RECENT ASSIGNMENT

Drag and drop to match the following regarding the immune system: [ 10pts
Structure Line of defence Activity
Complement ?rt.cu.i.tis andbadiM Ld kill b*c.lerid dhd exlracrfluldi Ltogels Skin
3rd line 2nd line (2) Macrophages Eat arit fjens and dead tissues and connects to specific defences
Protective barrier Macrophages Inflammation
1st Line ALUd-Uli immune tetts jnd cloLLing 2n'- line Kills target and heip targel be recognised by other defence cells
T cells 2nd line [1] B cells 3rd line
Kills cancerous and virus infected cells
Inflammation can be triggered by: ( 1 pt
O tissue injury
O infection
O allergens
® all of the above
Mast cells are important in inflammation as: I 1 pt
® they release histamine and chemotactic factors
O they kill virus infected cells
O they are a resident population of cells in the liver that screen the blood
O they directly trigger the activities of the B cells
In inflammation, prostaglandins are responsible for: ( t pt
O Triggering pain.
O Bronchospasm.
O Vasoconstriction.
O All of the above.
Signs of systemic inflammation differ from local inflammation as the they are ( i pt seen and include.
O throughout the body: hunger
O at the trigger site; loss of appetite
O throughout the body: fever
O n closely related body systems; symptoms that depend on the organs involved
Complete the following flow chart to remind yourself of the general steps in [ ?pts a normal inflammatory response:
Clear dead cells and debris
Phagocytes
Prostaglandins & Leukotrienes
Increased vasodilation
Mast cell
Chronic inflammation occurs when:
L T P*
O A. A damaging stimulus persists, which maybe infectious, autoimmune or a toxin.
O B. Inflammation is triggered for a brief period of time.
O C. Inflammatory cells cause damage to healthy tissues.
O 0. A and C are correct.
Chronic inflammation occurs when: I i pt
O A. A damaging stimulus persists, which maybe infectious, autoimmune or a toxin,
O 8. inflammation istriggered for a brief period of time.
O C. inflammatory cells cause damage to healthy tissues.
O D. A and C are correct.
Which of the following is one of the initial triggers that attracts the first I i pt inflammatory cells to the synovial joints in a case of Rheumatoid Arthritis
(RA)?
O joint wear and tear.
O Aging tissues.
O Rheumatoid Factor.
O Osteoporosis,
In contrast to RA, the mechanism of damage for Osteoarthritis is: I i pt
O Autoimmune com p I exes.
O Injury or wear and tear to the joint cartilage layer.
O Re lea s e of e nzym es fro m chon d rocytes.
O Microbes attracts ng i nfl amm aiio n.
Drag and drop the correct activities to the COX-1 and COX-2 enzyme [ 9 p^
pathways.
Constitutive
Stomach protection
Platelet aggregation
Cytoprotective prostaglandins
Inducible
Vasodilation
Pain
Regulating piatielet aggregation
Inflammatory prostaglandins
Indicate on the diagram (using the labels provided) which drugs are inhibiting each pathway/the production of each product.
I 3 pts
Aspirin
Celecoxib
Corticosteroids
Insult, injury,
infection
Phospholipase activation
Leukotrienes
| ' ' 'I J I I -...II |l II il
Cell membrane phospholipids
......................... 111
When blocking each of the COX pathways with medications, what could go [ 7pts wrong? Indicate below which labels are most commonly associated with each specific COX pathway inhibition.
Side effects of inhibiting COX-1
Side effects of inhibiting COX-2
Peptic ulcer formation
No platelet aggregation
Increased risk of strokes and myocardial infarction
No regulation of clotting
Problems with wound healing (i.e. due to reduced acute inflammation}
Stomach pain & irritation
Excessive bleeding
Corticosteroids are sometimes used to control a flare of inflammation in [ 1 pt chronic conditions such as RA. They must be carefully evaluated for use in a patient with inflammatory conditions because:
O They influence many other systems in addition to those related to regulating immune cell function.
O They are not highly protein bound but disrupt the protein binding of other medications causing significant side effects.
O They replace adrenaline, so when you withdraw them they can lead to adrenal fatigue.
O Ail of the above are correct.
What are some of the risks of systemic corticosteroid use?
71 pts
Hint: check out your Lehne's Pharmacology for nursing care textbook for help with this question.
