Evolving models of health care and Stress

Question 1

Disease is recognized and classified by?

Answer 1

1. The type of organ damage
2. By functional impairment
3. By an underlying etiological process
   (think pathology)
   (you can have a disease without having a sickness –> person has HTN but never feels it)

Question 2

Sickness refers to behaviors manifested by an individual who:

Answer 2

1. Feels ill or believes that/she is ill
2. Sickness is a patient state where you feel super crappy
3. Can feel sick and yet have no identifiable disease
4. Does not include how someone else feels
   (think how patient feels) (feel like i have the flu)

Question 3

What is meant by the sick role?

Answer 3

Feeling sick relative to the rest of the community
Frees person from obligation to perform the tasks of everyday living (aka getting out of work early)
(regarding role in the community with secondary gain) (person is actually sick and they get something out of it)

Question 4

What is illness?

Answer 4

1. Totality of the patient’s experiences
2. Includes how patient feels, behaves, perceives his/her condition
3. How others respond to patient
4. Shaped by cultural beliefs and experiences
   (overall global entity that involves others and is personally and culturally shaped)

Question 5

Is failure to vaccinate indirect or direct risk?

Answer 5

Indirect risk (prevention failures)

Question 6

needle exchange program is what type of prevention?

Answer 6

primary

Question 7

Biomedical model is what?

Answer 7

making medicine discipline specific (hit in head with metal rod then surgery so based on science)

Question 8

Biopsychosocial model is what?

Answer 8

1. Multiple determinants in the development of disease

2. Hierarchical organization of biological and social systems that contribute to the disease and illness.

Question 9

What is the term for no stress?

Answer 9

eustress (and when put under stress you adapt)

Question 10

Brain derived neurotrophic factors (BDNF) grow brand new neurons. So what activities in your daily life promote BDNF to grow neurons?

Answer 10

Exercise or interacting with the environment or some mind stimulating event

Question 11

What activities in your life do not promote BDNF to grow new neurons?

Answer 11

Most stimulants like cocaine or being over 70 or stress all depromote BDNF
(stress causes cortisol secretion in excess and this in itself is neurodegenerative and therefore depromotes BDNF)

Question 12

What is stress?

Answer 12

A special type of transaction between a person and the environment
A specific type of transaction between a person and the environment
(attribution of meaning –> daughter wanting to do a post mordum exam on a dog to help other dogs where son wanted nothing to do with the exam)

Question 13

What are the three components of stress?

Answer 13

stressor (life event)
psychological state of stress (feelings of threat)
physiological

Question 14

Stress causes increased release of ACTH and cortisol, why is this bad for you?

Answer 14

Cortisol initially boosts the immune system however after the initial or acute phase is over (usually about 2 weeks) cortisol actually depresses the immune system and therefore opening up the body for more infections and medical conditions.

Question 15

What is the ergotropic system in relation to stress?

Answer 15

Integrates functions preparing individual for positive actions
(this is basically the sympathetic system)

Question 16

Can you ergotropic system be on forever?

Answer 16

no you can not keep your ergotropic system on for forever eventually your parasympathetics will kick in

Question 17

What is the trophotropic system in relation to stress?

Answer 17

Reverses ergotropic process

so basically the sympathetics get turned into parasympathetics

Question 18

What system are you in in high stress and low stress situations?

Answer 18

High stress = ergotropic activity

Low stress = trophotropic activity

Question 19

How does the hippocampus work in regards to stress and stress response?

Answer 19

Hippocampus prevents imprinting of fearful thoughts and images, unless one thing happens which is stress because cortisol is secreted in excess and therefore this prevents the hippocampus from pushing away these fearful thoughts and images

Question 20

Does stress cause infertility?

Answer 20

yes. high levels of chronic stress can result in glucocorticoid inhibition of hypothalamus release of luteinizing hormone (LH) and follicle stimulating hormone (FSH). This inhibits testosterone release and sperm production (males) and egg production (females)

Question 21

Majority of illness seen by primary care physicians are result of body’s what?

Answer 21

evolving efforts to adapt to challenges and restore homeostasis

Question 22

Describe the normal stress response curve

Answer 22

zero stress at bottom of curve (something like sleeping)
as stress goes up and up performance also goes up and up
however as soon as you hit the optimal stress then if you go past the performance goes down

Question 23

Describe how the normal stress response curve changes for new learners

Answer 23

new learners and new performers learn and perform better with lower stress

Question 24

Describe how the normal stress response curve changes for expert learners (Ex. olympic athletes)

Answer 24

expert learners perform better with higher amounts of stress. Extra sympathetic drive to perform better.

Question 25

What is metabolic syndrome?

Answer 25

Extra weight around the middle of the body

Insulin resistance-body cannot use insulin effectively to control amount of sugar in body

Question 26

What effect does moderate and chronic stress have on normal growth and development?

Answer 26

Moderate stress–> has a facilitative effect on growth process
Chronic stress –> impairs normal growth and development

Question 27

Women is how much more prevalent then in men?

Answer 27

2x

Question 28

Chronic steroids do what to the immune system?

Answer 28

Suppress it

in cancer allows invading tumor cells to penetrate

Question 29

What are some psychological consequences of stress?

Answer 29

1. Anticipatory anxiety (is not regular anxiety, direct stimulus to which it is attached; ex going to the dentist)
2. Depression
3. Learned Helplessness (rat example; rat learned after 30 days of being confined that he cant do anything and is depressed according to imaging studies; tx rat with environmental stimulus,engage the rat in a maze with food faster)
4. Post Traumatic stress disorder (PTSD)

Question 30

In regards to stress, the more stress units you have the greater likelihood you are of what?

Answer 30

being sick
so for example: death of a spouse is 100 stress units and divorce is 73 stress units and martial separation is 65 units so therefore the person who has greatest likelihood of being sick in this example is the person who just had a spouse die