Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med 4 > Approach to Fatigue > Flashcards

Approach to Fatigue Flashcards

1
Q

dry eyes

dry mouth

parotid gland dysfunction

A

schirmers test to test if eyes are watery

anti Ro and La Anti-Nuclear Antibodies

sjorgrens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

acute fatigue lasts

subacute fatigue lasts

chronic fatigue lasts

A

acute fatigue lasts less than 1 month

subacute fatigue lasts 1 to 6 months

chronic fatigue lasts more than 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

3+ months of:

multi-site pain

fatigue

sleep disturbances

no evidence of inflammation

HA

paresthesias

cognitive/psych sxs

A

fibromyalgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

N/V

diffuse abdominal pain

polydipsia

polyuria

dehydration

A

DKA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

repetitive jerking movements of twitching of legs or arms during sleep

A

periodic limb movement disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are some infections that can cause fatigue

A

endocarditis

tuberculosis

PNA

EBV

parasite

hepatitis

HIV

CMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

proximal aching and stiffness (pelvis, neck, shoulder)

worse in the morning for more than 1 hour

stiffness after long periods of inactivity (gel phenomenon)

associated w/ giant cell temporal arteritis (HA, vision changes, jaw pain)

A

rapidly improves w/ LD steroids

polymyalgia rheumatica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

prosthetic valves, IVDU, indwelling IV catheter, immunosuppressed, recent dental/ sx procedure

fever, chills, anorexia, WL

cardiac murmur

petechiae

splinter hemorrhages (red-brown lines under nail bed)

janeway lesions (NT red macules on palms and soles)

osler nodes (tender violet SQ nodules on fingers and toes

roth spots (exudate, edematous hemorrhagic retinal lesions)

A

BCX + echo

endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Family Hx

polydipsia

polyphagia

polyuria

what do you always check

A

DM

check eyes and feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are some psych illnesses that can cause fatigue

A

depression

anxiety

somatization disorder

grief

substance abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

malar/ discoid rash

raynauds

photosensitivity

migratory symmetric joint pain

A

Anti Smith, Anti-DNA, Anti Phospholipid Anti-NuclearAntibodies

SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

black

dehydration, hypoxia, high altitude and exercise aggravates

A

HbS in RBC on electrophoresis

target cells, howell jolly bodies

sickle cell disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

acrocyanosis (dark gray fingertips)

dark urine

(anemia)

A

autoimmune hemolytic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

leukemia cutis, skin lesions

70 y/o

weakness and fatigue

infections

increased bleeding

organomegaly

LAD

A

> 30% lymphocytes

chronic lymphoblastic leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

sick contacts

sore throat

posterior pharynx exudates

splenomegaly

A

EBV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

black, retired age

fatigue, weak, back pain, bone pain

hyperviscosity syndrome (bleeding mucous membranes, vision probs, neuro sxs)

A

rouleaux formation (stacked coins), anemia, M spike, Bence Jones proteins

CRAB: Calcium more than 10.5, Renal insufficiency, Anemia, Bone Lesions

multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are some Rheum/ inflammatory causes of fatigue

A

RA

SLE

polymyalgia rheumatica

IBS

sarcoidosis

sjorgrens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

prox extremity weakness

myocarditis

raynauds

can’t get up, can’t reach

interstitial lung dz

plus

heliotrope rash/ shawl sign/ grottons papule

occult malignancy

A

dermatomyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

DOE

chest pain

cough

lupus pernio (hard purple lesion on the face)

erythema nodosum

uveitis

arthralgias

A

non caseating granulomas

lung biopsy required

sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

sleep walking

sleep talking

head banging

night terrors

A

parasomnias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

edema

SOB

productive cough- frothy pink sputum

orthopnea

PND

DOE

A

CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

kid

fever

fatigue

pallor

hepatosplenomegaly

LAD

A

lymphoblasts on BM bx and peripheral smear

acute lymphoblastic leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

N/V, constipation

polydipsia

polyuria

bone pain, muscle weakness

depression, confusion, lethargy

palpitations, syncope, arrhythmia

A

hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are some malignant causes of fatigue

A

anemia

leukemia

lymphoma

hodgkins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

prox extremity weakness

myocarditis

raynauds

can’t get up, can’t reach

interstitial lung dz

A

increased CK and aldolase

polymyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

irresistable urges to move legs when falling asleep

crawling/ burning/ painful sensations in the legs

A

restless leg syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

amnesia

slow speech

confusion, repetitive questions

dizziness

HA

emotional volatility

decreased focus and attention

sleep disturbance

A

TBI

ent msk

respiratory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are some neurologic causes of fatigue

