QuestionSBA
QuestionChoice
This is an important differential as this can present very vague such as tiredness and fatigue.

Widespread pain is less likely and bloods would show a low haemaglobin.
10005980
e
Anaemia
QuestionChoice
This patient likely has fibromyalgia. The main symptom is widespread pain that can vary in severity. This condition can result in extreme sensitivity to touch and painful stimuli.

This condition can cause tiredness, poor sleep quality, memory and cognitive impairment.

Fibromyalgia is often associated with IBS.

The pathophysiology is not fully understood but is thought to be influenced by abnormal pain signalling.
10005976
a
Fibromyalgia
QuestionChoice
This is an auto-inflammatory disease so is associated with pain and stiffness in the morning that lasts for longer than 30 minutes.

Activity tends to relieve the pain, whilst rest can exacerbate it.

Patients tend to present with 3 or more tender, warm, swollen joints bilaterally with systemic features such as fatigue and fevers.
10005977
b
Rheumatoid arthritis
QuestionChoice
Hypothyroid is due to decreased T3 and T4 levels in the blood. Symptoms include constipation, feeling cold, dry skin and nails, fatigue and memory changes.

Hypothyroid can cause muscle aches and stiffness as in this case but investigations would show low T3 and T4.
10005978
c
Hypothyroidism
QuestionChoice
This condition tends to present in young men under 45 years of age. They have morning pain and stiffness that persists over 30 minutes and is relieved by exercise.

People with AS tend to have stiffness and aching pains in the lower back which can progress up the spine.

'Widespread pain' is very unique to fibromyalgia.
10005979
d
Ankylosing spondylitis
Concept
Chapter
2693
4462
Fibromyalgia
Topic
146
Rheumatology
13742
A 50 year old female presents to the GP with widespread pain that is worse in her back and neck. She describes the pain as a constant ache but can be burning in nature. This has been present for 5 months.

She also struggles with fatigue and headaches.

Past medical history of high blood pressure and inflammatory bowel syndrome (IBS).

A full blood work up is performed which is all normal. What is the likely diagnosis?
a