[25F] Experiencing fatigue, leg pain, and transient vision loss upon standing

Patient Description

A 25-year-old female presents with a complex of symptoms including persistent fatigue severe enough to confine her to bed, bilateral leg pain described as a muscle ache with a severity of 8/10, and episodes of vision blacking out every time upon standing up for the past 2 weeks. The patient has also reported a weight loss of 10 pounds over the course of one and a half months. She experiences pain during urination and occasional numbness in her fingers and toes. The patient has a history of depression, anxiety, and bipolar disorder, diagnosed a year ago, and is currently on Seroquel (25mg), Lexapro (20mg), Vistaril (25mg twice daily), and Buspirone (15mg as needed). She has recently discontinued Trazodone. There are no known allergies or adverse reactions to medications, and no recreational drug use or alcohol misuse is reported. The patient does not notice any heart palpitations or rapid heartbeat with the syncope episodes. There is no significant family history of chronic illnesses. The patient's symptoms are persistent and not alleviated by rest or any particular habits.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Chronic Fatigue Syndrome (CFS): This condition is characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest. This could explain your constant fatigue, muscle pain, and the need to rest frequently.

    • There's no single test to confirm a diagnosis of chronic fatigue syndrome. You may need a variety of medical tests to rule out other health problems that have similar symptoms.
  • Orthostatic Hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down. This could explain your episodes of black vision when standing up.

    • Treatment of orthostatic hypotension focuses on promoting blood flow. This may involve lifestyle changes or medication.
  • Urinary Tract Infection (UTI): UTIs can cause pain and discomfort during urination. This could explain the pain you're experiencing when you need to urinate.

    • Treatment for UTIs typically involves antibiotics to clear the infection.

Please note that these are only potential diagnoses and you should consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Consult with a healthcare provider: They can provide a formal assessment and order relevant tests if necessary. They can also provide appropriate treatment based on your symptoms and medical history.

  2. Maintain a healthy lifestyle: Regular exercise, a balanced diet, and adequate sleep can help manage symptoms of chronic fatigue syndrome and promote overall health.

  3. Stay hydrated: Drinking plenty of fluids can help prevent UTIs and manage symptoms of orthostatic hypotension.

  4. Monitor your symptoms: Keep track of your symptoms and any changes in your health. This can help your healthcare provider make an accurate diagnosis.

What you should look out for

  • If your symptoms worsen or you develop new symptoms, consult with a healthcare provider immediately.
  • If you experience severe pain, loss of consciousness, or other severe symptoms, seek emergency medical attention.

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a doctor. Always consult with a healthcare provider for an accurate diagnosis and treatment.

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9 mo ago


People Also Ask


What is chronic fatigue syndrome and how is it diagnosed?

Chronic fatigue syndrome (CFS) is a condition characterized by extreme fatigue that doesn't improve with rest and can't be explained by an underlying medical condition. Diagnosis is challenging as there is no specific test for CFS; it often involves ruling out other conditions with similar symptoms through various medical tests.


What are the common symptoms and treatments for orthostatic hypotension?

Orthostatic hypotension is a form of low blood pressure that occurs when standing up from sitting or lying down, leading to symptoms like dizziness or blacking out. Treatment focuses on lifestyle changes such as increasing fluid and salt intake, wearing compression stockings, and sometimes medication to improve blood flow.


How can urinary tract infections be prevented and treated?

Urinary tract infections (UTIs) can be prevented by staying hydrated, urinating regularly, and practicing good hygiene. Treatment typically involves antibiotics prescribed by a healthcare provider to clear the infection.


Can medications for mental health conditions cause symptoms like fatigue and dizziness?

Yes, some medications for mental health conditions, such as those used to treat depression and anxiety, can cause side effects like fatigue and dizziness. It's important to discuss any side effects with a healthcare provider, as they may need to adjust the medication or dosage.


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