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62 year-old male weight loss of 8kg in 6 months (≥5% body weight over 6…

- - - - Laboratory Testing:
        
        Complete blood count
        
        Liver enzymes
        
        Albumin
        
        Renal function, electrolytes
        
        Glucose
        
        Calcium
        
        TSH
        
        HIV
        
        Consider:
        
        Erythrocyte Sedimentation Rate
        
        C-reactive Protein
        
        Lactate Dehydrogenase
        
        Prostate-specific Antigen
        
        Imaging:
        
        Chest x-ray
        
        Consider:
        
        Abdominal imaging (Ultrasound or CT)
        
        Age appropriate screening
        
        Breast
        
        Colorectal
        
        Cervical cancers
        
        No eitology: Continued close clinical follow up
    - - Yes
        
        Social isolation
        Limited access to food
        Poverty
        Poor oral health (dentals, cavities) :star:
        Age-related physiologic causes (eg, diminished smell, taste, functional capacity, etc)
        
        Reassess weight in 3 month after receive help from other specialist
      - No -> ask for changes in appetite
        
        Increased
        
        Diabetes (Uncontrolled T1DM)
        
        Hyperthyroidism
        
        Symptoms: nervous, sweaty, warm
        
        Malabsorption (Pancretic insufficiency and celiac disase)
        
        Symptoms: frequent bowel movements or diarrhea, or large difficult to flush, malodorous stools
        
        Oropharyngeal Dysfunction
        
        Increase exercise
        
        Decreased
        
        Malignancy : :star: Cachexia (loss of muscle mass, and is caused by inflammatory metabolic derangements)
        
        Gastrointestinal cancer
        
        Symptoms: abdominal pain, early satiety, blood in stool, trouble swallowing
        
        Pheochromocytoma
        
        Symptoms: facial flushing or dizziness when stand
        
        Signs: High Blood Pressure
        
        Prostate
        
        Lung
        
        Colorectal
        
        Pancreatic
        
        Depression :star: (mini mental state/geriatric depression tool)
        
        Symptoms little interest or pleasure
        
        Dementia
        Anxiety
        
        Gastrointestinal Diseases :star:
        
        Mesenteric ischemia: Abdo pain when eat
        
        Infection
        
        HIV
        
        Symptoms and Hx: injected drugs, had unprotected sex, or infection received blood transfusions
        
        Tuberculosis
        Symptoms - fevers, chills, night sweats
        
        Drug Side Effect
        
        Nausea- inducing drugs can also cause anorexia
        
        antipsychotic withdrawal
        
        thyroxine
        
        herbal drugs
        
        Cardiovascular Diseases
        
        Advance Heart Failure -> cardiac cachexia
        
        Evidence of heart failure
        
        Pulmonary Diseases :star:
        
        COPD, interstitial lung disease, vasculitides, lung cancer
        
        Neurological Diseases
        
        Parkinson
        
        Stroke
        
        Multiple sclerosis
        
        Neuromuscular disorders
        
        Renal Dysfunction
        
        Uremic cachexia -> cytokine and enuropeptide signal to hypothalamus
        
        Advance renal failure -> protein energy malnutrition
        
        Connective Tissue Disease
        
        Symptoms: new rashes, joint pain, or joint swelling
        
        Diseases: rheumatoid arthritis, lupus, sarcoidosis
        
        Endocrine:
        Chronic adrenal insufficiency
        
        Substance abuse
        
        heroin/methamphetamine
        
        alcohol