McCance Pathophysiology Ch. 11 - Stress & Disease
Exhaustion occurs if stress continues when which stage of the general adaptation syndrome is not
successful?
a. Flight or fight
b. Alarm
c. Adaptation
d. Arousal - (correct Answer) - ANS: C
Exhaustion occurs if stress continues and adaptation is not successful, ultimately causing impairment of
the immune response, heart
failure, and kidney failure, leading to death. The other stages occur before the adaptation stage.
Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?
a. Adrenal cortex
b. Hypothalamus
c. Anterior pituitary
d. Limbic system - (correct Answer) - ANS: B
The alarm phase of the GAS begins when a stressor triggers the actions of the hypothalamus and the
sympathetic nervous system
(SNS). The other organs are not stimulated by the alarm phase of GAS
During an anticipatory response to stress, what is the reaction from the limbic system stimulated by?
a. The retronucleus of the anterior pituitary
b. The anterior nucleus of the hippocampus
c. The paraventricular nucleus of the hypothalamus
d. The prefrontal nucleus of the amygdala - (correct Answer) - ANS: C
The paraventricular nucleus (PVN) of the hypothalamus must be stimulated to cause the limbic system to
be stimulated. The other
areas are not involved in the stimulation of the limbic system.
Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?
a. Norepinephrine
, b. Epinephrine
c. Cortisol
d. Adrenocorticotropic hormone (ACTH) - (correct Answer) - ANS: A
The release of norepinephrine promotes arousal, increased vigilance, increased anxiety, and other
protective emotional responses.
Epinephrine's effects are primarily on the cardiovascular system. Cortisol's chief effects involve metabolic
processes. By inhibiting
the use of metabolic substances while promoting their formation, cortisol mobilizes glucose, amino
acids, lipids, and fatty acids and
delivers them to the bloodstream. ACTH binds with specific receptors on the adrenal glands which
causes the release of the
glucocorticoids.
Perceived stress elicits an emotional, anticipatory response that begins where?
a. Prefrontal cortex
b. Anterior pituitary
c. Limbic system
d. Hypothalamus - (correct Answer) - ANS: C
The perception of stress initiates a series of events in the central and peripheral nervous systems. In the
brain, stress elicits an
anticipatory response that activates the limbic system; the brain area is responsible for motivation,
emotions, and cognition.
A student asks the healthcare professional how immunity is decreased by stress. The professional
responds that during a stress
response, the helper T (Th) 1 response is suppressed by which hormone?
a. ACTH
b. Cortisol
c. Prolactin
d. Growth hormone - (correct Answer) - ANS: B
Cortisol acts to suppress the activity of Th1 cells, which leads to a decrease in innate immunity and the
proinflammatory response.
Cortisol also stimulates the activity of Th2 cells, which increases adaptive immunity and the
Exhaustion occurs if stress continues when which stage of the general adaptation syndrome is not
successful?
a. Flight or fight
b. Alarm
c. Adaptation
d. Arousal - (correct Answer) - ANS: C
Exhaustion occurs if stress continues and adaptation is not successful, ultimately causing impairment of
the immune response, heart
failure, and kidney failure, leading to death. The other stages occur before the adaptation stage.
Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?
a. Adrenal cortex
b. Hypothalamus
c. Anterior pituitary
d. Limbic system - (correct Answer) - ANS: B
The alarm phase of the GAS begins when a stressor triggers the actions of the hypothalamus and the
sympathetic nervous system
(SNS). The other organs are not stimulated by the alarm phase of GAS
During an anticipatory response to stress, what is the reaction from the limbic system stimulated by?
a. The retronucleus of the anterior pituitary
b. The anterior nucleus of the hippocampus
c. The paraventricular nucleus of the hypothalamus
d. The prefrontal nucleus of the amygdala - (correct Answer) - ANS: C
The paraventricular nucleus (PVN) of the hypothalamus must be stimulated to cause the limbic system to
be stimulated. The other
areas are not involved in the stimulation of the limbic system.
Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?
a. Norepinephrine
, b. Epinephrine
c. Cortisol
d. Adrenocorticotropic hormone (ACTH) - (correct Answer) - ANS: A
The release of norepinephrine promotes arousal, increased vigilance, increased anxiety, and other
protective emotional responses.
Epinephrine's effects are primarily on the cardiovascular system. Cortisol's chief effects involve metabolic
processes. By inhibiting
the use of metabolic substances while promoting their formation, cortisol mobilizes glucose, amino
acids, lipids, and fatty acids and
delivers them to the bloodstream. ACTH binds with specific receptors on the adrenal glands which
causes the release of the
glucocorticoids.
Perceived stress elicits an emotional, anticipatory response that begins where?
a. Prefrontal cortex
b. Anterior pituitary
c. Limbic system
d. Hypothalamus - (correct Answer) - ANS: C
The perception of stress initiates a series of events in the central and peripheral nervous systems. In the
brain, stress elicits an
anticipatory response that activates the limbic system; the brain area is responsible for motivation,
emotions, and cognition.
A student asks the healthcare professional how immunity is decreased by stress. The professional
responds that during a stress
response, the helper T (Th) 1 response is suppressed by which hormone?
a. ACTH
b. Cortisol
c. Prolactin
d. Growth hormone - (correct Answer) - ANS: B
Cortisol acts to suppress the activity of Th1 cells, which leads to a decrease in innate immunity and the
proinflammatory response.
Cortisol also stimulates the activity of Th2 cells, which increases adaptive immunity and the
