NURS 665 Exam 3
Chronic Fatigue Syndrome Diagnosis - answer-Clinical diagnosis based on over 6
months of new and significant fatigue that is not relieved by adequate rest and sleep
and which is exacerbated in a delayed fashion by any physical, mental and emotional
over-activity.
- Onset of symptoms develop after a viral or other infection and often during a period of
increased psychosocial stress.
- Routine tests for hematological and biochemical dysfunction, endocrinopathy,
inflammation, autoimmunity and immune deficiency are normal.
Chronic Fatigue Syndrome (CFS) - answer Tiredness, sleep affected, sensitivity to light
and sound
· Flu like illnesses
· Myalgia/fatigued, feel worn out
· Headaches
· Pharyngitis
· Low-grade fever
· Cognitive complaints
· GI symptoms
· Tender lymph nodes but no enlargement - often dismissed by medical
· Often accompanied by non-restorative sleep, headaches, hypersensitivity to lights and
sounds, impaired concentration and short term memory.
Treatment of Chronic Fatigue Syndrome - answer· Pharmacological - antidepressants,
symptomatic treatment such as analgesics for muscular pain - NSAIDS not effective
· Non-pharmacological - reduce workload, encourage daily activities and resist fatigue,
frequent rest periods, validating complaints
o CBT (overcome and correct mistaken beliefs such as fear that any activity causing
fatigue worsens the disorder), self help groups (group dynamics help), vitamins,
minerals, herbal products
Fibromyalgia - answer· pain and 3 month duration (know timeline and symptoms)
o Constant dull widespread pain that lasts more than three months
o Affects sleep, increased sensitivity to odors, noise, bright lights, or temperature
o Stiffness and muscle tenderness
o TX-lyrica, gabapentin (off-label), cymbalta
Abuse - answerTaking/using more than intended, treating an ailment
Cross-tolerance - answer-tolerance for a substance one has not taken before as a result
of using another substance similar to it
-tolerance built up for one substance increased it for another (ETOH and benzos)
, Detoxification - answerRidding the body of a toxin/substance, a set of interventions to
do manage it
Misuse - answerTaking/using to elicit a feeling (no pain or ailment involved)
Tolerance - answerThe diminishing effect with regular use of the same dose of a drug,
requiring the user to take larger and larger doses before experiencing the drug's effect
Withdrawal - answerPhysical response to a substance when it has stopped. diagnosis
used to describe a substance-specific syndrome that results from the abrupt cessation
of heavy and prolonged use of a substance.
As with substance use disorder, in practice, the specific substance is identified, for
example, "alcohol withdrawal" or "opioid withdrawal."
Duration is specific to substance
Dependence - answerA state in which there is a compulsive or chronic need, as for a
drug. Example- caffeine
Neurotransmitters in Addiction - answer· The primary neurotransmitters possibly
involved in developing substance use disorders are the opioid, catecholamine (mainly
dopamine), and GABA systems.
-The dopaminergic neurons in the ventral tegmental area (VTA) are important. These
neurons project to the cortical and limbic regions, especially the nucleus accumbens.
-This pathway is involved in the sensation of reward and may represent the primary
mediator of the effects of such substances as amphetamine and cocaine.
-The locus ceruleus, the largest group of adrenergic neurons, probably mediates the
effects of the opiates and the opioids. -These pathways have collectively been called
the brain-reward circuitry.
Pathways in Addiction - answerAmygdala and nucleus accumbus (reward pathway
Neurotransmitters involved in amphetamine/stimulant use disorders - answer-Dopamine
-GABA
Substance Use Disorder - answer-Continued substance craving and use despite
significant life disruption and/or physical risk
-MUST cause impairment and severity specifiers is measured by number of symptoms
present (mild 2-3, moderate 4-5, severe 6 and above)
Timeline for signs and symptoms of alcohol withdrawal - answer· Stage 1 mild
symptoms
-Tremors
-6-8 hours after last drink
· Stage 2 moderate symptoms
-Percepetual disturbances
Chronic Fatigue Syndrome Diagnosis - answer-Clinical diagnosis based on over 6
months of new and significant fatigue that is not relieved by adequate rest and sleep
and which is exacerbated in a delayed fashion by any physical, mental and emotional
over-activity.
