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Approach to Unintentional Weight Loss (Medication/Substance (alcohol,…
Approach to Unintentional Weight Loss
Fever, Fatigue
Endocrinopathy
Hyperthyroidism
:check: hand tremors, mood swings, anxiety, palpitations, skin dryness, insomnia, good appetite
:silhouette:warm skin, lid lag and stare, abdominal pain, dysphagia and goiter
Diabetes Mellitus
:check: increased thirst,
extreme hunger
, frequency, fruity breath, irritability
:silhouette: eye hemorrhage, acanthosis nigricans, absent light touch sensation, loss of deep tendon reflexes in ankles, muscle atrophy, claw toes, ulcers
:mag: Hba1c, random glucose, fasting glucose
Adrenal Insufficiency
:check: salt craving, nausea and vomiting, constipation/diarrhea, diffuse myalgia, memory impariment
:silhouette: hyperpigmentation or vitiligo, splenomegaly, swelling tonsils, dental caries (can be caused by MTb)
Pheochromocytoma
:check: triad of headache, sweating, tachycardia; visual blurring, polyuria, polydipsia, constipation
:silhouette: pulmonary edema caused dullness, tachycardia, tremor, pallor, weakness
Infectious
HIV
:check: myalgia, nausea, diarrhea, headache, periorbital pain, dry cough
:silhouette: nontender lymphadenopathy, pharyngeal edema, rash
MTb
:check: chills, night sweat, cough, haemoptysis
Hep C
:check: fatigue, nausea, anorexia, myalgia, arthralgia, weakness
:silhouette: jaundice, spider nevi, gynecomastia, ascites, splenomegaly, palmar erythema, clubbing, asterixis
Helminthic Infection
:check: diarrhea, abdominal pain, urtycharia (depending on bug)
Malignancy
Stomach
:check: epigastric pain, early satiety, malabsorption, dysphagia, haemoptysis
:mag: EGD, upper endoscopy, barium study
Pancreatic
:check: epigastric pain, dark urine, pale stools
:silhouette: jaundice, hepatomegaly, RUQ mass, Courvoisier's sign
:mag: abd. ultrasound, CT
Colorectal
:check: vomiting blood, pain, change in bowel habits
:silhouette: abdominal distention
:mag: colonoscopy, Fe deficient anaemia, positive focal occult bloods
Lung
:check: cough, hemoptysis, chest pain, SOB
:silhouette: hoarseness of voice
:mag: hypercalcemia, SIADH
Lymphoma
:check: flu like symptoms, may be absent in hodgkin
:silhouette: painless lymphadenopathy
Rheumatologic
:check: joint pain, morning sickness, rashes, photosensitivity, alopecia
:mag: serological testing for ACPA and other antibodies
Dysphagia, Oral
Problems
Denture Problem
:silhouette: Oral Cavity and denture condition
Dental Caries/Abscess
:silhouette: Dental Condition, visible abscess, pain in biting
Oesophageal Stricture/Webs
:check: Dysphagia, Chest Pain
:silhouette: Hoarse Voice, Wheezing
Dyspnea
Exertional Fatigue
Chronic Diseases
Congestive Heart Failure
:check: fatigue, swelling, palpitation, frequency, lack of appetite, pink foamy mucus, chest pain
:silhouette: Rales at lung base, jugular distention, edema, hepatomegaly, abnormal heart sounds
Chronic Lung Disease
:check: Difficulty Breathing, Wheezing; history of COPD/Smoking
:silhouette: Barrel chest, wheezing, decreased breath sounds, hyperresonance on percussion, prolonged expiration, cyanosis
Advanced Kidney Disease
:check: Nausea, Vomiting, Loss of Appetite, Fatigue, Itching, peripheral oedema, frequency, change in urine colour
:mag: hypertension, decreased GFR, increased creatinine
Altered Mental State
Psychiatric
Depression
:check: lack of motivation, hopeless, irritability
Eating Disorders
:check: excessive methods to reduce weight
Self perceived flaws in body image
Mania
:check: does not need to sleep, always preoccupied
:silhouette: Mental Status Examination
Delusion/Paranoia
:check: non existent 'voices' advising on diet
Neurologic
Stroke
Dementia
Parkinson's
ALS
Medication/Substance
alcohol
cocain
amphetamines
Marijuana
Tobacco
Indigestion, Abdo Pain
Change in Stool Patterns
Malignant GI
#
Non-Malignant GI
Pancreatic Insufficiency
:check: epigastric pain radiating to back, nausea, vomiting relieved by sitting upright, postprandial pain (15-30min)
:mag: pancreatic function tests
Celiac Disease
:check: fatty floating stools, may be asymptomatic, muscle weakness, anxiety
Inflammatory Bowel Disease
:check: Bloody diahrrea, frequent bowel movements, colicky pain, urgensy, incontinence, palpitations
:silhouette: abdominal tenderness, tachycardia, pallor
Peptic Ulcer Disease
:mag: Upper Endoscopy, Ba radiography, H. pylori culture
:check: epigastric pain, radiation to the back, 2-5h postprandial, belching, epigastric fullness, early satiety, nausea
Mesenteric Ischaemia
:check: FHX, nausea, vomiting, posprandial pain, bloody diarrhea
:silhouette: cardiac arrhythmia, abdo. tenderness, guarding, bowel sounds, distension of bowel, peritoneal signs
:red_flag: anorexia, abdominal pain, early satiety, obstruction