FATIGUE, ASTHENIA AND DEPRESSION

Question 1

refers to the universally familiar state
of weariness or exhaustion resulting from physical or
mental exertion.

Answer 1

Fatigue

Question 2

although it connotes more of an inability or disinclination

to be active, physically or mentally.

Answer 2

Lassitude

Question 3

Meaning of fatigue

(1) biochemical and physiologic changes in muscles and a reduced capacity to generate force manifest as __________
(2) a disorder in behavior, taking the form of a reduced output of work____________ or a lack of endurance; and
(3) a subjective feeling of tiredness and discomfort.

Answer 3

weakness, or asthenia;

(work decrement

Question 4

findings associated with neurasthenia

Answer 4

The usual associated
symptoms are anxiety, irritability, depression, insomnia,
headaches, dizziness, difficulty in concentrating, reduced
sexual drive, and loss (or sometimes increase) of appetite

Question 5

fatigue and intolerance of exercise (i.e.,
fatigue with mild exertion) are prominent manifestations
of __________

Answer 5

myopathic disease

Question 6

type of glycogen storage disease, __________________is exceptional in that fatigue and weakness are
accompanied by pain and sometimes by cramps and contracture

Answer 6

McArdle phosphorylase

deficiency,

Question 7

___________is at times associated with disproportionate
weakness and fatigue of respiratory muscles,
which leads to dyspnea and retention of carbon dioxide

Answer 7

acid

maltase deficiency,

Question 8

__________ is a common complaint among patients with postconcussive
syndrome

Answer 8

Inordinate

fatigue

Question 9

drugs associated with fatigue

Answer 9

beta-adrenergic
blocking agents, antiepileptics, antispasticity drugs, anxio­
lytics, chemotherapy and radiation therapy and, paradoxically,
many antidepressant and antipsychotic drugs.

Question 10

complains of severe fatigue for many months or even
years after a bout of infectious mononucleosis or some
other viral illness

Answer 10

postviral fatigue syndrome.

Question 11

what is chronic fatigue syndrome

Answer 11

disabling fatigue for at least 6 months,

coupled with an arbitrary number (6 or 8) of persistent or recurrent somatic and neuropsychologic symptoms including low-grade fever, cervical or axillary lymphadenopathy, myalgias, migrating arthralgias, sore throat, forgetfulness, headaches, difficulties in concentration and thinking, irritability,
and sleep disturbances

Question 12

the
___________ is the structure most implicated by the loss
of endurance and the presence of associated symptoms
such as orthostatic intolerance, tachycardia and some of
the endocrine changes

Answer 12

hypothalamus

Question 13

best tx for fatigue syndrome

Answer 13

They are probably best treated with
gradually increasing exercise levels and perhaps with
antidepressant medication

Question 14

In the _______________ the patient is suddenly overwhelmed
by feelings of apprehension, or a fear that he
may lose consciousness and die, have a heart attack or
stroke, lose his reason or self-control, become insane,
or commit some horrible crime

Answer 14

panic attack,

Question 15

Episodic o r sustained anxiety without a disorder of

mood (i.e., without depression) is classified as __________ or formerly, anxiety neurosis

Answer 15

generalized

anxiety disorder,

Question 16

Symptoms of persistent anxiety
with insomnia, lassitude, and fatigue should always raise
the suspicion of a ___________ especially when they begin in middle adult life or beyond

Answer 16

depressive illness,

Question 17

An extremely stressful, or traumatic event that causes
fear and helplessness, triggers a persistent psychological
state in which the patient reexperiences the event, avoids
reminders of it, and is in a constant state of hyperarousal

Answer 17

Posttra u m atic St ress D i s o r d e r ( PTS D )

Question 18

difference between PTSD and anxious depression

Answer 18

the critical difference

being the existence of a triggering traumatic event.

Question 19

The biologic distinctions that have been made
between anxious depression and PTSD include lower than normal _________ levels, an attenuated increase of
these levels in the immediate aftermath of the event, and
an exaggerated __________ in response to dexamethasone

Answer 19

cortisol

suppression

Question 20

initial meds for PTSD

Answer 20

Selective serotonin reuptake inhibitors

Question 21

feeling of self-doubt about
being able to cope with some situation over a period of
time

Answer 21

stress

Question 22

The term ________ refers to perturbations of
behavior and accompanying physiologic changes that are ascribable to environmental challenges of such intensity
and duration as to overwhelm the individual’s adaptive
capacity.

Answer 22

stress syndrome

Question 23

The dramatic syndrome of ballooning of the left
ventricular apex, or ___________(sonamed for the shape of the Japanese octopus trapping
pot), is a manifestation of catecholamine excess caused
by acute stress

Answer 23

takotsubo-like cardiomyopathy

Question 24

Irritability

is also a common symptom of________

Answer 24

obsessive-compulsive disorders.

Question 25

Short-temperedness

and irritability are also common features of the_________

Answer 25

manic

state.

Question 26

suggests that the dominant
feature of the experience of anxiety is simply the physical
experience of the associated autonomic discharge

Answer 26

James-Lange theory of emotion

Question 27

During periods of intense anxiety, _______

excretion is increased to 2 or 3 times normal.

Answer 27

aldosterone

Question 28

In addition to the role of the amygdala, animal studies
have related acute anxiety to a disturbance of function
of the ________ and _________ the principal norepinephrine-containing nuclei.

Answer 28

locus ceruleus and the septal and hippocampal

areas,

Question 29

the role for the _________ in eliciting many of the autonomic
features (particularly increased heart rate) of excessive
arousal and anxiety

Answer 29

anterior

cingulate gyrus

Question 30

most cases formerly
diagnosed as ________ are now regarded as
depression with superimposed anxiety

Answer 30

hypochondriasis