#213 Fatigue for Primary Care with Nina Mingioni MD - A Common Sense Framework

Listen as our esteemed guest Dr. Nina Mingioni (Jefferson) walks us through her approach to fatigue, from differential diagnosis, to the evidence behind physical exam, laboratory workup, and beyond!

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Credits

• Writer, Producer, Infographic, and Cover Art: Hannah R. Abrams
  
• Hosts: Hannah R Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP
  
• Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of nodderly.com
  
• Guest: Nina Mingioni MD, FACP

Sponsor: VCU Health CE

Time Stamps

• 00:00 Intro, disclaimer, guest bio and a bad pun
  
• 03:00 Guest one-liner
  
• 07:10 Case from Kashlak, Defining fatigue; Taking a general history
  
• 11:36 Most common causes of fatigue and how to elicit them from the history
  
• 20:39 Physical exam for fatigue; Medications that cause fatigue;
  
• 25:25 Exam findings and LRs for anemia; Sleep apnea
  
• 30:55 Lab workup for fatigue; Expanded testing: Ferritin, Vitamins, EBV, Rheumatologic diseases, Celiac disease, Lyme
  
• 47:55 Spiel to the patient when no answer is found
  
• 51:14 Other diagnoses to consider: Fibromyalgia, Myalgic Encephalomyelitis
• 55:09 Take home points and Outro