Symptoms Flashcards
Fatigue that is loner than ____ months and fluctuates in severity is usually functional and the patient may have identifiable stressors
6 months
Fatigue associated w/ psychiatric causes is frequently worse when? and alleviated by what?
worse in the morning and may be alleviated by activity
Who is physiologic fatigue common in
mothers of newborns
shift workers
athletes who overtrain
when is fatigue worsened w/ organic dz?
with activity
Darkening of the skin + fatigue points to what?
Addison’s
pale appearance + fatigue points to what?
anemia
Diagnosis with persistent or relapsing fatigue not previously present
chronic fatigue syndrome
Lab tests for fatigue with no obviously PE finding
CBC, ESR< comprehensive metabolic profile, UA< thyroid, pregnancy testing, HIV (if suspected) creatinine kinase (if muscle weakness)
A nonanemic patient with low serum ferritin can receive what to help relieve symptoms of fatigue?
Iron
what is considered a fever?
temp above 38.3ºC (101 F)
when are fevers typically the highest?
evening
when are fevers typically the lowest?
morning
antipyretic meds supress what?
prostaglandin formation
why do many patients with fever experience myalgia
hypothalamus increases muscle tone to generate heat and raise body temperature
what fevers can produce convulsions
104-106 F
what conditions can cause reucrrent or intermittent fever?
malaria hepatitis B leptospirosis brucellosis disseminated fungal infections
a cyclic pattern of high fevers for 1-2 weeks alternating with afebrile periods are pathognomonic for what?
PelEbstein fever ogf Hodgkin’s disease
Fevers persisting for 3 weeks, exceeding temp of 101 F and eluding 1 week of intensive diagnostic study
fever of unknown origin (FUO)
Fever plus petechial eruptions on teh skin can suggest what?
meningococcemia or Rockyu Mountain supotted fever
Petechiae at the juntion of the hard and soft palate and fever occur w/ what
mononucleosis
Splinter hemorrhages and conjunctival petechiae suggest what?
endocarditis
what is an important sign of Lyme disease?
erythema chronicum migrans
common causes of increased metabolic rate
chronic infection
hyperthyroidism
excessive exercise
malignancy
what is unintended weight loss
> 5% in 1 month
>10% in 6 months
what test measures the absorptive capacity of the proximal small intestine [19] and is used to determine whether defects in the intestinal epithelium are responsible for malabsorption.
D-xylose test
what is the leading cause of unexplained weight loss
major depression (especially in elderly)
what is the prototypical occult neoplasm associated w/ dramatic weight loss?
carcinoma of the pancreas
sudden, transient loss of consciousness and postural tone followed by spontaneous recovery
syncope
sensation of impending syncope w/o loss of consciousness
presyncope
what type of syncope is always sudden in onset w/ little prodrome
cardiac
most common cause of syncope. have a prodrome of weakness, light-headedness, diaphoresis and nausea
vasovagal
reflux (neurally-mediated) syncope that occurs during or immediately after provocative stimuli such as coughing, swallowing, warm places, pain, urinating
situational syncope
what is orthostatic hypotension
decrease in systolic BP of >20 mmHg and in diastolic BP >10 within three minutes of standing
type of vertigo due to abnormalitites in the vestibular end organs
peripheral vertigo
vertigo due to the abnormalitites in the central nervous system
central
most common type of peripheral vertigo
BPPV
what type vertigo is usually sudden w/ onset and severity and only lasts for a few minutes
peripheral
what type vertigo is more gradual in onset with mild intesntiy but can be chronic
central vertigo
type of vertigo that starts w/ movement
peripheral
what test is used to illict BPPV
Dix-Hallpike
what is a positive test w/ the Dix Halpike test?
patient will report vertigo and exhibition a mixed torsional and vertical nystamgus w/ upper pole of eye beating toward the affected ear
what manuever is done to treat BPPV
Epley manuver
what type ulcer is formed because of high acid
duodenal
when does pain occur w/ a duodenal ulcer?
2-3 hours after a meal
what relieves pain w/ a duodenal ulcer?
food
what may aggreavate a gastric ulcer
food
main way to see peptic ulcers
radiographic studies- barium swallow and endoscopy
How can GERD be documented
esophageal mamometry and pH monitoring
tx for H pyloria
pepto bismol, PPI and tetracycline for 2 weeks
