FATIGUE, ASTHENIA AND DEPRESSION Flashcards
refers to the universally familiar state
of weariness or exhaustion resulting from physical or
mental exertion.
Fatigue
although it connotes more of an inability or disinclination
to be active, physically or mentally.
Lassitude
Meaning of fatigue
(1) biochemical and physiologic changes in muscles and a reduced capacity to generate force manifest as __________
(2) a disorder in behavior, taking the form of a reduced output of work____________ or a lack of endurance; and
(3) a subjective feeling of tiredness and discomfort.
weakness, or asthenia;
(work decrement
findings associated with neurasthenia
The usual associated
symptoms are anxiety, irritability, depression, insomnia,
headaches, dizziness, difficulty in concentrating, reduced
sexual drive, and loss (or sometimes increase) of appetite
fatigue and intolerance of exercise (i.e.,
fatigue with mild exertion) are prominent manifestations
of __________
myopathic disease
type of glycogen storage disease, __________________is exceptional in that fatigue and weakness are
accompanied by pain and sometimes by cramps and contracture
McArdle phosphorylase
deficiency,
___________is at times associated with disproportionate
weakness and fatigue of respiratory muscles,
which leads to dyspnea and retention of carbon dioxide
acid
maltase deficiency,
__________ is a common complaint among patients with postconcussive
syndrome
Inordinate
fatigue
drugs associated with fatigue
beta-adrenergic
blocking agents, antiepileptics, antispasticity drugs, anxio
lytics, chemotherapy and radiation therapy and, paradoxically,
many antidepressant and antipsychotic drugs.
complains of severe fatigue for many months or even
years after a bout of infectious mononucleosis or some
other viral illness
postviral fatigue syndrome.
what is chronic fatigue syndrome
disabling fatigue for at least 6 months,
coupled with an arbitrary number (6 or 8) of persistent or recurrent somatic and neuropsychologic symptoms including low-grade fever, cervical or axillary lymphadenopathy, myalgias, migrating arthralgias, sore throat, forgetfulness, headaches, difficulties in concentration and thinking, irritability,
and sleep disturbances
the
___________ is the structure most implicated by the loss
of endurance and the presence of associated symptoms
such as orthostatic intolerance, tachycardia and some of
the endocrine changes
hypothalamus
best tx for fatigue syndrome
They are probably best treated with
gradually increasing exercise levels and perhaps with
antidepressant medication
In the _______________ the patient is suddenly overwhelmed
by feelings of apprehension, or a fear that he
may lose consciousness and die, have a heart attack or
stroke, lose his reason or self-control, become insane,
or commit some horrible crime
panic attack,
Episodic o r sustained anxiety without a disorder of
mood (i.e., without depression) is classified as __________ or formerly, anxiety neurosis
generalized
anxiety disorder,
Symptoms of persistent anxiety
with insomnia, lassitude, and fatigue should always raise
the suspicion of a ___________ especially when they begin in middle adult life or beyond
depressive illness,
An extremely stressful, or traumatic event that causes
fear and helplessness, triggers a persistent psychological
state in which the patient reexperiences the event, avoids
reminders of it, and is in a constant state of hyperarousal
Posttra u m atic St ress D i s o r d e r ( PTS D )
difference between PTSD and anxious depression
the critical difference
being the existence of a triggering traumatic event.
The biologic distinctions that have been made
between anxious depression and PTSD include lower than normal _________ levels, an attenuated increase of
these levels in the immediate aftermath of the event, and
an exaggerated __________ in response to dexamethasone
cortisol
suppression
initial meds for PTSD
Selective serotonin reuptake inhibitors
feeling of self-doubt about
being able to cope with some situation over a period of
time
stress
The term ________ refers to perturbations of
behavior and accompanying physiologic changes that are ascribable to environmental challenges of such intensity
and duration as to overwhelm the individual’s adaptive
capacity.
stress syndrome
The dramatic syndrome of ballooning of the left
ventricular apex, or ___________(sonamed for the shape of the Japanese octopus trapping
pot), is a manifestation of catecholamine excess caused
by acute stress
takotsubo-like cardiomyopathy
Irritability
is also a common symptom of________
obsessive-compulsive disorders.
Short-temperedness
and irritability are also common features of the_________
manic
state.
suggests that the dominant
feature of the experience of anxiety is simply the physical
experience of the associated autonomic discharge
James-Lange theory of emotion
During periods of intense anxiety, _______
excretion is increased to 2 or 3 times normal.
aldosterone
In addition to the role of the amygdala, animal studies
have related acute anxiety to a disturbance of function
of the ________ and _________ the principal norepinephrine-containing nuclei.
locus ceruleus and the septal and hippocampal
areas,
the role for the _________ in eliciting many of the autonomic
features (particularly increased heart rate) of excessive
arousal and anxiety
anterior
cingulate gyrus
most cases formerly
diagnosed as ________ are now regarded as
depression with superimposed anxiety
hypochondriasis
