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Fatigue
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Fatigue
, Asthenia, Fatigue Red Flags
See Also
Fatigue in Cancer
Fatigue Causes
Chronic Fatigue Syndrome
Fatigue Diagnostic Testing
Medication Causes of Fatigue
Definitions
Fatigue
Unable to perform activity repeatedly
Asthenia
Physical exhaustion without weakness
Types
Secondary Fatigue (20% of non-chornic causes)
Fatigue with underlying medical cause
Fatigue lasts between 1 and 6 months
Physiologic Fatigue (80% of non-chronic causes)
Fatigue due to lifestyle causes
Chronic Fatigue
Fatigue that lasts longer than 6 months
See
Chronic Fatigue Syndrome
Causes
Fatigue Causes
See
Medication Causes of Fatigue
Symptoms
Frequent presentations
"I can't get out of bed in the morning"
"I'm feeling 'all in'"
"I'm tired all the time"
Lack of pep or energy
Usually complaint of "always tired"
However on careful questioning, varies throughout day
Low vitality
Persistent Exhaustion or
Tiredness
Strongly desire rest or sleep
Associated symptoms
Subjectively weak
Headache
Assorted pain
Symptoms
Differentiate from
Sleepiness
Fatigue is provoked by activity with delayed recovery
Exercise
offers a temporary respite from
Sleepiness
Nonrestorative rest and sleep
Sleepiness
improves with a nap
Poor muscle endurance and mental exhaustion
Diagnosis
Factors suggestive of psychogenic cause
Fatigue lasting longer than 4 months
No associated signs or symptoms
Fatigue that is worse in morning
Improves with activity
Fluctuating course
Stressful social history
Exhaustive lifestyle
History of psychological condition
Symptoms
Red Flags (suggestive of organic or physical cause)
Fatigue relieved with rest or sleep
Refreshed in morning
Less than ordinary activity causes Fatigue
Ill appearing, tired or worn patient
Weight loss
Dyspnea
Signs
Red Flags (suggesting Organic
Fatigue Causes
including neoplasm)
Lymphadenopathy
Cardiac murmur
Thyroid
Goiter
Edema
Inflammatory
Arthritis
findings
Decreased muscle tone or other focal neurologic deficit
Careful
Neurologic Exam
is critical
Labs
See
Fatigue Diagnostic Testing
Management
Daily
Exercise
(30 minutes of
Moderate Aerobic Activity
)
Stress reduction
Adequate sleep (8 hours per night)
See
Sleep Hygiene
Treat underlying causes of Fatigue
Anemia
Depression
Course
Fatigue may persist for >1 year in 50% of patients
References
Goroll (2000) Primary Care Medicine, Lippincott, p. 41
Lipken in Dornbrand (1992) Ambulatory Care, p. 5-8
Morrison (2001) Obstet Gynecol Clin North Am 28:225-40 [PubMed]
Rosenthal (2008) Am Fam Physician 78(10): 1173-9 [PubMed]
Valdini (1988) J Fam Pract 26:33-8 [PubMed]
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