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The immune system is not an autonomous system. This discovery was confirmed by demonstrating that the immune system can be altered by which of the following? A. Stress B. Suppressed emotions C. Diet D. Conditioning E. Relaxation The answer is: D R. Ader and N. Cohen discovered that the immune system could be conditioned by neutral taste stimuli. The immunosuppressive drug cyclophosphamide (CY) was used in a taste aversion study to cause nausea and vomiting.

They found that a single pairing of saccharin-flavored water with CY and a subsequent exposure to saccharin water alone produced the desired conditioning, as well as immunosuppression. Follow-up studies reconfirmed that immune system responses can be conditioned to neutral stimuli in both animals and humans. Immunologists previously had assumed that the immune system was autonomous. Ader and Cohen’s discovery opened up a new area of research—psychoneuroimmunology. Studies in this area have demonstrated that many immune components can be altered by behavioral factors such as stress, depression, isolation, relaxation, and bereavement.

All of the options listed in the question have some effect on the immune system, but the ability to modify the immune system by conditioning was an outstanding discovery that greatly advanced the entire field of immunology. 2. For almost three years, a 50-year-old woman has been caring for her mother who is chronically ill with Alzheimer’s disease. A recent immunologic assessment of the caregiver daughter found that her A. Cellular immune system control of latent viruses was poor B. Percentage of T lymphocytes was high C. Helper/suppressor ratio was higher than normal D.

Circulating neutrophils were decreased in number E. Natural killer The answer is: A J. K. Kiecolt-Glaser and B. A. Esterling both reported studies of the changes that occur in the immune systems of caregivers who have been under the constant stress of caring for a family member with Alzheimer’s disease for many months (average 33 months). A battery of immunologic assessments found that the caregivers had suppressed immune systems; cellular immune system control of latent viruses was poorer than that of a matched control group, the percentage of T lymphocytes was lower, and the helper/suppressor ratio was smaller.

The data suggest that chronic and, at times, severe stress can cause persistent changes in immunity. Furthermore, these changes can occur in several components of immunosurveillance. In a study of residents living near Three Mile Island, Baum reported that even six years after the nuclear accident, long-term stress resulted in negative changes in the residents’ immune systems. This finding was indicated by poor cellular control over latent viruses, higher numbers of circulating neutrophils, and lower numbers of B cells and cytotoxic T lymphocytes in the residents. Thus, stress has a direct psychophysiologic effect on immunity.

Some bodily changes, such as increased levels of cortisol, can actually destroy immune tissue. Stress also can change physiologic systems and may result in increased drug use, smoking, and alcohol use, which can contribute to negative chronic effects on the immune system. There is some evidence that adaptation to stress can occur, but this doesn’t appear to happen in more severe cases such as the caretakers of patients with Alzheimer’s disease. 3. A 40-year-old man develops depressed mood, anhedonia, initial and terminal insomnia, loss of appetite, a 10-lb weight loss, and difficulty with sexual arousal.

The clinical features of the patient’s psychiatric illness suggest dysfunction of which of the following? A. Frontal lobes B. Pituitary C. Hippocampus D. Hypothalamus E. Corpus callosum The answer is: D Clinical studies of patients with major depressive disorders indicate that an intrinsic regulatory defect involving the hypothalamus underlies the disorder. It also involves the monoamine pathways. The hypothalamic modulation of neuroendocrine activity has been implicated, as have been the neurotransmitter systems of serotonin and norepinephrine. Recent evidence suggests a major role for the heritability of such neurochemical disorders.

The role of behavior in stimulating or triggering such mechanisms is also being explored. While the frontal lobes, the pituitary, the hippocampus, and the corpus callosum are related to the emotions, memory, and neural communications, they do not play as major a role in the depressive disorders as does the hypothalamus. 4. The fact that the pituitary secretion of endorphins is closely linked to the secretion of adrenocorticotropic hormone (ACTH) suggests that endorphins facilitate the ability to respond to which of the following? A. Retarded growth B. Hypertension C. Stress D. Chronic pain E.

Tachycardia The answer is: C Under stressful conditions, the organism secretes endorphins and ACTH together. Proopiocortin is a common precursor. The close link between endorphins and ACTH suggests that they serve a mediation function for a closely related set of adaptation responses. Thus, they can facilitate one’s response to stress and at the same time help one to withstand pain and mobilize for coping activity to deal with the stressful challenge or threat. Almost every physical stress agent increases plasma levels of -endorphin as well as adrenocorticotropin and corticosterone. . The diathesis-stress model of psychophysiologic disorders postulates the presence of which of the following major factors? A. Inadequate coping style B. Individual response stereotype C. Lack of health belief resolution D. Adequate homeostatic restraints E. Unconditioned stimulus The answer is: B The diathesis-stress model of psychophysiologic disorders states that individuals are predisposed toward a particular mental or physiologic reaction and that the disorder will become manifest as a reaction to stress.

