ME/CFS Flashcards
what is myalgic encephalomyelitis/chronic fatigue syndrome?
dysregulation of CNS, immune system, cellular energy metabolism, ion transport, CV abnormalities
hypometabolic state - measured with seahorse technology
presentation of ME/CFS needed for Dx
impairment of daily function
post exertion malaise
unrefreshing sleep
plus one of:
cognitive impairment
orthostatic intolerance
Canadian consensus criteria for ME/CFS
pathological fatigue post exertion malaise unrefreshing sleep chronic pain neurocognitive symptom autonomic symptom (difficulty standing) endocrine symtoms (temp control) immune symptoms (flu, sensitivity)
how to measure post-exertional malaise
unable to perform as well on dy 2 of a 2-day maximal cardiopulmonary test protocol
goals of treatment for ME/CFS
increase QoL
treat orthostatic intolerance
add salt
help sleep
major differences between CFS and fibromyalgia
ME/CFS is more severe
people with FM benefit from moderate activity, in CFS it is not
FM is chronic widespread pain and fatigue
difference bw CFS and depression
immune, autonomic and endocrine symptoms are not seen in depression
what is polymyalgia rheumatica?
inflammatory disease
proximal muscle pain and stiffness with rest
flu-like symptoms
PE findings of polymyalgia rheumatica?
no loss of muscle bulk
unable to raise arms, standing up from seated/bed position
reduced shoulder ROM
lab findings of polymyalgia rheumatica?
elevated ESR (inflammation)
normal muscle enzymes
normal EMG
management of PE?
prednisone maintenance dose
presentation of giant cell arteritis
fatigue, scalp tenderness, jaw claudication, fever
new onset severe headache
PE findings of giant cell arteritis
temporal artery is tender tot ouch or has decreased pulsation
occipital artery may be tender
lab findings of giant cell arteritis
ESR elevated
temporal artery biopsy is abnormal (skip lesions, mononuclear cells and granulomatous inflammation)
US: halo sign
Tx for giant cell arteritis
prednisone
DMARDs
biologics
