Harrison's PodClass: Internal Medicine Cases and Board Prep Ep 179: A 62-Year-Old with Fatigue
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Jan 15, 2026 The discussion revolves around the complex nature of fatigue, distinguishing it from weakness and assessing its causes. The hosts share insights on patient history, physical exams, and differential diagnoses, emphasizing common conditions such as depression and hypothyroidism. They highlight the importance of a targeted approach to laboratory evaluations and recommend structured exercise as part of management. Listeners gain a deeper understanding of fatigue's multifaceted challenges in primary care and the necessity for individualized care.
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Define Fatigue Precisely
- Fatigue is a subjective sense of physical and mental weariness distinct from weakness or sleepiness.
- Clinicians must ask about difficulty initiating or maintaining voluntary mental or physical activity to clarify the complaint.
Distinguish Fatigue From Other Symptoms
- Differentiate fatigue from muscle weakness, somnolence, and dyspnea by targeted history and exam.
- Avoid broad unfocused testing until you have localizing clues to guide diagnostics.
Case: 62-Year-Old With Morning Slowness
- The 62-year-old man reports 3–4 months of difficulty getting started in the morning and daytime concentration problems despite normal sleep.
- He used an energy drink that caused jitteriness but did not relieve his exhaustion.