Two major factors are postulated by the model: (1) individual response stereotype, consisting of a predisposition to respond physiologically to various situations and in a particular way; and (2) inadequate homeostatic restraints caused by stress-induced breakdown, previous accident, infection, or trauma, or by genetic predisposition. Situational determinants play an important role as does one’s perception of the situation, which generates increased or decreased physiologic response. While one’s coping style and one’s values or attitudes can play a role, they are not considered to be major factors in the diathesis-stress model.

The role of learned response can also be important, but is not a major postulate. 6. Which theory of pain states that psychological processes directly exert influence on the pain perception process? A. Gate control theory B. Nociceptor theory C. Pattern theory D. Polymodal nociceptor theory E. Specificity theory The answer is: A We know that pain is not the result of direct transmission from the skin to the brain. A complex pathway allows opportunities for alteration and modulation of the incoming pain signals by other signals, including the inhibiting impulses that descend from the brain.

The gate control theory proposes that there is a structure in the dorsal horn of the spinal cord that acts as a gate for increasing or decreasing nerve impulse flow from the peripheral fibers to the central nervous system. This allows sensory input to be reviewed and modified at the gate before it evokes pain. Sensory input is increased or decreased by the activity of large diameter fibers (A fibers), small diameter fibers (A and C fibers), and descending fibers from the brain.

Impulses from the large fibers can close the gate, inhibiting transmission, while activity from the small fibers can open the gate to enhance transmission. Efferent impulses from the brain provide further influence and the access route for the psychological processes of anxiety, depression, attention, and past experience to alter the gate and thus directly influence the pain perception process. When the output of the spinal cord T cells exceeds a critical threshold level, neuromechanisms are activated that are responsible for both pain perception and behavioral responses to the pain.

Nociceptors are nerve endings that transmit pain. Polymodal nociceptors are nerves that maximally respond to mechanical and temperature stimulation. The pattern theory states that pain sensations are the result of nerve impulse patterns being transmitted from and coded at the peripheral site. The specificity theory states that there are specific sensory receptors for touch, warmth, and pain. 7. Which of the following is the most common organic explanation for a sleep disturbance in a healthy person? A. Disruption of normal circadian rhythms B. Accumulation of hepatic enzymes C.

Overarousal and high activity during the day D. Suppressed REM sleep E. Misuse of hypnotics The answer is: A About 30 to 35% of the people who cannot sleep have a relatively simple organic cause for the problem. The two most frequent organic causes are disruption of normal circadian rhythms and the inevitable consequences of aging. The most common disruptions of normal circadian rhythms are related to travel (jet lag) and behavioral changes in one’s normal daily routine, such as napping, irregular sleep hours and conditions, alteration in meal times, and unusual work schedules.

Normal aging is the next most common factor as it is more difficult to reset one’s biologic clock the older one gets. It has been estimated that most people over age 60 sleep only about 5. 5 h per day, and since stage 4 NREM sleep also declines with age, the lighter stages of NREM sleep allow the person to awaken more often, sometimes generating the worry that one cannot sleep or that one is not getting enough sleep. Accumulation of hepatic enzymes is a frequent side effect of prolonged use of sleeping pills.

The most common psychosocial cause of insomnia is emotional disturbance. 8. The relationship between social and biologic processes in the causation of psychopathology has historically been classified by which of the following terms? A. Classically conditioned B. Organic and functional C. Genetic and familial D. Neuropathologic and sociopathologic E. Psychoanalytic and dynamic The answer is: B The relationship between social and biologic processes has historically been regarded by psychiatry and medicine as organic and functional.

Organic mental illnesses have included the dementias and the toxic psychoses. The functional mental illnesses have included the various depressive syndromes, the schizophrenias, and the neuroses. When anatomic evidence of brain lesions was produced, the diseases were called organic, and those that lacked these features were labeled functional. This distinction should be considered artificial and historical since organic and functional diseases affect mentation and vice versa. In fact, all mental processes are biologic and any alteration of these processes is organic.

The most significant questions to ask about disease or behavior concern the degree to which a biologic or behavioral process is determined by genetic and developmental factors versus toxic or infectious agents versus environmental, social, or behavioral determinants. Psychoanalytic (dynamic) approaches and an understanding of conditioning (learning) played important roles in the evolution and development of a more integrated biobehavioral understanding of human behavior and human biology. 9. A 22-year-old male has just entered medical school and has decided to “assert himself” by beginning to smoke cigarettes.

