Stress

Question 1

Stress

Answer 1

refers to an internal or external event or demand of life experienced by the individual that is perceived and appraised for scope and meaning on a continuum to determine whether resources and abilities for management are available, exceeded, or exhausted.

Question 2

Coping

Answer 2

Represents an individuals response to stress

Question 3

Stress can stem from

Answer 3

Psychosocial, emotional, physical or physiological stimuli

Question 4

Many experience what with stress

Answer 4

Anxiety, depression and grief

Question 5

Stress treatment

Answer 5

Psychotherapy and short term drug treatment

Long term therapy may be required

Question 6

Walter B. Cannon discovered

Answer 6

The flight or fight response

Question 7

Hans Selye work showed…

Answer 7

physiological stress invloed enlargement of the adrenal gland, decreased lymphocyte levels, development of bleeding ulcers

Question 8

Stress impairs the ability to…

Answer 8

Resist future stressors

Question 9

Alarm stage

Answer 9

Stressor triggers the hypothalamic pituitary adrenal axis
Activates sympathetic nervous system
Arousal of body defences

Question 10

Resistance / Adaptation stage

Answer 10

Begins with the actions of adrenal hormones

Mobilization contributes to “fight or flight”

Question 11

Exhaustion Stage

Answer 11

Occurs only if stress continues and adaptation is not successful
Leads to stress-related disorders

Question 12

3 stages of general adaptation syndrome

Answer 12

Alarm stage
Resistance/ Adaptation stage
Exhaustion stage

Question 13

Sources of stress

Answer 13

Physiological

Psychological/ Emotional

Question 14

Physiological stress

Answer 14

Originates from a physiological trigger and is associated with injury or illness

Question 15

Psychological/ Emotional stress

Answer 15

More common, encountered on a regular basis and generates a star of unpleasant arousal

Question 16

3 types of stress

Answer 16

Acute
Episodic
Chronic

Question 17

Acute stress

Answer 17

Most common, usually for a short period of time, occurs in reaction to a real or perceived demand, threat or pressure

Question 18

Episodic stress

Answer 18

Self-inflicted stress, taking on unrealistic assignments beyond what is reasonably expected

Question 19

Chronic stress

Answer 19

Sustained demand, threat or pressure that is harmful, to health and wears on individuals continuously

Question 20

Allostasis

Answer 20

Stability through change

Brain continuously monitors for future events and anticipates what is required from neuroendocrine and automatic systems

Question 21

Allostatic overload

Answer 21

Over activation of adaptive systems

Highly individualized

Question 22

Hypothalamus secretes

Answer 22

Corticotropin- releasing hormone (CRH)

Question 23

Pituitary releases

Answer 23

Adrenocorticotropic hormone

Question 24

Adrenal secretes

Answer 24

Cortisol and catecholamines

Question 25

Cortisol

Answer 25

``` Secreted during stress Reaches all tissues Affects protein metabolism Promotes resolution and repair Elevates blood glucose level Shown to induce T-cell apoptosis ```

Question 26

What does cortisol stimulate

Answer 26

Gluconeogenesis

Question 27

What is an example of a powerful anti-inflammatory and immunosuppressive agent

Answer 27

Cortisol

Question 28

Abnormal elevations linked to cortisol are

Answer 28

``` Obesity Sleep deprivation Lipid abnormalities Hypertension (HTN) Diabetes Atherosclerosis Loss of bone density ```

Question 29

Cortisol secretion during stress inhibits what

Answer 29

initial inflammatory effects

Question 30

Catecholamines are released from

Answer 30

The adrenal medulla

Question 31

Catecholamines

Answer 31

Mimic direct sympathetic stimulation Increases pro inflammatory cytokine production Increases HR, BP and impairs wound healing

Question 32

a- adrenergic receptors

Answer 32

a1 and a2

Question 33

B- adrenergic receptors

Answer 33

B1 and B2

Question 34

Neuropeptide Y (NPY)

Answer 34

sympathetic neurotransmitter | Growth factor

Question 35

Histamines

Answer 35

pro inflammatory Target mast cells Induces acute inflammation and allergic reaction while suppressing Th1 and promoting Th2 activity

Question 36

Role of immune system

Answer 36

Stress directly related to pro inflammatory Link between stress, immune function, and disease/ cancer Immune system affected by neuroendocrinefactors Stress response decreases T-cell cytotoxicity and B- cell function

Question 37

Psychosocial stress manifests as

Answer 37

physiological, emotional, cognitive, and behavioural changes

Question 38

Psychosocial stress puts the individual at risk for

Answer 38

immunological defecits

Question 39

Psychosocial distress aggression associated with...

Answer 39

Changes in T- and B- cell in numbers

Question 40

Psychosocial distress is linked to

Answer 40

Chronic disorders if severe

Question 41

Coping with Psychosocial distress may be...

Answer 41

adaptive or maladaptive

Question 42

Maladaptive coping may contribute to

Answer 42

adverse health effects

Question 43

Individual risk factors

Answer 43

``` Impaired cognition Chronic health conditions including mental health issues Multiple significant life changes Socioeconomic status Caregiver Individual in a foreign country Limited resources Age Changes in health conditions ```

Question 44

Stress-age syndrome

Answer 44

Excitability changes in the limbic system and hypothalamus

Question 45

Stress- age syndrome increases

Answer 45

Catecholamines, ADH, ACTH, and Cortisol

Question 46

Stress- age syndrome decreases

Answer 46

Testosterone, thyroxine, and other hormones

Question 47

Consequences of Chronic stress

Answer 47

Heightened responses | Exhaustion of resources leads to a loss of homeostasis

Question 48

Primary prevention of stress

Answer 48

Stress management Counselling Maintenance of positive relationships Maintenance of optimal health

Question 49

Collaborative interventions

Answer 49

A patient interview is completed in order to determine what therapy will be ordered

Question 50

Many patients related to stress require

Answer 50

A combination of behavioural and drug therapy

Question 51

Pharmacological therapy

Answer 51

``` Anxiolytics Hypnotics Antidepressants Psychotherapeutics Muscle relaxants Antimigraine agents Selective serotonin reuptake inhibitors ```

Question 52

What is the goal of pharmacological treatment

Answer 52

Reduce anxiety by reducing the overactivity in the CNS, improve coping skills

Question 53

Anxiolytics action

Answer 53

reduce anxiety by reducing overactivity in the CNS; binds to GABA receptors

Question 54

Anxiolytics Indication

Answer 54

Ethanol withdrawal, insomnia, muscle spasms, seizure disorders, anxiety

Question 55

Anxiolytics contraindication

Answer 55

Known drug allergy | Narrow angle glaucoma, pregnancy

Question 56

Anxiolytics Adverse effects

Answer 56

CNS depression, hypotension, drowsiness, dizziness, lethargy, headache, ataxia, slurred speech, depression, bradycardia, hypotension, constipation, diarrhea, nausea, vomiting

Question 57

Anxiolytics Prototype class

Answer 57

Benzodiazepines

Question 58

Anxiolytics prototype drug

Answer 58

Lorazempam