Fatigue Flashcards
Tired, waking at night and noises in sleep are symptoms of what
Sleep apnoea
Lack of energy, palpitations, pale skin and shortness of breath are signs of what
Iron deficiency anaemia
Tired, thirsty, peeing more, weight loss are signs of what
Diabetes
Extreme fatigue for more than 3 months, thinking memory concentration problems are flu like symptoms are signs of what
Chronic fatigue syndrome
Causes of tiredness
Insomnia, unhealthy lifestyle, stress, depression, hormonal changes, illnesses, some medical treatments
Differential diagnoses for tiredness
Hypothyroidism,
Diabetes,
Vit d deficiency,
Anaemia,
Coeliac disease,
Glandular fever,
Lupus,
Pregnancy,
Menopause,
Cancer
FBC helps to eliminate
Anaemia (iron deficiency- Microcytic, hypochromic RBC)
Alcohol abuse (macrocytic cells)
Infection (WBC count)
U&E looks at
Kidney function - ckd, electrolyte abnormalities if urea is raised
Thyroid function test
Checks TSH and fT4 levels
CRP checks
Inflammation/ infection nonspecific
Other tests
Coleiac screen, antibody screen, EBV serology (glandular)
Symptoms of hypothyroidism
Weight gain with reduced appetite,
Tiredness,
Cold intolerance,
Bradycardia,
Dry, rough skin,
Depression,
Enlarged thyroid gland,
Hair loss,
Low libido,
Swollen face
Most common cause of autoimmune hypothyroidism
Hashimoto’s disease
NK cells show both
Adaptive and innate immunity
NK cells work by
Killing all cells which don’t show MHC1 molecules
Innate immune cells work by
Attacking cells which display PAMPS
PAMPS
Pathogen associated molecular patterns
Autoimmunity due to
- Mutation in a host cell or its training
- Molecular mimicry
- Environmental, high stress, genetic
Molecular mimicry
Foreign cell contains antigen which resembles host antigens e.g. after an infection
Explain Hashimotos
TPO is processed by APC and presented to T cell using interactions between MHCII and TCR, and B7 and CD28
T cells present antigen to specific B cell using interactions between TCR and MCII, and CD40L and CD40
B cells activate, mature, proliferate and produced anti TPO antibodies which attack the thyroid gland
Sites of immune tolerance in NK cells and B and T cells
NK - MHCI negative cells
B and T - complementarity
Treatment of hypothyroidism
Levothyroxine
Once daily for life
Preclinical hypothyroidism
Normal t4
High tsh
Vit d deficiency presents as
Bone abnormalities
Hormone levels in hypothyroidism
High TSH
Low thyroxine
Hormone levels in hypothyroidism
High TSH
Low thyroxine
