Final answer:
The patient should undergo a comprehensive medical evaluation to determine the underlying cause of her complex symptoms. Symptomatic treatment and potential lifestyle modifications should be discussed. Referrals to specialists may be necessary for further assessment.
Step-by-step explanation:
The patient, a 36-year-old female presenting with a 3-year history of fatigue that worsens after activity and does not improve with rest, accompanied by a variety of other symptoms such as diffuse myalgia and arthralgia, constipation, dizziness, headaches, urinary urgency, memory problems, and paresthesias, suggests a complex clinical picture that may require a multi-disciplinary approach for diagnosis and treatment.
Given the myriad of symptoms that do not fit a single diagnosis readily, a thorough medical evaluation is warranted. This should include a detailed patient history, physical examination, and possibly a range of laboratory and imaging tests to rule out potential causes such as autoimmune disorders, endocrine abnormalities, chronic infections, and other systemic conditions. Depending on the initial findings, referrals to appropriate specialists such as a rheumatologist, neurologist, or endocrinologist may be necessary for further assessment and specialized tests.
In terms of immediate management, it is important to address any specific symptoms that can be treated symptomatically, such as providing pain relief for myalgia and arthralgia, and managing constipation. In addition, discussing with the patient about the potential need for lifestyle modifications, stress management, and possibly psychological support can be valuable, as chronic fatigue can be exacerbated by factors such as stress and mental health problems.