In an attempt to persuade him that smoking will damage his entire body, you inform him that which of the following is the most immediate effect of cigarette smoking? A. Lower lymphocyte function B. Lower immune function C. Mucociliary damage D. Addiction to the nicotine E. Destruction of the macrophages in his lungs The answer is: C The most immediate effect of cigarette smoking is damage to the respiratory tract’s mucus and cilia. Damaged mucus and cilia have a reduced ability to trap invading organisms, dust, and other foreign particles. As a result, the work of other agents of the immune system will be increased.

Initially, low levels of tobacco smoke and nicotine have a stimulatory effect on lymphocytes, but then shift to an inhibitory effect at higher doses. Smoking stimulates macrophages at first, but later they are destroyed. The other options listed in the question also occur, but not as rapidly as the mucociliary damage. 10. A college student who is worried about final examinations presents to the student health service with rapid breathing and a high degree of anxiety. Hyperventilation is most apt to result in which of the following A. Increased sympathetic activity B. Increased CO2 in the blood C.

Increased acid in the blood D. Decreased vasoconstriction E. Increased oxygen to the brain The answer is: A Hyperventilation is a physiologic response to anxiety, panic, hypervigilance, or threat cues. There are physiologic, behavioral, and psychological changes as a result of hyperventilation. Typically, there is reduced CO2 in the blood, which lowers the blood’s acid level. Other results of hyperventilation include increased sympathetic activity, cardiac arrhythmias, increased heart rate, decreased oxygen supplied to the brain, and increased cerebral vasoconstriction.

There is a sense of fear that is focused on a threatening situation or somatic complaint, a temporary impairment, and defective decision making marked by vacillation and an impulsive choice of options 11. Damage to dopamine neurons in the midbrain is a central feature of the pathophysiology of Parkinson’s disease. The loss of midbrain dopamine in this disease is accompanied by which of the following? A. An increase in the dopamine transporter B. A decrease in dopamine 1 receptor density C. An increase in dopamine 2 receptor density D. A decrease in dopamine synthesis in remaining dopamine neurons E.

An increase in both dopamine 1 and dopamine 2 receptor density The answer is: E Although there are hypotheses and models of neurotransmitter dysfunction for many psychiatric and neurologic diseases, Parkinson’s disease remains the model disorder in which damage to a specific neural pathway characterized by a particular neurotransmitter can explain most or all of the pathophysiology of the disease. It has been known for decades that patients with Parkinson’s disease have biochemical evidence of greatly decreased dopamine function in the brain because of degeneration of the nigrostriatal tract.

A neurotoxic model of the disease, produced in primates by administration of a derivative of meperidine (MPTP), demonstrated that severe damage to dopamine-containing nigrostriatal neurons produced nearly all of the signs and symptoms of Parkinson’s disease. As dopamine neurons in the nigrostriatal tract degenerate, compensatory changes occur that also contribute to the pathophysiology. These changes include a matching loss of the dopamine transporter and a compensatory rise in both dopamine 1 and dopamine 2 postsynaptic receptor density.

The remaining dopamine neurons synthesize and release more dopamine as a compensatory mechanism. These secondary physiologic changes probably explain some of the signs and symptoms seen in patients with advanced Parkinson’s disease who are being treated with agents that augment dopamine production. One example is the “on-off” phenomenon in which patients have abnormal increases in movement after administration of dopamine-augmenting agents, probably because of hypersensitive dopamine receptors in remaining neurons of the nigrostriatal tract. 2. The daughter of a 65-year-old man describes her father as having changed from an active, vivacious, caring person to one who occasionally has trouble learning new facts, has very little motivation to do any activity, and rarely expresses feelings or emotions for his grandchildren whom he has adored. Which area of the brain is most apt to be involved in this type of behavior change? A. Hypothalamus B. Reticular activating system C. Heteromodal association areas D. Limbic system E. Unimodal association areas The answer is: D

The limbic system includes regions of the limbic cortex, as well as a group of interconnected structures that surround the core of the forebrain. The limbic system forms a circuit whose primary function was formerly regarded as modulating motivation and emotional responses. Studies have discovered that the hippocampal formation and the limbic cortex that surround it are involved in learning and memory, rather than emotional behavior. However, the remaining sections of the limbic system are responsible for emotions, feelings, moods, and motivation.

