TREATMENTS &
RESEARCH

Search the
latest
treatment
information
here.

Dr. Huntley's
Diagnosis
Checklist

Have a symptom?
See what questions
a doctor would ask.
 

Fatigue

Contents
  1. Read book excerpt
  2. Aplastic anemia: Introduction
  3. Aplastic anemia Causes
  4. Aplastic anemia Complications
  5. Aplastic anemia Treatments
  6. Clinical trials
  7. Aplastic anemia Overview
  8. More book excerpts for Aplastic anemia

Fatigue: Excerpt from In a Page: Signs and Symptoms

Fatigue is a very common, although nonspecific, presenting symptom that refers to the sensation of exhaustion during or after usual activities, or a feeling of inadequate energy to begin these activities. Fatigue is a difficult clinical complaint because there are many possible explanations. This difficulty is compounded by the subjective nature of the complaint and the potential seriousness of some of the etiologies. A thorough history and physical exam are crucial in narrowing down the differential and identifying serious causes.

Differential Diagnosis

  • Infectious
    –Acute viral or bacterial infection
    –Chronic infection (e.g., subacute bacterial endocarditis, osteomyelitis, tuberculosis, HIV, viral hepatitis, mononucleosis)
  • Hematologic
    –Anemia
    –Thrombotic thrombocytopenic purpura
    –Polycythemia vera
  • Cardiac
    –Congestive heart failure
    –Congenital heart disease
    –Valvular heart disease
    –Coronary artery disease
  • Pulmonary
    –COPD
    –Obstructive sleep apnea
    –Poorly controlled asthma
  • Endocrine
    –Hypothyroidism/hyperthyroidism
    –Diabetes, types I and II
    –Pregnancy
    –Perimenopause
    –Addison's disease
  • Rheumatologic
    –Rheumatoid arthritis
    –Systemic lupus erythematosus
    –Sjögren's syndrome
    –Polymyalgia rheumatica
  • Gastrointestinal
    –Inflammatory bowel disease
    –Portal hypertension (e.g., cirrhosis)
  • Acute or chronic renal failure
  • Neurologic
    –Parkinson's disease
    –Multiple sclerosis
  • Psychiatric (e.g., depression, anxiety or panic disorder, anorexia nervosa or bulimia, somatization disorder)
  • Malignancy
  • Chronic fatigue syndrome
  • Fibromyalgia
  • Tension headache
  • Primary obesity
  • Medication side effects (e.g., β-blockers, phenytoin, digitalis, antidepressants, muscle relaxants, hypnotics)
  • Drug intoxication or withdrawal (e.g., alcohol, opioids, benzodiazepines, barbiturates, cocaine)

    • Workup and Diagnosis

    • Complete history and physical exam are essential, including screening for malignancy, chronic infection, chronic cardiopulmonary disease, and psychiatric disease
    • Initial workup may include CBC, chemistries, glucose, calcium, urinalysis, liver function studies, TSH, stool guaiac, and age-appropriate cancer screening (e.g., PAP smear, mammography, flexible sigmoidoscopy, PSA)
    • Further testing based on history and physical findings may include chest X-ray (for dyspnea, cough, abnormal lung exam), ECG (for chest pain, dyspnea), echocardiogram (heart murmur), appropriate cultures and/or serology if infection is suspected (e.g., PPD, HIV, hepatitis), malignancy workup, pregnancy test, ANA, ESR, RF, and Lyme titers
    • Further testing based on abnormal initial labs may include anemia workup (reticulocyte count, iron studies, vitamin B12 and folate levels, hemoglobin electrophoresis), hepatitis workup (GGTP, viral hepatitis serologies, ultrasound of the liver), renal ultrasound, bone marrow biopsy, colonoscopy, and thyroid function tests
    • Appropriate imaging studies based on initial workup may include head CT/MRI, abdominal ultrasound or CT, cardiac stress testing, bone X-rays and/or bone scan

