Fatigue

Question 1

Tired, waking at night and noises in sleep are symptoms of what

Answer 1

Sleep apnoea

Question 2

Lack of energy, palpitations, pale skin and shortness of breath are signs of what

Answer 2

Iron deficiency anaemia

Question 3

Tired, thirsty, peeing more, weight loss are signs of what

Answer 3

Diabetes

Question 4

Extreme fatigue for more than 3 months, thinking memory concentration problems are flu like symptoms are signs of what

Answer 4

Chronic fatigue syndrome

Question 5

Causes of tiredness

Answer 5

Insomnia, unhealthy lifestyle, stress, depression, hormonal changes, illnesses, some medical treatments

Question 6

Differential diagnoses for tiredness

Answer 6

Hypothyroidism,
Diabetes,
Vit d deficiency,
Anaemia,
Coeliac disease,
Glandular fever,
Lupus,
Pregnancy,
Menopause,
Cancer

Question 7

FBC helps to eliminate

Answer 7

Anaemia (iron deficiency- Microcytic, hypochromic RBC)

Alcohol abuse (macrocytic cells)

Infection (WBC count)

Question 8

U&E looks at

Answer 8

Kidney function - ckd, electrolyte abnormalities if urea is raised

Question 9

Thyroid function test

Answer 9

Checks TSH and fT4 levels

Question 10

CRP checks

Answer 10

Inflammation/ infection nonspecific

Question 11

Other tests

Answer 11

Coleiac screen, antibody screen, EBV serology (glandular)

Question 12

Symptoms of hypothyroidism

Answer 12

Weight gain with reduced appetite,
Tiredness,
Cold intolerance,
Bradycardia,
Dry, rough skin,
Depression,
Enlarged thyroid gland,
Hair loss,
Low libido,
Swollen face

Question 13

Most common cause of autoimmune hypothyroidism

Answer 13

Hashimoto’s disease

Question 14

NK cells show both

Answer 14

Adaptive and innate immunity

Question 15

NK cells work by

Answer 15

Killing all cells which don’t show MHC1 molecules

Question 16

Innate immune cells work by

Answer 16

Attacking cells which display PAMPS

Question 17

PAMPS

Answer 17

Pathogen associated molecular patterns

Question 18

Autoimmunity due to

Answer 18

1. Mutation in a host cell or its training
2. Molecular mimicry
3. Environmental, high stress, genetic

Question 19

Molecular mimicry

Answer 19

Foreign cell contains antigen which resembles host antigens e.g. after an infection

Question 20

Explain Hashimotos

Answer 20

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

Question 21

Sites of immune tolerance in NK cells and B and T cells

Answer 21

NK - MHCI negative cells

B and T - complementarity

Question 22

Treatment of hypothyroidism

Answer 22

Levothyroxine

Once daily for life

Question 23

Preclinical hypothyroidism

Answer 23

Normal t4
High tsh

Question 24

Vit d deficiency presents as

Answer 24

Bone abnormalities

Question 25

Hormone levels in hypothyroidism

Answer 25

High TSH
Low thyroxine

Question 26

Hormone levels in hypothyroidism

Answer 26

High TSH
Low thyroxine