Fatigue
Fatigue
It is the excessive tiredness on exertion.The severe form of fatigue is known as ‘exhaustion’.
Common Causes
1.Physiological– overwork, insomnia.
2.Pathological–
Nutritional Deficiency, Dyselectrolytaemia
Congestive cardiac failure (CCF), Hepatic Failure, Uraemia, Malignancy, Immunocompromised States, Sleep-Apnoea Syndrome
Myxoedema, Diabetes Mellitus, Addison’s Disease, Thyrotoxicosis
Tuberculosis, Brucellosis, Post-Viral Infectious States (e.g. Influenza Or Infectious Mononucleosis), Collagen Vascular Diseases (e.g. SLE)
Anaemia, Lymphoma And Leukaemias
Multiple Sclerosis, Myasthenia Gravis, Myopathies, Poliomyelitis
Drugs— beta- Blockers, Sedatives, Corticosteroids, alpha- Methyldopa, Antihistaminics, Anti-Epileptic Drugs
3.Functional (At least in 50% cases The Cause Is Functional)– Anxiety, Sleep Disorders, Depression, Chronic Fatigue Syndrome
Underlying Mechanism
1.Accumulation Of Lactic Acid In Muscles And Circulation
2.Deficiency Of Oxygen
3.Creatinine Depletion From Muscles
Clue To Diagnosis
1.More at rest, disappears on activity, clinically WNL, investigations NAD → Functional.
2.Cachexia with the loss of weight → tuberculosis, haematological or systemic malignancy.
3.Tremor + muscle cramps → dyselectrolytaemia.
4.Females in their 20-50 years of age, fatigue after minimal exertion → chronic fatigue syndrome.
5.Hypotension + hyperpigmentation → Addison’s disease.
6.↑ Appetite + weight loss → thyrotoxicosis.
7 Polyuria + polyphagia + polydipsia → diabetes mellitus (fatigue may be presenting complaint).
8.Frequent awakening at night + snoring + pauses in breathing during sleep + daytime sleepiness → sleep-apnoea syndrome.
9.Recent H/O viral illness + tiredness → post-viral (goes away after few weeks or month).
10.Early morning wake-up + tiredness maximum in the morning which persists all along the day + anorexia → depression.
Treatment
1.Graded exercise programme
2.Treatment of underlying aetiology
3.Psychotherapy (e.g. in case of CFS)
4.Antidepressants (e.g. SSRI), tranquillizers, anti-anxiety drugs (e.g. clonazepam, buspirone), vitamins and electrolytes powder as and when necessary.
» This post is written for the purpose of solving MCQs. Not for other use
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