Do you feel thirsty? Do you pass urine more frequently? No Is your apetite good? No
Looks at the tongue conjuctiva and sclera. (If severe pallor, that’s the cause.) If icterus, that is the cause) Are you addicted to Guthka, tobacco or alcohol?
Do you feel breathless on walking? Do you have cough, lowgrade fever or sweating? No So there are no symptoms of tuberculosis, which may sometimes present with only weakness) Ausculate the chest carefully: RS for Tuberculosis and CVS for murmurs. Palpate the abdomen for Liver, Spleen and Epigastric Lump. (Carcinoma of stomach and Liver must be ruled out in elderly patients) Do you have sexual weakness? No (Ask a direct question, as many patients feel shy to express sexual weakness and present as general weakness.) Ask for history of exposure to venereal diseases.
Look for features of Myxoedema. Bradycardiam Hoarse voice, delayed relaxation of deep reflexes.
Key points for Fatigue:
Diabetes, Anemia, tuberculosis, HIV, Myzoedema, RHD, alignancy, Addictions, Sexual Weakness.
Action:
If clinically normal, you must rule out anemia, diabetes, HIV, tuberculosis and renal failure. If indicated S.T3, T4, TSJ.
If investigations are normal, treat with Tonics, Injections of Bplex and Durabolin, Aerobic Exercses or walking and SOS Anti-depressants.
