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    Common Complaint: Primary Complaint in 5-7% of General Practice Encounters

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    Roberto León-Ferré
    Fatigue is a common complaint that accounts for about 5-7% of general practice encounters. Investigations are often done to exclude underlying diseases, but only identify a cause in less than half of patients. The most common precipitating factors for fatigue complaints are stressful life events and illnesses like respiratory infections, while conditions like hypothyroidism and anemia are identified in under 3% of patients. For evaluation, providers should obtain a history of symptoms, medications, sleep, mood, and red flag features; and initial tests may include a CBC, ESR, CRP, glucose, TSH, and UA. Further tailored testing based on symptoms could include tests for renal, liver, or cardiac function, celiac disease

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    Common Complaint: Primary Complaint in 5-7% of General Practice Encounters

    Uploaded by

    Roberto León-Ferré
    8 views1 page
    Fatigue is a common complaint that accounts for about 5-7% of general practice encounters. Investigations are often done to exclude underlying diseases, but only identify a cause in less than half of patients. The most common precipitating factors for fatigue complaints are stressful life events and illnesses like respiratory infections, while conditions like hypothyroidism and anemia are identified in under 3% of patients. For evaluation, providers should obtain a history of symptoms, medications, sleep, mood, and red flag features; and initial tests may include a CBC, ESR, CRP, glucose, TSH, and UA. Further tailored testing based on symptoms could include tests for renal, liver, or cardiac function, celiac disease

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    Fatigue

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    Fatigue is a common complaint that accounts for about 5-7% of general practice encounters. Investigations are often done to exclude underlying diseases, but only identify a cause in less than half of patients. The most common precipitating factors for fatigue complaints are stressful life events and illnesses like respiratory infections, while conditions like hypothyroidism and anemia are identified in under 3% of patients. For evaluation, providers should obtain a history of symptoms, medications, sleep, mood, and red flag features; and initial tests may include a CBC, ESR, CRP, glucose, TSH, and UA. Further tailored testing based on symptoms could include tests for renal, liver, or cardiac function, celiac disease

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    8 views1 page

    Common Complaint: Primary Complaint in 5-7% of General Practice Encounters

    Uploaded by

    Roberto León-Ferré
    Fatigue is a common complaint that accounts for about 5-7% of general practice encounters. Investigations are often done to exclude underlying diseases, but only identify a cause in less than half of patients. The most common precipitating factors for fatigue complaints are stressful life events and illnesses like respiratory infections, while conditions like hypothyroidism and anemia are identified in under 3% of patients. For evaluation, providers should obtain a history of symptoms, medications, sleep, mood, and red flag features; and initial tests may include a CBC, ESR, CRP, glucose, TSH, and UA. Further tailored testing based on symptoms could include tests for renal, liver, or cardiac function, celiac disease

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    Fatigue

    Common complaint: primary complaint in 5-7% of general practice encounters. About are isolated consults, with no follow-up consultations on the subject (presumably because it improves in most patients). Investigations may exclude diagnosis and reassure, but have low rate of identifying an underlying disease. A diagnosis is made in less than half of patients, and many are only descriptive (stress) Precipitating factors for consultation can be: - stressful life events (underlying 2/3 of fatigue complaints): work disputes, family probs, bereavement, financial difficulties - illnesses such as respiratory tract infections. Hypothyroidism and anemia identified in <3% of patients Other conditions: Addisons, renal failure, liver failure, CO poisoning, celiac disease, pregnancy, sleep apnea, domestic abuse. H/P: Bleeding (menorrhagia, GI) GI/Urinary symptoms (polyuria, polydipsia) Sleep: Quality and length, daytime sleepiness, snoring Recent infections, joint pains/swelling Psych: Mood, motivation, concentration, mental health issues OTC meds, Alcohol Skin changes (hyperpigmentation of Addisons) BP Red flags: Features of malignancy (hemoptysis, dysphagia, rectal bleeding, breast lump, postmenopausal bleeding), weight loss, LAD (non-tender, firm, hard, >2cm in diameter, progressively enlarging, supraclavicular, axillary) Focal neurologic signs Features of inflammatory arthritis, vasculitis, CTD Features of cardiorespiratory disease Sleep apnea Investigations warranted in those who have not recovered after one month, or whose initial presentation is atypical or associated with red flag symptoms. Younger patients are less likely to have underlying disease, as are patients who consult frequently Reasonable initial tests: CBC, ESR, CRP, Glucose, TSH, FT4UA/micro Tailored tests: Cr, lytes, LFTs, Celiac disease, Calcium, Ferritin, Monospot, Sleep study

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