HYHO Fatigue

Question 1

What is the broad ddx of fatigue?

Answer 1

DEAD TIRED

Depression

Environment/lifestyle

Anxiety, Anemia

Diabetes/endocrine

Thyroid, tumors

Infection

Rheumatologic

Endocarditis/CV
Drugs

Question 2

What qualifies as chronic insomnia?

Answer 2

waking up at least 3 nights per week for 3 months

due to irregular sleep cycle (ex. shift workers, travel)

Question 3

What is secondary tx of insomnia?

Answer 3

pharm - limit use 2-4 times/wk

Benzodiazepines

Benzodiazepine receptor agonists

Tricyclic Antidepressants

Trazodone

Diphenhydramine

Question 4

If left untreated, what are complications of OSA?

Answer 4

inc MVA

HTN

HF

impaired glucose tolerance

increased risk of CVA

Question 5

How do you tx periodic limb movement disorder?

Answer 5

dopamine agonists (pramipexole or ropinirole)

OR

anti-epileptics (gabapentin, pregabalin or carbamazepine)

Question 6

What must you not miss with fatigue complaint?

Answer 6

anemia

hypothyroid

DM

depression/anxiety

OSA

Question 7

What is the five model approach to hypothyroid?

Answer 7

Question 8

What is the anterior chapman pt of the thyroid? visceral somatics?

Answer 8

a. Second intercostal space
b. T1-4; CN X(Vagus)