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NBCE Part 2 Fatigue disease summary
Clinical diagnosis
71
Health Care
Professional
04/10/2013

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Term
endocrine disorder due to failure of the adrenal cortex to function, often autoimmune destruction;
Definition
Addison’s disease:
Term
presents with fatigue, weakness, nausea, vomiting, weight loss, amenorrhea [in females] and decreased libido with hyperpigmentation of skin;
Definition
Addison’s disease:
Term
Na+ will be low and K+ will be high, the Na+:K+ ratio <30:1, cortisol will fail to rise after injection of ACTH.
Definition
Addison’s disease:
Term
Condition characterized by prolonged fatigue which is worse on exertion, unknown etiology;
Definition
Chronic fatigue syndrome:
Term
may present with sore throat, tender cervical lymph nodes, unrefreshing sleep, muscle pain, post-exertional malaise, impaired memory
Definition
Chronic fatigue syndrome:
Term
presents with change in bowel habit either constipation or diarrhea, weight loss;
Definition
Colon cancer:
Term
fecal occult blood will be positive, colonoscopy and biopsy will be diagnostic.
Definition
Colon cancer:
Term
inability of the heart to effectively pump blood out; may be caused by coronary heart disease, hypertension, valvular heart disease or congenital heart defects;
Definition
Congestive Heart Failure:
Term
presents with dyspnea on exertion, paroxysmal nocturnal dyspnea, basal crackles in both lungs, distended jugular veins and bilateral ankle edema;
Definition
Congestive Heart Failure:
Term
BNP >500 pg/dL will confirm the diagnosis
Definition
Congestive Heart Failure:
Term
excess secretion of aldosterone, may be due to an adrenal cortical adenoma or hyperplasia;
Definition
Conn’s disease:
Term
presents with hypertension, headaches, muscle weakness, polyuria and polydypsia;
Definition
Conn’s disease:
Term
hypokalemia, hypernatremia with elevated serum aldosterone levels; CT scan will confirm the diagnosis.
Definition
Conn’s disease:
Term
excessive cortisol secretion may be due to an ACTH-secreting pituitary adenoma or exogenous steroids;
Definition
Cushing’s disease/syndrome:
Term
presents with truncal obesity, moon face, buffalo hump, purple abdominal striae with recurrent infections;
Definition
Cushing’s disease/syndrome:
Term
hypokalemia, hypernatremia, elevated cortisol levels;
Definition
Cushing’s disease/syndrome:
Term
CT scan of the skull or abdomen may show the secreting tumor in the sella turcica or the abdomen tumor.
Definition
Cushing’s disease/syndrome:
Term
mental illness involving the body, thoughts and moods;
Definition
Depression:
Term
may present with at least 4 of the following: sleep disturbance, interest loss, guilt feelings, energy lack, poor concentration, appetite change, psychomotor retardation or agitation or suicidal thoughts plus sadness for at least two weeks; all blood tests are normal.
Definition
Depression:
Term
loss of ADH secretion, often associated with head trauma;
Definition
Diabetes insipidus:
Term
presents with polyuria, polydypsia due to intense thirst; unable to concentrate the urine even after water deprivation, urine has a constant specific gravity <1.006.
Definition
Diabetes insipidus:
Term
polyuria, polydypsia and polyphagia with complications such as peripheral neuropathy and pre-senile cataracts;
Definition
Diabetes mellitus:
Term
FBS >126 mg/dL.
Definition
Diabetes mellitus:
Term
chronic widespread musculoskeletal pain disorder of unknown origin, mainly in women;
Definition
Fibromyalgia
Term
presents with 11 out of 18 tender points with fatigue and unrefreshing sleep; all blood tests are normal.
Definition
Fibromyalgia
Term
autosomal recessive disorder resulting in increase accumulation of iron in the body;
Definition
Hemochromatosis:
Term
presents with fatigue, polyuria, polydypsia with increased skin pigmentation, joints pains and decreased libido;
Definition
Hemochromatosis:
Term
excessive serum iron levels, beak-like osteophytes at the radial margins of metacarpal heads on x-ray of the hands.
Definition
Hemochromatosis:
Term
associated with RNA retroviral infection,sexually transmitted or contaminated blood transfusions,
Definition
HIV/AIDS:
Term
presents with initially as a flu-like illness and later with recurrent infections with opportunistic organisms such as Pneumocystis jiroveci [pneumonia], Cryptosporidium parvum [diarrhea] or HHV Type 8 [Kaposi sarcoma];
Definition
HIV/AIDS:
Term
ELISA and Western Blot tests will be positive.
Definition
HIV/AIDS:
Term
overactive thyroid gland with excess production of thyroxin;
Definition
Hyperthyroidism:
Term
presents with a goiter, tachycardia, bilateral exophthalmos and a fine tremor of the outstretched hands.
Definition
Hyperthyroidism:
Term
T3 and T4 will be high and TSH will be low
Definition
Hyperthyroidism:
Term
[Graves disease].
