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Pathophysiology - Unit IV > Comfort & Chronic Fatigue Syndrome > Flashcards

Comfort & Chronic Fatigue Syndrome Flashcards

1. Pain 2. Chronic Fatigue Syndrome

1
Q

What is the most common symptom that makes a person seek medical attention?

A

Pain.

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2
Q

Pain is always?

A

Subjective.

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3
Q

Most reliable indicator of pain?

A

The patient’s self report of pain.

A clinician needs to accept and respect this self-report, absent clear reasons for doubt.

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4
Q

Pain without an identifiable cause should not be routinely attributed to?

A

Psychological causes. A uniform pain threshold does not exist. Pain can exist when no physical cause can be found.

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5
Q

Pain tolerance varies depending on?

A
  • Heredity
  • Energy level
  • Coping Skills
  • Prior experiences with pain
  • Patients with chronic pain may be more sensitive to pain and other stimuli
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6
Q
  • What are the mechanisms of pain?
A
  1. Trandsduction
  2. Transmission
  3. Perception
  4. Modulation
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7
Q
  • What is transduction?
A

Involves nerve fibers that react to thermal, chemical, and mechanical stimuli.

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8
Q
  • What is transmission?
A
  • After nerve fibers are activated, the information is transmitted to the central nervous system.
  • The dorsal root of the spinal cord receives, transmits, and processes sensory impulses.
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9
Q
  • What is perception?
A

Afferent nerve fibers within the dorsal room then transmit the impulses through the brainstem and thalamus, to the cortex of the brain, where the experience of pain is perceived.

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10
Q

Where is pain perceived?

A

In the cortex of the brain.

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11
Q
  • What is modulation?
A
  • Process of altering the stimuli by either inhibiting or facilitating nociceptive signals.
  • Modulation of the pain signals occur at the peripheral, spinal cord, and brain levels.
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12
Q

What is pain threshold?

A

Lowest intensity of painful stimuli that the patient perceives as pain.

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13
Q

How does a patient’s threshold vary?

A

Depends on psychological factors, but is essentially the same for all people who have intact central and peripheral nervous system.

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14
Q

What is pain tolerance?

A

Different for each patient. Some patients tolerate high levels of pain with little distress and others have distress at low levels.

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15
Q

Affecting factors of pain tolerance?

A
  • Family
  • Occupational roles
  • Spiritual beliefs
  • Culture
  • Sexual identity/stereotypes
  • Communication skills
  • Stage of growth and development
  • Personality
  • Fear and anxiety
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16
Q

Principles of pain management?

A
  • Establish a therapeutic relationship.
  • Alleviate anxiety.
  • Provide distraction or diversion.
  • Anticipate fears.
  • Provide physical care.
    • Non-pharmalogical and pharmalogical.
    • Anticipate pain (post-op ambulation).
    • Repositioning/positioning patient).
17
Q

Assessment of pain consists of?

A
  1. Location
    - - Where is the pain?
  2. Onset & Pattern
    - - When did it start?
    - - Was it sudden or develop overtime?
    - - Is it continuous or intermittent?
  3. Extension or Radiation
    - - Does the pain move to other areas?
  4. Duration
    - - How long does the pain last?
  5. Character or Quality
    - - Describe your pain to me, sharp, dull, shooting, aching?
  6. Precipitating, aggravating and alleviating factors.
    - - What starts the pain?
    - - What makes it worse?
    - - What makes it better?
  7. Associated Manifestations
    - - Anorexia
    - - Nausea
    - - Restlessness
    - - Insomnia
  8. Effects on ADLs
    - - Sleep
    - - Appetite
    - - Concentration
    - - Work/school
    - - Relationships
    - - Activities
    - - Emotional State
18
Q

How do you know if a person has CFS?

A
  • 6 or more consecutive months
  • Fatigue is not due to ongoing exertion or other medical conditions associated with fatigue.
  • The fatigue significantly interferes with daily activities and work.
19
Q

Medical conditions associated with fatigue?

A

Must be ruled out by a doctor after diagnostic tests have been conducted to diagnose person with CFS.

20
Q

What does CFS stand for?

A

Chronic Fatigue Syndrome.

21
Q
  • How many symptoms do you need to be diagnosed with CFS?
A

4 out of 8.

22
Q
  • What are the signs and symptoms of CFS?
A
  1. Post exertion malaise > 24 hours
  2. Unrefreshing sleep
  3. Significant impairment of short-term memory or concentration
  4. Muscle pain
  5. Pain in the joints without swelling or redness
  6. Headaches of a new type, pattern, or severity
  7. Tender lymph nodes in the neck or armpit
  8. A sore throat that is frequent or recurring
23
Q

What causes CFS?

A

Unknown.

24
Q
  • What are the triggers that may cause CFS?
A
  1. Infections
  2. Immune disorders: Myalgic encephalitis and immune dysfunction go together. Cytokines cause immune system changes.
  3. Stress
  4. Trauma
  5. Toxins
25
Q
  • Stress or infection causing CFS?
A

CFS may be caused by stress or a viral infection, which may lead to chronic production of cytokines (inflammatory mediators) and then to CFS?

26
Q

What are cytokines?

A

Inflammatory mediators.

Immune System -> Lymphoid Organs -> T Cells -> Cytokines -> Immunological Changes -> Cutaneous energy, Markers of immune activation.

27
Q

What causes adrenal insufficiency?

A

Physical or emotional stress, alters the activity of the hypothalamic-pituitary adrenal axis, or HPA axis, leading to altered release of corticotrophin-releasing hormone (CRH), cortisol, and other hormones. These hormones can influence the immune system and many other body systems.

28
Q

Commonly reported pre-onset condition in CFS patients?

A

Physical or emotional stress.

29
Q

NDX for CFS?

A

Fatigue due to sleep problems.

30
Q

Treatment for CFS?

A
  1. Establish a regular bedtime routine.
  2. Avoid napping during the day.
  3. Incorporate an extended wind down period.
  4. Use the bed only for sleep and sex.
  5. Schedule regular sleep and wake times.
  6. Control noise, light, and temperature.
  7. Avoid alcohol, caffeine, and tobacco.

Pathophysiology - Unit IV (4 decks)

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