Chapter: Medicine Study Notes : Patient Management

Tiredness Examination - Patient Management

Sleep disturbance: eg anxiety, sleep apnoea, narcolepsy,

Tiredness

· Differential:

· Sleep disturbance: eg anxiety, sleep apnoea, narcolepsy,

o Depression

o Anaemia

o Endocrine: hypothyroidism, hypocortisol (Addison‟s), diabetes, hypercalcaemia (due to PTH)

o Infection (eg EBV)

o Cancer

o Drugs: alcohol intoxication, sedative drugs,

o Head injury (eg subdural haematoma)

o Post ictal states

o Hypoglycaemia

o Hepatic encephalopathy, Wernicke‟s encephalopathy

o Chronic heart failure

o Malabsorption (eg coeliac disease)

o Pregnancy

· Sleepiness

· Varies according to circadian cycle: two sleep gates each day, 2 – 3 pm and 10 – 11 pm (correlates with melatoin)

· Obstructive sleep apnoea is the most common cause of excessive sleepiness. ® MVA (driving drowsy is the same as driving drunk)

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Medicine Study Notes : Patient Management : Tiredness Examination - Patient Management |