Fatigue and Pallor SOCRATES Associated features Headache Fatigue Pallor Dyspnoea Angina Weight loss Weight gain Hair changes Appetite change Shortness of breath Altered mental status Temperature intolerance Vision changes Eyes popping out Tachycaria Bradycardia Acne Medications Blood thinning medications Medical history Chronic diseases GIT diseases Bone disease Chronic lung disease Malabsorption disease Specifically ask about any known deficiencies Surgery Especially recent ones. Menstrual cycle if female Surgical history Resection of stomach and the terminal ileum. Vaccinations Allergies Social history Diet Smoking Alcohol Recreational drugs Travel history Chronic malarial infection or intestinal parasite infection. Exercise Occupation Differentials Iron deficiency anaemia Fatigue Lethargy Pallor Brittle nails and koilonychia Pica Angular cheilitis -> inflammation and fissuring of the corners of the mouth. Atrophic glossitis -> erythematous, oedematous, painful tongue with loss of tongue papillae. CKD Fatigue and weakness Uremic first Pleuritis Asterix Signs of uremic encephalopathy: Seizures Somnolence coma Increased infections Leukemia Fever Painless lymphadenopathy Bone pain Features of SVC syndrome Airway obstruction Lymphoma Swollen lymph nodes Fever Weight loss Hepatosplenomegaly Upper GI Abdominal pain Vomit Fever Nausea Weight loss Appetite change Lower GI Abdominal pain Fever Weight loss Appetite changes Changes to bowel habits Cushing’s syndrome Easy bruising Hirsutism Acne Weight gain Ecchymosis Bone fractures and weakness Muscle weakness Hyperglycaemia Anxiety Irritability Purple abdominal striae Depression Mood changes Hypothyroidism Fatigue Hair loss Weight gain Constipation Bradycardia Puffy appearance Cold intolerance Hoarseness Pretibial and peri-orbital edema Hyperthyroidism Heat intolerance Excess sweating Tachycardia and palpitations Onycholysis Infiltrative dermopathy Lid lag Lid retraction Chest pain Tremors Pregnancy PCOS Menstrual problems Infertility issues Insulin resistance Hirsutism Androgenic alopecia Oily skin Acanthosis nigricans Metabolic syndrome -> especially obesity. Infections Malaria Intestinal parasites Chronic alcohol use Chronic disease Bone marrow disease Blood loss Menstruation Surgery