Medscape: Quiz: How Much Do You Know About Chronic Fatigue Syndrome?

[Never Give Up]

Physician education has begun.

New link: http://reference.medscape.com/viewarticle/854962

Sign in, or sign up and then sign in to view the article and quiz.

Whoo hoo!

 

[Bob]

This is the link for the article:
http://www.medscape.com/viewarticle/854962

@Never Give Up, u might want to delete your weblink because it's telling everyone your username, and asking us to provide your password.

 

[Effi]

@Bob your link still goes to the same username page. I tried finding the article through google, but ended up at the same login page (very strange!). Maybe a problem at the Medscape website?

 

[halcyon]

Physician education has begun.


Whoo hoo!

You might want to use this link instead as I think your link embeds your username in it.

 

[halcyon]

@Bob your link still goes to the same username page. I tried finding the article through google, but ended up at the same login page (very strange!). Maybe a problem at the Medscape website?

I think it messes up your cookies when you use someone else's link like that. You'll probably have to click log out even though you're not actually logged in under their account and relogin, then try Bob's link.

 

[A.B.]

Chronic fatigue syndrome (CFS) is a disorder characterized by persistent fatigue lasting for more than 6 months, has no clear cause, and is accompanied by cognitive difficulties. CFS was initially termed "encephalomyalgia" (or "myalgic encephalomyelitis") because British clinicians noted that the essential clinical features of CFS included both an encephalitic component (manifesting as cognitive difficulties) and a skeletal muscle component (manifesting as chronic fatigue). More recently, the US Institute of Medicine proposed that the condition be renamed "systemic exertion intolerance disease" to better reflect the condition's hallmark defining symptom: postexertional malaise. How much do you know about this often controversial condition? Test your knowledge with our short quiz.

1. Which of the following is not one of the symptoms used to diagnose CFS, according to the Centers for Disease Control and Prevention (CDC)?

* Muscle pain
* Sore throat
* Multijoint pain
* Rash

(65% got it right, and the CDC criteria are listed on the next page)

2. Which of the following infectious agents has been suspected to be responsible for CFS, although not yet definitively?

* Chlamydia pneumoniae
* Staphylococcus aureus
* Candida albicans
* Campylobacter jejuni

(18% got it right)

3. Which of the following symptoms may indicate CFS?
* A single lymph node that is large and tender
* Generalized adenopathy
* Crimson crescents
* Trigger points

(Only 9% got it right)

4. Which of the following is the most consistent laboratory abnormality in patients with CFS?
* Extremely low erythrocyte sedimentation rate (ESR) (0-3 mm/h)
* Elevated natural killer cell activity
* Decreased white blood cell count
* Increased serum aminotransferase levels

(30% got it right)

5. Which of the following is recommended as standard therapy for CFS?
* Dietary change
* Vitamin supplementation
* Routine antiviral agents
* None of the above

(64% got it right)

I sincerely hope this is not the physician education that was supposed to follow the IoM or P2P reports.

 

[Effi]

I think it messes up your cookies when you use someone else's link like that. You'll probably have to click log out even though you're not actually logged in under their account and relogin, then try Bob's link.

You can get rid of that page if (on that page) you click on 'login' after where it says "Not username?"

Apparently you can't read it without signing up first. Thanks @A.B. for posting what's in it.

 

[halcyon]

I sincerely hope this is not the physician education that was supposed to follow the IoM or P2P reports.

I don't think it is. That's mostly the CDC's gig.

 

[Bob]

Are they actually asking about CFS?

Chlamydia pneumoniae may be a cause? (Really? Since when?)

Crimson crescents are a symptom that can indicate CFS? (Really? What are they?)

Extremely low erythrocyte sedimentation rate (ESR) (0-3 mm/h) is the most consistent laboratory funding? (News to me!)

 

[Bob]

I sincerely hope this is not the physician education that was supposed to follow the IoM or P2P reports.

It's focused on the current CDC criteria. But I don't know if that answers the question.

 

[halcyon]

Chlamydia pneumoniae may be a cause? (Really? Since when?)

