MRCP UK EXAMINATIONS

Detailed explanation-1: -Corticotrophin-releasing hormone (CRH), secreted in response to surgical stress, activates the hypothalamic–pituitary–adrenal (HPA) axis cascade and its metabolic consequences. Corticotrophin-releasing hormone stimulates the anterior pituitary gland to secrete adrenocorticotropic hormone (ACTH).

Detailed explanation-2: -The surgical stress response has three key components: Sympathetic nervous system activation. Endocrine response with pituitary hormone secretion and insulin resistance. Immunologic and hematologic changes including cytokine production, acute phase reaction, neutrophil leukocytosis, and lymphocyte proliferation.

Detailed explanation-3: -Following surgical or accidental trauma, the nervous system activates the stress response by sending impulses from the injured site to the hypothalamus. The hypothalamus either removes its inhibitory tone on the pituitary or releases hormones which stimulate the production and/or release of pituitary hormones.

Detailed explanation-4: -Physical stress stimulates the HPA and sympathetic nervous system. Cortisol has various physiologic effects, including catecholamine release, suppression of insulin, mobilization of energy stores through gluconeogenesis and glycogenolysis, suppression of the immune-inflammatory response, and delayed wound healing.

Detailed explanation-5: -Surgical stress is the systemic response to surgical injury and is characterized by activation of the sympathetic nervous system, endocrine responses as well as immunological and haematological changes. Measurement of surgical stress is used in anaesthesia, physiology and surgery.