Rheumatologic conditions Flashcards
Who does CFS primarily affect
F>M
average age: 29-35
occurs more frequently among minority populations and those with a lower social-economical status and education level are at a higher risk
what is the pathophysiology of CFS
unclear underling pathophysiology - diagnosis of exclusion
what is fatigue
described as weakness, tiredness and lethargy
what are the clinically concerning factors of fatigue
difficulty initiating activities
difficulty completing activities
memory and concentration difficulties
how is CFS diagnosed
with exclusion criteria - there are no objective physical exam findings.
requires 6 months of fatigue and all self reported symptoms
what are we ruling out when trying to determine CFS
ruling out medical or psychiatric conditions that might be causing fatigue
what is the treatment of choice for CFS
cognitive behavioral therapy and graded exercise
what is cognitive behavioral therapy (CBT)
psychotherapy technique aimed at changing throught/behavior
what is Graded exercise therapy (GET)
home exercise program to improve conditioning and exercise tolerance
what are alternative treatment options for CFS
remaining active, physically and socially.
treat any co-occurring anxiety or affective disorders (common)
what is typically unhelpful in CFS treatment
medications
What is the common patient presentation of fibromyalgia
affects 3-10% of the population
F>M
average age: 20-50
what is the pathophysiology of Fibromyalgia
underling pathophysiology unknown
? abnormal pain perception, ? related to sleep disorder, ? depression, ? viral infectious etiology
what is the typically fibromyalgia presentation
MSK pain and impairment in functioning
chronic, achy pain and stiffness that usually involves the neck, shoulder, low back and hips
associated with
fatigue, sleep disturbances, subjective numbness, headache, IBS
How many tigger pints to diagnose fibromyalgia
11 of the 18 trigger points PLUS widespread chronic pain
how is fibromyalgia diagnosed
symptoms for more than 3 months
there is no specific imaging or lab testing
rule out: amemia, thyroid abnormalities, electrolyte abnormalities
what are the 5 approaches to the treatment of fibromyalgia
- patient education
- non-pharmacologic options
- pharmacologic options
- treat any co-morbid conditions
- identify any available community resouces
what falls under patient education for fibromyalgia treatment
treatments can improve the symptoms, disease is not progressive, ID most distressing symptoms, Set treatment expectations (not complete relief of symptoms)