M2. Lesson 2. Check understanding.

M2. Lesson 2. Check understanding.

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Question 1 of 4

1. Question

Why is it clinically important to distinguish post-exertional malaise (PEM) from general fatigue in people with ME/CFS? Chose all correct responses.

Both PEM and fatigue improve with graded increases in exercise

PEM is based on fundamental physiology that is associated with immune and autonomic dysregulation, ATP production, and oxygen consumption

PEM requires different management, and inappropriate treatment may worsen symptoms and lead to sustained functional decline

PEM and fatigue are synonymous and require the same management strategies

The distinction has minimal impact on long-term patient outcomes

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Question 2 of 4

2. Question

What is the typical timing of PEM onset? Choose the correct response.

Always within 30 minutes of activity

It may be immediate but often occurs hours or even days after the trigger

Only after extreme physical exertion

Immediately after exertion

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Question 3 of 4

3. Question

Which of the following is not a common feature of PEM?

Worsening of cognitive dysfunction

Flu-like symptoms

Orthostatic intolerance exacerbation

Consistent improvement after aerobic exercise

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Question 4 of 4

4. Question

Rachel, 50, reports fatigue worsening with activity. However, her symptoms start immediately during exertion (not delayed), resolve within hours of rest, and she has no cognitive or autonomic symptoms. Exercise testing shows normal recovery. She has well-controlled hypothyroidism and recent life stress.
What is the most appropriate next step for Rachel??

Diagnose ME/CFS and recommend strict pacing and activity avoidance

Investigate and optimize other causes of fatigue; consider graded activity if appropriate

Prescribe stimulants to help her push through the fatigue

Assume this is early ME/CFS and monitor for disease progression

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