Bone loss (osteoporosis)
I mm u nos u press! ? n
Hyperglycaemia
Encephalopathy
Muscle weakness & loss
Fluid retention
Weight gain
Dyslipidemia
Cataracts
Reduced hunger
Adrenal insufficiency
DMARDs (Disease Modifying Anti Rheumatic Drugs) are often prescribed for ( 1 pt cases of chronic inflammation associated with RA because:
O A. They inhibit COX-2 but in a different and more effective way than celecoxib and also inhibit lipooxygenase.
O C. They are functionally very similar to aspirin but do not cause gastrointestinal or renal impairment.
O B. They have less severe/wide spread side effects than corticosteroids, but can still reduce inflammation and disease progression.
O D. They are all highly targeted immunosuppressants that only have an effects on the immune cells causing
Which of the following belong to each of the Central Nervous System or the [ 12 pts Peripheral Nervous System?
Autonomic Nervous System
Control centres
Spinal Cord
Sensory Division
Communicates to and from the rest of rhe body
Sympathetic Nervous System
Somatic Motor System
Parasympathetic Nervous System
Spina! nerves
integration of sensory information & coordinating body function
Brain
Cranial nerves
Central Nervous System
Peripheral Nervous System
The parasympathetic and sympathetic nervous systems: [ 1 pt
O A. Continuously work together to maintain homeostasis.
O B. Only operate at extremes - only all sympathetic or only all parasympathetic activity at any moment.
O C. Are part of the somatic nervous system.
O D. B and C are correct.
Adrenergic receptors respond to the release of: [ 1 pt
O A. Adrenaline
O B. Acetylcholine
O C. Noradrenaline
O 3. A and C are correct
Cholinergic receptor subtypes include: ( 1 pt
O Muscarinic and Nicotinic receptors.
O Alpha and Beta receptors.
O Beta 1 and Beta 2 receptors.
O Ail of the above.
Cardiovascular regulatory mechanisms controlled by the Peripheral Nervous ( 1 pt System (PNS) include:
O A. Vasoconstriction
O B. Loca I m ecti an i sm s (au to regu lation)
O C. I ncreased heart rate
O D. A and G are correct.
What normal physiological function of the airways can lead to an asthma [ 1 pt attack and difficulty allowing air flow in the lungs?
O Ventilation
O Perfusion of the alveoli
O Bronchodilation
O Bronchoconstriction
Inflammation is: [ ipt
O A normal and essential process.
O A process that is tightly controlled in healthy people.
O A process that can cause disease.
O All of the above.
Inflammation (part of asthma) is controlled by the pathway(s), and I 1 pt
brings to the affected area.
O COX-2; B cells, macrophages and immune proteins
O COX-1: macrophages and T cells
O Lipoxygenase: specific defence cells
O COX-2 and lipoxygenase; immune cells and proteins
What normal physiological function of the airways can lead to an asthma [ 1 pt attack and difficulty allowing air flow in the lungs?
O Ventilation
O Perfusion of the alveoli
O Bronchodilation
O Bronchoconstriction
Inflammation is:
O A normal and essential process.
O A process that is tightly controlled in healthy people.
O A process that can cause disease.
O All of the above.
I ’P' I
Inflammation (part of asthma) is controlled by the pathway(s), and [ 1 pt
brings to the affected area.
O COX-2; B cells, macrophages and immune proteins
O COX-1: macrophages and T cells
O Lipoxygenase: specific defence cells
O COX-2 and lipoxygenase; immune cells and proteins
Which Sympathetic Nervous System based receptor controls heart rate as a I i pt primary cardiovascular function?
O A pha 1 receptors
O Seta 1 receptors
O Muscarinic receptors
O Beta 2 receptors
Respiratory sensory receptors called stretch receptors are located in the I 1 pt and when activated result in.
C brain stem; decreased respiratory race
O lung smooth muscle; increased respiratory rate
O brairt stem; increased respiratory race and deeper breathing
O lung smooth muscle; decreased respiratory rate and lung volume
Drag and drop the labels to indicate the adrenergic receptor and the effect of [ 12pts the stimulation on a particular organs for the sympathetic and parasympathetic nervous system.
