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Updated 25 September 2015

What's your diagnosis? – Case 29: tired and drained

Miss F is a 23-year-old preschool teacher who has been feeling tired and drained over the last month. Use the information below to see if you can figure out this week's case.

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Miss F, a 23-year-old teacher, is worried about her progressively worsening tiredness. Her symptoms started soon after she took up a new position at a local school. She is generally healthy.

The following is a summary of her doctor's notes:

History

Over the last month:

1.  Feeling tired for the most part of the day.

2.  Struggles to get up in the mornings because of a feeling of malaise.

3.  Poor sleep despite going to bed before 10 every night.

4.  Noticed that she has been feeling more emotional recently.

5.  Finds it difficult to concentrate at work and easily snaps at the children.

6.  Despite being invited by friends, she prefers staying at home.

7.  Appetite seems to be normal.

8.  Not currently in a relationship.

9.  Family lives far from home.

10.  Previously enjoyed painting as a hobby, but currently doesn't have the energy.

- No family history of disease.

- Smoker and uses alcohol.

Examination

Generally appears to be healthy.

Cardio: normal heart sounds, regular pulse

Respiratory: normal

Abdominal: normal

Neurological: normal

Side room:

Normal blood pressure, pulse and temperature

Urine: clear

Use the above information and answer the following questions:

1. What other questions would you like to ask Ms F?

2.  Are there any other important sideroom investigations?

3.  Is there anything else you will look out for on examination?

4.  Would you consider doing blood tests? If yes, what tests would you do?

5.  What is the most likely diagnosis?

NOTE: Health24's on-site GP Dr Owen Wiese reveals new cases on Thursdays. The answer is posted with the story on Mondays, or you can get it in our Daily Tip – sign up here.

Previously on What's Your Diagnosis?

What's your diagnosis? -  Case 1: vomiting and weight loss

What's your diagnosis? -  Case 2: eye pain

What's your diagnosis? -  Case 3: strange behaviour and a bullet in the back

What's your diagnosis? -  Case 4: seeing odd things

What's your diagnosis? - Case 5: mysterious lungs

What's your diagnosis? - Case 6: runner with seizures

What's your diagnosis? - Case 7: swollen knee

What's your diagnosis? - Case 8: bloody semen

What's your diagnosis? - Case 9: confusing neurological signs

What's your diagnosis? - Case 10: diabetic teenager with unusual signs and symptoms

What's your diagnosis? - Case 11: bruising with no apparent reason

What's your diagnosis? - Case 12: severe tummy pain

What's your diagnosis? - Case 13: severe sore throat

What's your diagnosis? - Case 14: abdominal pain and swelling

What's your diagnosis? - Case 15: the world is spinning

What's your diagnosis? - Case 16: numbness in forearm

What's your diagnosis? - Case 17: burning urine

What's your diagnosis? - Case 18: boy with persistent fever

What's your diagnosis? – Case 19: lady who can't lose weight

What's your diagnosis? – Case 20: chest pain next to breastbone

What's your diagnosis? – Case 21: burning sensation in vagina

What's your diagnosis? – Case 22: vomiting and headaches

What's your diagnosis? – Case 23: frequent urination

What's your diagnosis? – Case 24: painful and swollen leg

What's your diagnosis? – Case 25: swollen knee and fever

What's your diagnosis? – Case 26: swelling of face

What's your diagnosis? – Case 27: sudden severe leg pain

 
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