Differential Diagnosis for 81-year-old Female with Extreme Fatigue and Weakness
- Single most likely diagnosis:
- Deconditioning syndrome: Given the patient's history of not getting out of her chair for 2 weeks due to extreme weakness and fear of falling, deconditioning syndrome is a likely diagnosis. This condition occurs when a person experiences a decline in physical function due to prolonged periods of inactivity, leading to muscle weakness, fatigue, and decreased mobility.
- Other Likely diagnoses:
- Electrolyte imbalance: The patient's history of diarrhea 2 weeks ago could have led to an electrolyte imbalance, which can cause fatigue, weakness, and shortness of breath.
- Anemia: The patient's extreme fatigue and weakness could be indicative of anemia, which is a common condition in older adults.
- Congestive heart failure (CHF): The patient's history of paroxysmal A-fib and hypertension increases her risk for CHF, which can cause fatigue, weakness, and shortness of breath.
- Vitamin D deficiency: The patient's known vitamin D deficiency could be contributing to her fatigue and weakness, as vitamin D plays a role in muscle function and overall health.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Pulmonary embolism (PE): Although the patient's symptoms are non-specific, a PE could cause shortness of breath and fatigue, and would be a life-threatening condition if missed.
- Sepsis: The patient's history of diarrhea and current symptoms of fatigue, weakness, and shortness of breath could be indicative of sepsis, which is a life-threatening condition that requires prompt treatment.
- Cardiac ischemia: The patient's history of hypertension and paroxysmal A-fib increases her risk for cardiac ischemia, which could cause fatigue, weakness, and shortness of breath.
- Rare diagnoses:
- Guillain-Barré syndrome: This rare autoimmune disorder could cause the patient's extreme fatigue and weakness, although it is less likely given the absence of other typical symptoms such as numbness or tingling.
- Myasthenia gravis: This rare neuromuscular disorder could cause the patient's weakness and fatigue, although it is less likely given the absence of other typical symptoms such as muscle twitching or drooping eyelids.