CDC and #MEAction: ME/CFS Resources for Medical Students - Flashcards

[ahimsa]

I recently found out about this page on the CDC website:

ME/CFS Resources for Medical Students

I think it's fairly new? The date at the top is May 13, 2024 but that could just be the last update.

The last item on the resource list is "Infection-Associated Chronic Illness Flashcards - An Anki flashcard deck for medical students." That was created relatively recently (some time last year?) by the #MEAction team as part of their "Teach ME, Treat ME" medical education project. I knew about the flashcard set (saw it on their website) but did not know that the CDC referred to it.

I think this information belongs here in the resources forum but please move if it belongs elsewhere.

Overview

Most medical schools in the United States do not have ME/CFS as part of their physician training. So, CDC provides key ME/CFS resources for the next generation of healthcare professionals in training.

Learning about the ME/CFS case definition and symptoms helps healthcare professionals better diagnose and care for patients with ME/CFS. Viewing case studies and hearing directly from patients promotes compassionate care.

The illness is often misunderstood and might not be taken seriously by some healthcare providers. More education is urgently needed so healthcare providers are prepared to provide timely diagnosis and appropriate care for patients.

The resources below will help you learn about ME/CFS. You can bring these back to your schools and peers to share. They are a starting point to discuss the importance of all medical, nursing, and allied health students learning about ME/CFS.

The format of the website makes it difficult to copy/paste text from the listed resources so here's a screenshot:

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Moderation note: there is a thread on an event promoting this resource here:
Reddit Q&A session about #MEAction Medical Flashcards on Monday, Feb. 24, 2025

Some of the following posts have been moved from that thread.

 

[Utsikt]

How good are MEA at basic ME/CFS facts?

 

[Utsikt]

I tried to sign up to get access to the flashcards, but you need to install a program on a computer. Are anyone able to download the cards or somehow make the available here?

 

[Yann04]

MEA

Is MEA an acronym for the ME Association or ME Action. I know you mean MEAction in this case but now I’m questioning whether I’ve been interpreting it wrong as the ME Association in the past.

 

[Yann04]

I think Anki has phone apps and even a web interface.

It’s a FOSS project.

 

[ahimsa]

I tried to sign up to get access to the flashcards, but you need to install a program on a computer. Are anyone able to download the cards or somehow make the available here?

Yeah, I noticed that additional software was required when I first posted about these flashcards.

Today I finally read the instructions, created an AnkiHub account (just the AnkiWeb account was not what I needed) and then downloaded the Anki software app.

I have no idea how to use this tool correctly but here's a screenshot of the first set of questions in the flashcard deck:

I didn't do the rest of the instructions to download this deck and then use it with the app.

 

[Hutan]

The deck was created for our #TeachMETreatME campaign with #MEAction Georgia volunteers, #MEAction staff and expert clinician reviewers, and features insightful and crucial information about infection-associated chronic conditions, including ME/CFS, Long COVID, POTS, hEDS, MCAS, and more!

Can we see the flashcards anywhere?

 

[ahimsa]

How good are MEA [#MEAction?] at basic ME/CFS facts?

You could check out the #MEAction website to see how you feel about the information they share.

Home page:

https://www.meaction.net/

What is ME?

https://www.meaction.net/learn/what-is-me/

Handouts/tools:

https://www.meaction.net/tools/

Long Covid info ("Stop. Rest. Pace."):

https://www.meaction.net/stoprestpace/

 

[ahimsa]

Can we see the flashcards anywhere?

I have not yet been able to configure the flashcard tool (show the question, guess an answer) to work correctly with this deck.

But I was able to see the flashcard questions at this link after I created an AnkiHub account ("Infection-associated Chronic Illness, Created by ale067"):

https://app.ankihub.net/decks/0991ce84-9d41-410e-835d-183e2bea4c0b

I got this link on this page:

https://millionsmissing.meaction.net/teachME/

EDIT: oops, posted the wrong link, it has now been corrected!

 

[Utsikt]

here's a screenshot of the first set of questions in the flashcard deck:

Those are not too bad!

 

[Sasha]

Is the ME/CFS, POTS, MCAS, hEDS, chronic Lyme question worrying? I don't know what answer they were giving for it.

