Weight Loss Flashcards
What are some causes of unintentional weight loss with normal intake?
hyperthyroidism
increased exercise
malabsorption (bowel or pancreas related)
diabetes mellitus
What are some causes of unintentional weight loss with decreased intake?
malignant
drug related
psychosocial
What are some important questions to ask in the history?
time period
intake
drugs
associated symptoms - thirst/heat intolerance/diarrhoea
What are drugs that can cause weight loss?
antidiabetics (metformin)
nauseating medications
What are some features of the weight loss suggesting malignancy?
progressive symptoms
nocturnal symptoms
family history
What are some of the signs on examination to look out for in weight loss?
BMI/nutritional baseline lymphadenopathy clubbing thyrotoxic organomegaly/masses oedema
What are some initialinvestigations in weight loss?
FBC LFT U+E bone profile HbA1c coeliac TFT HIV ESR endoscopy CTCAP if ?malignancy CXR/USS if not malignancy
What are the alternative fuel stores when hepatic glycogen is exhausted?
protein - gluconeogenesis
fat (FFAs/ketone bodies)
What happens to the BMR in sepsis?
increases
What happens protein in sepsis?
negative nitrogen balance
increased gluconeogenesis
increased production of acute phase proteins
What happens in starvation and sepsis?
glucose demand increases
glycogen stores rapidly used
increased gluconeogenesis
In starvation how can you inhibit gluconeogenesis?
administer glucose
What happens when you administer glucose in sepsis?
gluconeogenesis is not suppressed
What is sarcopenia?
loss of lean muscle mass (part of normal ageing)
What accelerates sarcopenia?
inflammation/sepsis/malignancy
decreased activity
poor intake
