Quiz: Stress and Psychosomatic Diseases — 20 questions

1. Which combination best defines health in the biopsychosocial perspective?

A. Psychological stability, social popularity, and disease absence

B. Social participation, genetic traits, and physical endurance

C. Physical, psychological, and social well-being together

D. Physical fitness, economic security, and medical access

Answer: (C)

Explanation

Health is understood as the association of an individual's physical, psychological, and social health. Economic conditions and genetic traits may influence health but do not constitute this definition.

2. Which pattern best describes the relationship between somatic disease and psychological functioning?

A. Somatic disease affects the body without altering social activity

B. Psychological disorders commonly produce major somatic disease

C. Somatic disease can impair psychological and social functioning

D. Psychological disorders and somatic diseases affect each domain equally

Answer: (C)

Explanation

A physical or somatic disease can cause psychological disorders and reduce social activity. The reverse relationship is described as rare rather than common.

3. What does psychosomatic medicine primarily study?

A. Inherited causes of physical disease and personality traits

B. Treatment of psychological disorders without bodily symptoms

C. Social causes of illness without psychological involvement

D. Interactions between somatic and psychological disorders

Answer: (D)

Explanation

Psychosomatic medicine examines interactions between somatic and psychological disorders, including bodily disorders influenced partly or wholly by the psyche. It is broader than the study of purely psychological disorders.

4. How did Hans Selye define stress?

A. A psychological interpretation of danger without bodily adaptation

B. A specific disease mechanism directed toward one organ

C. A nonspecific physiological process adapting the organism to aggression

D. A permanent anatomical injury caused by emotional conflict

Answer: (C)

Explanation

Hans Selye described stress as a nonspecific physiological process through which the organism adapts to an aggression. This differs from a mechanism directed at one particular organ or function.

5. What can result when stress produces a defensive reaction against aggression?

A. Functional or organic disorders may develop

B. The body becomes resistant to all subsequent aggression

C. Anatomical lesions form in every stressed individual

D. Psychological symptoms appear without any bodily effects

Answer: (A)

Explanation

Stress generates a defensive reaction and can be associated with both functional and organic disorders. It does not imply that every stressed person develops an anatomical lesion.

6. According to Alexander's model, which sequence correctly matches stress duration with its typical physical outcome?

A. Acute: emotional reaction; repetitive: functional disorder; permanent: lesional disorder

B. Acute: lesional disorder; repetitive: emotional reaction; permanent: functional disorder

C. Acute: social withdrawal; repetitive: anatomical healing; permanent: emotional reaction

D. Acute: functional disorder; repetitive: lesional disorder; permanent: emotional reaction

Answer: (A)

Explanation

Alexander's model links acute stress with emotional reactions having physical expression, repetitive stress with functional disorders, and permanent stress with lesional somatic disorders. Functional disorders lack an objective anatomical lesion, unlike lesional disorders.

7. What distinguishes a functional psychosomatic disorder from a lesional psychosomatic disease?

A. A functional disorder is psychological, whereas a lesional disease is unrelated to stress

B. A functional disorder lacks an objective lesion, whereas a lesional disease has anatomical pathology

C. A functional disorder has anatomical pathology, whereas a lesional disease lacks bodily changes

D. A functional disorder follows permanent stress, whereas a lesional disease follows acute stress

Answer: (B)

Explanation

Functional psychosomatic disorders have no objective anatomical lesion, while lesional psychosomatic diseases have an anatomopathological substrate. The distinction concerns observable bodily pathology, not whether stress is involved.

8. Which condition is best classified as a digestive psychosomatic manifestation that may be functional?

A. A confirmed gastric ulcer with tissue pathology

B. A myocardial infarction occurring during severe stress

C. A blood-pressure peak during emotional stimulation

D. Recurrent constipation associated with emotional reactions

Answer: (D)

Explanation

Digestive psychosomatic manifestations can include functional symptoms such as constipation, vomiting, diarrhea, and colic. A gastric ulcer is instead classified as a lesional psychosomatic disease because it has an anatomical substrate.

9. Why can a gastric ulcer be classified as a lesional psychosomatic disease?

A. It represents an emotional reaction that leaves no bodily alteration

B. It has an anatomopathological substrate with a predominant psychological factor

C. It produces digestive symptoms without an objective anatomical lesion

D. It is caused by cardiovascular changes during acute stress

Answer: (B)

Explanation

A gastric ulcer is lesional because it involves an anatomopathological substrate, while psychological factors may be predominant in its development. The absence of an objective lesion characterizes functional disorders instead.

10. Which group consists entirely of cardiovascular psychosomatic manifestations?

A. Ulcerative colitis, angina-like neuralgia, colic, and pallor

B. Palpitations, tachycardia, bradycardia, and systolic blood-pressure peaks

C. Vomiting, regurgitation, colic, and gastralgia

D. Constipation, diarrhea, pallor, and gastric ulceration

Answer: (B)

Explanation

Cardiovascular psychosomatic manifestations include palpitations, tachycardia, bradycardia, and systolic blood-pressure peaks, among others. Vomiting, colic, and gastralgia are digestive manifestations.

