MS1 - Fatigue / Chronic Fatigue Syn (#1)

Fatigue is a subjective feeling of

tired, weak, or lack of energy that can interfere with ADLs

Fatigue can present as all of the following EXCEPT

feeling of euphoria; high energy

What is the main difference between tiredness and fatigue?

Tiredness is usually temporary and can be alleviated by rest, while fatigue is a chronic condition that does not improve with sleep and often persists despite rest.

A silent symptom is a physical or mental s/s of a disease or condition that is

absent or subtle so it is easily overlooked and discovered incidentally during exam

These symptoms are considered silent because

they do NOT cause noticeable outward signs

difficult to detect and measure w/o specific screening

pts who are experiencing fatigue often feel

misunderstood or overlooked

Acute fatigue include all of the following symptoms EXCEPT:

persistent exhaustion or persistent weakness

Chronic fatigue include all of the following EXCEPT:

relieved by rest

The subjective should include all of the following

Therapeutic alliance, key points, roles, goals, and fatigue experience

The activity and function part of the objective should include all of the following EXCEPT

cognition/perception

Body Structure/Impairment part of the objective should include

review of systems

Fatigue part of the objective should include

Description, Impact; 6MWT

Which VAS scale is best to use for a Fatigue Description Measurement?

Horizontal 10cm

What is the diagnosis-specific fatigue measurement tools called?

Chronic Fatigue Syndrome Symptom Severity Questionnaire

______________ measures the functional impact of fatigue

Modified Fatigue Impact Scale - 5

(mFIS-5)

True or False. The 6 min walk test is walking along a curved line between 2 points 60 feet (2 meters) apart for 6 mins.

False. The 6MWT is the distance a patient can walk in a straight line for 6 minutes.

What score the Patient Health Questionnaire-2 (PHQ-2) requires a referal?

2 or more

Patient Health Questionnaire-4 (PHQ-4) =

A screening tool that assesses both depression and anxiety symptoms, consisting of 2 items each from the PHQ-2 and the Generalized Anxiety Disorder-2 (GAD-2).

What do you do if the patient expresses that management is not important or that they are not confident that they can do it?

Acknowledge their feelings, provide education on the benefits of management, and explore barriers to confidence.

Differential diagnosis for physical exertion include

Strenuous exercise, prolonged standing or sitting, or lack of PA

Differential diagnosis for Mental stress

Anxiety, depression, or other psychological factors

Differential diagnosis for Sleep disturbance

Insomnia, sleep apnea, or other sleep disorders

Differential diagnosis for Medical conditions

Anemia, cancer, chronic fatigue syn, multiple sclerosis, thyroid disorders

Differential diagnosis for Medications

Sedatives, antidepressants, chemotherapy drugs

Fatigue Management involves

phys Interventions, cog Strategies, behavioral adaptations

What are the four ps of activity pacing (energy conservation)?

plan, pace, prioritize, position

What is the single, most impactful sleep change that should be implemented?

consistent wake up times

Aerobic exercise has the potential to

improve fatigue

All exercise should start at __________ and be ______ progress.

a very lose dose; slowly

Aerobic Exercise include all of the following EXCEPT

success in unnecessary

Resistance Exercise include all of the following EXCEPT:

isolation of large muscle groups

CHF is also known as

Myalgic Encephalomyelitis (ME)

CFS is characterized by

persistent, unexplained fatigue (chronic fatigue lasts 6 months or longer

What are triggers of CFS?

phys stress, psycho stress, infection/cold, distressing event

What are the hallmark signs and symptoms of CFS?

persistent fatigue >6 months, post exertional malaise (PEM), orthostatic intolerance, muscle weakness, muscle/joint pain, brain fog, headaches, sore throats, fever, fluctuating symptoms

CFS is thought to result from dysregulation between

nervous, immune, hormonal, and autonomic systems

Cognitive involvement of CFS =

decrease in short term memory and concentration, forgetfulness, headaches

CV involvement of CFS =

decrease in BP and/or HR, lightheadedness/dizziness

MSK involvement with CFS =

muscle pain/weakness, joint pain without swelling/redness, possible deconditioning and muscle shortening with prolonged inactivity

Energy/Sleep involvement

increased fatigue, PEM, feeling tired even after a full night's sleep