Generalised Symptoms - Tiredness

Question 1

Key questions

-tiredness questions

Answer 1

When did this start
Speed of onset 
Duration 
Progression
Any past episodes?

What is tiredness to them? - difficulty getting to sleep/staying asleep/early waking/not waking up rested?
Normal sleep pattern
Impacts of tiredness

Systems review

Question 2

What are your possible differentials

Answer 2

Anemia - SOBOE, pale
-vegan, vegetarian

Hypothyroidism - weight gain, thin hair, cold, low mood,
-changes in periods, bowel habits => menorrhagia, constipation

Depression - low mood, apathy, low energy

Diabetes - polydipsia, polyuria, frequent infections, weight loss

Malignancy - constitutional

• blood in sputum, urine, feces
• changes in bowel, urine habits

MSK - joint, back pain?
-RA, inflammatory joint issues

Infection - systemically unwell

• sexual activity - HIV?
• B symptoms - TB?
• travel history - tick, insect bites?
• N+V, RUQ pain - acute hepatitis?

Question 3

Key questions in systemic review

Answer 3

B symptoms
CV - SOB. pallor
Resp - cough, wheeze, blood in sputum
GI - N+V, RUQ pain, bowel changes
GU - urinary changes, blood, period changes, sexual activity
Psych - low mood
MSK - joint, back pain