Definition
Hyperthyroidism:
Term
Hashimoto’s autoimmune thyroiditis;
Definition
Hypothyroidism:
Term
presents with fatigue, weight gain, hoarse voice, coarse brittle hair, constipation, goiter, loss of the outer third of the eyebrows and slow to relax deep tendon reflexes [Woltman’s sign];
Definition
Hypothyroidism:
Term
T3 and T4 are low and TSH is high
Definition
Hypothyroidism:
Term
decreased hemoglobin and red blood cell count due to either iron deficient diet or excessive blood loss from heavy menstrual periods or from the GI tract;
Definition
Iron deficiency anemia:
Term
presents with fatigue, pallor, koilonychia; microcytic hypochromic anemia.
Definition
Iron deficiency anemia:
Term
multisystem disorder resulting from excess exposure to lead found in paint or industrial fumes;
Definition
Lead poisoning:
Term
presents with fatigue, anemia, blue gum line, clumsiness, difficult behavior and epileptic seizures or emesis [vomiting];
Definition
Lead poisoning:
Term
microcytic hypochromic anemia with basophilic stippling of red blood cells, thick transverse radiodense metaphyseal line [lead line].
Definition
Lead poisoning:
Term
malignant white blood cell disease; may be a genetic predisposition-Philadelphia chromosome in CML
Definition
Leukemia:
Term
presents with fatigue, weight loss, generalized lymphadenopathy, splenomegaly, recurrent infections or bleeding gums;
Definition
Leukemia:
Term
WBC count > 25,000/mm3 and thrombocytopenia, bone biopsy will confirm the diagnosis.
Definition
Leukemia:
Term
malignant lung tumor, more common in smokers, males>females;
Definition
Lung cancer:
Term
presents with fatigue, chronic cough, hemoptysis and weight loss; chest x-ray will show an irregular mass;
Definition
Lung cancer:
Term
biopsy will confirm the diagnosis.
Definition
Lung cancer:
Term
may be Hodgkin’s or non-Hodgkin’s type, may be related to HHV type 4 [EBV];
Definition
Lymphoma:
Term
presents with fatigue, painless cervical lymphadenopathy, anemia, weight loss, cyclical [Pel Epstein] fever, night sweats, shortness of breath or recurrent infections;
Definition
Lymphoma:
Term
biopsy is diagnostic-Reed Sternberg cells=Hodgkin’s lymphoma.
Definition
Lymphoma:
Term
chronic autoimmune neuromuscular junction disorder, seen more commonly in middle-aged females;
Definition
Myasthenia gravis:
Term
presents bilateral ptosis, diplopia, difficulty in chewing an fatigue worse towards the evenings;
Definition
Myasthenia gravis:
Term
Acetylcholine antibodies are present, Tensilon [edrophonium] injection relieves the ptosis transiently.
Definition
Myasthenia gravis:
Term
upper airway obstruction at night, seen in overweight males with very short necks;
Definition
Obstructive sleep apnea:
Term
excessive snoring with repeated episodes of no breathing for more than 10 seconds;
Definition
Obstructive sleep apnea:
Term
daytime sleepiness, headaches; diagnosis should be confirmed in a sleep lab.
Definition
Obstructive sleep apnea:
Term
metabolic bone disorder characterized by repeated episodes of osteolysis and excessive but ineffective osteoblastic activity, may be caused by a paramyxo viral infection;
Definition
Paget’s disease of the bone:
Term
presents with fatigue, increased hat size, visual or hearing defects; cotton wool appearance in the skull.
Definition
Paget’s disease of the bone:
Term
Vitamin B12 deficiency due to lack of Intrinsic Factor caused by autoimmune destruction of the parietal cells in the stomach;
Definition
Pernicious anemia:
Term
presents with fatigue, beef tongue, paresthesia in the fingers and toes or problems with balance;
Definition
Pernicious anemia:
Term
macrocytic normochromic anemia with low Vitamin B12 serum levels.
Definition
Pernicious anemia:
Term
chronic multisystem disease of unknown origin, characterized by non-caseous granulomas;
Definition
Sarcoidosis
Term
presents with fatigue, dyspnea; hypercalcemia, chest x-ray will show bilateral hilar lymphadenopathy.
Definition
Sarcoidosis
Term
damage to the sinoatrial node due to ischemic heart disease;
Definition
Sick Sinus Syndrome:
Term
may present with episodes of tachycardia alternating with bradycardia;
Definition
Sick Sinus Syndrome:
Term
ECG is diagnostic-alternating runs of tachycardia and bradycardia.
Definition
Sick Sinus Syndrome:
Term
a chronic infection caused by Mycobacterium tuberculosis, characterized by Ghon focus and complex with caseous necrosis and granulomas;
Definition
Tuberculosis:
Term
presents with cough, night sweats, fever, hemoptysis and weight loss;
Definition
Tuberculosis:
Term
chest x-ray may show apical consolidation and cavitation; sputum with show Ziehl Neelsen staining bacilli which grow best in the Lowenstein Jensen medium.
Definition
Tuberculosis:
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