- Onset of symptoms develop after a viral or other infection and often during a period of
increased psychosocial stress.
- Routine tests for hematological and biochemical dysfunction, endocrinopathy,
inflammation, autoimmunity and immune deficiency are normal.
Chronic Fatigue Syndrome (CFS) - answer Tiredness, sleep affected, sensitivity to light
and sound
· Flu like illnesses
· Myalgia/fatigued, feel worn out
· Headaches
· Pharyngitis
· Low-grade fever
· Cognitive complaints
· GI symptoms
· Tender lymph nodes but no enlargement - often dismissed by medical
· Often accompanied by non-restorative sleep, headaches, hypersensitivity to lights and
sounds, impaired concentration and short term memory.
Treatment of Chronic Fatigue Syndrome - answer· Pharmacological - antidepressants,
symptomatic treatment such as analgesics for muscular pain - NSAIDS not effective
· Non-pharmacological - reduce workload, encourage daily activities and resist fatigue,
frequent rest periods, validating complaints
o CBT (overcome and correct mistaken beliefs such as fear that any activity causing
fatigue worsens the disorder), self help groups (group dynamics help), vitamins,
minerals, herbal products
Fibromyalgia - answer· pain and 3 month duration (know timeline and symptoms)
o Constant dull widespread pain that lasts more than three months
o Affects sleep, increased sensitivity to odors, noise, bright lights, or temperature
o Stiffness and muscle tenderness
o TX-lyrica, gabapentin (off-label), cymbalta
Abuse - answerTaking/using more than intended, treating an ailment
Cross-tolerance - answer-tolerance for a substance one has not taken before as a result
of using another substance similar to it
-tolerance built up for one substance increased it for another (ETOH and benzos)
, Detoxification - answerRidding the body of a toxin/substance, a set of interventions to
do manage it
Misuse - answerTaking/using to elicit a feeling (no pain or ailment involved)
Tolerance - answerThe diminishing effect with regular use of the same dose of a drug,
requiring the user to take larger and larger doses before experiencing the drug's effect
Withdrawal - answerPhysical response to a substance when it has stopped. diagnosis
used to describe a substance-specific syndrome that results from the abrupt cessation
of heavy and prolonged use of a substance.
As with substance use disorder, in practice, the specific substance is identified, for
example, "alcohol withdrawal" or "opioid withdrawal."
Duration is specific to substance
Dependence - answerA state in which there is a compulsive or chronic need, as for a
drug. Example- caffeine
Neurotransmitters in Addiction - answer· The primary neurotransmitters possibly
involved in developing substance use disorders are the opioid, catecholamine (mainly
dopamine), and GABA systems.
-The dopaminergic neurons in the ventral tegmental area (VTA) are important. These
neurons project to the cortical and limbic regions, especially the nucleus accumbens.
-This pathway is involved in the sensation of reward and may represent the primary
mediator of the effects of such substances as amphetamine and cocaine.
-The locus ceruleus, the largest group of adrenergic neurons, probably mediates the
effects of the opiates and the opioids. -These pathways have collectively been called
the brain-reward circuitry.
Pathways in Addiction - answerAmygdala and nucleus accumbus (reward pathway
Neurotransmitters involved in amphetamine/stimulant use disorders - answer-Dopamine
-GABA
Substance Use Disorder - answer-Continued substance craving and use despite
significant life disruption and/or physical risk
-MUST cause impairment and severity specifiers is measured by number of symptoms
present (mild 2-3, moderate 4-5, severe 6 and above)
Timeline for signs and symptoms of alcohol withdrawal - answer· Stage 1 mild
symptoms
-Tremors
-6-8 hours after last drink
· Stage 2 moderate symptoms
-Percepetual disturbances