    Treatment

    • Treatment is targeted at specific underlying medical problems, if determined (e.g., thyroid disease, chronic infection, malignancy)
    • Stop or change offending medications
    • Consider trial of antidepressant therapy and/or cognitive behavioral psychiatric therapy
    • Regularly scheduled physical activity
    • Improve sleep hygiene
    • Referral to support groups
    • Discontinue offending medications
    • Chronic fatigue syndrome and fibromyalgia are often treated with supportive care, healthy diet, moderate exercise, and low-dose antidepressants
    • Weight loss for obesity

    Book Source Details

    • Book Title: In a Page: Signs and Symptoms
    • Author(s): Scott Kahan, Ellen G. Smith
    • Year of Publication: 2004
    • Copyright Details: In a Page: Signs and Symptoms, Copyright © 2004 Lippincott Williams & Wilkins.

    More About Aplastic anemia

    More Medical Textbooks Online about Aplastic anemia

    Review other book chapters online related to Aplastic anemia:

    Medical Books Excerpts
    • ANEMIA
    • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
    • [ read ]
    • FATIGUE
    • "Algorithmic Diagnosis of Symptoms and Signs" (2003)
    • [ read ]
    • Anemia
    • "In a Page: Signs and Symptoms" (2004)
    • [ read ]
    • Fatigue
    • "In a Page: Signs and Symptoms" (2004)
    • [ read ]
    • Anemia
    • "In A Page: Pediatric Signs and Symptoms" (2007)
    • [ read ]
    • Fatigue
    • "In A Page: Pediatric Signs and Symptoms" (2007)
    • [ read ]
    • Pallor
    • "In A Page: Pediatric Signs and Symptoms" (2007)
    • [ read ]
    • ANEMIA
    • "Differential Diagnosis in Primary Care" (2007)
    • [ read ]
    • Fatigue
    • "Handbook of Signs & Symptoms (Third Edition)" (2006)
    • [ read ]
    • Pallor
    • "Handbook of Signs & Symptoms (Third Edition)" (2006)
    • [ read ]
    • Fatigue
    • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
    • [ read ]
    • Pallor
    • "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
    • [ read ]
    • Anemia
    • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
    • [ read ]
    • Fatigue
    • "The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter" (2000)
    • [ read ]
    • Anemia
    • "Field Guide to Bedside Diagnosis" (2007)
    • [ read ]
    • Fatigue
    • "Field Guide to Bedside Diagnosis" (2007)
    • [ read ]
    • Pallor
    • "Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series" (2007)
    • [ read ]
    • Fatigue
    • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
    • [ read ]
    • Pallor
    • "Signs & Symptoms: A 2-in-1 Reference for Nurses" (2007)
    • [ read ]
    • Fatigue
    • "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
    • [ read ]
    • Pallor (Anemia)
    • "The Diagnostic Approach to Symptoms and Signs in Pediatrics" (2006)
    • [ read ]
    • Fatigue
    • "Nursing: Interpreting Signs and Symptoms" (2007)
    • [ read ]
    • Pallor
    • "Nursing: Interpreting Signs and Symptoms" (2007)
    • [ read ]
    • ANEMIA
    • "Differential Diagnosis in Primary Care" (2007)
    • [ read ]
     

    Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.



    More About This Book:
    Title: In a Page: Signs and Symptoms
    Authors: Scott Kahan, Ellen G. Smith
    Publisher: Lippincott Williams & Wilkins
    Copyright: 2004
    ISBN: 1-4051-0368-X

     » Next page: Anemia (In A Page: Pediatric Signs and Symptoms)

    Rate This Website

    What do you think about the features of this website? Take our user survey and have your say:

    Website User Survey

    Medical Tools & Articles:

    Next articles:

    Tools & Services:

    Medical Articles:

    Forums & Message Boards
     
    HONcode We subscribe to the HONcode principles

    By using this site you agree to our Terms of Use. Information provided on this site is for informational purposes only; it is not intended as a substitute for advice from your own medical team. The information on this site is not to be used for diagnosing or treating any health concerns you may have - please contact your physician or health care professional for all your medical needs. Please see our Terms of Use.

    Home | Symptoms | Diseases | Diagnosis | Videos | Tools | Forum | About Us | Terms of Use | Privacy Policy | Site Map | Advertise

    Copyright © 2009 Health Grades Inc. All rights reserved.