Tiredness and Fatigue Flashcards
The commonest cause of tiredness is______
psychological distress, including anxiety states, depression and somatisation disorder
An Australian study showed that fatigue presents at
a rate of __________
1.4 per 100 encounters
Prolonged or chronic tiredness is characterised
clinically by ________
disabling tiredness, typically lasting more than 2 weeks, associated with nonrestorative sleep, headaches and a range of other musculoskeletal and neuropsychiatric symptoms
_______is defined as
debilitating fatigue, persisting or relapsing over 6
months, associated with a significant reduction in
activity levels of at least 50%, and for which no
other cause can be found
Chronic fatigue syndrome (CFS)
What are the red flags for tiredness?
- Unexplained weight loss
- Sleep disturbance
- Symptoms of depression
- Drug and alcohol abuse
- Persistent fever
T or F
Overweight children are likely to fatigue more
rapidly than children of normal weight
T
_________causing
recurrent episodes of fever, pharyngitis, malaise and
adenopathy can occur, especially in teenagers, who
present with chronic exhaustion that is frequently
mistaken for malignancy
Chronic EBV infection
When should the bereavement stage should have been compensated?
With
time, usually around 6 to 12 months, a compensated
stage is reached, fatigue gradually abates, and the
patient resumes normal activities
Factors leading to ‘abnormal grief
reaction’,
• unexpected death
• high dependence upon the dead person
• guilt feelings, especially in a love/hate
relationship
Burnout is a clinical syndrome with three components:
1
2
3
- long-term emotional exhaustion
- depersonalisation of others and
- lack of personal accomplishment
How does burn out differ with stress-related depression
It is similar to stress-related depression but mood
lowering is temporary and work-specific
ICD classifies burn out as?
‘problems related to life management’ as a
‘state of vital exhaustion’
_______syndrome that arises when a person who has a
strong neurotic need to succeed in a particular task
becomes confronted with the impossibility of success
in that task
burnout
Mx of burnout
Management involves appropriate counselling, which
aims to help the patient to identify life stressors, set
realistic personal goals and develop good support
mechanisms.
This complex syndrome, which causes profound
and persistent tiredness, is also referred to as
myalgic encephalomyelitis, chronic neuromuscular
viral syndrome, postviral syndrome, chronic
EBV syndrome, viral fatigue state, epidemic
neuromyasthenia, neurasthenia, Icelandic disease,
Royal Free disease and Tapanui disease
Chronic fatigue syndrome
What are the Typical features of CFS
- extreme exhaustion (with minimal physical effort)
- headache or a vague ‘fuzzy’ feeling in the head
- aching in the muscles and legs
- poor concentration and memory
- hypersomnia or other sleep disturbance
- waking feeling tired
Other features of CFS
• emotional lability/anxiety • depressive-type illness, mood swings • arthralgia (without joint swelling) • sore throat • subjective feeling of fever (with a normal temperature
What virus is CFS related to?
Epidemiologically it has been related to Coxsackie
B virus infections
Mechanism of CFS
Immune system dysfunction with
chronic overproduction of cytokines (e.g. interferon)
is a possible pathogenetic mechanism
Duration of sx for CFS
6 mos
PE findings for CFS
Apart from mild pharyngeal infection, cervical
lymphadenopathy or localised muscle tenderness, the
physical examination is normal
What Tx may work for CFS
Cognitive behaviour therapy appears to help some
patients, as do relaxation therapy, meditation, stress
management and psychotherapy, where indicated
What is the emphasis in the Mx of CFS?
The emphasis should be placed on caring, rather
than curing, until a scientific solution is found
_________affects 5% of the American
population with a peak age of 35 years (range 20–60)
and a female:male ratio of 10:1. T
he management is similar to CFS but the prognosis less optimistic
Fibromyalgia