Thus, the 65-year-old man’s limbic system is the site primarily responsible for his learning difficulty, lack of motivation, and his recent loss of emotional feelings for his grandchildren. 13. A 30-year-old secretary who is a single mother with two preschool children has frequent symptoms of anxiety, tension, headaches, and insomnia. Which of the following behavioral interventions could be the most effective in relieving her symptoms? A. Progressive muscle relaxation B. Psychoanalytic psychotherapy C. Hypnosis D. Selective biofeedback E. Interpersonal psychotherapy The answer is: A

Progressive muscle relaxation, or a reasonable variation, can serve as a powerful therapeutic technique for treating generalized anxiety, insomnia, headaches, neck tension, and mild forms of agitated depression. It has also effectively been used to reduce pain, the side effects of cancer chemotherapy, nausea, and mild hypertension, preferably before pharmacologic intervention. Relaxation therapy is based on the premise and observation that muscle tension is a physiologic response to anxiety and stress. There is a significant reduction in experienced anxiety if tense muscles can be relaxed.

Muscle relaxation also can change the physiologic activation process. The Jacobson relaxation procedure involves tensing selected muscles for about 10 seconds, and then completely relaxing them and noticing the difference in sensation. Eventually, the patient is able to relax particular muscle groups from their present level of tension. Other effective methods of relaxation include systematic deep breathing, transcendental meditation, and yoga. 14. Individuals with borderline hypertension are most often considered to have a physiologic pattern that is consistent with which of the following?

A. Excess dietary salt intake B. Increased activation of the sympathetic nervous system C. Higher prevalence among poor black Americans D. Obesity E. Sustained vigilance in the individual The answer is: B Essential hypertension, perhaps more accurately called “established” hypertension, has no single cause that can be identified. Fifteen percent of the population, over 35 million people, are inflicted with this disease/disorder. Its occurrence increases with age, is more prominent among poor black Americans, and is less frequent among women before the age of 50.

Because increased blood pressure does not have observable symptoms and the most effective drugs to treat it often cause unpleasant side effects, compliance of individual patients is often low. Physiologic factors associated with risk of hypertension are age and heredity, and behavioral factors are salt intake, obesity, and stress. It is increasingly recognized that, like coronary heart disease, numerous social, behavioral, environmental, and cultural factors interact with physiologic and genetic factors to predispose an individual to hypertension.

While all of the options in the question are valid for general hypertension, borderline hypertension represents an increased activation of the sympathetic nervous system by the interaction of all of the listed biologic, environmental, and behavioral factors. Different physiologic and/or behavioral mechanisms may be implicated at different stages of hypertension. For example, elevated output of blood from the heart with little increased resistance to flow in the body’s vasculature exists with borderline hypertension and results from increased activation of the sympathetic nervous system.

This, along with increased levels of blood and tissue catecholamines, is the body’s response to psychological and environmental stress. In older persons with more established hypertension, the output of the heart is more normal, but the resistance to blood flow is elevated. 15. When an axon is cut, rapid local degeneration of the axon and myelin sheath occur, as well as changes in the cell body that affect synapses with other neurons. This pattern of degeneration is caused by which of the following? A. Gliosis B. Axonal transport C. Phagocytosis D.

Insert surname2 Professor’s name Student’s name Course title Date Macroeconomic Models The

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Macroeconomic Models

The modern Dynamic Stochastic General Equilibrium DSGE Models offers the most effective and complete way when it comes to analyzing many economic situations. The modern macroeconomics heavily relies on them. The models indeed are stochastic, dynamic, and they characterize the general equilibrium of the economy. Creating the three strategic modeling choices; First, the behavior of the firms, consumers, and financial intermediaries, if present, formally it is derived from the micro foundations, Secondly, the competitive economy underlying environment, which with some of essential distortions added, from the nominal rigidity to the monopoly power to data issues. Thirdly, the model is estimated as a system rather than the previous macroeconomic generation models of equation by equation. Each of the DSGE model usually focuses on one or more frictions in trying to isolate the main casual links in an economy.

While literally, many DSGE models are currently in existence, with different degrees and details of complexity, all of them have common characteristics, some which are even reflected in the very term. They are dynamic in that, the RBC tradition of models usually begins with individual utility function of a rational, representing agent trying to maximize his utility over infinite horizon changing the labor supply and demand for the goods which are consumed in each period. DSGE models also contain stochastic element and lastly, are general equilibrium models. All the markets, which include the goods and labor markets, are always kept at equilibrium and this is an essential characteristic.

The firms which are operating in DSGE models are monopolistically competitive, based on constant elasticity of substitution utility function. Given that the household prefers variety and can only see the different products as imperfect substitutes, businesses have some pricing power and each is faced with a demand curve which is sloping downward (Wickens & Michael, 2014).

Works Cited

Wickens, Michael. “How useful are DSGE macroeconomic models for forecasting?.” Open Economies Review 25.1 (2014): 171-193.

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