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Tiredness / Fatigue in Adults (PG)
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1. What is the primary aim of the initial consultation in a patient presenting with fatigue?
*
Refer for sleep study
Prescribe multivitamins
Start antidepressants
Identify red flags and potential reversible causes
2. What is the typical symptom pattern in iron-deficiency anaemia?
*
Weight gain and dry skin
Fatigue, pallor, and breathlessness on exertion
Dizziness and tinnitus
Sleepiness, loud snoring, night sweats
3. Which tool is useful for screening depression in patients with fatigue?
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DASS
MMSE
PHQ-9
ISI
4. Which metabolic condition is a potential cause of fatigue?
*
Gout
Psoriasis
Diabetes mellitus
Acne
5. Which of the following is a feature of Addison's disease that may present as fatigue?
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Tachycardia and tremor
Jaundice
Hyperpigmentation and weight gain
Postural hypotension
6. According to NICE, which initial blood tests are recommended in unexplained fatigue?
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FBC, ESR or CRP, LFTs, U&Es, TSH, HbA1c
D-dimer, cardiac enzymes
FBC, vitamin D, ferritin
Calcium, urate, magnesium
7. When should chronic fatigue syndrome (CFS) be suspected?
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Fatigue for one week after infection
Fatigue lasting >4 months with no identifiable cause
Snoring and poor sleep
Fatigue resolved by rest
8. Which of the following is least likely to cause physical fatigue?
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Hypothyroidism
Generalised anxiety disorder
Anaemia
Chronic kidney disease
9. What is a common lifestyle factor contributing to fatigue?
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Daily yoga
Low-calorie diet
Poor sleep hygiene
High water intake
10. Which red flag symptom warrants urgent investigation in a patient with fatigue?
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Unintentional weight loss
Generalised aches
Early morning wakening
Mild memory problems
11. Which condition might present with fatigue, low mood, and loss of interest in activities?
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Depression
Diabetes
Coeliac disease
Hyperthyroidism
12. Which condition may present with fatigue and dry skin, weight gain, and cold intolerance?
*
Anaemia
Hypothyroidism
Diabetes insipidus
Hyperthyroidism
13. Which of the following is an appropriate initial management step in fatigue due to stress?
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Lifestyle advice and stress management
Immediate antidepressants
High-protein diet
Referral for polysomnography
14. Which of the following is NOT recommended in chronic fatigue syndrome management?
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Sleep hygiene advice
Cognitive behavioural therapy
Graded activity management
Excessive bed rest
15. What might suggest fatigue due to coeliac disease?
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Weight gain and fluid retention
Snoring and morning headaches
Itching and rash
Iron-deficiency anaemia and GI symptoms
16. Which of the following is the most common cause of tiredness in adults presenting to primary care?
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Psychological causes (e.g. depression, anxiety)
Hypothyroidism
Anaemia
Sleep apnoea
17. Which history clue suggests fatigue may be psychological in origin?
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Loud snoring and gasping
Constipation and cold intolerance
Pallor and spoon nails
Early morning waking and low mood
18. What is the most appropriate management for fatigue due to iron deficiency anaemia?
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Vitamin D replacement
Corticosteroids
Oral iron supplementation
Blood transfusion
19. Which condition is characterised by excessive daytime sleepiness and loud snoring?
*
Chronic fatigue syndrome
Obstructive sleep apnoea
Anaemia
Diabetes mellitus
20. What symptom is most suggestive of chronic fatigue syndrome (CFS)?
*
Post-exertional malaise
Daytime sleepiness
Snoring at night
Occasional tiredness