Key Feature 2: Ask about other constitutional symptoms as part of a systematic approach to rule out underlying medical causes in all patients complaining of fatigue.
Skill: Clinical Reasoning
Per my previous post, my DDx for fatigue (adapted from the LMCC Objectives) includes pharmacologic side effects, (very) general medical disease, and idiopathic aetiologies. At least 3 of the 7 general medical disease categories (namely infectious, neoplastic-malignant, and connective tissue disorders) may include aetiologies that have fatigue along with other constitutional symptoms such as fevers, chills, night sweats, unintentional weight loss, and general malaise.
Neither of the patients I saw today who were concerned about fatigue (see previous post) endorsed constitutional symptoms associated with their fatigue. This one question meant that no infectious, malignant, or connective tissue disease workup was therefore warranted (at least not without other suggestive clinical signs and symptoms).