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

May 11, 2020, 07:00 AM

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