Aquifer Case 26

Question 1

what is chronic fatigue syndrome?

Answer 1

symptoms of fatigue for at least 6 months with moderate, substantial or severe intensity at least 1/2 the time –> post-exertional malaise, unrefreshing sleep, cognitive impairment and orthostatic related symptoms

patients must have the following 3 symptoms:

1. a substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities that persists for more than six months and is accompanied by fatigue, which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest.
2. post-exertional malaise: worsening of a patient’s symptoms and function after exposure to physical or cognitive stressors that were normally tolerated before disease onset.
3. unrefreshing sleep

with at least one of the two follow as well:
1. cognitive impairment

2. orthostatic intolerance

Question 2

what are some common causes of fatigue in adults

Answer 2

1. OSA
2. anemia
3. occult malignancy
4. coronary artery disease

Question 3

which labs would you get for fatigue?

Answer 3

1. CBC
2. glucose
3. ESR
4. TSH
5. Fe studies with ferritin

Question 4

for which cancers does the USPTF recommend screening?

Answer 4

1. breast
2. lung
3. colon
4. cervical