Case Scenario

Mr R is a 34 year old, recently married primary teacher.

He presents to you (a GP trainee) with 2 weeks of feeling increasingly tired. He describes feeling tired all day when teaching his class.

He gets home from work around 6.30pm. He reports falling asleep on the sofa every evening. He’s in bed by 10.30 .

He starts his day at 5.30am

He no longer wakes up in the morning feeling refreshed. He’s worried.

What are the Differential Diagnoses?

What further questions would you ask?

What Red Flags should you be keeping mind?

You may find the following links useful:

• Tiredness/fatigue in adults (Last revised in March 2020)

• Fatigue and TATT Dr Hayley Willacy, Last edited Apr 2019

• Managing patients with nonspecific signs and symptoms of cancer Feb 2020 Cancer Research UK