GPA - Fatigue, Night sweats, Insomnia, Flashcards
Key PE for fatigue
Conjunctival pallor, lymphadenopathy, thyroid exam, oropharynx, Heart/ung abdomina neurological extremity: pallory, coolness occult blood
DDX - Fatigue 40 yo r Tired, hopeless, suicidal lost job, marital problems money problems
Depression
Hypothyroid
Anemia
adjustment disorder
Workup - Fatigue 40 yo r Tired, hopeless, suicidal lost job, marital problems money problems
CBC - anemia
TSH - Thyroid
HIV/STD - marital problems
PHQ-9
DDX - Fatigue Fatigue insomnia nightmares about past experience avoiding similar situations
PTSD Depression Hypothroidism GAD anemia
Workup - Fatigue Fatigue insomnia nightmares about past experience avoiding similar situations
CBC
TSH
Calcium
Urine toxology : self medicating
DDX - Fatigue 55yom Fatigue wt loss constipaiton Colon cancer hx
Colon cancer Hypothyroidism Depression Renal failure Hypercalcemia- confusion, lethargy and fatigue
Workup - Fatigue 55yom Fatigue wt loss constipaiton Colon cancer hx
Rectal exam Occult blood test CBC CMP: Calcium, BUN:CR, AST/ALT, TSH COlonsocopy Barium enema
DDX - Fatigue Fatigue wt gain Sleepiness COld intolerance constipation dry skin
Hypothyroid:hashimotos thyroidits
Depression
Anemia
Diabetes
Workup - Fatigue Fatigue wt gain Sleepiness COld intolerance constipation dry skin
Thyroid pannel: TSH, T3, T4
Anti TPO, Anti TG
CBC
HBA1C
DDX - Fatigue Obese F Fatigue and daytime sleepiness Snores Naps multiple times daily never refreshed Htn
Sleep Apnea Hypothyrodism Chronic fatigue syndrome Narcolepsy Depression anemia
WOrkup- Fatigue Obese F Fatigue and daytime sleepiness Snores Naps multiple times daily never refreshed Htn
Sleep study - polysomnography
CBC
TSH
ECG
DDX - Fatigue 20yo M Fatigue thirst increased appetite Polyuria
DM- Type I
Depression
Diabetes insepidus
Primary Polydipsea
Workup - Fatigue 20yo M Fatigue thirst increased appetite Polyuria
Glucose tolerance test, HbA1C
UA: specific gravity
CBC, Electrolytes
BUN/CR- renal failure
DDX - Fatigue
sleepy during day
recent change to night slift
sleep apnea
depression
anemia
DDX - Fatigue
sleepy during day
recent change to night slift
CBC - anemia, gI bleed? poor diet cop
Sleep study: polysomnography
PHQ-9
DDX - Night sweats 30yo m Night sweats cough swollen glands x 1 month
Tuberculosis Acute HIV Lymphoma Leukemia Hyperthyroidism
Workup - Night sweats 30yo m Night sweats cough swollen glands x 1 month
Sputum culture: gram stain, acid fast HIV-antibody testing TSH, FT4 CXR CBC PPD Interferon Gamma Release Assay
DDX - Insomnia 3 weexs 7hrs niglty, no snoreing stress: new college, BF broblems 3-4 cups coffee daily
Stress induced insomnia
drug induced insomnia; caffeine
circadian rhythem disorder
depression i
WOrkup- Insomnia 3 weexs 7hrs niglty, no snoreing stress: new college, BF broblems 3-4 cups coffee daily
Polysommnography - sleep study Mental status exam PHQ9 CBC TSH
DDX - Insomnia
several months poor sleep
daytime fatigue
snores loudly
Obstructive sleep apnea Insomnia daytime hypersonmnia Hypothyroid anemia
workup - Insomnia
several months poor sleep
daytime fatigue
snores loudly
CBC
TSH
polysommnography
ECG
DDX - Insomnia 3 weeks, fatigue with trouble sleeping easily falls asleep, wakes at 3 am unintentinal wt loss. inability enjoy life
Depression
Hyperthyroidism
insomnia
WOrkup - Insomnia 3 weeks, fatigue with trouble sleeping easily falls asleep, wakes at 3 am unintentinal wt loss. inability enjoy life
Mental status exam
TSH
CBC
Polysomnography
