Clinical Case 022: Feeling faint and fatigued August 15, 2011 This case is a spot diagnosis. 50 yo woman presents to the GP complaining of feeling chronically tired, and recently “faint” – pre-syncopal on standing. Check out the 2 pictures below and let me know the diagnosis in the comments section below. The prize for the best answer = the love and respect of your peers! I will post the answer and a review next week. TwitterFacebookLinkedInEmailRedditPocket Related Posts Clinical Case 087: Sepsis Kimberley-style (for ACEM) Clinical Case 073: Sorting out the RIF raff Clinical Case 083: Itchy britches About The Author Casey Parker I am a GP working in Broome, NW of Western Australia. I work as a hospital DMO (District Med Officer) doing Emergency, Anaesthestics, some Obstetrics and a lot of miscellaneous primary care. Also on the web as @broomedocs | + Casey Parker | Contact 7 Comments itt subacute infective endocarditis? August 15, 2011 Reply marco anz rendu-weber-osler disease August 16, 2011 Reply Minh Le Cong HI Casey I will have a go. It looks like Osler Weber Rendu syndrome or hereditary telangiectasiae Initially I thought of sub acute endocarditis given the palmar lesions but the lip lesions are diagnostic of my final answer of HHT ( hereditary haemorrhagic telangiectasiae) she is tired due to chronic anaemia due to chronic GIT bleeding from the lesions in her bowels. August 16, 2011 Reply andrew ho Symptomatic anemia secondary to osler weber rendu syndrome to rule out bgit August 16, 2011 Reply Jake Hand foot and mouth? August 16, 2011 Reply Brady Looks like Janeway’s lesions to me – infective endocarditis. August 16, 2011 Reply Tim Leeuwenburg Looks like telengiectasia to me; presume iron deficient from GI bleeding and hence chronically tired. I think it’s called Osler-Weber-Rendu syndrome (hereditary haemorrhagic telangiectasia) http://www.wrongsideoftheroad.com.au http://www.ki-yak.blogspot.com August 17, 2011 Reply Add a Comment Cancel replyYour email address will not be published. Required fields are marked *Comment Notify me of follow-up comments by email. Notify me of new posts by email.