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Fatigue (Fever (HIV (HIV antibodies HIV viral load CD4 counts), TB (PPD …

- - - - Primary hyperparathyroidism:
        Parathyroid adenoma
        Parathyroid CA
        Secondary Hyperparathyroidism
        Renal Failure / Chronic Kidney Disease
        Extraneoplastic Manifestations (non parathyroid cancer)
        PTHrP
        FHH
        
        Calcium
        PTH
        Vitamin D (1,25)
        PO4
- - - - 24 hour urine cortisol
        Salivary cortisol (late night)
        Dexamethasone suppression test
- - - - widespread musculoskeletal pain
        and chronic fatigue > 3 m
    - - Rash
        Hematologic
        Immunologic
        Neurologic
        Oral ulcers
        Serositis
        Arthritis
        ANA
        Renal
        Photosensitivity
    - - Symmetrical joints > 3
        Morning stiffness > 1 hour
        Joint swelling
        Large joints
        Hand joints
    - - Age > 50 at onset
        Widespread pain shoulder and pelvic girdle
        Morning stiffness > 30 minutes
        Joint swelling
    - - three symptoms:
        A substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities, that persists for more than 6 months and is accompanied by fatigue, which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest, and
        Post-exertional malaise, and
        Unrefreshing sleep*
        At least one of the two following manifestations is also required:
        Cognitive impairment or
        Orthostatic intolerance