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Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?
a. Norepinephrine
b. Epinephrine
c. Cortisol
d. Adrenocorticotropic hormone (ACTH)
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.
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
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 antiinflammatory response. ACTH binds with specific receptors on the adrenal glands which causes the release of the glucocorticoids. Prolactin is secreted in response to a variety of stressful stimuli and acts as a second messenger for IL-2 and has a positive influence on B-cell activation and differentiation. Growth hormone affects protein, lipid, and carbohydrate metabolism; counters effects of insulin; and is involved in tissue repair.
Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of what?
a. Epinephrine and aldosterone b. Norepinephrine and cortisol c. Epinephrine and norepinephrine
d. Acetylcholine and cortisol
C. The sympathetic nervous system is aroused during the stress response and causes the medulla of the adrenal gland to release catecholamines (80% epinephrine and 20% norepinephrine) into the bloodstream. Sympathetic stimulation of the adrenal medulla does not cause the secretion of aldosterone, cortisol, or acetylcholine.
A severely stressed patient has cold, clammy skin. The healthcare professional quizzes the student about this effect. The student correctly answers that this effect is directly from which action?
b. Suppression of T-cell responses and enhancement of B-cell responses
c. Suppression of B- and T-cell responses
d. Enhancement of B- and T-cell responses
C. Androgens suppress T- and B-cell responses. Androgens do not enhance either B- or T-cell responses
Which statement is true concerning the differences between stress-induced hormonal alterations of men and women? a. After injury, women produce more proinflammatory cytokines than men, a profile that is associated with poor outcomes.
b. Androgens appear to induce a greater degree of immune cell apoptosis after injury, creating greater immunosuppression in injured men than in injured women.
c. Psychologic stress associated with some types of competition decreases both testosterone and cortisol, especially in athletes older than 45 years of age.
d. After stressful stimuli, estrogen is increased in women, but testosterone is decreased in men.
B. Androgens appear to induce a greater degree of immune cell apoptosis after injury, a mechanism that may elicit a greater immunosuppression in injured men vs. injured women. Men produce more proinflammatory cytokines. Competitive stress increases testosterone and cortisol. Estrogen is not increased in women after stressful stimuli.
A reduction in an individual's number of natural killer (NK) cells appears to correlate with an increased risk for the development of what?
a. Depression
b. Type 1 diabetes
c. Obsessive compulsive disorder (OCD)
d. Gastroesophageal reflux disorder (GERD)
A. A meta-analysis of studies shows a relationship between depression and the reduction in lymphocyte proliferation and natural killer cell activity. Currently, no research supports correlations between the number of NK cells and type 1 diabetes, OCD, or GERD.
Which cancer originates from connective tissue?
a. Osteogenic sarcoma
b. Basal cell carcinoma
c. Multiple myeloma
d. Adenocarcinoma
A. Cancers arising from connective tissue usually have the suffix -sarcoma. Carcinomas arise in epithelial tissue. Myeloma arises in the bone marrow.
Carcinoma refers to abnormal cell proliferation originating from which tissue origin?
a. Blood vessels
b. Epithelial cells
c. Connective tissue
d. Glandular tissue
increased production of its cells, also often considered precancerous. Metaplasia is an abnormal change in the characteristics of a tissue.
What is apoptosis? a. Normal mechanism for cells to self-destruct when growth is excessive b. Antigrowth signal activated by the tumor-suppressor gene Rb c. Mutation of cell growth stimulated by the TP53 gene d. Transformation of cells from dysplasia to anaplasia
A. Normal cells have a mechanism that causes them to self-destruct when growth is excessive and cell cycle checkpoints have been ignored. Unchecked proliferation could lead to malignancy.
What are tumor cell markers?
a. Hormones, enzymes, antigens, and antibodies that are produced by cancer cells
b. Receptor sites on tumor cells that can be identified and marked
c. Cytokines that are produced against cancer cells
d. Identification marks that are used in administering radiation therapy
A. Tumor (biologic) markers are substances produced by both benign and malignant cells that are found either in or on the tumor cells or in the blood, spinal fluid, or urine. Tumor markers may include hormones, enzymes, genes, antigens, and antibodies. Tumor markers are not receptor sites, cytokines, or identification marks for radiation.
