DPG in erythrocytes and decreased oxygen affinity of hemoglobin in tissues Increase in erythropoietin activity

• signs/symptoms of mild, moderate, and severe anemia

Mild anemia Usually no clinical symptoms Elderly with cardiovascular, pulmonary disease may have symptoms Mild to moderate anemia Fatigue, generalized weakness, and loss of stamina, followed by tachycardia and exertional dyspnea Moderate to severe anemia Orthostatic and generalized hypotension, vasoconstriction, pallor Tachypnea, dyspnea Tachycardia, transient murmurs, angina pectoris, heart failure Intermittent claudication, night cramps in muscles Headache, lightheadedness and faintness Tinnitus, roaring in the ears

• compare/contrast aplastic, Vitamin B deficiency, iron deficiency, and sickle-cell in terms of:

causes, signs/symptoms, lab results, treatment, prognosis Aplastic Anemia ˜ Stem cell disorder characterized by reduction of hematopoietic tissue, fatty marrow replacement, and pancytopenia (low RBC, WBC, and platelets) ˜Caused by toxic, radiant, or immunologic injury to the bone marrow stem cells ˜Diagnosed with bone marrow biopsy ˜Disease of the young (15-25) or old (>60) can occur due to chemotherapy ˜Insidious onset of symptoms ˜Late symptoms include weakness, fatigue, lethargy, pallor, dyspnea, palpitations, transient

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