Chronic Chlamydia pneumoniae infection: a treatable cause of chronic fatigue syndrome.
http://med.stanford.edu/chronicfatiguesyndrome/infections/chlamydia/chlamydia-experts.html

Crimson crescents are a symptom that can indicate CFS? (Really? What are they?)

http://www.ncbi.nlm.nih.gov/pubmed/1733396
http://www.immunesupport.com/93sum007.htm

Extremely low erythrocyte sedimentation rate (ESR) (0-3 mm/h) is the most consistent laboratory funding? (News to me!)

This one I think is mostly anecdotal. I haven't come across any research stating this but it may exist. There are certainly many people here with this finding.

 

[Never Give Up]

Will everyone Kindly delete the links with my username. Thank you.

Will post a better link when I have access to more thanu phone.

Thanks for letting me know!

 

[SOC]

That information sounds rather dated to me. Does it to anyone else?

I consider myself pretty knowledgeable about CFS and I think I would have failed that quiz.

I had never heard that extemely low ESR was a consistent lab finding before. I'm not even sure mine's ever been tested. Is it part of a standard battery of tests?

While it's awfully lightweight and outdated imo, at least it might make the point to any GP taking it that CFS is physiological, not psychological... which is some benefit... I guess.

 

[halcyon]

That information sounds rather dated to me. Does it to anyone else?

Not really. It's all things that have been found and never refuted or adequately followed up on.

I had never heard that extemely low ESR was a consistent lab finding before. I'm not even sure mine's ever been tested. Is it part of a standard battery of tests?

It's something that Cheney has talked about and I think it's mentioned in Osler's web. Byron Hyde also talks about it and relates it to Les Simpson's work on red blood cell abnormalities in ME patients. It was one of the first tests I was given when I got sick, it's a dead simple test. They put your blood in a tube and measure how far the red blood cells sink in an hour. It's an older less specific test to measure inflammation, CRP is probably used more often instead these days.

 

[heapsreal]

No mention of low nk function.
They mention increased nk cells?

Seems a bit ordinary .

 

[Valentijn]

Seems a bit dated and selective. But overall not bad - it's giving the impression of ME/CFS being a proper biological disease.

 

[HRManager]

Not really. It's all things that have been found and never refuted or adequately followed up on.


Byron Hyde also talks about it and relates it to Les Simpson's work on red blood cell abnormalities in ME patients.

Does anyone else here have Pelger Huet anomaly?

I was diagnosed with it (my dad who suffered from Fibro also passed it to me) in my 20s.

http://emedicine.medscape.com/article/957277-overview

 

[Gingergrrl]

It's something that Cheney has talked about and I think it's mentioned in Osler's web. Byron Hyde also talks about it and relates it to Les Simpson's work on red blood cell abnormalities in ME patients. It was one of the first tests I was given when I got sick, it's a dead simple test. They put your blood in a tube and measure how far the red blood cells sink in an hour.

The above quote is re: SED rate test and the idea that low SED rate correlates to ME/CFS (or at least that it did, am not sure if this is still part of the current criteria?)

Am asking b/c I finally had a SED rate test done and my score was "6" and below "20" was considered normal for women. So I know my score is normal but am unclear if it is considered "low."

@halcyon or @Sushi Do you happen to know? We discussed this once before but I couldn't find the exact thread in a google site search.

Thanks in advance!

 

[Sushi]

So I know my score is normal but am unclear if it is considered "low."

Mine tested at 2 once and 1 once--that is the range my doctor considered low.

 

[Gingergrrl]

Mine tested at 2 once and 1 once--that is the range my doctor considered low.

So it sounds like 1-2 is considered low but 6 is more normal (from an ME/CFS perspective)? Is that accurate? It seems like some ME/CFS criteria use low SED rate as a marker but was not sure what was considered "low"?!

Also just learned I have low iron but suspect this has no correlation to SED rate (which just measures inflammation from infection- I think?!)

ETA: or maybe SED rate measures general inflammation not from infection, too?

Thanks again.