What is one function of the tumor cell marker?
a. To provide a definitive diagnosis of cancer
b. To treat certain types of cancer
c. To predict where cancers will develop
d. To screen individuals at high risk for cancer
D Screening and identifying individuals at high risk for cancer are ways tumor markers can be used. The two other uses for these markers are to help diagnosis a specific type of cancer (not give a definitive diagnosis) and to follow the clinical course of a tumor.
Which statement supports the hypothesis that intestinal polyps are benign neoplasms and the first stage in the development of colon cancer?
a. Cancer cells accumulate slower than non-cancer cells.
b. An accumulation of mutations in specific genes is required to develop cancer.
c. Tumor invasion and metastasis progress more slowly in the gastrointestinal tract.
d. Apoptosis is triggered by diverse stimuli, including excessive growth.
B. Multiple genetic mutations are required for the evolution of full-blown cancer. This sequential development of cancer has been well documented in the transformation of benign colon polyps to colon cancer.
Autocrine stimulation is the ability of cancer cells to do what?
a. Stimulate angiogenesis to create their own blood supply
b. Encourage secretions that turn off normal growth inhibitors
c. Secrete growth factors that stimulate their own growth
d. Divert nutrients away from normal tissue for their own use
mutation in the ras gene converts it from a regulated proto-oncogene to an unregulated oncogene, an accelerator of cellular proliferation. Fusion, duplications, and proliferation of growth signals are not the cause of a ras gene converting to an oncogene.
Inherited mutations that predispose to cancer are almost invariably what kind of gene?
a. Proto-oncogenes
b. Oncogenes
c. Tumor-suppressor genes
d. Growth-promoting genes
C. Inherited mutations that predispose to cancer are almost invariably in tumor- suppressor genes. At present, no research supports the other options as factors related to how inherited mutations cause cancer.
In a normal, nonmutant state, what is an oncogene referred to as?
a. Basal cell
b. Target cell
c. Caretaker gene
d. Proto-oncogene
D In its normal nonmutant state, an oncogene is referred to as a proto-oncogene. A basal cell is in the innermost surface of epithelial tissue. Target cells are the recipients of mutations or substances. A caretaker gene is responsible for the maintenance of genomic integrity.
The professor explains to students that oncogenes are genes that are capable of what?
a. Undergoing mutation that directs the synthesis of proteins to accelerate the rate of tissue proliferation
b. Directing synthesis of proteins to regulate growth and to provide necessary replacement of tissue
c. Encoding proteins that negatively regulate the synthesis of proteins to slow or halt the replacement of tissue
d. Undergoing mutation that directs malignant tissue toward blood vessels and lymph nodes for metastasis
A. Oncogenes are independent of normal regulatory mechanisms; thus the cell is driven into a state of unregulated constitutive expression of proliferation signals and uncontrolled cell growth.
Burkitt lymphomas designate a chromosome that has a piece of chromosome 8 fused to a piece of chromosome 14. This is an example of which mutation of normal genes to oncogenes?
a. Point mutation
b. Chromosome translocation
c. Gene amplification
d. Chromosome fusion
B. Chromosome translocations, in which a piece of one chromosome is translocated to another chromosome, can activate oncogenes. One of the best examples is the t(8;14) translocation found in many Burkitt lymphomas; t(8;14) designates a chromosome that has a piece of chromosome 8 fused to a piece of chromosome 14. A point mutation is the alteration of one or a few nucleotide base pairs. Gene amplification is the result of repeated duplication of a region of a
a tumor-suppressor gene, allowing the process to become active. The remaining options do not describe the reason two hits are required.
How do cancer cells use the enzyme telomerase?
a. To repair the telomeres to restore somatic cell growth
b. As an intracellular signaling chemical to stimulate cell division
c. To switch off the telomerase to enable cells to divide indefinitely
d. To switch on the telomerase to enable cells to divide indefinitely
D Cancer cells, when they reach a critical age, somehow activate telomerase to restore and maintain their telomeres and thereby make it possible for cells to divide over and over again.
What are characteristics of benign tumors?
a. Benign tumors invade local tissues.
b. Benign tumors spread through the lymph nodes.
c. Benign tumors cause systemic symptoms.
d. Benign tumors include the suffix -oma.
D Benign tumors are usually encapsulated and well-differentiated. They retain some normal tissue structure and do not invade the capsules surrounding them or spread to regional lymph nodes or distant locations. Benign tumors are generally named according to the tissues from which they arise and include the suffix -oma. Benign tumors do not cause systemic symptoms
What does the health professions student learn about benign tumors?
a. The resulting pain is severe.
b. Benign tumors are not encapsulated.
c. Benign tumors are fast growing.
d. The cells are well-differentiated.