A

MS

myasthenia gravis

myositis

myasthenia gravis

myositis

parkinsons

dementia

TBI

migraine

CVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

hx of HTN, DM, a-fib, smoking, dyslipidemia

hypotension

pallor

sweating

tachycardia/ severe bradycardia

bilateral neuro sxs

A

CVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

dyspnea

chronic cough

sputum

cyanosis, tripoding, accessory muscle usage

tobacco stained fingers

JVD, S3 gallop

decreased breath sounds, wheezes, increased resonance on percussion, crackles at base

A

PFTs

COPD- chronic bronchitis vs emyphysema

31
Q

AIDs pt

+

visual disturbances

perivascular hemorrhages, white fluffy exudates

A

cytomegalovirus

32
Q

aching, heaviness, burning sensation in legs that is worse with standing, relieved by elevation

edema, dry, hyperpigmented, red skin

restless legs

pink/yellow ulcers on bones

arterial pulses present

telangiectasias, visbile variscosities

fatigue

A

venous insufficiency

33
Q

rest tremor

rigidity (lead pipe/ cog wheel)

akinesia-bradykinesia (mask face, loss of movement)

postural instability

fatigue

A

parkinsons

34
Q

fluctuating muscle weakness

ptosis, diplopia

dysarthria (difficulty speaking), difficulty chewing, dysphagia)

arm > leg weakness

aggravated by stress

thymoma/ thymic hyperplasia

A

dx by electrophysiology (NCS/ EMG) ⇒ worsens fatigue

myasthenia gravis

35
Q

what are idiopathic causes of fatigue

A

chronic fatigue syndrome

fibromyalgia

36
Q

immunocompetent pt- pulm infection

immunocompromised pt- night sweats, WL, abdominal pain, diarrhea, anemia

A

sputum cx ⇒ acid fast strain

37
Q

what are some ‘other’ physical conditions that cause fatigue

A

obstructive sleep apnea

insomnia

pregnancy

obesity

malnutrition

eating disorders

chronic pain

38
Q

3 most common causes of chronic fatigue

A

major depressive disorder

panic disorder

somatic symptom disorder

39
Q

what are some cardio/pulmonary causes of fatigue

A

CHF

COPD, emphsema

peripheral vascular disease

coronary artery disease

40
Q

foreign travel

night sweats

SOB

pleuritic retrosternal CP

post-tussive crackles

decreased fremitus

weight loss

LAD

A

CXR- apical cavitary lesions, military pattern

sputum CX x 3

TB

41
Q

excessive daytime sleepiness

episodic spells of suddenly falling asleep

sleep paralysis

vivid dreams

sudden, transient episode of muscle weakness triggered by laughing, crying, or terror (cataplexy)

A

narcolepsy

42
Q

HA

vision changes

hemiopsia (decreased peripheral vision)

A

pituitary adenoma

43
Q

what are some meds that cause fatigue

A

hypnotics

anti-hypertensives

muscle relaxants

anti-depressants

1st generation antihistamines

opioids

44
Q

hx of EBV

painless cervical LAD

mediastinal mass

hepatosplenomegaly

drinking ETOH ⇒ extreme pain

A

reed sternberg (multi-nucleated B cells on lymph bx)

⇒ ann arbor staging

hodgkins lymphoma

45
Q

6 + months of

intense fatigue

not improved with rest

worse with activity and or exertion

cognitive impairment

orthostatic intolerance

A

chronic fatigue syndrome

(diagnosis of exclusion)

46
Q

glossitis, GI sxs

ETOH, pregnant, anticonvulsants

A

elevated homocysteine

normal MMA

megaloblastic macrocytic anemia- folate deficiency

47
Q

pruritis

icterus

jaundice

abdominal swelling

confusion

RUQ pain

A

liver failure

48
Q

glossitis

GI sxs

neuro sxs (ataxia, confusion, stocking glove paresthesia)

hx of metformin, PPIs, H2 blockers, elderly, vegan

A

positive shilling test

increased MMA and homocysteine

megaloblastic macrocytic anemia- B12 deficiency

49
Q

diarrhea

gas

fatigue

A

IBS

50
Q

atherosclerosis

pain w/ elevation

claudication- calf/ thigh/ buttock

skin changes (blue/ pallor w/ elevation, dependent rubor, ulcers, necrosis)

atrophied, shiny, taut, hairless, cool skin

delayed cap refil, absent arterial pulses

dry pale/ necrotic ulcers

fatigue

A

peripheral artery disease

51
Q

cold

weak, lethargic, depressed

weight gain

dry skin

thick tongue

eyelid edema

bradycardia

A

TSH

hypothyroidism

52
Q

N/V

yawning, mood changes, constipation, fluid retention

visual/ auditory/ sensory/ motor + and - sxs

HA

confusion and exhaustion

A

migraine

53
Q

male:

decreased energy, libido, muscle mass, body hair

hot flashes

gynecomastia

infertilitiy

low testosterone

A

male hypogonadism

primary- testes prob (high FSH, LH)

secondary- pituitary prob (low/ normal FSH, LH)

