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CSI 1b > Tiredness > Flashcards

Tiredness Flashcards

1
Q

Causes of tiredness and fatigue

A

Insomnia
Unhealthy lifestyle
Stress, depression, bereavement
Hormonal changes (puberty, pregnancy or menopause)
Illness (glandular fever, COVID)
Chemotherapy and other medical treatments

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2
Q

Tiredness because of waking up at night (gasping, snorting, choking)

A

Sleep apnoea

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3
Q

Tiredness with lack of energy, noticeable heartbeats, shortness of breath and pale skin?

A

Iron deficiency anaemia

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4
Q

Tiredness, thirst, polyurea and noturea, weight loss?

A

Diabetes

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5
Q

Chronic tiredness, hard to stay still, nervous, anxious and irritable, muscle weakness?

A

Hyperthyroidism

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6
Q

Extreme fatigue for more than 3 months, problems with thinking, memory and concentration, flu-like symptoms?

A

ME or CFS

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7
Q

Things to help with tiredness?

A

Improve diet and exercise
Consistent sleep pattern
Good sleep routine
Relaxing sleep area

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8
Q

Makes tiredness worse

A

Smoking, alcohol
Caffeine or exercise before sleep
Smartphones and screens before bed

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9
Q

What percentage of patients who present with fatigue have a diagnosis made?

A

66%

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10
Q

What percentage of patients who present with fatigue receive diagnosis through blood tests?

A

Less than 10%

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11
Q

Possible causes of fatigue?

A

Anaemia, sleep apnoea, hypothyroidism, coeliac disease, CFS, diabetes, glandular fever, depression, restless legs, anxiety.
Malignancy, long COVID, pregnancy, stress, hyperthyroidism, vitamin D deficiency, Addison’s

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12
Q

Relevant blood tests for to check for hypothyroidism, anaemia, diabetes and renal function.

A

FBC - anaemia
Vitamin D
Thyroid function test - hypothyroidism
Urea and electrolytes - renal function
HbA1C - diabetes

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13
Q

Primary hypothyroidism bloods?

A

High TSH, low T3 and T4

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14
Q

Hypothyroidism symptoms

A

Bradycardia, cold intolerance, dry skin, fatigue, weight gain, constipation
Enlarged thyroid, dry hair, depression, brittle nails, infertility…

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15
Q

T4 production physiology?

A
  1. TSH binds to TSH-R on follicular cells - causes production of thyroglobulin and thyroperoxidase.
  2. Iodide enters colloid through Na+/I- cotrsnsporter.
  3. TPO and H2O2 catalyse iodination of iodide and reaction between TG and iodine.
    Reactions produce MIT and DIT.
  4. Coupling reactions between MIT and DIT with help from TG form T3 and T4.
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16
Q

Most common autoimmune hypothyroidism?

A

Hashimoto’s thyroiditis.

17
Q

Which antigen is considered foreign by immune cells in Hashimoto’s and what is the name of the antibodies?

A

Antigen - TPO
Antibody - anti-TPO

18
Q

Properties of adaptive immune system?

A

Specificity
Memory

NK both adaptive and innate

19
Q

Which cells are looking for the foreign antigens and in what order are other cells activated?

A

Antigen presenting cells find foreign antigen
APC present to T cells
T cells present to B cells

20
Q

Where are MHC I and II located?

A

MHC I on self cells
MHC II on APC

21
Q

Reactions between APC and T cells?

A

APC presents MHC II to TCR on CD4 cells
B7 ligand on APC also detected by CD28 receptor on T cell

B7 only present on APC when it is present with infected cell

22
Q

How do activated T cells find specific B cells?

A

T cell will use TCR to find specific MHC II on B cell.
B cell will then use CD40 receptor to find CD40L on T cell.
These 2 reactions lead to co-stimulation of B cells so activation, maturity and proliferation to produce antibodies (anti-TPO)

CD40L only present on T cells with infected material

23
Q

Why don’t innate immune cells attack host cells?

A

Because they look for PAMPs (pathogen associated molecular patterns)

24
Q

Examples of PAMPs?

A

Peptidoglycan
Lipopolysaccharides
Mannan
Flagella proteins

25
Q

Why don’t NK cells attack host cells?

A

They look for MHC I cells because they are present on all host cells
If no MHC I, NK will go to action

26
Q

What is central tolerance?

A

When B cells (in bone marrow) and T cells (in thymus) come into contact with self antigens.
If they react too strongly to these antigens, they undergo apoptosis (negative selection).
If they don’t react at all to these antigens, they undergo apoptosis.
We want a response but a WEAK response - positive selection.

27
Q

What are Treg cells?

A

Matured in thymus
If they come across a self cell, they dampen immune response.

28
Q

How can autoimmunity happen?

A

Genetic mutations can influence maturation of T cells in the thymus
Molecular mimicry - if the body is trained to remember a certain antigen that looks very similar to a self antigen, it can attack the self antigen.

29
Q

An increase in dietary ______ can worsen autoimmune thyroiditis

A

Iodine

CSI 1b (8 decks)

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