Week 19 - Fatigue

Question 1

What are some respiratory causes of fatigue ?

Answer 1

• sleep apnoea
• acute infection etc pneumonia
• chronic resp diseases like COPD, Bronchiectasis…

Question 2

What are some cardiac causes of fatigue ?

Answer 2

Any chronic cardiac disease e.g heart failure

Question 3

What are some haematological causes of fatigue ?

Answer 3

• anaemia
• lymphoma
• leukaemia

Question 4

What are some endocrine causes of fatigue ?

Answer 4

• hypothyroidism
• diabetes

Question 5

What are some musculoskeletal causes of fatigue ?

Answer 5

• MS
• MND
  …. Any chronic musculoskeletal condition

Question 6

What are some GI causes of fatigue ?

Answer 6

• coeliac disease
• IBD (Crohns or UC)
• malignancy
• hepatitis B or C (chronic)

Question 7

What are some neuro causes of fatigue ?

Answer 7

• stroke
• parkinsons
• MS

Question 8

What are some gynae causes of fatigue ?

Answer 8

• heavy menstruation (can cause anaemia)
• pregnancy

Question 9

What are some psychological causes of fatigue ?

Answer 9

• anxiety
• depression
• poor sleep etc

Question 10

What blood tests are involved in the ‘tired all the time tests’

Answer 10

• FBC
• TFTs
• Vit D levels
• renal function (U+Es)
• coeliac disease autoantibodies IgA tissue transglutaminase

Question 11

What type of anaemia is iron deficiency anemia ?

Answer 11

Microcytic anaemia

(small cell)

Question 12

What type of anaemia is early iron deficiency anemia ?

Answer 12

Normocytic anaemia

Question 13

What type of anaemia is acute blood loss, in terms of RBC size ?

Answer 13

Normocytic anaemia

Question 14

What type of anaemia is folate deficiency anemia ?

Answer 14

Macrocytic anaemia (megaloblastic)

Question 15

What type of anaemia is B12 deficiency anemia ?

Answer 15

Macrocytic anaemia (megaloblastic)

Question 16

What type of anaemia is seen in alcoholism, in terms of RBC size ?

Answer 16

Macrocytic anaemia (non-megaloblastic)

Question 17

What type of anaemia is seen in liver disease, in terms of RBC size ?

Answer 17

Macrocytic anaemia (non-megaloblastic)

Question 18

What type of anaemia is seen in sickle cell disease, in terms of RBC size ?

Answer 18

Normocytic anaemia

Question 19

What type of anaemia is seen in malaria, in terms of RBC size ?

Answer 19

Normocytic anaemia

Question 20

What type of anaemia is seen in thalassemia, in terms of RBC size ?

Answer 20

Microcytic anaemia

Question 21

What type of anaemia is seen in renal disease, in terms of RBC size ?

Answer 21

Normocytic anaemia

Question 22

What type of anaemia is seen in haemolytic anaemia, in terms of RBC size ?

Answer 22

Normocytic anaemia

Question 23

What signs of iron deficiency anaemia could you see on a blood film ?

Answer 23

• Hypochromic RBCs
• pencil cells

Question 24

What signs of folate/B12 deficiency anaemia could you see on a blood film ?

Answer 24

Hyper segmented neutrophils

Question 25

What are the causes of iron deficiency anemia ?

Answer 25

• dietary origin (lack of red meat or green veggies in diet)
• GI blood loss
• menstruation (heavy)

Question 26

In patients with iron deficiency anaemia, what would constitute red flag symptoms and require a 2WW referral to exclude cancer ?

Answer 26

• aged over 40 + weight loss + abdo pain
• aged over 50 + rectal bleeding
• aged over 60 + change in bowel habit

Anyone testing positive for blood in stool or with rectal/abdominal mass

Anyone with rectal bleeding AND…
- abdominal pain,
- altered bowel habit
- weight loss
- iron deficiency anemia