54
Q

what 5 things are often mistaken for fatigue but are NOT

A

weakness

somnolence

DOE

drowsiness

apathy

55
Q

what are lifestyle factors that you should ask about w/ a pt who presents with fatigue

A

physical activity- not enough/ too much

lack of effective sleep

unhealthy eating habits

alcohol or drugs

medications

jet lag

shift work

56
Q

paresthesias

neck flexion ⇒ electric shock down back/ limbs

optic neuritis

defective pupillary reaction to light (Marcus Gunn Pupil)

waxing waning/ recurring pattern (separated by time and space)

hyper reflexive DTRs, + babinski, clonus

nystagmus, inccordination, tremor, gait and balance probs, vertigo

uhthoff phenomenon- transient worsening due to elevated body temp

A

MRI w/ and w/out ⇒ hardened plaques in myelin of brain/ spinal cord/ optic nerve

CSF ⇒ oligoclonal band

Multiple Sclerosis

57
Q

fatigue

malaise

RUQ pain

N/V

+/- arthralgias

+/- jaundice/ dark urine/ pruritis/ light colored stool/ organomegaly

A

hepatitis

58
Q

fatigue, malaise

anorexia, N/V

pruritis, ecchymosis

metallic taste in mouth

SOB

DOE

restless legs

hx of pericarditis, encepalopathy, seizures

A

GFR

chronic kidney disease

59
Q

exhuasting after usual activities

difficulty concentrating and remembering

lack of motivation and emotional stability

insufficienct energy to initiate and/or maintain usual activities

A

fatigue

60
Q

hx of HIV/ autoimmune dz

fam hx

exposure to pesticides/ hair dye

painless diffuse/isolated LAD

mediastinal mass

abdominal fullness

night sweats, fever, WL (B sxs)

A

BX, CT/PET

lugano staging

non-hodgkins lymphoma

(No Reed Sternberg cells!!!!)

61
Q

LAD

fever, HA

upper trunk, neck, face rash

mucotaneous ulcers

myalgia, arthralgia

N/V/D

A

HIV

62
Q

hypoglycemia

N/V WL

orthostatic hypotension

muscle weakness and pain

hyperkalemia

hypotension

salt craving

bronze skin

A

low cortisol ⇒ cosyntropin stimulation test

adrenal insufficiency

(decrease of androgens and cortisol)

primary- adrenal prob (addisons disease… also low aldosterone)

secondary- anterior pituitary/ hypothalamic prob

63
Q

weakness and fatigue

infections

increased bleeding

hemorrhages and white plaques in eye

male

chemical/radiation/chemo exposure

tobacco

MDS

downs

A

> 20% myeloid blasts (BM and CBC)

auer rods

Acute Myeloid Leukemia

64
Q

jaundice

gallstones

dark urine

(anemia)

A

immature, nucleated RBCs, schistocytes

hemolytic anemia

65
Q

what are some endocrine/ metabolic causes of fatigue

A

hypothyroidism- primary vs secondary

DM

pituitary insufficiency

adrenal insufficiency

hypercalcemia

renal failure

hepatic failure

66
Q

weakness and fatigue

infections

increased bleeding

(anemia)

A

aplastic anemia

67
Q

productive cough

fever

SOB

pleuritic CP

chills

A

PNA

68
Q

glossitis

angular cheilitis

koilonychia

pica

dysphagia

restless legs

A

CBC and iron studies

IDA

69
Q

chronic fatigue syndrome triggers

A

immune destruction

infections

nutrition deficiency

neurally mediated hypotension

stress

70
Q

fever

WL

night sweats

3 phase:

  1. <10% blasts
  2. 10-19% blasts
  3. >20% blasts
A

philly chromosome/ BCR-ABL

chronic myeloid leukemia

71
Q

daytime sleeping

snoring, gasping, choking

increased risk of HTN, CVA, MI

overweight

A

measure neck circumference

obstructive sleep apnea

72
Q

symmetric joint pain

AM stiffness for more than 1 hour

movement improves

bakers cyst

MCP and PIP stiffness/ swelling that spares DIP

A

see joint space narrowing and erosions on XRay

Rheumatoid Arthritis

73
Q

fatigue is a possible exacerbation of (3)

A

exertion

acute illness

nonproductive sleep

Clin Med 4 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions