What are the effects of cortisol during the stress response? (Select all that apply)

Choice A reason: Increased skin pigmentation is associated with Addison’s disease due to elevated ACTH stimulating melanocytes. Cushing syndrome, caused by excess cortisol, typically causes skin thinning and bruising, not hyperpigmentation. The excess cortisol does not directly affect melanin production, making this choice incorrect.

Choice B reason: Cushing syndrome leads to weight gain, not weight loss, due to cortisol’s promotion of fat deposition in central areas (e.g., abdomen, face). Increased appetite and altered metabolism contribute to obesity, not weight loss, making this choice incorrect as it contradicts the metabolic effects of hypercortisolism.

Choice C reason: Cushing syndrome often causes hypertension, not decreased blood pressure, due to cortisol’s mineralocorticoid effects, increasing sodium retention and vascular resistance. Decreased blood pressure is more associated with adrenal insufficiency, making this choice incorrect as it does not align with Cushing syndrome’s pathophysiology.

Choice D reason: Cushing syndrome, characterized by excess cortisol, suppresses the immune system by inhibiting inflammatory responses and reducing lymphocyte activity. This increases susceptibility to infections and impairs wound healing, making decreased immune response a hallmark complication, which is why this choice is correct.

Choice A reason: Diarrhea is not a typical feature of autonomic dysreflexia, which involves sympathetic overactivity causing vasoconstriction. Bowel dysfunction may occur in spinal cord injury, but it is not specific to dysreflexia, making this incorrect.

Choice B reason: Tachycardia can occur in autonomic dysreflexia due to sympathetic stimulation, but it is less specific than headache, which is a hallmark symptom from severe hypertension, making this choice incorrect.

Choice C reason: Autonomic dysreflexia, often triggered by stimuli below the injury level, causes severe hypertension, leading to a pounding headache due to increased intracranial pressure. This is a hallmark symptom, making this the correct choice.

Choice D reason: Hypotension is not associated with autonomic dysreflexia, which causes hypertension from unopposed sympathetic responses. Hypotension may occur in spinal shock, not dysreflexia, making this choice incorrect.