Pupil dilation Muscarinic 2
Muscarinic 3 5 ra nt Mtxra rta n n
increased activity Beta 1
Beta 2 No effect
Decreased activity Increased heart rate
tfdwcjor'twiLtitn AJpna 1
Organ System Sympathetic Nervous System Parasympathetic Nervous System
Adrenergic receptor Effect On the organ system Muscarinic receptor Effect on the organ system
Heart Sinoatrial node Decreased heart rate
Blood Vessels Hone
Lung - smooth muscle Seta 1 Branch nd nation Muscarinic 3
Digestive System -smooth muscle Muscarinic 3
Eve Alpha 1 Pupil constriction
Consider the following two scenarios:
1) An extreme asthma attack
[ 8 pts
2) Tachycardia.
Fill in the table by dragging and dropping each option to the appropriate box to indicate the outcomes, best targets and drugs for each scenario.
Scenario 1: Extreme asthma attack involving narrowing of the airways Scenario 2: Tachycardia

[ i pt
A non-selective beta agonist will promote:
O Bronchodilation and increased heart rate.
O Bronchoconstriction and decreased heart rate.
O Bronchoconstriction and increased heart rate.
O Bronchodilation and decreased heart rate.
An example of a muscarinic antagonist is
and it works by
O nicotine; blocking the action of ACh at the nicotinic receptors
O muscarine; mimicking the action of ACh at the muscarinic receptors
O oxybutynin; mimicking the action of ACh at the muscarinic receptors
O atropine; blocking the action of ACh at the muscarinic receptors
Drag and drop each of the following labels into their correct treatment [ 17pts category (Five categories).
Inhibits Muscarinic receptors pi and p2 receptor agonist Causes cachycardia as well as dilation of airways
Isop re na line
No tachycardia with low dose Prevents asthma attacks
Prednisone
Is a good example of Quality use of medicines
Corticosteroid
Stimulates a1, a2, pi and p2 receptors
Ipratropium via nebuliser
Salbutamol
Causes dilation of the bronchioles by blocking cholinergic receptors
Only promotes dilation of airways via p2 receptors Inhibits the inflammatory response to an allergen
Causes anxiety, tachycardia, hypertension.
Adrenaline
N on-selective 0 agonist
Contemporary Health refers to:
[ 1 pt
¦' ’ T he state ^population hea Ith fro m p rev ions ce ntu ri es.
O The c u r rent hea It h status of ou r po p u lation s.
O Future health issues that may be faced by our populations.
O All of the above.
Of the top 10 causes of death in Australia, the common trait that many share is that they are:
I ^pt
O Due to i nfe ctiou s disease
O Due to genetic causes
O Related to lifestyle chorees
f.” The statement is false - the causes of each are unrelated
The two most common environmental risk factors for chronic disease in Australia are:
I T p1
O Alcohol misuse and poor diet
O Physical inactivity and obesity
O Tobacco and obesity
C Dietary risks and high blood pressure
Which of the following are a collective of risk factors for cancer?
I 8 pts
Why do socioeconomic factors influence health in Australia?
I i pt
O A. Environmental conditions may vary doe to poorer no us I ng and sanitation increasing risk, of disease transmission.
O B. In Australia we have a free public health system so there is no socioeconomic impact on health care.
C C. Financial constraints in a household/community can lead poorer diet and lifestyle increas ng certain health risks.
O D. A and C are correct.
A notifiable communicable disease in Australia is:
i pt
O Hepatitis C
O Rhinovtrus
O Genital Herpes
O Human Papillomavirus
Which of the following statements are true regarding the health and lifespan [ ?j ts
of Aboriginal Australians?
True
They have a 10% chance of reaching the age of 75 in co mparison to non Aboriginals. They are less likely to reach the age of 30 than Australians of other backgrounds.
They are more iikefy to suffer from dementia and atzheirners.
Bacterial infections are more common.
They are more likely to live in rural and remote areas.
Access to healthcare due to remote locations is the main reason Aboriginal Australians have shorter lifespans.
Which of the following are true or false when regarding Indigenous health? I sPts
The healthy BMI range for Indigenous Australians is lower than non-lndigenous Australians.
Diabetes and heart disease are more common in non-indigenous Australians.
Indigenous Australians are more likely to be located in remote locations away from medical care.
Almost every indigenous person over 55 has one chronic health Issue.
