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Clinical Prep > Fatigue > Flashcards

Fatigue Flashcards

1
Q

Classification (timeline) of fatigue

A

Acute <1 mo
Chronic >6 mo

Subacute is between 1 and 6 months

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2
Q

MDD a/w chronic fatigue

A

Which came first?

Depression or Fatigue?

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3
Q

Chronic Fatigue Syndrome- CFS

A

Worse w activity or Mental exertion

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4
Q

CFS- chronic fatigue synd

A

usually high fx individual- then all of a sudden they are hit hard with fatigue

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5
Q

Chronic Fatigue Synd triggers

A 
Infections
Immune dysfx
Neurally mediated hypotension
Depression
Sleep disruption
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6
Q

Infections that can lead to Fatigue

A 
Endocarditis
TB
Mono
Hepatitis
HIV
Parasitic
PNA
Cytomegalovirus
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7
Q

Endocrine/Metabolic

A 
Hypothyroid
DM
Pituitary insuff
Adrenal insuff
Hypercalcemia
Kidney or Liver failure
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8
Q

Cardio/pulm

A 
CHF
COPD
Emphysema
Periph vascular dz
Coronary artery dz
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9
Q

Neuro

A 
MS
Myasth gravis
Myositis
Parkinson
Dementia
TBI
STroke
Migraine
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10
Q

Inflamm/Rheum

A 
RA
Lupus
IBS
Sarcoidosis
Sjogren
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11
Q

CA

A

CA

severe anemia

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12
Q

Meds that can cause fatigue as SE

A 
Hypnotics
HTN meds
Muscle relaxant
Antidepressant
1st gen Antihist
Opioids
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13
Q

Q about fatigue

A

Was it gradual or sudden onset?

Daily?

Patterns of fatigue?

Affect ADL?

What do you mean by fatigue?

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14
Q

ROS with nose

A

Runny/congested

Antihistamine use!

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15
Q

HEENT ROS Qs that are important

A

head: HA, trauma
eyes: change in vision, visual fields
ears: pain, loss
throat: sore throat, diff swallowing, hoarse voice
neck: swelling, stiff, lymph nodes
resp: cough, SOB, CP, hx infections, CXR

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16
Q

More ROS

A

Neuro: numb, tingling, LOC, hx stroke

Endocrine: thirsty

Blood: easy bruising, bleeding, +FH genetic disorder

17
Q

GI

A

make sure to ask about rectal bleeding

18
Q

Reasonable labs to order

A

CBC w diff
CMP
TSH (thyroid)
ESR (inflammation)

19
Q

Tx options for Chronic fatigue

A 
CBT
Graded exercise therapy
Sleep hygiene
Education
Support group
Med trial
Special testing
Referral- social work, psychological evaluation
20
Q

Sleep Hygiene

A 
Sleep only as much necessary
Regular sleep schedule
Don't try to sleep unless tired
Exercise at least 4-5 hours before bed
Avoid caffine after lunch
Avoid alc before bed
Dont go to bd hungry
Make bedroom comfy
Avoid screen 30 min before
Deal w worries before bed
21
Q

Thyroid disease

A 
Abn HR
Fatigue
Weak
HA, depression
Cold sens
wt gain

Thin hair
Thick tongue

TSH increased
Low T3/T4

22
Q

Thyroid replacement meds

A

Levothyroxine

Synthroid, Levothroid, Levoxyl

23
Q

MDD

DSM-5

A

at least 2 weeks with >5 of the symptoms

no hx of mania

24
Q

Caution with SSRI, SNRI, and TCA

A

can predispose Manic episode

25
Q

SSRI side effects

A 
dry mouth
anorexia
diarrhea
fatigue
insomnia
loss libido
26
Q

SNRI

A

Cymbalta

Effexor

27
Q

Duloxetine (Cymbalta) caution

A

w LIVER DISEASE

contra if hepatic dysfx

28
Q

Venlaxafine (Effexor) caution

A

increase in BP

29
Q

Cymbalta can also be used for

A

Peripheral neurop

Fibromyalgia

30
Q

TCA common use for

A

Depression (not 1st line)
Neuropathic pain
Migraine proph

31
Q

Depression secondary to meds

A 
Opioids
Anticonvulsant
B-blocker
CCB
Benzos
NuvaRing
32
Q

Less stressed body better controls hormones that

A

control appetite

SLEEP IS GOOD

33
Q

Obstructive sleep apnea pts are at higher risk for

A

HTN
Stroke
Heart attack

34
Q

Meds used for Fibro

A

Duloxetine (Cymbalta)

Pregabalin (Lyrica)

Clinical Prep (41 decks)

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