 

[Nightsong]

The deck link in the instructions is broken; it gives me the error "This shared item is missing or currently unavailable". However, you can access both questions and answers by signing up for AnkiWeb.

Unfortunately, I don't think this resource can be recommended. Here are the questions:

 

[Hutan]

Yeah, there are a lot of problems with these flash cards. Here are some of the first questions.

What percentage of people with Long COVID are estimated to meet the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)?
A: 50%

What percentage of people with Long COVID are estimated to meet the diagnostic criteria for postural orthostatic tachycardia syndrome (POTS)?
A: 67%

A 35 yo man reports disabling fatigue, cognitive impairment, and shortness of breath that began after a suspected COVID-19 infection. Your attending diagnoses the patient with Long COVID and begins assessing him for the two most common infection-associated chronic illnesses seen in Long COVID which are:
A: ME/CFS and POTS

A 14yo girl with post-COVID myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) presents with dizziness on standing, headaches, purple toes, and tachycardia. For what common comorbidity of ME/CFS should the patient be assessed?
A. POTS

A man in his 30s reports allergic reactions to previously tolerated foods, with rash and digestive distress. The patient has a history of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and postural orthostatic tachycardia syndrome (POTS). What common comorbidity of these conditions was likely missed?
A. MCAS

After mononucleosis, a 43 yo woman with postural orthostatic tachycardia syndrome (POTS) experiences three atraumatic dislocations over six months. Prior to infection, the patient was a professional ballet dancer and instructor. What hereditary condition was likely exacerbated by EBV?
A. hEDS

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), postural orthostatic tachycardia syndrome (POTS), hypermobile ehlers danlos syndrome (hEDS), mast cell activation syndrome (MCAS), multiple sclerosis (MS), chronic lyme (PTLD) are all examples of what type of illness?
A. Infection-associated chronic illness

Your attending asks the following questions of a patient with suspected infection-associated chronic illness: “Can you bend over and place your palms flat on the floor?” What disease do you think they’re asking about?
A. hEDS

 

[Utsikt]

50 % of LC has ME/CFS isn’t good. 67 % of LC has POTS is also far too high. MCAS is debatable. The rest are okay, are they not?
Edit: the rest of Hutan’s post.

 

[Utsikt]

Is the ME/CFS, POTS, MCAS, hEDS, chronic Lyme question worrying? I don't know what answer they were giving for it.

I’m assuming Infection-Associated Chronic Illnesses.

 

[Hutan]

Which of the following is considered the best activity management strategy for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)?

Options: 4 is correct

Q_1 Do High Intensity Interval Training (HIIT) 3 or more times a week.
Q_2 Use a daily meditation app
Q_3 Gradually increase activity levels over a predetermined period of time (Graded exercise therapy)
Q_4 Increase or decrease activity levels based on symptoms (symptom-contingent pacing)

What is the best strategy for starting a person with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) on a new medication?

Q_1 Use the standard dose for their age and gender
Q_2 Use a higher dose because of the severity of the disease
Q_3 Start on a low dose and titrate up slowly
3 is correct

Your attending has just diagnosed your Long COVID patient with a common infection-associated chronic illness. There are no FDA-approved medications for this illness, but your attending says low dose naltrexone and pyridostigmine can be prescribed off label. What is the diagnosis?
A. ME/CFS

 

[Trish]

I really dislike such superficial questions, and they don't seem necessarily ones I would want my doctor to be taught as an intro to ME/CFS or LC.

 

[Utsikt]

Q_4 Increase or decrease activity levels based on symptoms (symptom-contingent pacing)

That’s a terrible description of pacing..

 

[Hutan]

Q_4 Increase or decrease activity levels based on symptoms (symptom-contingent pacing)

That’s a terrible description of pacing..

That was actually one of the few questions that I thought was ok. I think most of it is a mess of poorly evidenced conjecture.

I have no idea why the CDC would be supporting this and it reflects poorly on MEAction also.

 

[Utsikt]

That was actually one of the few questions that I thought was ok. I think most of it is a mess of poorly evidenced conjecture.

I have no idea why the CDC would be supporting this.

It was good in the sense that it showed some normal wrong answers. But ‘increasing or decreasing activity based on symptoms’ sounds like a surefire way to crash repeatedly - at least for someone new to the game. Isn’t the purpose of pacing to avoid PEM?

Maybe they don’t know any better?