D. A benign tumor is well-differentiated with its tissue appearing similar to the tissue from which it arose. The other options are characteristic of a malignant tumor.
What is the major virus involved in the development of cervical cancer?
a. Herpes simplex virus type 6
b. Herpes simplex virus type 2
c. Human papillomavirus
d. Human immunodeficiency virus
C. Infection with specific subtypes of human papillomavirus (HPV) causes virtually all cervical cancers. The remaining options are not known to be associated with cervical cancer.
A healthcare professional is caring for four patients with cancer. Which patient does the professional educate about brachytherapy?
a. Lung
b. Colon
c. Cervical
d. Brain
What is the role of caretaker genes? a. Maintenance of genomic integrity b. Proliferation of cancer cells c. Secretion of growth factors d. Restoration of normal tissue structure
A. Caretaker genes are responsible for the maintenance of genomic integrity. The other options are not roles assumed by caretaker genes.
In a normal, nonmutant state, what is an oncogene referred to as?
a. Basal cell
b. Target cell
c. Caretaker gene
d. Proto-oncogene
D. In its normal nonmutant state, an oncogene is referred to as a proto-oncogene. A basal cell is in the innermost surface of epithelial tissue. Target cells are the recipients of mutations or substances. A caretaker gene is responsible for the maintenance of genomic integrity.
A healthcare professional is caring for a patient undergoing chemotherapy. What is the skin-related health risk the professional should assess the patient for and be prepared to treat?
a. Infection
b. Ultraviolet damage
c. Pain
d. Erythema
A. Decreased renewal rates of the epidermal layers in the skin may lead to skin breakdown and dryness, altering the normal barrier protection against infection. The healthcare professional should assess the patient for infection regularly and be prepared to treat any infection noted. Radiation therapy may cause skin erythema (redness). Pain and ultraviolet damage is not related to chemotherapies.
Which gastrointestinal tract condition can be an outcome of both chemotherapy and radiation therapy?
a. Increased cell turnover
b. Constipation
c. Stomatitis
d. Bloody stool
C. Chemotherapy and radiation therapy may cause a decreased cell turnover, thereby leading to oral ulcers (stomatitis), malabsorption, and diarrhea.
A healthcare professional is caring for four patients with cancer. Which patient does the professional educate about brachytherapy?
a. Lung
b. Colon
c. Cervical
d. Brain
C. Radiation sources, such as small 125I-labeled capsules (also called seeds), can also be temporarily placed into body cavities, a delivery method termed brachytherapy. Brachytherapy is useful in the treatment of cervical, prostate, and
Research has shown a link between cancer and which sexually transmitted disease?
a. Syphilis
b. Gonorrhea
c. Human papillomavirus
d. Pelvic inflammatory disease
C. Human papillomavirus (HPV) is the most common sexually transmitted virus in the United States. High-risk, or oncogenic, HPVs can cause cancer. A persistence of infection with high-risk HPV is a prerequisite for the development of cervical intraepithelial neoplasia (CIN) lesions and invasive cervical cancers. No research supports such a link between syphilis, gonorrhea, or pelvic
Research has supported that alcohol consumption has a convincing impact on increasing the risk of which cancer?
a. Lung
b. Breast
c. Pharynx
d. Pancreas
C. Research had shown that alcohol consumption has a convincing positive impact on the risk of developing pharynx cancer. No research supports such a connection with the remaining options.
A healthcare professional advises patients to exercise because it has a probable impact on reducing which cancer?
a. Liver
b. Endometrial
c. Stomach
d. Colon
D. The expert panel report on exercise of the World Cancer Research Fund/American Institute for Cancer Research found a convincing impact of exercise on risk of colon cancer.
Pricking one's finger with a needle would cause minimal pain, whereas experiencing abdominal surgery would produce more pain. This distinction is an example of which pain theory?
a. Gate control theory
c. Specificity theory
b. Intensity theory
d. Pattern theory
C. According to the specificity theory, a direct relationship exists between the intensity of pain and the extent of tissue injury. The remaining options are not related to the intensity of perceived pain.
Which statement is true regarding the gate control theory (GCT) of pain?
a. The pain gate is located in the brain.
b. A closed gate increases pain perception.
