Chronic Fatigue Syndrome

Question 1

When is chronic fatigue syndrome diagnosed?

Answer 1

After >,3 months of disabling fatigue affecting mental + physical function >50% of the time in the absence of other disease which may explain Sx

Question 2

Describe the epidemiology of CFS

Answer 2

F > M
past psychiatric hx has not been shown to be a RF

Question 3

List 9 symptoms of CFS

Answer 3

Sleep problems: insomnia, hypersomnia, unrefreshing sleep, a disturbed sleep-wake cycle
Muscle +/or joint pains
Headaches
Painful LNs without enlargement
Sore throat
Physical or mental exertion worsens Sx
General malaise or ‘flu-like’ Sx
Dizziness
Nausea
Palpitations

Question 4

List 4 ways in which CFS can cause cognitive dysfunction

Answer 4

Difficulty thinking
Inability to concentrate
Impairment of short-term memory
Difficulties with word-finding

Question 5

What investigations should be performed when suspecting CFS?

Answer 5

FBC + Ferritin: r/o anaemia, polycythaemia
U&Es: r/o electrolyte imbalance/ kidney disease
LFTs: r/o liver disease
Glucose + HbA1c: r/o DM
TFTs: r/o hypo/ hyper
CRP + ESR: r/o infection, inflammation
Calcium: r/o hypercalcalemia + MM
CK: r/o neuromuscular cause
Anti-TTG: r/o coeliac
Urinalysis: r/o UTI, inflammation, DM

Question 6

What are the 4 key symptoms of CFS?

Answer 6

Debilitating fatigue that is worsened by activity
Post exertional malaise/ Sx exacerbation
Unrefreshing sleep +/or sleep disturbance
Cognitive dysfunction

Question 7

Describe management of CFS

Answer 7

Refer to specialist CFS service
Energy management: managing activities to stay within energy limit
CBT

Question 8

What is the advice about exercise in CFS?

Answer 8

Don’t advise to exercise if not part of a programme overseen by CFS specialist team
Only recommend if patient feels ready to progress their physical activity beyond current ADLs

Question 9

What is CFS also known as?

Answer 9

Myalgic encephalomyelitis