A 37-year-old woman comes to the office because of a 3-month history of "tiredness". She says that she has not felt like herself for "quite some time now" but this fatigue is making it difficult to just get out of bed. She has been calling in sick to work a couple of times and week and her supervisor recommended that she "seek help." She has no other symptoms, does not have any chronic medical conditions, does not take any medication, and has not recently suffered a concussion. She denies severe psychological stress. Her temperature is 37.2 C (99.0 F), blood pressure is 110/70 mm Hg, pulse is 65/min, and respirations are 15/min. Her physical examination is unremarkable. A complete blood count is normal. The most appropriate next step is to
A. order a biochemical profile
B. order a chest x-ray
C. prescribe fluoxetine
D. reassure her that this will pass and schedule a follow-up visit in 1 week
E. refer her to a psychiatrist
|