M2. Lesson 3 check understanding quiz

A patient presents with persistent fatigue and cognitive complaints. Which screening question is most likely to suggest post-exertional malaise (PEM)?

Mark, 38, reports worsening symptoms over the past 3 months despite ‘not doing anything different.’ He works part-time from home, which feels manageable. However, he also does school pickups (20 min drive), cooks dinner most nights, and tries to maintain weekend family activities. He no longer has ‘good days and bad days’ – every day feels difficult.

Sarah, 45, reports with chronic fatigue that started 18 months ago. She reports feeling ‘okay’ most days. On questioning, she reveals she stopped working 6 months ago, rarely leaves the house, and has her groceries delivered. She says she ‘learned to live with it’ by avoiding activities that make her worse.

What is your next best step in Sarah’s assessment?