Fatigue symptom inventory scale, fluid in ear tinnitus cure - How to DIY

The history is the most important part of the evaluation of fatigue, while the physical examination and laboratory studies provide supporting data.
Since one quarter to one third of patients presenting with fatigue in a primary care setting are depressed, early diagnosis of depression is important in clinical practice.
For the screening of obstructive sleep apnoea, the use of the Epworth Sleepiness Scale is advised.

Performing a physical examination is important not only to rule out specific causes of fatigue, such as cancer or hypothyroidism, but also to ensure that the patient feels his or her complaint is being taken seriously and viewed as a health problem worth investigating. A formal cardiopulmonary examination should focus on excluding CHF and chronic lung disease, both important causes of fatigue. Finally, a preliminary neurological examination is warranted, including assessment of muscle bulk, tone, and strength; abnormalities would suggest an underlying neurological disorder accounting for the patient's fatigue.

Patients with clinical symptoms or biochemical evidence for diabetes insipidus should have a urine specific gravity and osmolality, and consideration for possible water deprivation or desmopressin tests performed under expert guidance.

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