11. Why is myocardial infarction described as a disease of civilization with psychosomatic relevance?

A. Psychological factors may contribute directly or indirectly, and some infarctions occur during severe stress

B. Psychological factors create an anatomical lesion without any cardiovascular involvement

C. Myocardial infarction is a functional disorder that lacks tissue pathology

D. Severe stress produces cardiovascular symptoms but has no relationship to infarction

Answer: (A)

Explanation

Myocardial infarction is considered a disease of civilization in which psychological factors may act directly or indirectly, and some events occur during severe stress. It remains a serious organic cardiac disease rather than a purely functional disorder.

12. Which finding is recognized as a neurological psychosomatic manifestation rather than proof of objectively established paralysis?

A. Spinal cord compression

B. Pseudoparalysis

C. Peripheral nerve transection

D. Bacterial meningitis

Answer: (B)

Explanation

Pseudoparalysis is listed among neurological psychosomatic manifestations and does not establish objectively confirmed paralysis. Spinal cord compression can produce genuine neurological impairment, so it is not the intended psychosomatic example.

13. Which dermatological finding may be associated with psychosomatic factors?

A. Pruritus

B. Renal colic

C. Bone fracture

D. Bacterial pneumonia

Answer: (A)

Explanation

Pruritus is identified as a possible dermatological psychosomatic manifestation, along with some cases of urticaria, hair loss, and acne. This does not mean that every dermatological disease has a psychological origin.

14. A patient reports painful urination and increased urinary frequency during psychological distress; which classification best fits these symptoms?

A. Dermatological manifestations involving urticaria

B. Urogenital psychosomatic manifestations involving urination

C. Sexual-function manifestations involving impotence

D. Neurological manifestations involving paresthesia

Answer: (B)

Explanation

Dysuria and pollakiuria are urogenital manifestations involving urination and may occur psychosomatically. Impotence concerns sexual function, whereas paresthesia and urticaria belong to different manifestation groups.

15. What does a constitutional factor contribute to the development of a psychosomatic disorder?

A. It represents an external conflict that directly triggers biological dysfunction.

B. It confirms that a symptom has an exclusively organic cause.

C. It predisposes certain organs or functions to dysfunction under stress.

D. It provides psychological support during a period of emotional strain.

Answer: (C)

Explanation

A constitutional factor creates increased vulnerability in particular organs or biological functions when psychological stress occurs. An external conflict is instead a stress factor, not a constitutional predisposition.

16. Which situation is an example of a psychosomatic stress factor?

A. A pre-existing sensitivity of the bladder

B. A prolonged conflict at work

C. An inherited vulnerability of the stomach

D. A naturally anxious personality

Answer: (B)

Explanation

Professional conflicts are among the life, social, family, and other stressful situations that can contribute to biological dysfunction. An inherited or organ-specific vulnerability describes a constitutional factor rather than an external stressor.

17. Which characteristic is considered especially important in determining psychosomatic disorders?

A. A generally anxious personality that reacts strongly to stress

B. A stable personality with no variation in emotional responses

C. A detached personality that remains unaffected by stressful events

D. A personality defined mainly by physical strength and endurance

Answer: (A)

Explanation

Personality is described as the principal element, particularly when an individual is generally anxious and reacts to stress. Physical endurance does not represent the psychological vulnerability emphasized in psychosomatic disorders.

18. Why should complementary examinations be performed before concluding that a symptom is psychogenic?

A. To exclude or confirm associated organic disease before assigning psychological causation

B. To replace evaluation of the symptom with a general psychological label

C. To demonstrate that every unexplained symptom results from emotional conflict

D. To begin psychological treatment without assessing the somatic component

Answer: (A)

Explanation

Psychosomatic assessment requires appropriate examinations to exclude or confirm associated organic disease before determining the psychological contribution. Assigning a psychological cause prematurely may cause an organic illness to be missed.

19. Which intervention belongs to the psychological management of a psychosomatic disorder?

A. Antibiotic therapy directed at a confirmed bacterial infection

B. Surgical correction of an organ without psychological assessment

C. Physical rehabilitation aimed at restoring muscle strength

D. Psychological support combined with treatment for anxiety or depression when indicated

Answer: (D)

Explanation

Psychological management may include psychotropic treatment, tranquilization, psychological support, and socio-familial support. Surgery, antibiotics, and physical rehabilitation are directed primarily at specific somatic conditions.

20. Why are psychosomatic disorders difficult for conventional medicine to treat effectively?

A. Their symptoms cannot be examined or related to any biological function.

B. Effective healing requires addressing the patient's stress, which is described as almost impossible.

C. Their treatment depends mainly on identifying a single constitutional vulnerability.

D. They respond rapidly to physical treatment but relapse because diagnosis is unnecessary.

Answer: (B)

Explanation

These disorders are difficult because effective healing would require acting successfully on the patient's stress, described as almost impossible. The challenge is not an absence of biological symptoms or a need to identify just one constitutional factor.