Chronic fatigue

Question 1

time frame of acute, subacute, and chronic fatigue?

Answer 1

acute: less than 1 month relived by rest

subacute: between 1 to 6 months

chronic: over 6 months not relived by rest

Question 2

diagnostic criteria of fatigue?

Answer 2

clinically relevant fatigue is composed of 3 major components:
1. generalized weakness
2. easy fatiguability
3. mental fatigue

Question 2

secondary vs physiologic fatigue?

Answer 2

secondary: underlying medical conditions. may last 1 to 6 months

physiologic: lifestyle imbalance of sleep, diet, exercise, activity, alleviated with rest

Question 2

What is the ESS?

Answer 2

Epworth sleepiness scale.
under 10 = excessive daytime sleepiness
10 or more = further evaluation

Question 3

What is FSS?

Answer 3

fatigue severity scale

less than 36 = no fatigue
more = further evaluation

Question 4

do all patients with chronic fatigue meet the criteria for chronic fatigue syndrome?

Answer 4

no 2 thirds do not

Question 5

what % of patients with chronic fatigue have a medical or psychological explanation?

Answer 5

7%

psychiatric disorders are predominant.

Question 6

is SEID considered a biological or psychological disorder?

Answer 6

biological

Question 7

what is the major diagnostic criteria for SEID?

Answer 7

at least 6 months duration
Not resolved with rest
reduced activity to under 50%
exclusion of other conditions

Question 8

what is the physical crtieria for SEID?

Answer 8

low grade fever
non exudative pharyngitis
lymphadenopathy

Question 9

The patient must also have at least one of the following ____?

Answer 9

1. cognitive impairment
2. orthostatic intolerance

Question 10

when to refer?

Answer 10

secondary organic causes of fatigue
infections not responsive to treatment
difficult hyper or hypo thyroidism
severe psychological illness
malignancy

Question 11

although lab results only affect management in 5%, what tests would be indicated?

Answer 11

CBC, ESR, chemistry panel, thyroid, pregnancy, urinalysis