Tiredness Flashcards

1
Q

What are 10 medical reasons for feeling tired?

A
  1. Anaemia
  2. Sleep apnoea
  3. Underactive thyroid
  4. Coeliac disease
  5. Chronic fatigue syndrome
  6. Diabetes
  7. Glandular fever
  8. Depression
  9. Restless legs
  10. Anxiety
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2
Q

What is Anaemia?

A
  1. iron deficiency anaemia
    - ulceror takingnon-steroidal anti-inflammatory drugs (NSAIDs), pregnancy, heavy periods
  2. muscles feel heavy, and you get tired very quickly.
  3. possible to have too much iron, which can also cause tiredness, when it’s known as iron-overload disorder (haemochromatosis).
    - rare inherited condition that affects men and women between the ages of 30 and 60
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3
Q

What is Sleep apnoea?

A
  1. throat narrows or closes during sleep and repeatedly interrupts your breathing.
  2. Results inloudsnoringand a drop in your blood’s oxygen levels.
  3. difficulty in breathing means you wake up often in the night and feel exhausted the next day
    - most common in overweight middle-aged men
    - Drinking alcohol and smoking makes it worse
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4
Q

What is an underactive thyroid?

A
  • too little thyroid hormone (thyroxine) in your body. -This makes you feel tired.
  • likely to put on weight and have aching muscles and dry skin
  • most common in women and happens more often as you get older.
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5
Q

What is coeliac disease?

A
  • lifelong disease caused by the immune system reacting to gluten
  • Gluten is a protein found in bread, cakes and cereals.
  • Other symptoms of coeliac disease, apart from tiredness, are diarrhoea, bloating, anaemia and weight loss
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6
Q

What is chronic fatigue syndrome?

A
  1. (also known as myalgic encephalomyelitis, or ME) is a severe and disabling fatigue that goes on for at least 4 months
  2. may be other symptoms, such as muscle or joint pain
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7
Q

What is diabetes?

A
  • One of the main symptoms of type 1 and type 2 diabetes is feeling very tired.
  • Other key symptoms are feeling very thirsty, peeing a lot (particularly at night) and weight loss
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8
Q

What is glandular fever?

A
  • common viral infection that causes fatigue, along with fever,sore throatandswollen glands.
  • Most cases happen in teenagers and young adults.
  • Symptoms usuallyclear up within4 to6 weeks, but the fatigue can linger for several more months.
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9
Q

What is depression?

A
  • As well as making you feel very sad, depression can also make you feel drained of energy.
  • It can stop youfalling asleep or cause you to wake up early in the morning, which makes you feel more tired during the day.
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10
Q

What is restless legs?

A
  • This is when you get an overwhelming urge to move your legs, which can keep you awake at night
  • You might also have an unpleasant crawling sensation or a deep ache in your legs. Or your legs might jerk spontaneously through the night.
  • Whatever your symptoms, your sleep will be disrupted and poor quality, so you’ll feel very tired throughout the day.
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11
Q

What is anxiety?

A

-Feeling anxious is sometimes perfectly normal.
-But some people have constant uncontrollable feelings of anxiety that are so strong they affect their daily life.
-Doctors call this generalised anxiety disorder (GAD).
-It’s a common condition, affecting slightly more women than men. As well as feeling worried and irritable, people with GAD often feel tired.
Read more aboutanxiety.

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12
Q

What % of patients with fatigue receive a diagnosis?

A

around 66%

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13
Q

What % of patients with fatigue receive a diagnosis through blood tests?

A

<10%

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14
Q

What are symptoms of hypothyroidism?

A
  1. Slow heartbeat
  2. Cold intolerance
  3. Dry skin
  4. Fatigue
  5. WeIght gain
  6. Consitpation
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15
Q

What is a mechanism by which the immune system attacks thyroid cells?

A

Hashimoto’s disease

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16
Q

How do you sift out physical causes of tiredness?

A
  1. Define type of tiredness: drowsiness, short of breath, weakness
  2. Why did this patient present?
  3. Screen for red flags
  4. Explore any psychosocial factors
  5. Examine patient
  6. Plan
17
Q

What are some red flags?

A
  1. Lymphadenopathy
  2. Weight loss
  3. Specific malignancy features - 4. focus on lung, breast, colon, upper GI and gynae
  4. Joint pains
  5. Focal neurology
  6. Infective symptoms: TB, 8. Glandular fever and Lyme
18
Q

What are initial blood?

A
  1. FBC: not just for anaemia but also iron deficiency, and haematological malignancy.
  2. Thyroid function
  3. ESR
  4. Glucose
19
Q

What are the most likely causes of undertactive thyroid?

A
  • Autoimmune
  • can be damaged by surgery, radiotherapy, some medicine or another medical problems and some women develop an underactive thyroid after they give birth (often temporary)
20
Q

What are the symptoms of underactive thyroid?

A
  1. Feeling tired/depressed
  2. . Thinking more slept or less clearly than usual
  3. Having dry skin
  4. Putting on weight
  5. Feeling the cold more than usual
  6. Having constipation
  7. Getting irregular periods, if your a women
21
Q

What are the symptoms like after a few months or years?

A
  1. Having very dry flaky skin
  2. Have coarse hair, or lose some of your hair
  3. Put on weight, even though you are not eating any more food than usual
  4. Feeling depressed
  5. Feeling sluggish and din it difficult to think clearly
  6. Have a hoarse voice
22
Q

How do you take levothyroxine?

A
  • Take on tablet a day on empty stomach - most before breakfast
  • Dose adjusted so not too much and start low and gradually increase and check with regular blood tests
  • May be several weeks before notice any difference, but should make you feel less tired and sluggish and if constipated or depressed these symptoms should improve
23
Q

What can happen if the dose is too high?

A
  • Atrial fibrillation

- Bones too thin

24
Q

What results are associated with an underactive thyroid?

A
  1. High TSH

2. Low FT4

25
Q

What result is subclinical hypothyroidism?

A
  1. Slightly raised TSH

2. Normal FT4

26
Q

What happens if pregnant?

A

Increase dose by 25-50mcg daily