What manifestation(s) occur when a person has diabetes insipidus? (Select all that apply)

Choice A reason: Cortisol, a stress hormone, suppresses immune and inflammatory responses, slowing fibroblast activity and collagen synthesis, which impairs wound healing. This anti-inflammatory effect prioritizes energy allocation to stress response over tissue repair, making decreased wound healing a correct effect of cortisol during stress.

Choice B reason: Cortisol stimulates gastric acid secretion by enhancing gastrin release and reducing mucosal protection, increasing the risk of ulcers. This effect supports energy mobilization during stress by promoting digestion but can lead to gastrointestinal complications, making increased gastric acid secretion a correct effect.

Choice C reason: Cortisol promotes gluconeogenesis and glycogenolysis in the liver, elevating blood glucose levels to provide energy for the stress response. It also induces insulin resistance, ensuring glucose availability for critical tissues like the brain, making increased blood glucose a correct effect of cortisol.

Choice D reason: Cortisol suppresses the immune response by inhibiting cytokine production and lymphocyte proliferation, reducing inflammation and immune activity. This does not align with increased immune response, as cortisol’s immunosuppressive effects are well-documented, making this choice incorrect for the stress response.

Choice E reason: Cortisol increases blood pressure via mineralocorticoid effects, enhancing sodium retention and vascular tone. This supports cardiovascular stability during stress, not decreased blood pressure, which would be counterproductive in a fight-or-flight response, making this choice incorrect for cortisol’s effects.

Choice A reason: Hypoparathyroidism causes hypocalcemia due to low parathyroid hormone, reducing bone resorption and calcium absorption. Hypercalcemia requires increased calcium mobilization, which hypoparathyroidism prevents, making this choice incorrect for a person at risk of hypercalcemia.

Choice B reason: Chronic renal failure typically causes hypocalcemia due to impaired vitamin D activation and phosphate retention, binding calcium. Hypercalcemia is rare unless overtreated with calcium supplements, making this choice incorrect for typical renal failure scenarios.

Choice C reason: Low plasma albumin reduces bound calcium, lowering total serum calcium, not causing hypercalcemia. Free calcium may remain normal, but total calcium decreases, making this choice incorrect for a person at risk of hypercalcemia.

Choice D reason: Bedbound, immobile individuals are at risk for hypercalcemia due to increased bone resorption from lack of weight-bearing activity. Osteoclasts break down bone, releasing calcium into the blood, causing hypercalcemia, making this the correct choice.