Deafness from otitis media is equally prevalent in all Australians.
Which if the following is FALSE regarding elderly Australians? ( 1 pt
O Their hospital stays are on average twice as long as younger people.
O They are more likely to suffer adverse effects from polypharmacy.
O They are more likely to follow instructions for their medications as they know they are unwell.
O They require more funding for their medical care, as they suffer from more comorbidities.
Which of the following is correct regarding Obesity? [ 1 pt
O it is less common in indigenous populations and low socioeconomic groups.
O Increased levels of the hormone Leptin have been linked with obesity.
O It Is the number one cause of death in Australia.
O All people who are obese will develop Type 2 Diabetes.
During a hyperglycemic state we secrete into the blood, which [ 1 pt
O Insulin; prevents the uptake of glucose into our cells
O Glucagon; prevents the uptake of glucose into our cells
O Insulin; allows the uptake of glucose into our cells
O Glucagon; allows the uptake of glucose into our cells
Chronic elevation of blood glucose can:
[ 1 pt
O A. Cause a decrease in insulin sensitivity.
O B. Encourage the development of atherosclerosis.
O C. Lead to osteopenia and osteoporosis.
O D. A. and Ei are correct.
Match the following definitions to 3 key signs associated with Diabetes.
I 3 pre
Short term stress is a normal part of human physiology. Its role is to: [ 1 pt
O This statement is incorrect - it's an abnormal process as it's disruptive to homeostasis.
O Equip the body to respond to a physical challenge or threat.
O Exhaust the adrenal glands.
O Stimulate skeletal muscles to contract.
Which of the following can trigger a stress response?
I i p*
O Physical exertion (e.g. running a marathon).
O Grief (e.g. from death of a loved one).
O Panic or anxiety (e.g. having to give an oral presentation in front of your class).
O Ail of the above.
Which of the following labels belong to each of the phases of of Stress?
I 5 pts
During the Resistance stage of the General Adaptation Syndrome (GAS): [ i pt
O We get the most acute feeling of stress and anxiety (i.e. increased heart rate, increased breathing, etc) with this resistance stage.
O There is a progressive breakdown of the compensatory mechanisms during this stage.
O Hormones such as cortisol are triggered allow our body to adapt and begin to reserve glucose, water and ensure we are able to continue to provide vital nutrients to our organ systems.
O Cortisol takes over triggering the release of adrenaline and this is why we continue to feel stressed.
Which of the following hormones is associated with the responses of the [ i pt Alarm stage of the General Adaptation Syndrome (GAS)?
O Ronin
O Glucocorticoids
O Cortisol
O Adrenaline
Chronic elevation of cortisol due to prolonged periods of stress can result in which of the following:
Osteoporosis
Increased risk of gastric ulcer Decreased risk of cancer
Protection from autoimmune disease
Hylerglycaemia
Decreased adrenaline effects
Hypedipidaemia
Increased rates of atherosclerosis
Decreased wound healing
Increased risk of autoimmune conditions
Increased bone strength
Hypotension
Decreased stroke risk
Infection
Decreased coronary disease risk
I 15 pts
IJ Pt
True
Physiological stress triggers hormone release directly via the while
psychological stress has to pass through the first before reaching
the same structure.
O cebrebral cortex; hypothalamus
O hypothalamus; pituitary
O hypothalamus; cerebral cortex
O somatic nerves; autonomic nerves
Cortisol raises blood lipid levels indirectly by, which triggers that triggers the activation of adipose tissue.
O enhancing the actions of adrenaline; glucagon release
O stimulating noradrenaline release; insulin release
O stimulating glucagon release; renin release
O Enhancing the action of acetylcholine; cholinergic receptors
I 1 pt
Which of the following hormones directly trigger an increase in circulating lipids and glucose?
Adrenocorticotropin hormone
Growth Hormone
Cortisol
Glucagon
Thyrotropin releasing hormone
Glucocorticoids
Adrenaline
Corticotropin releasing hormone
Mineralocorticoids
Thyroid hormone
I 10 pcs
[ Tpt
Relaxation techniques work in opposition to stress by:
O Reducing heart rate and smooth muscle tone.
O increasing metabolic rate and immune function.
O Decreasing immune function and respiration rate.
O Decreasing ventilation while increasing smooth muscle tone.