Weight loss

Question 1

Definition

Answer 1

Unintentional weight loss is often a manifestation of significant underlying disease and should never be ignored

Question 2

Causes

Answer 2

Systemic disease

• malignancy
• cardiac failure
• chronic resp distress
• renal failure
• liver failure

Endocrine

• DM

Infective

• TB
• HIV

Psychiatric

• depression
• anorexia

other

• any terminal illness
• substance abuse (laxatives)

Question 3

History

Answer 3

General

• timeframe
• amount of weight loss
• dietary history (decreased intake from loss of apetite or loss of interest)
• perception of body image
• sexual history
• systemic enquiry for malignancy

Cardio-resp

• dyspnoea, orthopnoea, paroysmal nocturnal dyspnoea and peripheral oedema

GI

• lethargy, diarrhoea, steatorrhoea and abdominal discomfort are various symptoms of malabsorption
• liver disease - jaundice, dark urine, pale stools, itching, prolonged bleeding
• GI malignancy- abdominal pains, change in bowel habit, tenesmus, blood or musc in stools

renal

• lethargy, anorexia, nocturia, oliguria, polyuria, haematuria

Haematology

• localised non tender lymphadenopathy
• persisten genralised lymphadenopathy - HIV

Endo

• polydipsia, polyuria with weight loss - DM
• thyrotoxocicois

Question 4

History

Answer 4

Inspection

• endocrine disorders - goitre, pigmentaiton
• Signs of CLD
• tachypnoea, pursed lip breathing - COPD
• JVP - congestive heart failure

Palpation and auscultation

• peripheral oedema - cardiac failure, malabsoption, renal and liver diease
• auscultaiton - widespread creps and PO from cardiac failure
• plapation - hepatomegaly and ascites